Dr Rod Pearce, AMA Federal Councillor, with Luke Bona, Radio 2GB

The Australian Medical Association has made the recommendation to doctors in a report urging them for the first time to discuss with patients their dieting habits. Claiming dieting is now an early factor leading to more serious psychiatric disorders such as anorexia and bulimia, and the stats are just terrifying.

This to this. One in every hundred teenage girls and young women are thought to be affected by anorexia, while about two in every 100 are believed to have bulimia. Some children as young as nine years of age are showing excessive worry about being fat.

The AMA says doctors should discuss with patients their dieting history, and how they feel about themselves in this self image claiming doctors have a genuine role to play in detecting early warning signs and hopefully preventing dieting, leading to real health problems.

Co-author of the report is Dr Rod Pearce. He joins me on the phone now. Good morning doctor.

PEARCE: Good morning.

BONA: What about the pressure on women from magazines and movie stars and the like. There is pressure everywhere for women I think in particular, to look a certain way. Would you agree?

PEARCE: Yeah definitely, and it's one of those things where you want to at least have a discussion about. And we believe it's the profession's responsibility to be working with their patients and the community to find out what's acceptable and what's not and to handle it in a responsible way rather than creating those pressures that are unrealistic.

BONA: You look at any one of these magazines. I see teenage girls and I see the magazines they read. The cover on every weekly or monthly issue always has a new diet, always has a slim girl on the front. The models in all the commercials are all very very thin and I don't like - I'll probably get complaints here - I don't like thin women. I live curvy women. I'm funny like that. But they all look very very thin and it does set a standard. It says to impressionable young kids, this is how we think you should look.

PEARCE: The evidence and research that we've been doing shows that you end with an idealised image of what a person should look like, whether it's male or female. And any individual with some vulnerability and a little bit of low self esteem just magnifies that out of proportion and says well this the ideal imagine. And this is what I look like and so therefore that's proof that I'm not adequate. I'm not okay at what I'm doing and that gets changed and people really exaggerate their own depression and their self image because it doesn't live up to that ideal and that can be the beginning of quite serious psychological problems.

BONA: It worries you as a parent when you have children that you see as healthy teenage kids who are obsessed with dieting.

PIERCE And we think that's why it has to be one of the things first asked and openly asked on normal sort of history taking. It's no longer something that we can just pretend doesn't happen. And we think doctors also need to examine their own views too as to what they find acceptable.

And if they have some ill-founded views themselves or some image of their own they've got to realise that that can have a severe impact on patients as well. So it's not only a patient feeling more comfortable to talk about it. It's a open recognition of the risk that it puts some of our patients at and also the doctors responsibility to look at their own prejudice and issues and views regarding weight and shape.

BONA: All women seem to diet. You watch the phones will ring and I'll get complaints again. But I mean it, it seems to me that all women diet. And doesn't that speak volumes about their self image and poor body imagine. Does that have a psychological affect?

PEARCE: Definitely triggers it off. Particularly if they're a little bit vulnerable to start with when they think they're not matching up. And when they believe that the only way they are going to match society's expectations is to fit some idealised body image, then that certainly makes it worse.

So it's about how to hand that in a responsible way, and say to people normal things about valuing yourself for yourself. To look at all the statistics on the dieting and saying that fad dieting has a relatively low risk of actually working. It's a low win strategy and it almost always has a negative affect because then you have less value because you failed in this diet again. And it's like giving up smoking. They try to give it up and then they feel bad because they fail to succeed. Rather than the real issue is saying be healthy, think healthy and get on with your life the way you want it to be.

BONA: You've got to be so careful with what you say to your kids too. My little six year old the other day she finished dinner and she had a slice of apricot pie and she asked for seconds. And I said "what do you need second for you fat pig". And I thought what am I saying, you can't do that? You don't think kids to ever think that they're fat and overweight. I was having a joke with her but you've got to be careful with what you say, haven't you?

PEARCE: And it's so each to do it and we recognise it's easy for all of us to do it. This is really the first time we've actually put on paper a principle about body image because we think it's time that it's out in the open, that we're all talking about it. Rather than just say well we don't approve but what are we going to do about it.

Now we think we think to get on the front foot and actually make a statement about it. And it's for men and women, it's for anorexia, bulimia, it's for those that have a image that they all have to be like Arnold Swartznegger. All of that needs to be discussed and that needs to be built into the standard dealing with our patients and their long term futures.

BONA: Dr Rod Pierce, I thank you for your time this morning.

PEARCE: Thank you for your interest.

BONA: That's a pleasure. Dr Rod Pearce, co-author of this report given to the AMA.

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