Download Who is at risk for developing an eating disorder

Who is at risk for developing an eating disorder?
These disorders usually appear in bright, attractive young women between the
ages of twelve and twenty-five, although there are both older and younger
exceptions. At least ten percent (10%) of the people with eating disorders are
male, possibly more. Researchers are just now beginning to determine how
widespread these problems are in men and boys.
Who is at risk for developing anorexia nervosa?
People who become anorexic often were good children -- eager to please,
conscientious, hard working, and good students. Typically they are peoplepleasers who seek approval and avoid conflict. They may take care of other
people and strive for perfection, but underneath they feel defective and
inadequate. They want to be special, to stand out from the mediocre masses.
They try to achieve that goal by losing weight and being thin.
Some clinicians believe that the symptoms of anorexia are a kind of symbolic
language used by people who don't know how to, or are afraid to, express
powerful emotions directly, with words. For example, making one's body tiny and
thin may substitute for, "I'm not ready to grow up yet," or "I'm starving for
attention." Refusing to eat may translate to "I won't let you control me!"
People who develop anorexia often feel stressed and anxious when faced with
new situations. Many are perfectionists who have low tolerance for change
(including the normal physical changes their bodies experience at puberty),
feeling that it represents chaos and loss of control. Some set rigid, unrealistic
standards for themselves and feel they have failed totally when they cannot
achieve and maintain the degree of excellence they demand of themselves.
In addition to restricting food, classic anorexics also restrict other areas of their
lives. They are risk-averse individuals, preferring to live closely circumscribed
lives, with few changes in established routines, to which they tightly cling. They
need to become more adventurous and learn how to cope with expanded
horizons.
Although people who have anorexia nervosa don't want to admit it, many fear
growing up, taking on adult responsibilities, and meeting the demands of
independence. Many are overly engaged with parents to the exclusion of peer
relationships. They use dieting and weight preoccupations to avoid, or
ineffectively cope with, the demands of a new life stage such as adolescence,
living away from home, or adult sexuality.
Who is at risk for developing bulimia?
People who become bulimic often have problems with anxiety, depression, and
impulse control; for example, shoplifting, casual sexual activity, binge shopping,
alcohol and drug abuse, and cutting and other self-harm behaviors. They do not
handle stress gracefully. They may be dependent on their families even though
they fiercely profess independence. Many have problems trusting other people.
They have few or no truly satisfying friendships or romantic relationships.
They may diet, thinking to improve their lives and feel better about themselves.
The deprivation leads to hunger, which leads to powerful cravings, which lead to
binge eating. Feeling guilty, and afraid of weight gain, they try to remove calories
from their bodies by vomiting, laxative abuse, fasting, or other methods of
purging.
Bulimics binge not only on food but also in other areas of their lives, often taking
in more than they can handle: relationships, jobs, responsibilities, family duties,
and sometimes possessions and alcohol and other drugs. They need to learn to
set limits and boundaries, slowing down and stepping back a bit so they don't feel
so overwhelmed, rather than "purging" by cut-and-run behaviors when they find
themselves over-involved.
Are some people at special risk?
Because of intense demands for thinness, some people are at high risk for eating
disorders -- wrestlers, jockeys, cheerleaders, sorority members, socialites,
dancers, gymnasts, runners, models, actresses, and entertainers.
Western culture -- an incubator for eating disorders
People with eating disorders seek external solutions for internal problems. They
feel empty, depressed, anxious, fearful, sorrowful, guilty, frustrated, insecure and
depressed. They want to feel better, which is good, but they choose woefully
ineffective ways of doing that. In fact, starving and stuffing have the opposite
effect: they cause MORE emotional pain and distress.
Nonetheless, manipulating food and body weight is encouraged by Western
culture, which exhorts all of us, and especially women, to improve ourselves by
"fixing" the external package, the body. Make-over reality shows on TV are a
prime example. The message is, "Change your hair color and style, buy new
clothes, paint your face, shove your feet into shoes that hurt and make walking
difficult, tone your muscles AND LOSE WEIGHT and you will be happy, admired,
and loved -- an instant new identity, a new you.
The problem is, of course, that sprucing up the outside (or starving it to death)
does not fix what's wrong on the inside. True happiness and deep contentment
are achieved through psychological and spiritual growth and ultimate realization
of one's worth and place in the world, not by abusing the body. It takes a lot of
wisdom and maturity to realize and accept this hard truth, and the young people
most vulnerable to eating disorders are those who most lack those
characteristics.
What causes eating disorders?
There are many theories, many interwoven factors, and no one simple answer
that covers person with an eating disorder. For any particular individual, some or
all of the following factors will combine to produce starving, stuffing, and purging.
Biological factors
According to recent research (Archives of General Psychiatry 2006; 63:305-312)
Genetic factors account for more than half (56 percent) of the risk of developing
anorexia nervosa. Work on the genetics of bulimia and binge eating continues.
