2007-02-15
In the mirror: Teens struggle with body image
By Aimee Heckel January 29, 2007
The 13-year-old girl refused to untie her sweater from around her waist.
She was ashamed of her stomach. She thought everyone was looking at how fat it was, like it was a deformity. She began dieting and weighing herself about 20 times a day.
She was at the edge of developing an eating disorder, but her mother caught her just in time. She brought her daughter to a therapist, and within two months, the girl began loosening up the sweater until she felt confident enough to lose it completely.
The girl's therapist described her as "teeny tiny" — no stomach bulge at all. But the girl saw her body differently.
Like many other American teenagers — mostly girls — she had a warped body image. A person's body image is not necessarily connected to reality, local therapists say.
Think: If you're having a good day and you feel upbeat, you are more likely to think you look good. If you're stressed and depressed, you are likely to feel unattractive, even if you look the same as you usually do.
Developing a healthy body image is crucial for adolescents; a negative image can lead to a lifetime of eating disorders and low self-esteem.
And these perceptions begin at the beginning. Even toddlers pick up messages from society, their parents, daycare and friends about how they should view their bodies. If parents don't clear up mixed messages and let their children know they are more than their body shape, children can start to act out dangerous eating habits.
Local therapists tell stories about increasingly more preteens popping diet pills, skipping lunch or heading to the bathrooms at school to purge what they do eat at lunch.
One 4-year-old girl refused to eat the snacks at her preschool because she was afraid of getting fat.
Two-thirds of all American girls have been on a diet before the age 10. Nearly half of 9- to 11-year-olds are "sometimes" or "very often" on diets, according to a study by Colgate University. Forty-two percent of first- to third-grade girls said they want to be thinner, another national study showed.
Eighty percent of 10-year-olds said in another national survey they were afraid of being fat.
Superior-based therapist Dorie McCubbrey knows that fear firsthand. She developed an eating disorder in elementary school, after seeing most of the women in her family diet regularly. Parents have a tremendous impact as role models for their children, be it good or bad, McCubbrey says.
"This is the season right now to be losing weight," says McCubbrey, who now counsels people on healthy weight maintenance and body acceptance. "There are healthy ways to lose weight, and if you are trying to lose weight, be very careful about what you say in front of your kids, because they will pick it up."
When a person's body image is inaccurate, it often means they're using their body as something they can change when they feel like their life is out of control, according to McCubbrey. She saw one 6-year-old girl who refused to eat after her parents got a divorce.
"Any kind of trauma, whether mild or severe, can trigger someone to use their body as a means of control," McCubbrey says. "And that needs to be taken very seriously."
'Your body's a wonderland'
Isabelle Tierney, a therapist in Boulder, says 80 percent of her clients struggle with their body image. She speaks to local students and trains school counselors about positive body image.
Few people admire their bodies for the "marvels" that they are, Tierney says. She often guides her clients through meditation where they think about their skin, muscles, blood, the cells and the complex organs inside.
"Nobody teaches kids and adolescents how incredible the body is, the way the muscles work," she says. "It allows me to jump, run, wrestle. When you start seeing your body, as opposed to an object that is supposed to look a certain way to be liked, but as a magnificent system — and if you take care of it, it'll work for you — it shifts you into an incredible place where you think, 'Wow, my body is amazing.'"
Tierney runs the Web site, www.bodybeloved.com, which teaches an "inside-out" view on body image. That means letting your inside define your outside, rather than letting your feelings depend on what's going on outside: How others view you, whether you're in a good mood, if you have a boyfriend or girlfriend.
Tierney recommends teaching this as young as possible.
"I have three kids myself, and I always say, 'What does your body need? Take care of this machine working for you,'" she says.
Celebrating real beauty
As a teenager, Audrey Brashich got caught up in society's definition of beauty. She was a teen model, landing gigs with magazines such as YM, Seventeen, Elle Girl, Cosmo Girl, Lucky and Self.
Brashich also was elected to her New York high school's student government, one of the first girls chosen since the school's founding in 1709, she says.
