# Is this an eating disorder? **URL:** \ **Category:** In My Humble Opinion\ **Created:** [October 27, 2013, 1:48pm UTC](https://boards.straightdope.com/t/is-this-an-eating-disorder/672371 "2013-10-27T13:48:46Z")\ **Posts on this page:** 8\ **Page:** 2
**Author:** ![DSeid](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/dseid/32/20194_2.png) [@DSeid](https://boards.straightdope.com/u/DSeid)\ **Post date:** [October 29, 2013, 1:44am UTC](https://boards.straightdope.com/t/is-this-an-eating-disorder/672371/21 "2013-10-29T01:44:53Z")
> [@Hari\_Seldon](#): > > … Incidentally, I have told him that people our age seem to do a little better being a bit overweight, but he simply doesn’t believe me. Actually, I find it hard to believe too. Correlation doesn’t imply causation and maybe so many seventy and eighty year olds are wasting away that the statistics are skewed. Some context … 1. Similar findings are found for younger populations, not quite overweight but top “normal” BMI, 23 to 25 or even 26 (depending on the exact study) has lowest mortality rates, and under 21 to under 19 goes up somewhat dramatically. 2. “Overweight” is as defined by BMI values. A BMI of 28, the middle of that lowest mortality rate quintile for males, and 26, the middle of the female lowest rate quintlie, are both in the middle 25% of BMIs for 75 year old males and females respectively. So while it is “overweight” by BMI definition it is also “average” or at least “typical.” 3. Yes, it is a marker. It certainly could be that good health and good habits result in a more solid BMI and poor habits or temperment issues (lower activity, less social networks, more sub-clinical depression, etc.) result in low BMI. It might not be the BMI causing the outcomes but the other way around. 4. BMI is not a precise measure of fatness or leaness, especially in this “overweight” range. Higher BMI in this range may reflect more retained fat-free mass, with the same or even less fat mass. 5. That said as **Athena** notes, it makes some sense that there might be some advantage to having some reserves going into one’s 70s 80s and beyond. Prolonged illnesses happen. Some modest amount of fat reserves help spare fat free mass from being utilized for energy during those time periods. Greater fat free mass is both a marker of good health and required for full independent function. Here’s another [more recent article](http://jech.bmj.com/content/early/2011/02/04/jech.2010.123232.full) on the subject. > [@](#): > > In this population-based study of elderly men and women, we found increased total mortality in elderly individuals with a BMI below 25. No excess mortality was found in overweight individuals (BMI 25–29.9) and only a moderate increase in mortality was observed with increasing BMI in obese individuals (BMI≥30). In the lower BMI range, the strongest impact of BMI on mortality was found for deaths from respiratory diseases. These results were not explained by the presence of cancer or lung disease at baseline. … > > … Reverse causation—that is, the possibility that pre-existing illnesses or conditions associated with increased mortality lead to loss of body weight—is a concern in studies of lower BMI and mortality.21 22 To overcome this problem in our analyses, we used several methods. First, we excluded deaths occurring during the first year of follow-up. Second, we repeated the analyses of mortality excluding participants with a history of cancer at baseline as these patients might have reduced weight because of the disease. However, the relation between low BMI and mortality was not influenced by this exclusion. Finally, to explore the effect of underweight-associated pulmonary disease, we analysed both total mortality and mortality from respiratory diseases in individuals not reporting asthma/chronic bronchitis at baseline. Neither of these two BMI-mortality relations were significantly influenced by this exclusion. > > In addition, we stratified the analyses for smoking habits (figure 2) and found that the increased total mortality in subjects with low BMI was not due to smoking. Nevertheless, some unknown bias from pre-existing diseases or conditions might have influenced the BMI–mortality relations. … > > … We found the optimal weight with the lowest mortality