Also, once a person begins to starve, stuff, or purge, those behaviors in and of
themselves can alter brain chemistry and prolong the disorder. For example, both
undereating and overeating can activate brain chemicals that produce feelings of
peace and euphoria, thus temporarily dispelling anxiety and depression. In fact
some researchers believe that eating disordered folks may be using food to selfmedicate painful feelings and distressing moods.
Media factors
Quote: Advertising has done more to cause the social unrest of
the 20th century than any other single factor. --Clare Boothe
Luce, American author and diplomat (1903-1987)
People in Western countries are flooded by media words and images. An
average U.S. child, for example, sees more than 30,000 TV commercial each
year (TV-Turnoff Network, 2005). That child sees more than 21 hours of TV each
week plus dozens of magazines and many movies every year. In those media,
happy and successful people are almost always portrayed by actors and models
who are young, toned, and thin. The vast majority are stylishly dressed and have
spent much time on hair styles and makeup.
Factoid: According to Health magazine, April 2002, 32% of female TV network
characters are underweight, while only 5% of females in the U.S. audience are
underweight.
In contrast, evil, stupid, or buffoonish people are portrayed by actors who are
older, frumpier, unkempt, perhaps physically challenged. Many are fat.
Factoid: Again according to Health magazine, only 3% of female TV network
characters are obese, while 25% of U.S. women fall into that category.
Most people want to be happy and successful, states that require thought,
personal development, and usually hard work. The media, especially ads and
commercials for appearance-related items, suggest that we can avoid the hard
character work by making our bodies into copies of the icons of success.
Reading between the lines of many ads reveals a not-so-subtle message -- "You
are not acceptable the way you are. The only way you can become acceptable is
to buy our product and try to look like our model (who is six feet tall and wears
size four jeans -- and is probably anorexic). If you can't quite manage it, better
keep buying our product. It's your only hope."
The differences between media images of happy, successful men and women
are interesting. The women, with few exceptions, are young and thin. Thin is
desirable, or so they are portrayed. The men are young or older, but the heroes
and good guys are strong and powerful in all the areas that matter -- physically,
in the business world, and socially. For men in the media, thin is not desirable;
power, strength and competency are desirable. Thin men are seen as skinny,
and skinny men are often depicted as sick, weak, frail, drug addicted, criminal or
deviant.
These differences are reflected in male and female approaches to self-help.
When a man wants to improve himself, he often begins by lifting weights to
become bigger, stronger, and more powerful. When a woman want to improve
herself, she usually begins with a diet, which will leave her smaller, weaker, and
less powerful. Yet females have just as strong needs for power and control as do
males.
Many people believe this media stereotyping helps explain why about ninety
percent of people with eating disorders are women and only ten percent are men.
In recent years it has become politically correct for the media to make some
effort to combat eating disorders. We have seen magazine articles and TV shows
featuring the perils and heartbreak of anorexia and bulimia, but these efforts
seem weak and ineffective when they are presented in the usual context. For
example, how can one believe that a fashion magazine is truly motivated to
combat anorexia when their articles about that subject are surrounded by
advertisements featuring anorexic-looking models? How can one believe that the
talk show hostess is truly in favor of strong, healthy female bodies when she
frequently prods her stick-like thighs and talks about how much she wants to lose
weight from her already scrawny body?
In May 1999, research was published that demonstrated the media's unhealthy
affect on women's self-esteem and body awareness. In 1995, before television
came to their island, the people of Fiji thought the ideal body was round, plump,
and soft. Then, after 38 months of Melrose Place, Beverly Hills 90210, and
similar western shows, Fijian teenage girls showed serious signs of eating
disorders. For details of the study, see the Harvard Medical School press
release.
In another study, females who regularly watch TV three or more nights per week
are fifty percent more likely than non-watchers to feel "too big" or "too fat." About
two-thirds of the TV-watching female teens dieted in the month preceding the
survey. Fifteen percent admitted vomiting to control their weight. TV shows like
the two mentioned above are fantasies, but all over the world young women, and
some not so young, accept them as instructions on how to look and act. That's
really a shame.
An important question for people who watch TV, read magazines, and go to
movies -- do these media present images that open a window on the real world,
or do they hold up a fun-house mirror in which the reflections of real people are
distorted into impossibly tall, thin sticks (or impossibly muscular, steroiddependent male action figures)? Media consumers need to be wise consumers
of visual images.
Even so-called health oriented magazines can contribute to the problem. Five
years after reading magazine articles about dieting, teenage girls were more
likely to control weight by fasting, vomiting, smoking cigarettes or abusing
laxatives than girls who never read such articles. The message underlying these
articles in many cases is "You should be concerned about your weight, and you
should be doing something about it." It's unclear if the toxic message is conveyed
in the article itself or the pictures of thin models that accompany the words.
