Over the years, as my colleagues and I have discussed or carried out various screening programs and obesity prevention programs, some, particularly those working in the dietetics or agricultural extension fields, have voiced concerns that educational or behavioral change programs designed to increase physical activity and/or moderate high fat intake, carry the risk of increasing the probability of some youth "going down an equally unhealthy road" of over-exercising and overt dieting to the point of anorexia nervosa/ bulimia.

This cautionary note also implies we should not measuring body mass index or waist circumference as outcome measurements 9even if the measurements are done privately and not revealed to the research participant). While I respect this concept and have had experience caring for adolescents with either obesity or eating disorders, I don't believe that attempting to decrease risk for obesity in later years, by helping kids to be less sedentary and/or eating fewer "empty calories", necessarily increase the risk of eating disorders.

I have not seen evidence in the literature that such health education programs etc. increase the risk of eating disorders, but I was wondering if someone out there knows of published or unpublished research studies which address this topic, as my colleagues and I here in Vermont are in the process of developing a research program in this area.

Thanks, Larry Craig Lawrence Kien, M.D., Ph.D.The Mary Kay Davignon Green and Gold Professor, Depts. of Pediatrics and MedicineUniversity of Vermont