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January 22, 1982

The flip side of obesity: those who undereat

JAMA. 1982;247(4):421-422. doi:10.1001/jama.1982.03320290007004

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Though Americans often are chided for their tendency to overeat, there are many—particularly adolescent girls and menstruating women—who are not eating enough and whose preoccupation with "thinness" is damaging their health.

Nathan J. Smith, MD, professor of pediatrics and orthopedics in the Division of Sports Medicine, University of Washington School of Medicine, Seattle, told a symposium on diet and exercise in Orlando, Fla, that to maintain their energy balance—avoid taking in more calories than they expend in exercise—many people are depriving themselves of essential nutrients, such as iron. The symposium was sponsored by the American Medical Association and the Florida Medical Association.

"It is... difficult and often impossible to assure nutritional adequacy... with diets of less than 2,000 calories for adults and adolescents," said Smith.

He added that the problem of depleted nutrients has been best documented in studies of adolescent girls and women in their reproductive years who must