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> **Why the** **IMPACT ACT is smart policy for addressing obesity and
> eating disorders.**
>
> **[Outlining the Issue]{.underline}:**

-   Obesity is considered a key health priority for the U.S. government.
    The Healthy People 2010 goals identify obesity as one of the
    Nation\'s leading health problems and include objectives of
    increasing the proportion of adults who are at a healthy weight,
    reducing the proportion of adults who are obese, and reducing the
    proportion of children and adolescents who are obese.

-   Whereas Congress has recognized the risks of obesity in its policy
    development there has been no attempt to balance the concern of
    overweight with the epidemic of risky weight loss strategies and
    eating disorders. Eating disorders affect millions of Americans and
    can cause serious physical results including death.

-   Simply urging overweight individuals to be thin has not reduced the
    prevalence of obesity and may result in other problems including
    body dissatisfaction, low self-esteem, and eating disorders.

-   Weight control programs should promote a healthy lifestyle including
    regular physical activity and healthy eating, in such a way that
    they do not put individuals at risk for the development of an eating
    disorder.

-   With the introduction of the IMPACT Act Congress offers an
    intelligent approach toward the prevention of obesity that also
    addresses the prevention of eating disorders simultaneously,
    recognizing the interdependence of the two health problems.

-   We applaud these efforts and ask you to support the IMPACT Act.

**[What the IMPACT Act Will Do:]{.underline}**

1\. PROVIDE GRANTS FOR THE TRAINING OF HEALTH PROFESSIONALS

> The Secretary will award grants to eligible entities to train primary
> care physicians and other licensed or certified health professionals
> on how to identify, treat, and prevent obesity or eating disorders and
> aid individuals who are overweight, obese, or who suffer from eating
> disorders.

2\. PROVIDE GRANTS TO INCREASE PHYSICAL ACTIVITY AND IMPROVE NUTRITION.

> The Secretary with CDC and the heads of other appropriate agencies,
> will award competitive grants to eligible entities to plan and
> implement programs that promote healthy eating behaviors and physical
> activity to prevent eating disorders, obesity, being overweight, and
> related serious and chronic medical conditions. Such grants may be
> awarded to target at-risk populations including youth, adolescent
> girls, racial and ethnic minorities, and the underserved.

Eating Disorders Fact Sheet

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#### Millions of Americans suffer from eating disorders, known as anorexia nervosa, bulimia nervosa, binge eating disorder, and eating disorders not otherwise specified (EDNOS). An estimated 90% + are adolescent and young women, though men and adults suffer from eating disorders as well. Eating disorders have serious mental and physical health consequences including death. In fact anorexia has the highest mortality rate of any mental illness \-- up to 20%.

**National Household Survey: Results are Unveiled**

**Eating Disorders Often Untreated, Often Impair Lives**

WASHINGTON January 29, 2007 - The first nationally representative study
of eating disorders in the United States appears in the February 2007
edition of Biological Psychiatry. The National Comorbidity Survey
Replication (NCS-R) is a nationally representative survey of the U.S.
population that was administered face-to-face to a sample of 9,282
English-speaking adults ages 18 and older between February 2001 and
December 2003. Among the results:

-   Lifetime prevalence of individual eating disorders is 0.6-4.5%.

-   Lifetime prevalence of anorexia nervosa is .9% in women, .3% in men.

-   Lifetime prevalence of bulimia nervosa is 1.5% in women, .5% in men.

-   Lifetime prevalence of binge eating disorder is 3.5% in women, 2.0%
    in men.

-   Eating disorders frequently impair the sufferer\'s home, work,
    personal, and social life.

-   Binge eating is more common than anorexia or bulimia and is commonly
    associated with severe obesity.

-   Eating disorders display substantial comorbidity with other mental
    health disorders.

-   While eating disorders often coexist with other mental health
    disorders, eating disorders often go undiagnosed and untreated. A
    low number of sufferers obtain treatment for the eating disorder.

-   Researchers found a surprisingly high rate of anorexia and bulimia
    among men, representing approximately one fourth of the cases of
    each disorder.

The EDC points out that survey included people 18 and older, which would
exclude children and teens struggling with the disorder. Also, the
survey authors note that they may have missed sufferers with severe
anorexia, regardless of age. The EDC notes that the actual percentages
of people with eating disorders may be higher than the study\'s
findings.

James I. Hudson, Eva Hiripi, Jr., Harrison G. Pope, & Ronald C. Kessler.
(2007). \"The Prevalence and Correlates of Eating Disorders in the
National Comorbidity Survey Replication,\" Biological Psychiatry,
348-358.

**Other Facts about Eating Disorders**

#### Doubled since 1960s 

#### Increasing in younger age groups, as young as 7 years 

#### Occurring increasingly in diverse ethnic and sociocultural groups 

#### 40-60% of high school girls diet 

#### 13% of high school girls purge 

#### 30-40% of junior high girls worry about weight 

#### 40% of 9-year-old girls have dieted 

#### 5-year-old girls are concerned about diet 

*Source: Journal of the American Academy of Child and Adolescent
Psychiatry*

# 

# Mortality

> Anorexia Nervosa has the highest mortality rate of any psychiatric
> disorder, as high as 20%. Death can occur after severe bingeing in
> bulimia nervosa as well.

**Treatment Can Work**

####  With early detection and intervention 

####  Treatment must be as complex as the illness including attention to the following

#### Nutritional 

#### Medical 

#### Psychiatric 

#### Psychotherapy with patient, family 

**Rates of Recovery**

#### 1/3 recover after initial episode 

#### 1/3 fluctuate with recovery and relapse 

#### 1/3 suffer chronic deterioration 

#### If patients do not receive adequate treatment then multiple re-hospitalizations are common.

**Health Consequences**

Anorexia Nervosa Bulimia Nervosa

+-----------------------------------+-----------------------------------+
| -   Heart Muscle Shrinkage        | -   Electrolyte imbalance, heart  |
|                                   |     arrhythmia, heart failure     |
| -   Slow and Irregular Heart      |                                   |
|     Beats                         | -   Teeth erosion and cavities    |
|                                   |                                   |
| -   Heart Failure                 | -   Irritation and tears in the   |
|                                   |     throat, esophagus and stomach |
| -   Amenorrhea                    |                                   |
|                                   | -   Laxative dependence           |
| -   Kidney Stones and Kidney      |                                   |
|     Failure                       | -   Emetic Toxicity               |
|                                   |                                   |
| -   Lanugo (Development of        | -   Death                         |
|     Excessive Fine Body Hair on   |                                   |
|     Face, Arms and Legs)          |                                   |
|                                   |                                   |
| -   Muscle Atrophy                |                                   |
|                                   |                                   |
| -   Delayed Gastric Emptying,     |                                   |
|     Bowel Irritation              |                                   |
|                                   |                                   |
| -   Constipation                  |                                   |
|                                   |                                   |
| -   Osteoporosis                  |                                   |
|                                   |                                   |
| -   Death                         |                                   |
+-----------------------------------+-----------------------------------+