Reproduced from the National Eating Disorders Association Website

Reproduced from the National Eating Disorders Association Website 2003 -2004 http: //www. national eating disorders. org Teensource 2004

Body image is. . 1. 2. 3. 4. How you see yourself when you look in the mirror or when you picture yourself in your mind. What you believe about your own appearance (including your memories, assumptions, and generalizations). How you feel about your body, including your height, shape, and weight. How you sense and control your body as you move. How you feel in your body, not just about your body.

Negative body image is. . . 1. 2. 3. 4. A distorted perception of your shape--you perceive parts of your body unlike they really are. You are convinced that only other people are attractive and that your body size or shape is a sign of personal failure. You feel ashamed, self-conscious, and anxious about your body. You feel uncomfortable and awkward in your body.

Positive body image is. . . ü ü A clear, true perception of your shape--you see the various parts of your body as they really are. You celebrate and appreciate your natural body shape and you understand that a person`s physical appearance says very little about their character and value as a person. You feel proud and accepting of your unique body and refuse to spend an unreasonable amount of time worrying about food, weight, and calories. You feel comfortable and confident in your body.

Every Body is Different n It is important to remember that every body is different. We all have different genetics. Even if everyone started eating the same things and did the same amount of exercise for a whole year, we would not all look the same at the end of the year. This is because each person’s genetics influence their bone structure, body size, shape, and weight differently.

How can you calculate your ideal body weight? n n Well, your "ideal" body weight is the weight that allows you to feel strong and energetic and lets you lead a healthy, normal life. For example, when your body is healthy and at its ideal body weight, you are not too tired, too easily frustrated, too anxious or angry, and you have the energy to talk to your friends, participate in sports, and concentrate on school or work. When searching for your ideal weight, don’t rely on charts, formulas, and tables to dictate what’s right for you. Instead, eat balanced meals full of nutritious foods and enjoy regular, moderate exercise. This will help you be your ideal weight.

Ideal body weight? n Most of all, avoid comparing your body with your friends’ bodies or the people you see in advertisements or on your favorite TV shows. If you do start to compare yourself to others, try to remember that we are all naturally different which means we all have special qualities about us. n Make a list of some of your strengths. What do you like to do? What makes you unique?

Remember these Keys to an Ideal Body Resist the pressure to judge yourself and others based on weight, shape, or size. Respect people based on the qualities of their character and accomplishments, rather than just because of their appearance.

People with negative body image have a greater likelihood of developing an eating disorder and are more likely to suffer from feelings of depression, isolation, low self-esteem, and obsessions with weight loss. We all may have our days when we feel awkward or uncomfortable in our bodies, but the key to developing positive body image is to recognize and respect our natural shape and learn to overpower those negative thoughts and feelings with positive, affirming, and accepting ones. Accept yourself -- Accept your body. Celebrate yourself -- Celebrate your body.

What are Eating Disorders n Eating disorders are serious emotional and physical problems that can have life-threatening consequences for females and males.

Anorexia Nervosa Characterized by self-starvation and excessive weight loss Symptoms include: n ü ü ü Refusal to maintain body weight at or above a minimally normal weight for height, body type, age, and activity level Intense fear of weight gain or being “fat” Feeling “fat” or overweight despite dramatic weight loss Loss of menstrual periods Extreme concern with body weight and shape

Bulimia Nervosa n n ü ü ü Characterized by a secretive cycle of binge eating followed by purging. Bulimia includes eating large amounts of food--more than most people would eat in one meal--in short periods of time, then getting rid of the food and calories through vomiting, laxatives abuse, or over-exercising. Symptoms include: Repeated episodes of bingeing and purging Feeling out of control during a binge and eating beyond the point of comfortable fullness Purging after a binge, (typically by self-induced vomiting, abuse of laxatives, diet pills and/or diuretics, excessive exercise, or fasting) Frequent dieting Extreme concern with body weight and shape

Binge Eating Disorder (also known as COMPULSIVE OVEREATING) n Characterized primarily by periods of uncontrolled, impulsive, or continuous eating beyond the point of feeling comfortably full. While there is no purging, there may be sporadic fasts or repetitive diets and often feelings of shame or self-hatred after a binge. People who overeat compulsively may struggle with anxiety, depression, and loneliness, which can contribute to their unhealthy episodes of binge eating. Body weight may vary from normal to mild, moderate, or severe obesity.

