I appreciate Dr Rubel's letter emphasizing the main thrust of my article: to recognize the high frequency of dietary seesaw patterns. I could not agree more that these unhealthy means of weight control are serious matters for women and for men as well! Those persons who seek professional attention for their aberrant eating patterns are often physically, psychologically, and socially incapacitated.Accurate information about the prevalence of the disorders is simply not known and is most difficult to obtain. In addition to those who come to medical attention, untold others may be doing themselves irreparable harm. I also agree that the methods are clearly not a way to achieve a satisfactory life. I suggest, however, that an even greater number of persons, apparently well adjusted, are controlling their weight through intermittent fasting, vomiting, and purging. Far from advocating or condoning these behaviors, I lament them, but suspect that
Lucas AR. Weight Control-Reply. JAMA. 1982;248(2):170–171. doi:10.1001/jama.1982.03330020016011
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