Re-defining the problem. As a working definition of obesity based on this new approach to the problem, we might consider the following:

Obesity and overfatness result from the combined influences of the environment, behaviour and biology on increasing fat intake and reducing fat utilisation. Changes in body fat levels from their equilibrium or ’settling point’ are moderated by physiological adjustments which temper the impact of fat/energy balance on body fat change.

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How does this happen? In several ways. After a binge-purge episode, a woman usually skips the next meal or two. Her hunger increases. Her body’s cry for food grows stronger, pushing her closer to the inevitable binge.

Unrealistically strict diets have the same effect. Under such regimes a woman sets up rigid rules. She believes she must follow these rules perfectly. There is no margin for error. The trouble is that such rules are impossible to follow all the time. Once she breaks a rule, as she inevitably will, her thoughts spiral out of control. She thinks, “All is lost! I might as well go ahead and eat anything I want now, since I’m such a failure anyway.” And voila-a binge.

Some women go a step further. They try to hold off bingeing by distracting themselves through abuse of alcohol or illicit drugs. Unfortunately, these substances cause the woman to “let her guard down.” Once she surrenders her willpower, the urge to binge takes over. Now she not only binges and purges, she suffers from substance abuse as well.

One last point: Many women create strict rules about their personal appearance. As one patient said, “If I weigh more than a hundred pounds I can’t go out. I’ll call in sick at work. And I won’t be lying either – weighing more than a hundred pounds is sick!” The more such women stay home, the more isolated they become from other people. Lonely, depressed, and bored, they succumb to the temptation to binge.

The bulimic process, like the process of anorexia, eventually takes on a life of its own. The metabolic damage of purging impairs the ability to think clearly. Patients may describe themselves as being “in a fog” all day long. In time, the illness produces devastating feelings of depression, sometimes leading to thoughts (or even acts) of suicide.

There is much more to say about these illnesses, their patterns, and the impact they have on those who suffer from them. I include these brief sketches here hoping that you will recognize whether your own pattern, or that of someone close to you, reflects an eating disorder—and, if so, that you will recognize the stage the illness has reached.

Remember: The sooner you seek help, the greater the chance of recovery.

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On that particular day Sharon was lying in bed, watching TV and eating candy. At age 36, she was unhappy and feeling sorry for herself. Her son was about to get his driver’s license, and she felt that she wasn’t needed anymore. Then there was her weight: At 5 foot 2 and 132 pounds, she dressed in the closet to avoid looking at her body.

As Sharon nibbled on her candy bar and brooded about her life, the images on the TV screen grabbed her attention. It was the first-ever Ms. Olympia Bodybuilding Competition. As she watched the women show off their strong, shapely physiques, Sharon snapped out of her funk. “I announced to my husband, ‘I’m going to be a bodybuilder,’” she recalls.

The very next day, Sharon—who had not exercised in years— dug out an old leotard and headed for the local gym. Gradually, she established a regular workout routine using information she had gathered from books and magazine articles on weight training.

“When I first started out, I couldn’t climb a flight of stairs without being out of breath. Five pounds was the most I could lift,” Sharon says. “Now, I bench-press more than 100 pounds.”

To support her exercise program, Sharon made some changes in her diet, too. “I remembered all the nutrition information that I had learned from third grade on, such as the basic food groups and proper portions,” she says.

Within 3 years of starting her exercise program, she dropped four dress sizes. And Sharon, a woman who had once hidden in her closet to get dressed, was ready to show off her 109-pound body in competition. Over the next 7 years, she entered a number of bodybuilding contests. She collected a total of 15 trophies, never placing less than second. “I was old enough to be my competitors’ mother,” she adds.

Now age 55, Sharon runs her own business, teaching other women how to lift weights and shape their bodies. “I want to set an example,” she says” I want them to know they can do this.”

W IN N ING ACTION

Show off your accomplishments. Sharon’s quite an achiever! But don’t feel you have to try out for the Ms. Olympia competition to get a sense of accomplishment. Training for any special event—a 5K, a swim meet, a bicycle race—will give you something to strive for. It will also motivate you to stick with a regular workout routine. If you’re not into competition, do it for charity. Many nonprofit organizations raise money through noncompetitive athletic events.

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