The National Eating Disorders Association (NEDA)'s partnership with the Strategies To Overcome and Prevent (STOP) Obesity Alliance pathologizes a group of people based only on their body size, creates conflicts of message and interest, and needlessly adds to the stigma that people of size already face in our society, while providing little or no help to people with actual eating disorders.
In a May press release, NEDA (in conjunction with STOP) stated that in dealing with weight the media should:
"Focus on the concept that weight status and the importance of maintaining a healthy weight is not about appearance, but about health"
The idea of "healthy weight" is a dangerous one. Health is multi-dimensional and includes past and current behaviors, genetics, environment, stress and access. There is no weight that someone can achieve that will make them healthy. If we want to have a real discussion about health, especially when dealing with the sensitive subject of eating disorders, we need to take weight out of the discussion completely and talk about health.
Pathologizing body size by claiming that there is such thing as a "healthy weight", or that obesity is a disease in and of itself, is highly problematic on multiple levels. Use of the term "healthy weight" ignores the fact that there are healthy obese people and unhealthy thin people. It sends a dangerous message to people of size that healthy habits are not enough unless they lead to weight loss, and to thin people that they are healthy regardless of their habits. Both of these statements are incorrect.
Obesity is defined by Body Mass Index - a statistical tool that was never meant to be an indicator of health. If your weight in pounds times 703 divided by your height in inches squared is greater than 30 you are considered obese. That does not constitute a physical or mental health diagnosis. The diagnostic tools that we have at our disposal mean that we can abandon the dangerous and highly inaccurate practice of using body size as a proxy for mental or physical health.
All of NEDA"s other organization partners are eating disorder related, and the addition of the STOP Obesity Alliance to that list is giving people the mistaken impression that obesity constitutes an eating disorder diagnosis. Of course eating disorders are a spectrum of illnesses that includes emotions, attitudes, and behaviors surrounding weight and food issues and not a body size, but their partnership with an organization that considers obesity to be a disease makes this unclear, and their use of "healthy weight" type language muddies those waters.
This new partnership also conflicts with other messages on NEDA's website:
"No Weight Petition: Signing this declaration of independence from a weight-obsessed world may help you accept your body's natural shape and size"
"Shut down those voices in your head that tell you your body is not “right"
"Become a critical viewer of social and media messages. Pay attention to images, slogans, or attitudes that make you feel bad about yourself or your body. Protest these messages: write a letter to the advertiser or talk back to the image or message."
"Encouraging the media to present more diverse and real images of people with more positive messages about health and self-esteem may not eliminate eating disorders entirely, but it would help reduce the pressures many people feel to make their bodies conform to one ideal, and in the process, reduce feelings of body dissatisfaction and ultimately decrease the potential for eating disorders."
"Your “ideal” body weight is the weight that allows you to feel strong and energetic and lets you lead a healthy, normal life."
These messages are in conflict with the suggestion that obese people should view their bodies as diseased based only upon their size and regardless of their health or how they feel.
Finally , there are multiple conflicts of interest. The STOP Obesity Alliance is funded by:
Sanofi-Aventis: a French pharmaceutical firm that manufactured the weight loss drug Rimonabant (aka Acomplia, Zimulti et al.). They refuted reports about the medicine's psychiatric side effects until the European Medicines Agency issued a press release stating that the benefits no longer outweighed the risks for the drug based on data that patients had twice the risk of psychiatric disorders as a group on placebo. Approval of the drug was officially removed in January 2009 and they have, so far, failed to gain approval in the United States. They continue to pursue weight loss drug development.
Allergan: This company manufactures and sells the lap band that is used in weight loss surgery, has sponsored a contest to give away a surgery whose possible complications include death, has consistently pushed to have the weight at which a lap band is approved lowered, and created an organization to urge "Congress to recognize obesity as a disease and support legislation to provide greater access to and acceptance of all effective treatments, including weight-loss surgery". In other words, creating a problem that they will then sell their product to solve.
Amlyn: a pharmaceutical company which, until August of this year, was seeking approval for the weight loss drug pramlintide/metreleptin. Per Christian Weyer, M.D., Senior Vice President, Research and Development "With our partner, Takeda, we look forward to continuing to explore new options for the obesity market." (Although they appear as a source of funding on the May 2009 press release, they are no longer listed on the STOP website as a source of funding. They abandoned approval attempts for their diet drug in August.)
As Dr. Weyer points out, these companies look at obese people as a market for their product. Obviously they stand to profit from a health paradigm that treats body size as a disease, since no actual health issues will we be required for prescription of their products, and insurance companies may have more reimbursement requirements. NEDA has partnered with a group that was founded and is funded by those who stand to profit from declaring a group of people "diseased" based only on their body size and regardless of their actual health.
People of size face tremendous stigma in our society - stigma that may already be negatively affecting their physical and mental health. For that reason and those above we ask that NEDA end its partnership with the STOP Obesity Alliance, and cease using all language that uses body size as a proxy for mental or physical health, take the utmost care to avoid stigmatizing or pathologizing obese people as part of their work, and consider endorsing a Health at Every Size® Philosophy that puts focus on actual health rather than body size.