"The Tyranny of Thinness Obsession"
                        Donna E. Shalala
             Secretary of Health and Human Services
                          October, 1994

     A former college classmate of mine says she's lost 1000
pounds in her life, but still weighs the same.  The problem is,
she regains every pound she loses.  

     This woman constantly is embarking upon some new fad -- like
the rotation diet, the one-meal-a-day diet, or the liquid diet. 

     Looking in the mirror fills her with shame and guilt -- and
drives her to stop eating.  It's a desperate, endless cycle, and
she never sees anything but imperfection.  

     This is what I call the tyranny of thinness obsession. 
Feeling remorse about something as harmless as a late-night pizza
break or only nibbling a holiday meal.  Cruelly criticizing each
imagined flaw in the mirror.  Buying clothes a size too small. 
Never really feeling good about oneself.  

     The tyranny of thinness obsession is mainly a problem for
women, created at least in part by the socialization of girls and
women to be beautiful above all else.
     
     Studies show that about half of American women believe they
need to lose weight.  Often these feelings develop early -- when
we're still carrying lunch boxes to school -- and continue for a
lifetime.  
     
     I'm not only talking about the 3 to 4 percent of women who
develop serious eating disorders, but a much larger group: those
women who constantly feel guilt and even shame about their
appearance to the point of chronic dieting.  These are the women
who slip through the cracks of studies and surveys, the
statistically invisible millions living in denial -- severely
neglecting their health needs while harboring unrealistic
expectations of their bodies.      

     The consequences of continuous dieting can be unhealthful. 
By neglecting nutritional needs such as calcium and iron,
obsessive dieters increase their risk for problems such as
osteoporosis and anemia later in life. 
 
     Continuous dieting is also associated with dangerous and
severe eating disorders.  Anorexia nervosa, a refusal to eat
leading to extreme weight loss, can cause yellowing skin,
dehydration, excess body hair, gastrointestinal problems,
irreversible osteoporosis -- and it can be fatal.  

     Bulimia, a cycle of binge eating and purging through
vomiting, using laxatives, or exercising excessively, can damage
teeth and cause stomach lesions or tears in the esophagus.  Those
who use drugs to induce vomiting or frequent bowel movements can
eventually suffer heart failure or permanent damage to their
intestines.

     Fortunately, as public awareness increases, more people with
bulimia and anorexia nervosa are seeking help from health care
professionals.  Research shows that early treatment improves
one's chances of recovery -- but it is essential to get
professional treatment.   

     The tyranny of thinness obsession is something that all of
us can work together to prevent, especially on our college
campuses.  We have to shift the focus from thinness to health,
from the loneliness of helpless binges to the joys of healthful
eating, hanging out with friends, and doing well on exams.  
     
     That means that if you see a friend eating only celery and
carrots for the second dinner in a row, ask her, "Isn't there
another way?"  It means that if you are having a problem, seek
help for yourself.  It means refusing to allow cultural
stereotypes about women's bodies to remain unchallenged.

     The roots of thinness obsession and eating disorders grow in
the soil of powerful media messages to women that we must be
beautiful above all, and that large women are unfeminine. 
Fortunately, women are learning to reject these false messages
and striving instead to be healthy, strong, outspoken, and
competent.  I believe that women who feel good about themselves
and their accomplishments are always attractive.       

     It's a lot more healthful to play intramural soccer, take
long walks, or become a Big Sister than to waste time worrying
about the scale.  Women need to feel powerful because of our
minds, our health, our leadership, and our ability to be happy.

     Being thin and being healthy are not necessarily the same
thing.  We all must realize this, and free ourselves from
starvation diets and lonely binges.