Lies and laxatives


If the rash of advertisements for laxatives and dietary fibre are anything to go by, health, happiness, beauty and the envy of your peers are attainable through regular bowel movements. Do these ads have any validity, and why are they overwhelmingly aimed at women?

You're likely to have seen the ads: in which bloated, depressed women (as yet ignorant of the advertised product’s powers) lug around handbags heavy with food – symbolic of their sluggish digestive tracts. Or those featuring slim, smug women-in-the-know who saunter through offices to the chagrin of their heavier, less “regular” colleagues. Or the commercials in which women, freed from alimentary care, are bounced on picnic blankets.

These familiar characters tout a range of laxative and fibre-supplement products which, in various ways, act to aid peristalsis and ward off the presumed bane that is constipation. But there are very few, if any, male characters in these tales of digestive woe and triumph. Why should this be?

Do women suffer from constipation more?
Women do suffer more from constipation, but men are definitely affected too.

In North America, women are 2.2 times more likely to report constipation than men. Women have a higher risk of constipation mostly as a result of hormonal factors related to menstruation and pregnancy. Women are also more likely to suffer from irritable bowel syndrome (IBS), of which one of the primary symptoms is constipation.

But according to Harvard Medical School, chronic constipation is definitely also a "guy thing", particularly for older men. And the effects of constipation bother men too of course. A 2002 study showed that men’s work performance is affected twice as much by this problem as women’s work performance, and they also avoid their workplace toilets more than women do.

Women may worry more about constipation or have a higher rate of self-diagnosis, which probably means they seek treatment more often.

Thinly-disguised weight-loss products
But this still isn’t enough to explain why advertisers of laxatives and high-fibre health foods have identified women as their target market.

The additional advantage being punted is weight loss and enhanced physical attractiveness – which, as we and advertisers are well aware, is still of greater concern to women than it is to men.

A local advertising executive (who prefers to remain anonymous) we spoke to concurs: “Of course it’s about weight loss, and yes, women are targeted because there’s more pressure on them to lose weight. Physical attractiveness and losing weight is the selling point for most of these products.”

Overweight should, however, be a concern of both genders: in South Africa, an estimated 56% of women and 29% of men, aged 15 years or older, are overweight or obese. Nonetheless, there seems to be an unfair societal skewing towards women – a fact that advertisers abuse all too often.

But what’s the harm?
Some of the products being advertised – for example, high-fibre cer high-fibre cereal – can indeed help with weight loss. The fibre fills you up and keeps you satisfied throughout the morning without adding lots of kilojoules. But there is potential for abuse, especially of laxatives.

When advertisers of laxatives target women, they also target an audience that is prone to laxative abuse (when a person tries to get rid of unwanted kilojoules through the repeated misuse of laxatives). Laxative abuse is serious and dangerous, and is often linked to eating disorders such as anorexia and bulimia.

And there is potential for fibre-rich foods and supplements to be abused too. While concern about the health of your digestive system is a good thing, it is possible to become obsessed by it. Some people may develop an eating disorder called orthorexia, which involves being obsessed about healthy eating to the extent that it becomes detrimental to their overall health.

How important is “regularity” anyway, and how is it defined?
Constipation is defined as having a bowel movement fewer than three times per week. Some people think they're constipated if they don't have a bowel movement every day. But, says the US National Institutes of Health (NIH), "normal stool elimination may be three times a day or three times a week, depending on the person".

So, being "regular" can mean different things to different people. It's only when your bowel movements change that you should be concerned – and consult a doctor.

That said, it is important to ensure that you get enough fibre in your diet. The American Dietetic Association recommends a daily intake of 25g for women and 38g for men.

You should be able to stay regular through correct diet and exercise, and you don’t need laxatives except under certain medically sanctioned circumstances. You also don’t necessarily need high-fibre products, which can be expensive. By eating five portions of fruits and vegetables a day, and having whole-grain starches and legumes in between, you can avoid becoming constipated.

(Carine Visagie and Olivia Rose-Innes, Health24, updated April 2012)

- Peppas, G. et al. (2008) Epidemiology of constipation in Europe and Oceania: a systematic review. BMC Gastroenterol. 2008; 8: 5.
- Harvard Health Publications. Chronic Constipation: A Strain for Men.
- MORI survey of 1,171 people on 15-19 February 2002, commissioned by Dulcolax

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