Other Eating Disorders n n n Can include some combination of the signs and symptoms of anorexia, bulimia, and/or binge eating disorder. While these behaviors may not be clinically considered a full syndrome eating disorder, they can still be physically dangerous and emotionally draining. All eating disorders require professional help.

Health Consequences of Eating Disorders n Eating disorders are real, complex, and devastating conditions that can have serious consequences for health, productivity, and relationships n Eating disorders are not just a “fad” or a “phase. ” They are serious, potentially lifethreatening conditions that affect a person’s emotional and physical health.

Health Consequences of Anorexia Nervosa n ü ü ü ü In anorexia nervosa’s cycle of self-starvation, the body is denied the essential nutrients it needs to function normally. Thus, the body is forced to slow down all of its processes to conserve energy, resulting in serious medical consequences. Abnormally slow heart rate and low blood pressure, which mean that the heart muscle is changing. The risk for heart failure rises as the heart rate and blood pressure levels sink lower and lower. Reduction of bone density (osteoporosis), which results in dry, brittle bones. Muscle loss and weakness. Severe dehydration, which can result in kidney failure. Fainting, fatigue, and overall weakness. Dry hair and skin, hair loss is common. Growth of a downy layer of hair called lanugo all over the body, including the face, in an effort to keep the body warm.

Health Consequences of Bulimia Nervosa: n ü ü ü The recurrent binge-and-purge cycles of bulimia can affect the entire digestive system and can lead to electrolyte and chemical imbalances in the body that affect the heart and other major organ functions. Electrolyte imbalances that can lead to irregular heartbeats and possibly heart failure and death. Electrolyte imbalance is caused by dehydration and loss of potassium and sodium from the body as a result of purging behaviors. Potential for gastric rupture during periods of bingeing. Inflammation and possible rupture of the esophagus from frequent vomiting. Tooth decay and staining from stomach acids released during frequent vomiting. Chronic irregular bowel movements and constipation as a result of laxative abuse. Peptic ulcers and pancreatitis.

Health Consequences of Binge Eating Disorder: n Binge eating disorder often results in many of the same health risks associated with clinical obesity ü High blood pressure. High cholesterol levels. Heart disease as a result of elevated triglyceride levels. Secondary diabetes. Gallbladder disease. ü ü

Causes of Eating Disorders n n n While eating disorders may begin with the preoccupation with food and weight, they are most often about much more than food. Eating disorders are complex conditions that arise from a combination of long-standing behavioral, emotional, psychological, interpersonal, and social factors. Scientists and researchers are still learning about the underlying causes of these emotionally and physically damaging conditions. We do know, however, about some of the general issues that can contribute to the development of eating disorders.

General issues that can contribute to the development of eating disorders… n n People with eating disorders often use food and the control of food in an attempt to compensate for feelings and emotions that may otherwise seem over-whelming. For some, dieting, bingeing, and purging may begin as a way to cope with painful emotions and to feel in control of one’s life, but ultimately, these behaviors will damage a person’s physical and emotional health, self-esteem, and sense of competence and control.

Psychological Factors ü ü ü Low self-esteem Feelings of inadequacy or lack of control in life Depression, anxiety, anger, or loneliness Interpersonal Factors ü ü Troubled family and personal relationships Difficulty expressing emotions and feelings History of being teased or ridiculed based on size or weight History of physical or sexual abuse

Social Factors ü ü ü Cultural pressures that glorify "thinness" and place value on obtaining the "perfect body" Narrow definitions of beauty that include only women and men of specific body weights and shapes Cultural norms that value people on the basis of physical appearance and not inner qualities and strengths

Other Factors ü Scientists are still researching possible biochemical or biological causes of eating disorders. In some individuals with eating disorders, certain chemicals in the brain that control hunger, appetite, and digestion have been found to be imbalanced. The exact meaning and implications of these imbalances remains under investigation.

Eating disorders are complex conditions that can arise from a variety of potential causes. Once started, however, they can create a self -perpetuating cycle of physical and emotional destruction. All eating disorders require professional help.

Tips for Talking with a Friend Who May have an Eating Disorder n n n If you are worried about your friend’s eating behaviors or attitudes, it is important to express your concerns in a loving and supportive way. It is also necessary to discuss your worries early on, rather than waiting until your friend has endured many of the damaging physical and emotional effects of eating disorders. In a private and relaxed setting, talk to your friend in a calm and caring way about the specific things you have seen or felt that have caused you to worry.