Incidentally, only about 14 percent of teen boys report reading diet articles
frequently, compared with 44 percent of girls. And unlike their female peers,
those boys do not show long lasting negative effects on weight control behavior
that persist through time. (The study from which these figures come appeared in
the January 2007 issue of the journal Pediatrics.)
Media factors
Quote: Advertising has done more to cause the social unrest of
the 20th century than any other single factor. --Clare Boothe
Luce, American author and diplomat (1903-1987)
People in Western countries are flooded by media words and images. An
average U.S. child, for example, sees more than 30,000 TV commercial each
year (TV-Turnoff Network, 2005). That child sees more than 21 hours of TV each
week plus dozens of magazines and many movies every year. In those media,
happy and successful people are almost always portrayed by actors and models
who are young, toned, and thin. The vast majority are stylishly dressed and have
spent much time on hair styles and makeup.
Factoid: According to Health magazine, April 2002, 32% of female TV network
characters are underweight, while only 5% of females in the U.S. audience are
underweight.
In contrast, evil, stupid, or buffoonish people are portrayed by actors who are
older, frumpier, unkempt, perhaps physically challenged. Many are fat.
Factoid: Again according to Health magazine, only 3% of female TV network
characters are obese, while 25% of U.S. women fall into that category.
Most people want to be happy and successful, states that require thought,
personal development, and usually hard work. The media, especially ads and
commercials for appearance-related items, suggest that we can avoid the hard
character work by making our bodies into copies of the icons of success.
Reading between the lines of many ads reveals a not-so-subtle message -- "You
are not acceptable the way you are. The only way you can become acceptable is
to buy our product and try to look like our model (who is six feet tall and wears
size four jeans -- and is probably anorexic). If you can't quite manage it, better
keep buying our product. It's your only hope."
The differences between media images of happy, successful men and women
are interesting. The women, with few exceptions, are young and thin. Thin is
desirable, or so they are portrayed. The men are young or older, but the heroes
and good guys are strong and powerful in all the areas that matter -- physically,
in the business world, and socially. For men in the media, thin is not desirable;
power, strength and competency are desirable. Thin men are seen as skinny,
and skinny men are often depicted as sick, weak, frail, drug addicted, criminal or
deviant.
These differences are reflected in male and female approaches to self-help.
When a man wants to improve himself, he often begins by lifting weights to
become bigger, stronger, and more powerful. When a woman want to improve
herself, she usually begins with a diet, which will leave her smaller, weaker, and
less powerful. Yet females have just as strong needs for power and control as do
males.
Many people believe this media stereotyping helps explain why about ninety
percent of people with eating disorders are women and only ten percent are men.
In recent years it has become politically correct for the media to make some
effort to combat eating disorders. We have seen magazine articles and TV shows
featuring the perils and heartbreak of anorexia and bulimia, but these efforts
seem weak and ineffective when they are presented in the usual context. For
example, how can one believe that a fashion magazine is truly motivated to
combat anorexia when their articles about that subject are surrounded by
advertisements featuring anorexic-looking models? How can one believe that the
talk show hostess is truly in favor of strong, healthy female bodies when she
frequently prods her stick-like thighs and talks about how much she wants to lose
weight from her already scrawny body?
In May 1999, research was published that demonstrated the media's unhealthy
affect on women's self-esteem and body awareness. In 1995, before television
came to their island, the people of Fiji thought the ideal body was round, plump,
and soft. Then, after 38 months of Melrose Place, Beverly Hills 90210, and
similar western shows, Fijian teenage girls showed serious signs of eating
disorders. For details of the study, see the Harvard Medical School press
release.
In another study, females who regularly watch TV three or more nights per week
are fifty percent more likely than non-watchers to feel "too big" or "too fat." About
two-thirds of the TV-watching female teens dieted in the month preceding the
survey. Fifteen percent admitted vomiting to control their weight. TV shows like
the two mentioned above are fantasies, but all over the world young women, and
some not so young, accept them as instructions on how to look and act. That's
really a shame.
An important question for people who watch TV, read magazines, and go to
movies -- do these media present images that open a window on the real world,
or do they hold up a fun-house mirror in which the reflections of real people are
distorted into impossibly tall, thin sticks (or impossibly muscular, steroiddependent male action figures)? Media consumers need to be wise consumers
of visual images.
Even so-called health oriented magazines can contribute to the problem. Five
years after reading magazine articles about dieting, teenage girls were more
likely to control weight by fasting, vomiting, smoking cigarettes or abusing
laxatives than girls who never read such articles. The message underlying these
articles in many cases is "You should be concerned about your weight, and you
should be doing something about it." It's unclear if the toxic message is conveyed
in the article itself or the pictures of thin models that accompany the words.
Incidentally, only about 14 percent of teen boys report reading diet articles
frequently, compared with 44 percent of girls. And unlike their female peers,
those boys do not show long lasting negative effects on weight control behavior
that persist through time. (The study from which these figures come appeared in
the January 2007 issue of the journal Pediatrics.)