Weighty issues

What constitutes “ideal weight” and “ideal diet” for women remains controversial. The assumptions of scientists differ, yet they usually study body mass index (BMI), rather than weight, when making recommendations. Often the concern is about whether there is a relationship between BMI and chronic morbidity leading to mortality. The best research, of course, is longitudinal, following the same individuals over time rather than taking cross-sectional snapshots of a population.

Scientific research recommendations in the 21^st century are published in journal articles and/or textbooks, and subsequently, research findings may or may not get passed on to patients via health care practitioners. As a symbolic interactionist and a gerontologist, I know that women's weighty concerns are socially constructed in interactions with others. These “others” may or may not include health practitioners, but certainly do include romantic partners, tabloid idols, friends, and family members. I suggest that many of us who are not health practitioners consider short-term expectations of others, including what makes us attractive to others, what makes us happy when we interact with others, and what others expect of us and we expect of ourselves on a daily basis when we think about ideal weight. Am I wrong to suggest that the primary concern with weight is more about how we think we appear to others than it is about BMI?

In this issue of Health Care for Women International authors add to our knowledge of weighty issues. The phenomenological work of Groven and Glenn is helpful in explaining what is important to women when they consider weight loss surgery, and, if they decide to pursue surgery, whether it is successful months later. Sang-Yeon Kim and colleagues provide data explaining how weight is a component of self-image, and how this component differs by culture. It is interesting that Japanese women perceive themselves to be heavier than do Korean women, and that a self-constructed view of physical appearance may contribute to decisions regarding whether to accept health care advice. After reading further research by Groven on weight loss surgery, this time co-authored with Braithwaite, I inferred that advertisements for weight-loss surgery targeting women over-emphasize the benefits of surgery based on ideals for physical attractiveness post-surgery, while simultaneously under-emphasizing whether surgery will contribute positively to fulfilling other role expectations judged to be important to women.

Finally, we publish Kitae Sohn's work in which she estimates the degree to which age at menarche can serve as a predictor of future body fat in Indonesia. The author conducted this study to see if findings regarding such a relationship in more developed countries would also persist in Indonesia. She found that they did not, perhaps because the relationship found elsewhere is only strong when malnutrition has not been an issue.

I am pleased with all the articles in this issue, and yet, as an editor, I want something more. I think that readers would welcome submissions by researchers who consider the consequences of longitudinal change in the definition of what constitutes ideal weight. I challenge you to consider such an approach to weighty issues.