What to Say to a Friend – Step by Step n Set a time to talk. Set aside a time for a private, respectful meeting with your friend to discuss your concerns openly and honestly in a caring, supportive way. Make sure you will be some place away from other distractions. n Communicate your concerns. Share your memories of specific times when you felt concerned about your friend’s eating or exercise behaviors. Explain that you think these things may indicate that there could be a problem that needs professional attention. n Ask your friend to explore these concerns with a counselor, doctor, nutritionist, or other health professional who is knowledgeable about eating issues. If you feel comfortable doing so, offer to help your friend make an appointment or accompany your friend on their first visit.

Continued…What to Say to a Friend n Avoid conflicts or a battle of the wills with your friend. If your friend refuses to acknowledge that there is a problem, or any reason for you to be concerned, restate your feelings and the reasons for them and leave yourself open and available as a supportive listener. n Avoid placing shame, blame, or guilt on your friend regarding their actions or attitudes. Do not use accusatory “you” statements like, “You just need to eat. ” Or, “You are acting irresponsibly. ” Instead, use “I” statements. For example: “I’m concerned about you because you refuse to eat breakfast or lunch. ” Or, “It makes me afraid to hear you vomiting. ” n Avoid giving simple solutions. For example, "If you'd just stop, then everything would be fine!“ n Express your continued support. Remind your friend that you care and want your friend to be healthy and happy.

After talking with your friend, if you are still concerned with their health and safety, find a trusted adult or medical professional to talk to. This is probably a challenging time for both of you. It could be helpful for you, as well as your friend, to discuss your concerns and seek assistance and support from a professional.

How to Help a Friend With Eating and Body Image Issues n You cannot force someone to seek help, change their habits, or adjust their attitudes. You will make important progress in honestly sharing your concerns, providing support, and knowing where to go for more information!

Listen to Your Body Always worrying about counting calories and fat grams in order to control your weight can become difficult and tiresome. And, is there really a "perfect diet" out there anyway? After all, 95% of diets fail because diets don’t work. Why else would people have to keep searching for new ones all of the time?

Dieting n n n When was the last time you truly had fun dieting? Most likely you won’t remember it as a pleasurable experience. After all, it doesn’t feel so great to be getting hungry for lunch but forcing yourself to wait an extra hour. Do you remember feeling irritable? Did you get a headache or was your stomach growling? And, didn’t those "forbidden" or "off limits" foods seem to be calling your name even more than ever? Gosh, that doesn’t seem like very much fun, does it?

Why Diets Don’t Work n n n The reason diets don’t work and aren’t much fun is because your body needs food for energy, just like a car needs gas to drive. Food is fuel for your body! Your body knows what it needs in order to keep running efficiently--it needs the fuel of vitamin and nutrient rich foods from a variety of food groups. That’s why it’s important to listen to your body and respond to its natural hunger. It will tell you what it needs. And if you don’t listen, it will find ways to keep reminding you--like headaches, a growling stomach, and obsessing about food.

Keys to Listening to Your Body n The first key to listening to your body is being able to detect when you are getting hungry. If you are indeed truly hungry, and not just looking for food to cure your boredom, stress, or loneliness, then it is time to refuel. n n The second key is being able to know when you have had enough. Listen to your body. When you begin to feel full, you will know that you have had enough to eat. The goal is to feel content--not uncomfortably stuffed but not starving either. Sometimes this means eating 5 or 6 smaller meals a day instead of 3 large meals. And, remember it takes about 20 minutes for your body to realize it’s full. Also, be aware of what you are eating--sit, chew slowly, enjoy the tastes, smells, and textures of your food. The third key is moderation, nothing to extremes. Often people hear this advice and think it means they can eat whatever they crave, all the time. Obviously we cannot survive on potato chips or peanut butter cookies alone. And if you tried, chances are you'd probably start to crave some pasta or fresh fruit after awhile. These cravings are your body's way of helping you get the nutrients it knows you need.

Eat what you want, when you are truly hungry. Stop when you`re full. And eat exactly what appeals to you. Do this instead of any diet, and you are unlikely to ever have a weight problem, let alone an eating disorder. LISTEN TO YOUR BODY.

