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ans NEJM: shorter


the Tofler et al editorial has just about NO risk assesment or net
benefit comparisons.  it is nearly entirely outrage and
self-righteousness without argument.  CLAIMS are easy: these MDs needed
to take a critical thinking class at some point.



a) the "significant morbidity and mortality" from eating disorders is

absurd.  



the National Center for Health Statistics reports that 62 people died

from anorexia in 1992, the latest year that we have numbers for.  TWICE

as many women die in AIRLINE CRASHES as from ANOREXIA.



the health risks to women from "female athlete triad" are almost ZERO.



now, you all heard that Naomi Wolf 1991 card that says "150,000 American

women die of anorexia each year."  SHE LIED.  made it up.  Tofler et al

don't care.



Ted Byfield explained in July of 1994:



"Gloria Steinem in her book Revolution from Within: "In this country

alone... about 150,000 females die of anorexia each year." Naomi Wolf in

The Beauty Myth, citing the same 150,000 anorexia toll, demands: "How

would America react to the mass self-immolation by hunger of its

favourite sons?" While she didn't like to compare it to the Holocaust,

"the vast number of emaciated bodies starved, not by nature, but by men"

does suggest "a certain resemblance." Ann Landers confidently cites the

statistic and Joan Brumberg, former director of women's studies at

Cornell, declares in another book:  "These disorders are an inevitable

consequence of a misogynistic society that demeans women by objectifying

their bodies."



All these works were, of course, highly acclaimed by the media and

doubtless form part of the curriculum at countless "women's studies"

courses.  Meanwhile, it appears not one reporter in the United States or

Canada questioned the 150,000 figure. Ms. Sommers did. After all, it

meant the anorexia toll was more than triple the total number of

Americans killed each year in traffic accidents. She found that Ms.

Steinem got it from Ms. Wolf, who got it from Ms. Brumberg, who thought

she'd got it from the American Anorexia and Bulimia Association. No,

said the association's president, an association newsletter in 1985 had

merely said that 150,000 to 200,000 American women suffer from anorexia.

They don't die from it. The newsletter had been "misquoted." The actual

death toll was 101 in 1983, and 67 in 1988--out of a population of one

hundred million adult females. Thus the seeming "Holocaust." But where

was the media? Answer: believing the press agents."

(There's one born every minute, and he's probably a `journalist.'., Vol.

21, Alberta Report, 07-04-1994, pp 44)



b) the "extent of eating disorders" research is ludicrous.  



just in the literature cited by Tofler et al, from 1/2000 to 1/10 women

in the general population suffer from anorexia and bulimia, while from

1/10 to 2/3 women suffer "eating disorders".  



similarly, the "15 to 62% of female athletes" who suffer "eating

disorders" depends ENTIRELY on the fluid definitions used in the

individual studies.  for example, how would you answer this question:

"is your bodyweight very important to you?"  on several surveys a "yes"

to this question would give you an "eating disorder" because it would

mean that you were "pre-occupied" or "obsessed" with weight and on at

least one it would mean that you have "pre-clinical or sub-clinical

anorexia".  and VOILA, tens of thousands of female gymnasts are given

anorexia or made the victims of an "eating disorder" by a SURVEY.



of interest to Isaac may be the following HORRIFYING study reported in

the April 1994 Science News:



   ITHACA, N.Y. - More than 40 percent of lightweight football

players engage in dysfunctional eating patterns, the highest rate

ever reported among male athletes, a new study shows.  The

research suggests that male athletes, like female athletes, can

be at significant risk for eating disorders.

   To identify those at high risk for dysfunctional eating and

eating disorders, the team of nutrition, psychology and sports

and medicine experts from Cornell University and Ithaca College

that conducted the study has developed a new test that takes less

than 1 minute to administer and can accurately predict risk so

that education and intervention efforts may be targeted to those

players. ...

   "Athletes, especially those in sports with weight

restrictions such as wrestling, crew and lightweight football, as

well as body builders, are at risk for an eating problem that

could jeopardize their health," Koszewski points out."



the problem is that a SURVEY QUESTION from an overzealous researcher can

give you an "eating disorder."



c) Tofler et al HIDE the NET BENEFIT of being very underweight.  



since almost NO ONE dies or is seriously harmed by "female athlete

triad" it becomes horribly inconvenient for Tofler to COMPARE the

potential harm against the benefit of being very underweight.  so they

only point towards the harms.



hell, if i get to do that, it is easy to prove that eating is bad.  just

think, sometimes food tastes bad.



the mortality tables for ALL Americans for more than 50 years show

maximum lifespan for the EMACIATED.  sorry, but them's the facts.  being
NORMAL weight for your height will kill you (in comparison to being very
skinny).  being OVERWEIGHT is an early exit from life. 

so, elite female gymnasts are very skinny and thus delay menstruation

and that means they have thinner bones.  that causes some problems:  but

the health benefits from being skeletons FAR outweighs the harms.



the numerous and huge insurance company mortality tables are by far the

best evidence there is on these issues, but just in case, Eugenie Halsey

reported on CNN September 14, 1995:



"There's more reason than ever for women to keep extra pounds off,

thanks to a study that gives scientific support for staying lean. The

report found that women who weigh the least generally live the longest.



Previous studies had suggested that being too thin might increase the

risk of dying early. But when Dr. JoAnn Manson of Brigham and Women's

Hospital in Boston and her colleagues at Harvard excluded women who

smoked, they found just the opposite: that being even mildly overweight

increased the risk of premature sickness and death.



For example, their results showed that for a woman of average height, 5

feet 5 inches, a healthy person weighing less than 120 pounds had the

lowest risk of dying early, while one weighing 150 to 160 pounds had a

30 percent increased risk. And the risk was still greater, up 60

percent, for those weighing 161 to 175 pounds. Even putting on just 20

pounds in adulthood boosted a woman's chances of getting sick.



"Particularly if they gained more than 40 pounds, they had seven times

the risk of dying from coronary heart disease and about a 50 percent

higher risk of dying from cancer," Manson said.



Former Surgeon General C. Everett Koop said the study, reported in the

New England Journal of Medicine, should serve as "a major wake-up call"

for Americans. And the government is considering revising its height and

weight charts to endorse lower weights.  Current guidelines say women

who are 5-foot-5 should weigh between 126 and 161 pounds, depending on

body type.



Some nutrition experts are worried that the study, which looked at death

rates among more than 1,000 women, will send the wrong message. "(Women)

may interpret this as saying, 'Oh, my goodness, I must be 15 percent

below the average American woman's weight in order to attain quality of

life and longevity.' And in a way, they may look at this as condemning

them," said Dr. Pamela Peeke, an obesity expert.



One of her patients, Jennifer Cohen, agrees. "I probably will never get

to my average weight for my average height," she said. Cohen has lost 50

pounds, however, through diet and exercise. And Peeke said that even

losses of as little as 10 pounds can improve a patient's health.



Meanwhile, another study in the New England Journal provides more

evidence that yo-yo dieting, condemned in previous studies, may not be

harmful after all. Researchers looked at death rates among

Japanese-American men and found that weight fluctuations in those who

were healthy did not increase their risk of dying from heart disease or

other causes."



thanks for reading,

michael korcok
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