No one seemed to care about that.
"I was in a bunch of magazines, and a lot of people were asking me about that," she says. "Why is that so much more important than something else that took a lot of intelligence to achieve?"
Brashich, who now lives in Canada, says society's messages to girls perplexed her. So she decided to do some research.
Brashich published a book in May, "A Girl's Guide to Seeing Through Celebrity Hype and Celebrating Real Beauty," a body image and media literacy guide for teens. She says some girls don't realize there is more to life than feeling "pretty."
"The girls I've spoken to are torn. They want to fit in to what is beautiful, but be valued for other things they know are important and are told are important," she says.
She urges parents and teachers to talk to their children about what they see in the media — "raise questions and get kids thinking about what they see," she says.
"If you ask kids what's important in a role model, they'll make a mini list, or if you ask them what professions are the most important in the world, they'll probably say doctors and teachers," Brashich says. "Then ask them to name famous doctors and teachers, and they'll have a harder time. It shows them that we know these things are important, yet we don't see them in the media. Let's find them."
Contact Camera Staff Writer Aimee Heckel at (303) 473-1359 or heckela@dailycamera.com.
Eating Disorders: A National Epidemic
More than 10 million Americans struggle with eating disorders. Once considered a “rich white girls’ disease”, eating disorders are now detectable in all social classes and an increasing number of cultures. Most frighteningly, anorexia, one of the two major types of eating disorders, has the highest premature fatality rate OF ANY MENTAL ILLNESS. Research shows that the majority of people with severe eating disorders do not receive adequate care: only 1/3 of people with anorexia and 6% of people with bulimia receive mental health care. What are eating disorders? The DSM IV classifies anorexia (AN) and bulimia ( BN) as the two major types. Additionally, the DSMIV includes “Eating Disorders Not Otherwise Specified ( EDNOS)”, which includes Binge Eating Disorder and other eating disorders which do not fit into the anorexia and bulimia criteria. 1. Anorexia is characterized by self-starvation and excessive weight loss. The four diagnostic criteria are: 2. Resistance to maintaining a body weight at or above a normal weight for age and height Less then 85% of that expected Failure to make expected weight gain during growth, leading to body weight less than 85% of expected. BMI for age 5 th percentile or below 3. Intense fear of weight gain, or being “fat” even though underweight 4. Disturbance in the experience of body weight or shape, undue influence of weight or shape on self-evaluation or denial of the seriousness of low body weightLoss of menstrual periods, post-puberty Bulimia is characterized by a secretive cycle of binge eating followed by purging. The diagnostic criteria are: 1. Regular intake of large amounts of food accompanied by a sense of loss of control over eating behavior. 2. Regular use of inappropriate compensatory behaviors, including vomiting, laxative abuse, fasting, compulsive exercise. 3. Extreme concern with body weight and shape a) Purging-type: regularly engages in self-induced vomiting or misuse of laxatives, diuretics or enemas b) Non-purging type: regularly uses inappropriate compensatory behaviors such as fasting or excessive exercise Binge Eating Disorder Not Otherwise Specified includes: 1) Binge-eating without purging 2) obesity 3) Excessive Exercising 4) All criteria for Anorexia except a) Still has regular periods and/or b) in normal weight range 5) All criteria for Bulimia except a) Binge/purge less than 2 X/week or less than 3 months duration b) Purging after small amounts of food (2 cookies) Eating disorders have many precipitating factors, making them difficult to heal. Most researchers agree that bio-genetic factors, environmental factors, familial factors, and personality factors often combine to make a person highly susceptible. Although recovery rates vary, everyone agrees on this: the earlier a person with an eating disorder seeks treatment, the greater the likelihood of physical and emotional recovery. 85% of eating disorders begin during adolescence. Ideally then, treatment should start during in those early years. Unfortunately, because of the shame often associated with an eating disorder as well as its short-term benefits, few people willingly come forward during this phase. Educating mental health professionals, school personnel, and caregivers about the warning signs and potentially life-threatening consequences of eating disorders is thus vital, increasing possibility that people can be helped. * Following is the typical progression of anorexia, including warning signs: Anorexia often begins with dieting Dieting becomes more and more rigid and includes skipping meals, drastically cutting calories, fat, and protein and becoming more picky There is a denial of hunger/Refusal to eat The person can become obsessed with