David A. Gershaw, Ph.D.

Mary — a 5'3", 100 pound, 15-year-old — decided that she needed to lose weight to increase her attractiveness. By eating only a few vegetables a day and engaging in a vigorous exercise program, she dropped to 80 pounds. She still thinks that she weighs too much. She has difficulty in sleeping, is often depressed, and no longer has regular menstrual periods. Although she rarely dates, she is academically successful, earning high grades. She does not see herself as ill or in need of any treatment.

Alice — a 5'9", 160 pound, 17-year-old — says she has always been tall and a little chubby. In the past five years, her eating has been characterized by binges and vomiting. She will eat a quart of ice cream or a whole pie and then — to control her weight — she will make herself vomit. She wants to date, but is ashamed of her looks. She has taken pills to lose weight.

Mary has anorexia nervosa, a disorder in which a person loses 25% or more of her normal weight — but still feels fat and is fearful of becoming obese. Even when extremely thin, she still restricts food intake drastically. Even though she may be hungry, she still struggles in her "relentless pursuit of excessive thinness." This disorder usually develops in adolescence and occurs nine times more often in women than men.

Alice's condition — bulimia nervosa — is more common. Bulimia involved repeated "binge-purge" episodes, overeating followed by induced vomiting or laxative use. Most bulimics are women in their late teens or early twenties, who — like anorexics — are preoccupied with food, fear becoming obese and are often depressed or anxious. About 50% of anorexics are also bulimic. However, most bulimics fluctuate within or above the normal weight range, which helps them to keep their condition hidden.

At this time, we really do not know what causes either anorexia or bulimia. However, we are aware of a cultural factor that seems to contribute greatly to both disorders. In the United States, we are obsessed with weight. In countless ways, our culture says that "fat is bad." This motivates millions of young women to be "always dieting." Anorexia nervosa always begins as a weight-loss diet. The self-induced vomiting of bulimics nearly always begins after the diet has been broken and gorging has occurred. Psychological researchers in obesity have concluded that our extreme cultural standard of thinness for women has been accompanied by a steady increase in the number of serious eating disorders in women.

Women's perceptions of what men find attractive have been distorted by the extremely thin women seen in today's fashion magazines and advertisements. In a 1985 study of 500 University of Pennsylvania students — both men and women — psychologists April Fallon and Paul Rozin found drastic differences in various perceptions of weight among women. In the figure below, the averages are shown for:

A. What women perceive as being ideal

B. What women believe men prefer

C. What men actually prefer

D. What women perceive as their current body image.

As you can see, women tend to rate the "ideal weight" and "what men prefer" as being significantly thinner than "what men actually prefer." In addition, most women see themselves as being significantly fatter than any of these three standards — whether it is true or not. In a 1989 study, women with eating problems were asked to give the same estimates. These women indicated the same variation in their estimates. However, the ratings for "ideal weight" was even lower (2.3), and their estimate of their own current weight was higher (3.8). Many of these women overestimate their own weight by 25% or more.

In contrast, men do not indicate the same discrepancies, and they are far less likely to suffer eating disorders than women. In other words, men rated their current body weight, their ideal weight, and their perception of the weight women preferred for men as all quite similar.

In judging themselves, women need to be aware that the typical height-weight charts deal only with statistical averages. "Normal weight" varies about 10% either way from that point. So if the average weight for you is 120 pounds and you weighed between 108-132 pounds, you would be considered to be normal weight. Obesity — being fat — is defined as "more than 20% over" your statistical average. If you are only 5-10 pounds over your statistically average weight, you are not fat — you are still in the normal range.

*Adapted from David Myers' Psychology, Worth Publishing, 1986, pages 437-438, and Dennis Coon's Introduction to Psychology: Exploration and Application, West Publishing, 1995, pages 305-306.

Some people decide for health reasons that they need to lose weight. ie. Doctors orders. But not everyone is cut out for dieting and/or exercise and therefore seek a surgical fix. The liposuction price however can be pretty scary however, coupled with the fact that some people don't want to be labeled as the sort who was "too lazy to exercise". Its a difficult choice to make.