to be in the overweight categories (BMI 25–29.9), whereas moderately obese individuals had only a modest increase in mortality. This finding is in line with several previous studies of elderly individuals25 and has been described as the ‘obesity paradox’.24 It has also been observed that moderate overweight hospitalised elderly patients have reduced mortality.26 These findings are important because almost half of the elderly population are overweight (BMI 25–29.9) and it is frequently assumed that these individuals have increased mortality.24 One additional potential explanation for these findings showing so little downside to obesity in the elderly they discuss is that those prone to obesity related mortality may have already died before hitting this age group … hence the obese elderly are the healthy survivors. They also consider the group who become obese in old age and speculate that the complications of obesity take long enough to occur that they have little impact on someone already elderly. In any case it is clear if all we know is whether or not an elder is lean or “overweight” we should bet on the overweight one being healthier and living longer. ---
**Author:** ![Hari\_Seldon](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/hari_seldon/32/5173_2.png) [@Hari\_Seldon](https://boards.straightdope.com/u/Hari_Seldon)\ **Post date:** [October 30, 2013, 3:16pm UTC](https://boards.straightdope.com/t/is-this-an-eating-disorder/672371/22 "2013-10-30T15:16:56Z")
Thank you for this DSeid. It was very interesting. My BMI is 27 and I am not trying to lose any more weight (It was once up to 38). My wife’s is 30, but her gynecologist did some measurement and concluded that she had high muscle mass. My friend is 24 and his wife is under 14. Is the wife anorexic? She **claims** she wants to gain but cannot because of the nausea. She has certainly never suggested she wants to lose weight. If it hadn’t been her putting her husband on a diet, I wouldn’t have wondered whether she has a distorted body image. She never weighed over 100 lb in all the years I knew her, but the situation is now extreme. She is a former ballet dancer BTW, in the Canadian Ballet. I know a couple of other ex-dancers and they are both butterballs. It seems like once they stop training and dieting they go to fat. She didn’t. ---
**Author:** ![Senegoid](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/senegoid/32/6606_2.png) [@Senegoid](https://boards.straightdope.com/u/Senegoid)\ **Post date:** [October 30, 2013, 5:55pm UTC](https://boards.straightdope.com/t/is-this-an-eating-disorder/672371/23 "2013-10-30T17:55:46Z")
> [@Heehaw Jones](#): > > I decide exactly how many calories my dogs eat each day because they aren’t capable of doing it on their own. Your friend is being a good boy! He wasn’t embarrassed to admit this? I lived with a dog once who was allowed to free-feed to his heart’s content. We had a bowl of kibbles and a bowl of water set out at all times. Doggie ate as much as he wanted whenever he wanted. Typically, he ate small amounts at many times during the day. He was a perfectly healthy (weight-wise) dog, not overweight at all. He self-regulated quite well. (Although, being epileptic, he wasn’t otherwise perfectly healthy. I would have no idea if all his meds affected his appetite. But he seemed healthy and active.) ---
**Author:** ![Senegoid](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/senegoid/32/6606_2.png) [@Senegoid](https://boards.straightdope.com/u/Senegoid)\ **Post date:** [October 30, 2013, 5:59pm UTC](https://boards.straightdope.com/t/is-this-an-eating-disorder/672371/24 "2013-10-30T17:59:33Z")
I just noticed this: Your forced-diet friend came over to _your_ house on his “forced diet” day. Why didn’t he take advantage of the opportunity to pig out? Sound like he’s actually bought into his wife’s dietary prescription for him. ETA: From the OP: > [@Hari\_Seldon](#): > > I have a friend. He came over on Wednesday to watch the first game of the World Series (he has no cable). I offered him some desert. No, this was one of his 600 calorie days. He explained that two days a week, he is limited to 600 calories (soup only) and eats regularly the other 5. He is 5’7" and weighs just over 150 lb, but his wife insists he is too heavy and has put him on this diet. ---