food, cooking, and nutrition Compulsive rituals begin and quickly increase; the obsession worsens Exercise becomes excessive, sometimes up to 4 or 5 hours a day The person offers consistent excuses for avoiding meals or situations involving food Life/conversation is dependent on weight loss/gain Anxiety about being “fat” worsens despite obvious thinness Secrecy increases; isolation increases, including withdrawal from friends and usual activities Obsession and denial worsens, as brain and other body functions shut down The body shuts down. Death occurs. Bulimia’s warning signs are: Evidence of binge-eating: food disappears. Anywhere from 1,000 to 60,000 are consumed in one binge; sometimes, The person uses bathroom and/or shower right after a meal; you may find trash bags or other containers filled with vomit The bulimic exhibits puffiness, red eyes, red/callused knuckles and/or sore throat There is evidence of purging: dirty bathroom, laxative boxes, diet pills The person exercises rigidly and zealously The bulimic exhibits dental erosion, staining She creates a complex lifestyle schedule to facilitate bingeing and purging She withdraws from friends and usual activities There can be weight loss, though not always; dieting becomes a primary and constant concern The way bulimia progresses is exemplified here: It begins as an attempt to lose weight; body/psyche rebels; binge occurs The binge leaves the bulimic exhausted and uncomfortable; he feels deep guilt and shame; hates this out-of-control person; goes against who he strives to be, ie perfect. Extra pounds will show who she “really is” She has to UNDO the binge by purging: it seems to be the only antidote to the loss of control over food Vomiting as a solution often begins almost by accident (reads about it, friends talk about it…) Most people do this for a short time and can stop For others, binge-purge cycle becomes addictive: what begins as a rare cycle can take up most of the person’s time. Recent research has found that serotonin gets released during the binge-purge cycle. Many bulimics were prior anorexics It is crucial to understand that eating disorders SERVE IMPORTANT FUNCTIONS. Uncovering those functions and finding healthier ways to fulfill them is crucial to successful healing Below are some of anorexia’s important functions: As the person loses weight, dieting and weight loss take on a different function She/he finds a newfound control in life. She previously did not feel effective, especially as life is changing around her She believes that being thin will solve all problems She finds a new sense of power (does not have to give in to hunger); of superiority: she finally measures up There is a new sense of meaning, purpose to life She gets a new sense of challenge She gets a new sense of independence, the “good girl” saying no to authorities, often for first time in life Anorexia gives her an identity, which is often a fundamental developmental task. Following are some of bulimia’s important functions: “While I’m eating, nothing else matters” The bulimic can eat to satisfy emotional needs and not deal with the consequence. Food is an outlet for all the feelings and conflicts that cannot be exposed; Binge-purge blocks or lets out feelings that are experienced as unacceptable The bulimia is a way to cope with uncomfortable emotional states; it relieves stress, anxiety, low-self-esteem Unlike anorexic, the bulimic DOES acknowledge there’s something wrong but hopeless about what to do about it Treatment possibilities are varied, though their effectiveness is not always corroborated by science. Educating yourself on the various modalities as well as being trained in the specifics of eating disorders is a big step in effectively helping those who struggle with eating disorders. Here is some of the information we know: Family therapy is the most successful type of treatment IF the child is under 18 AND lives at home Cognitive-behavioral therapy has been studied extensively and offers strong positive outcomes, though not necessarily in the long-run Dialectical Behavioral Therapy is increasingly used in hospitals and clinics to some success The more support the client receives, the better her potential for recovery: a combination of individual, group, and family therapy is ideal though costly, as insurance only covers small, if any, portions of treatment. Other forms of therapies are proving successful in healing eating disorders, including art therapy, equine therapy, energy healing, and massage therapy, to name a few Pharmaceutical treatments can be effective for some but not all. SSRIs (anti-depressants) work especially well with bulimics. Money is being poured into research to support that a person’s risk for developing eating disorders is genetic. The latest such study showed that more than half (56%) a person’s risk for developing anorexia is determined by genes, with environmental factors determining the rest. * While there are a number of health consequences for anorexia, bulimia, and EDNOS, the length of this article does not allow me to focus on it. Please go to http://www.nationaleatingdisorders.org/ for further information.