The Media, Body Image, and Eating Disorders Eating disorders are complex conditions that arise from a variety of factors, including physical, psychological, interpersonal, and social issues. Media images that help to create cultural definitions of beauty and attractiveness are often acknowledged as being among those factors contributing to the rise of eating disorders. Media messages screaming “thin is in” may not directly cause eating disorders, but they help to create the context within which people learn to place a value on the size and shape of their body. To the extent that media messages like advertising and celebrity spotlights help our culture define what is beautiful and what is “good, ” the media’s power over our development of self-esteem and body image can be incredibly strong. n n

Dieting: Risks and Reasons to Stop n Americans spend more than $40 billion dollars a year on dieting and diet-related products. Dieting: Any attempts in the name of weight loss, "healthy eating", or body sculpting to deny your body of the essential, well-balanced nutrients and calories it needs to function to its fullest capacity. The Dieting Mindset: When dissatisfaction with your natural body shape or size leads to a decision to actively change your physical body weight or shape.

Dieting has become a national pastime, especially for women. . . n Americans spend more than $40 billion dollars a year on dieting and dietrelated products. That’s roughly equivalent to the amount the U. S. Federal Government spends on education each year. n It is estimated that 40 -50% of American women are trying to lose weight at any point in time. n One recent study revealed that 91% of women on a college campus had dieted. 22% dieted "often" or "always. " (Kurth et al. , 1995). n Researchers estimate that 40 -60% of high school girls are on diets (Sardula et al. , 1993; Rosen & Gross, 1987). n Another study found that 46% of 9 -11 year olds are sometimes or very often on diets (Gustafson-Larson & Terry, 1992). n And, another researcher discovered that 42% of 1 st-3 rd grade girls surveyed reported wanting to be thinner (Collins, 1991).

The Big Deal About Dieting: What You Should Know n n Dieting rarely works. 95% of all dieters regain their lost weight and more within 1 to 5 years. Dieting can be dangerous: • • • "Yo-yo" dieting (repetitive cycles of gaining, losing, & regaining weight) has been shown to have negative health effects, including increased risk of heart disease, long-lasting negative impacts on metabolism, etc. Dieting forces your body into starvation mode. It responds by slowing down many of its normal functions to conserve energy. This means your natural metabolism actually slows down. Dieters often miss out on important nutrients. For example, dieters often don’t get enough calcium, leaving them at risk for osteoporosis, stress fractures, and broken bones.

The Big Deal About Dieting: What You Should Know n Dieters often experience physical consequences such as: ü ü ü n n loss of muscular strength and endurance decreased oxygen utilization thinning hair loss of coordination dehydration and electrolyte imbalances fainting, weakness, and slowed heart rates Dieting also impacts your mind. When you restrict calories you restrict your energy, which in turn can restrict your brainpower. Medical studies indicate that people on diets have slower reaction times and a lesser ability to concentrate than people not on a diet.

The Big Deal About Dieting: What You Should Know n n All of the stress and anxiety about food and weight that preoccupy dieters actually can consume a portion of a dieters’ working memory capacity. Numerous studies link chronic dieting with feelings of depression, low-self-esteem and increased stress.

Dieting can lead to an eating disorder n n Many studies and many health professionals note that patients with eating disorders were dieting at the time of the development of their eating disorder. Dieting may not cause an eating disorder, but the constant concern about body weight and shape, fat grams and calories can start a vicious cycle of body dissatisfaction and obsession that can lead all too quickly to an eating disorder

Tired of Die-ting? Try Living!!! n n n Just imagine all of the time and energy you could save for other activities and interests in your life if you decided to stop dieting. We all need to take care of our bodies and make sure that we are fueling them with a nutritional balance of foods, but we don’t need to let the way our body curves or doesn’t curve determine how we feel about ourselves or how we live our lives. Next time the dieting desire crosses your mind, take a time-out. Think about the reasons why you want to lose weight. Are they really worth it? Think about the potential dangers of dieting. And, most of all, take the time to remember that you are worth so much more than what you weigh!

Some Basic Facts About the Media’s Influence in Our Lives: n According n n to a recent survey of adolescent girls, the media is their main source of information about women’s health issues (Commonwealth Fund, 1997). Researchers estimate that 60% of Caucasian middle school girls read at least one fashion magazine regularly (Levine, 1997). Another study of mass media magazines discovered that women’s magazines had 10. 5 times more advertisements and articles promoting weight loss than men’s magazines did (as cited in Guillen & Barr, 1994). n A study of one teen adolescent magazine over the course of 20 years found that in articles about fitness or exercise plans, 74% cited “to become more attractive” as a reason to start exercising and 51% noted the need to lose weight or burn calories (Guillen & Barr, 1994).