**Author:** ![Cat\_Whisperer](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/cat_whisperer/32/4839_2.png) [@Cat\_Whisperer](https://boards.straightdope.com/u/Cat_Whisperer)\ **Post date:** [October 30, 2013, 7:07pm UTC](https://boards.straightdope.com/t/is-this-an-eating-disorder/672371/25 "2013-10-30T19:07:54Z")
Someone who (from the sounds of it) is a perfectly normal, healthy weight who is dieting has totally bought into his wife’s disordered thinking. All this talk about BMI is a reminder that your BMI isn’t necessarily your best weight and health measurement, either. I think it can be part of figuring out how to be healthy, but it isn’t the whole story. ---
**Author:** ![LurkerInNJ](https://avatars.discourse-cdn.com/v4/letter/l/ed655f/32.png) [@LurkerInNJ](https://boards.straightdope.com/u/LurkerInNJ)\ **Post date:** [October 31, 2013, 3:05am UTC](https://boards.straightdope.com/t/is-this-an-eating-disorder/672371/26 "2013-10-31T03:05:19Z")
5’ 7"and 150 lbs is perfectly fine. That’s Marc Anthony with 10+ pounds added on. The 5’ 4" under 80 lbs wife is another story. She has a serious food aversion problem. My doctors use this method of height & weight for women, 100 lbs for 5’, plus 5 lbs for every 1 to 1 1/2 inches after the first 5 feet. 5’ 4" = 115 to 120 lbs for a medium to large frame woman. The height weight ratio for men is just a little bit higher for men. ---
**Author:** ![Cat\_Whisperer](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/cat_whisperer/32/4839_2.png) [@Cat\_Whisperer](https://boards.straightdope.com/u/Cat_Whisperer)\ **Post date:** [October 31, 2013, 3:55am UTC](https://boards.straightdope.com/t/is-this-an-eating-disorder/672371/27 "2013-10-31T03:55:25Z")
> [@LurkerInNJ](#): > > \ > My doctors use this method of height & weight for women, 100 lbs for 5’, plus 5 lbs for every 1 to 1 1/2 inches after the first 5 feet. 5’ 4" = 115 to 120 lbs for a medium to large frame woman. The height weight ratio for men is just a little bit higher for men. I think your doctors are significantly low - plugging those numbers into a BMI calculator for me at 5’6", it says “Be careful! Your waist to height ratio is too low!” I’m overweight now, but when I was at my fighting weight, I was around 150, healthy and very strong. ---
**Author:** ![Yllaria](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/yllaria/32/3452_2.png) [@Yllaria](https://boards.straightdope.com/u/Yllaria)\ **Post date:** [October 31, 2013, 5:30am UTC](https://boards.straightdope.com/t/is-this-an-eating-disorder/672371/28 "2013-10-31T05:30:24Z")
The friend and wife may have developed a defense against acknowledging the full significance of his wife’s problem. My grandmother lost homeostasis at the end of her life. Many elderly people do. The feedback loop that told her when to eat stopped working. She never felt hungry and it felt wrong to be eating when there was no trace of hunger. (It could have been worse. The loop that tells you when you’re thirsty can go, too, and that can have devastating effects if it’s not noticed and corrected for.) Being something of a drama queen and accustomed to overstating any illness, Grandma would talk mournfully about her lack of appitite constantly and do things like going to her regular restaurant, where the waitresses knew her, and making a big deal about not being able to get through an order of toast. (And then telling us all about how they worried over her.) My practical sister’s response when phoned was, “Grandma, there’s this stuff called Ensure. You can get it at the drug store. Drink three cans a day and then it doesn’t matter what you eat.” Losing homeostasis is a sign of decline due to aging. Her former experience in ballet may be helping her to shrug off the weight loss. A culture of thinness may be helping her to shrug off the wieght loss. But if she wasn’t anorexic before, then this is probably either age or disease related. (Just because they haven’t found the cause doesn’t mean there isn’t one.) Both of them are probably more comfortable believing that he needs to diet than worrying about the danger that her weight loss may represent. [Previous page](https://boards.straightdope.com/t/is-this-an-eating-disorder/672371.md?page=1)