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October 4, 2010

The Hunger Diaries: How Health Writers Can Be Putting You at Risk

Six popular bloggers advocate healthier living, but are they putting readers — and themselves — in danger?

ipod with donut

Photo Credit: Stephen Lewis

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Doctors consulted by Marie Claire supported the women's aim to be healthy, and said certain meals seemed more nourishing than others, but found aspects of the blogs alarming. "People can dabble in eating-disordered behavior without quite meeting the diagnostic criteria for an eating disorder," says Dr. Ovidio Bermudez, medical director of the Eating Disorders Program at Laureate Psychiatric Clinic and Hospital in Tulsa, Oklahoma. Bermudez has seen an uptick in patients with "subthreshold symptoms," who show some eating- or exercise-disordered behavior without having a full-blown illness. The blogs appear "pro-healthy eating," he says, but "the compulsiveness and lack of self-care" they exhibit are worrying.

Then there's the effect on readers. "The sheer number of food images and intense exercise descriptions can be particularly triggering to eating-disorder-prone followers," says Dr. Robyn Silverman, a developmental psychologist in Mount Freedom, New Jersey, whose book, Good Girls Don't Get Fat (published in October), addresses influences on female body image. Silverman worries readers could log on and "push their bodies to the extreme to match the workouts or eating habits of their idols, when it may be inappropriate." A disclaimer which ran on Weber's blog directed readers with eating disorders to a doctor, implying sick women read her site. And the bloggers inspire copycats. When Boyle announced a two-part fitness challenge—tackling Jillian Michaels' "No More Trouble Zones" program and training to beat her 5K record—116 commenters responded, many pledging to join her.

Reached by Marie Claire, the six bloggers denied having eating or exercise disorders. "The vast majority of Americans aren't anorexic or bulimic. They're overweight and have no idea how to eat healthy," says Boyle. "If they read blogs like mine, maybe they'd learn something." Anderson—who blogged about running a 5K, a 15K, and a marathon race in one weekend—says some readers have told her they've gotten hurt imitating her workouts. "I just assume people have common sense," she says. However, several commenters have questioned her lack of rest days during her training schedule.

Sari Shepphird, Ph.D., a clinical psychologist based in West Los Angeles who specializes in eating disorders, can't diagnose the women via their blogs. But generally, she says, exercising despite injury, illness, period loss, on "rest" days, or to compensate for calories are all signs of "exercise dependence," a condition found in half of eating disorders, and which, combined with an eating disorder, can lead to osteoporosis, hormone imbalances, and risk of cardiac arrest. Feeling guilty on days off is another clue, she says. Many of the bloggers do exercise when sick or "resting." Even Weber, whose posts feature recipes for cookies and pizza, can overdo it. Waking up early one day, she wrapped her blistered feet in moleskin for a run. Forced to stop after two miles because of her "shredded" feet, she wrote she was "so mad I started to cry." Haupert blogged about "exercise guilt" after three days without a workout; many readers sympathized.

"I'm disappointed to hear some of this," says Sarah Badger, communications manager of Stonyfield Farm. "We do due diligence in finding blogs with healthy messages."

"We can't comment on the perspectives of the bloggers," says Candace Mueller Medina, a Quaker Foods & Snacks spokeswoman. In a statement, Bimbo Bakeries, owner of Arnold and Oroweat, says, "We don't support extreme lifestyles." (The company brought a registered dietitian to the Summit.)

Miriam Rich, Boyle's editor at Gotham, says she doesn't know as much about Boyle's blog. "The book (Operation Beautiful, based on a trend Boyle started, asking women to stick Post-its with body affirmations out in public) celebrates positive notions of natural beauty."

Vulnerable readers might be getting a different message. In January, Liz Stark (online alias: veggiegirl), a Big Six follower who blogs about her diet and her Crohn's disease, posted a haunting video of herself, gaunt, with protruding cheekbones and thin hair. On the advice of her counselor, Stark said she was giving blogging a break; she had 20 pounds to gain. "The last thing I need to worry about is how to eat less and move more," she said. When we e-mailed her, she wrote tersely that blogging helped her "form friendships and learn new information."

"Sometimes concern is appropriate," says Anderson of the video. But "the blogger is making the choices that are right for her." Meanwhile, discussion of the 2011 Healthy Living Summit has already begun.

Katie Drummond is a New York—based journalist who covers health and science for AOL News.

To our readers: Thank you all for your responses to this article. Since the piece went online, hundreds of you have written to us. Twitter, Facebook, your blogs, and comments on our web site have all been lighting up with messages, and we are thrilled to hear from you. Some of you wrote in anger, while others applauded us for voicing concerns about this community. We believe the outpouring of comments proves the issues raised in the piece are important. This is a controversial subject, and we always welcome a good debate. Like every article published in Marie Claire, this one was researched and edited carefully over the course of many months, and we stand by its content. Thank you for letting us know how you feel — we are listening!

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