In the mirror: Teens struggle with body image
2007-02-14
By Aimee Heckel (Daily Camera)
Originally published 11:43 a.m., January 29, 2007
The 13-year-old girl refused to untie her sweater from around her waist. She was ashamed of her stomach. She thought everyone was looking at how fat it was, like it was a deformity. She began dieting and weighing herself about 20 times a day. She was at the edge of developing an eating disorder, but her mother caught her just in time. She brought her daughter to a therapist, and within two months, the girl began loosening up the sweater until she felt confident enough to lose it completely. The girl's therapist described her as "teeny tiny" — no stomach bulge at all. But the girl saw her body differently. Like many other American teenagers — mostly girls — she had a warped body image. A person's body image is not necessarily connected to reality, local therapists say. Think: If you're having a good day and you feel upbeat, you are more likely to think you look good. If you're stressed and depressed, you are likely to feel unattractive, even if you look the same as you usually do. Developing a healthy body image is crucial for adolescents; a negative image can lead to a lifetime of eating disorders and low self-esteem. And these perceptions begin at the beginning. Even toddlers pick up messages from society, their parents, daycare and friends about how they should view their bodies. If parents don't clear up mixed messages and let their children know they are more than their body shape, children can start to act out dangerous eating habits. Local therapists tell stories about increasingly more preteens popping diet pills, skipping lunch or heading to the bathrooms at school to purge what they do eat at lunch. One 4-year-old girl refused to eat the snacks at her preschool because she was afraid of getting fat. Two-thirds of all American girls have been on a diet before the age 10. Nearly half of 9- to 11-year-olds are "sometimes" or "very often" on diets, according to a study by Colgate University. Forty-two percent of first- to third-grade girls said they want to be thinner, another national study showed. Eighty percent of 10-year-olds said in another national survey they were afraid of being fat. Superior-based therapist Dorie McCubbrey knows that fear firsthand. She developed an eating disorder in elementary school, after seeing most of the women in her family diet regularly. Parents have a tremendous impact as role models for their children, be it good or bad, McCubbrey says. "This is the season right now to be losing weight," says McCubbrey, who now counsels people on healthy weight maintenance and body acceptance. "There are healthy ways to lose weight, and if you are trying to lose weight, be very careful about what you say in front of your kids, because they will pick it up." When a person's body image is inaccurate, it often means they're using their body as something they can change when they feel like their life is out of control, according to McCubbrey. She saw one 6-year-old girl who refused to eat after her parents got a divorce. "Any kind of trauma, whether mild or severe, can trigger someone to use their body as a means of control," McCubbrey says. "And that needs to be taken very seriously." 'Your body's a wonderland' Isabelle Tierney, a therapist in Boulder, says 80 percent of her clients struggle with their body image. She speaks to local students and trains school counselors about positive body image. Few people admire their bodies for the "marvels" that they are, Tierney says. She often guides her clients through meditation where they think about their skin, muscles, blood, the cells and the complex organs inside. "Nobody teaches kids and adolescents how incredible the body is, the way the muscles work," she says. "It allows me to jump, run, wrestle. When you start seeing your body, as opposed to an object that is supposed to look a certain way to be liked, but as a magnificent system — and if you take care of it, it'll work for you — it shifts you into an incredible place where you think, 'Wow, my body is amazing.'" Tierney runs the Web site, www.bodybeloved.com, which teaches and "inside-out" view on body image. That means letting your inside define your outside, rather than letting your feelings depend on what's going on outside: How others view you, whether you're in a good mood, if you have a boyfriend or girlfriend. Tierney recommends teaching this as young as possible. "I have three kids myself, and I always say, 'What does your body need? Take care of this machine working for you,'" she