Continued Fact about the Media n The average young adolescent watches 3 -4 hours of TV per day (Levine, 1997). n A study of 4, 294 network television commercials revealed that 1 out of every 3. 8 commercials send some sort of “attractiveness message, ” telling viewers what is or is not attractive (as cited in Myers et al. , 1992). These researchers estimate that the average adolescent sees over 5, 260 “attractiveness messages” per year.

Encouraging the media to present more diverse and real images of people with positive messages about health and self-esteem may not eliminate eating disorders entirely, but it would help reduce the pressures many people feel to make their bodies conform to one ideal, and in the process, reduce feelings of body dissatisfaction and ultimately decrease the potential for eating disorders.

Tips for Becoming a Critical Viewer of the Media n n One of the ways we can protect our self-esteem and body image from the media's often narrow definitions of beauty and acceptability is to become a critical viewer of the media messages we are bombarded with each day. Media messages about body shape and size will affect the way we feel about ourselves and our bodies only if we let them. When we effectively recognize and analyze the media messages that influence us, we remember that the media’s definitions of beauty and success do not have to define our self-image or potential.

To be a Critical Viewer, Remember: n n n All media images and messages are constructions. They are NOT reflections of reality. Advertisements and other media messages have been carefully crafted with an intent to send a very specific message. Advertisements are created to do one thing: convince you to buy or support a specific product or service. To convince you to buy a specific product or service, advertisers will often construct an emotional experience that looks like reality. Remember, you are only seeing what the advertisers want you to see. Advertisers create their message based on what they think you will want to see and what they think will affect you and compel you to buy their product. Just because they think their approach will work with people like you doesn’t mean it has to work with you as an individual. As individuals, we decide how to experience the media messages we encounter. We can choose to use a filter that helps us understand what the advertiser wants us to think or believe and then choose whether we want to think or believe that message. We can choose a filter that protects our self-esteem and body image.

Tips for Eating Well and Feeling Good about Yourself It is no fun to worry all the time about how much you weigh, how much you eat, or whether you are thin. Here are some things you can do.

Tips for Eating Well and Feeling Good about Yourself n Eat when you are hungry. Stop eating when you are full. n All foods can be part of healthy eating. There are no "good" or "bad" foods, so try to eat lots of different foods, including fruits, vegetables, and even sweets sometimes. n When having a snack try to eat different types. Sometimes raisins might be good, sometimes cheese, sometimes a cookie, sometimes carrot sticks or celery dipped in peanut butter. n If you are sad or mad or have nothing to do—and you are not really hungry—find something to do other than eating. Often, talking with a friend, or parent, or teacher is helpful. n Appreciate yourself for all you are – everyone should respect and like themselves, enjoy playing and being active, and eat a variety of healthy foods.

Continued…Tips for Eating Well and Feeling Good about Yourself n Remember: people who exercise and stay active are healthier and better able to do what they want to do, no matter what they weigh or how they look. n Try to find a sport (like basketball or soccer) or an activity (like dancing or karate) that you like and do it! Join a team, join the YMCA, join in with a friend or practice by yourself—Just do it! n Good health, feeling good about yourself, and having fun go hand in hand. Try out different hobbies, like drawing, reading, playing music, or making things. See what you’re good at and enjoy these things. n Remind yourself that healthy bodies and happy people come in all sizes, and that no one body shape or body size is a healthy one or the right one for everybody.

Continued…Tips for Eating Well and Feeling Good about Yourself n Some people believe that fat people are bad, sick, and out of control, while thin people are good, healthy, and in control. This is not true and it is unfair and hurtful. n Do not tease people about being too fat, too thin, too short, or too tall. And, don’t laugh at other people’s jokes about fat (or thin) people or short (or tall) people. Teasing is unfair and it hurts. n If you hear someone (your mom or dad, a sister or a friend) say they are "too fat and need to go on a diet, " TELL THEM—Please don’t, because dieting to lose weight is not healthy—and no fun—for kids or adults. TELL THEM—You think they look great just the way they are. TELL THEM—Don’t diet; eat a variety of foods and get some exercise. TELL THEM—Remember, being "thinner" is not the same as being

Appreciate yourself for all you are – everyone should respect and like themselves, enjoy playing and being active, and eat a variety of healthy foods.