says. Celebrating real beauty As a teenager, Audrey Brashich got caught up in society's definition of beauty. She was a teen model, landing gigs with magazines such as YM, Seventeen, Elle Girl, Cosmo Girl, Lucky and Self. Brashich also was elected to her New York high school's student government, one of the first girls chosen since the school's founding in 1709, she says. No one seemed to care about that. "I was in a bunch of magazines, and a lot of people were asking me about that," she says. "Why is that so much more important than something else that took a lot of intelligence to achieve?" Brashich, who now lives in Canada, says society's messages to girls perplexed her. So she decided to do some research. Brashich published a book in May, "A Girl's Guide to Seeing Through Celebrity Hype and Celebrating Real Beauty," a body image and media literacy guide for teens. She says some girls don't realize there is more to life than feeling "pretty." "The girls I've spoken to are torn. They want to fit in to what is beautiful, but be valued for other things they know are important and are told are important," she says. She urges parents and teachers to talk to their children about what they see in the media — "raise questions and get kids thinking about what they see," she says. "If you ask kids what's important in a role model, they'll make a mini list, or if you ask them what professions are the most important in the world, they'll probably say doctors and teachers," Brashich says. "Then ask them to name famous doctors and teachers, and they'll have a harder time. It shows them that we know these things are important, yet we don't see them in the media. Let's find them." Contact Camera Staff Writer Aimee Heckel at (303) 473-1359 or heckela@dailycamera.com. How do you see you? Tips for improving your body image: You don'tneed to change the way you look or act. Instead, change the way you think about yourself. Recognizethat your body is unique and your own. Stayhealthy, and talk to a doctor if you are concerned you don't have a healthy weight. Acceptthe things about your body you cannot change. Make goalsto change the things that you can, such as getting fit and eating nutritious food. Meeting a challenge is a good way to boost your self-esteem. Stopthe negative thoughts. Giveyourself three compliments every day. Every evening,list three things in your day that made you feel good. Even simple things, such as the sun or a song you heard. Focuson the good things in your life. Get helpif you need it. Talk to a trusted adult or Source: www.kidshealth.org. Tips for parents To help build positive body image: Keepcommunication open. Don't talknegatively about food or weight. Don't talkabout how "good" someone looks because they are skinny. Always havefun and healthy food available. Teachyour teen how to make healthy and fun foods, such as smoothies. Limitexposure to unhealthy messages from the media. Talk to them about what they are seeing. Complimentactions instead of appearances. Warning signs Signs of a possible eating disorder: Exercisingfor an hour or more daily with few or no days off. Havingan ongoing fear of weight gain, an unrealistic sense of "feeling fat" or an extreme emphasis on losing or maintaining weight. Significantchanges in weight. Avoidingcertain foods and feeling guilty about eating certain foods. Eatingfor emotional reasons, such as stress; also, uncontrollable patterns of compulsive eating or overeating and secretive eating. Frequentweighing or measuring the body with a tape measure. Usingdiet pills, laxatives, diuretics, appetite suppressants and weight-loss products. Usingexercise to "get rid of" food. Source: Eating disorder specialist Dorie McCubbrey. What to do If you believe someone has an eating disorder: Be supportive.People who have suffered eating disorders say the worst thing to do is isolate someone who has a disorder. For informationabout confronting a person with an eating disorder, check out www.anad.org, and click on "Eating disorder info and resources" and "Confronting." Be empathetic,but direct. Don't back down if the problem is denied. Contacta professional for help. Redirectthe focus from weight control to deeper, more meaningful goals. Emphasize inner qualities, and keep comments about appearance to a minimum. Learnthe facts about nutrition and fitness and share it with your child. Educate yourself through books or support groups. Don't labelfood as "good" or "bad." Sources: National Association of Anorexia Nervosa and Associated Disorders, Dorie McCubbrey.
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