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Eating Disorder Treatment News

Can We Compare Apples to Oranges or Apples to Pears?

“Time is a dressmaker specializing in alterations.” Faith Baldwin

By Susan Parish Walker

Can we compare apples to oranges or apples to pears? When one compares their body type to another person’s body type it is similar to comparing apples to oranges or an apple shaped body to a pear shaped body. If one is comparing their body type to others it becomes a futile attempt when there is such a remote chance that you have similar metabolic rates and body types. A women’s metabolic rate slows down approximately two to three percent every decade. A myriad of issues may affect the metabolic rate in a negative manner such as stress, hormonal imbalances, dieting, and the aging process. However, exercise increases the metabolic rate and women who exercise moderately generally maintain a healthy weight range throughout their lifespan.

Comparing Bodies

Let’s do a little retail therapy! Is a size 6 the same in all retail stores? Absolutely not! A size 6 at The Gap may be a size 8 at The Polo Store and various designers tailor their clothing in such a way that the sizes vary. However, if you go shopping many times girls and women in particular refuse to buy a larger clothing size. At the end of the day if you actually compare the waist of the different sizes of clothing they are all pretty much the same. Why have the weight on the scales and the size of the clothing becomes an obsession for American women?

Clearly, gender differences result in different body types and genetic predispositions play a significant role in the development of one’s body type. Men and women differ greatly in body types, body images, and how they maintain a healthy weight. Male and female reactions to lifestyle behaviors are varied and contingent upon physiological and biological factors such as behavioral history, genetics, and childhood.

This addresses biological risks that may affect one’s body type such as:  (1) Resting metabolic rate; (2) Fat-metabolizing enzymes; (3) Set point theory; and (4) Fat cell theory.

More specifically, fat cells are produced during the last trimester of prenatal life up to the first year of life between the ages of four and seven, and during the years between nine and thirteen. The fat cell production affects everyone’s weight management for throughout their lifespan.

Healthy Beginnings Have Happy Endings

“There is more difference within the sexes than between them.” Ivy Compton-Burnett

The objective will be to focus on relationships or Eating Disorder Inventory III scales for this chapter such as fear of intimacy, body dissatisfaction, binging episodes, and drive for thinness. Both men and women have a strong need for an intimate relationship and longevity through partnership. When people have intimacy in their relationships they feel less alone and more secure and confident. Knowing you have a strong support system to turn to in times of need provides important feelings of security, optimism, and hope, all of which are great antidotes to stress.

Healthy RelationshipsHowever, one of the most profound relationships an individual can develop is the relationship with oneself. Most individuals begin a relationship without examining their own values, ethics, and ideas. If an individual brings too many emotional needs or
baggage to the relationship it could be overwhelming for the other person. Consequently, the emotional dependency could result in emotional distance in the relationship.

More specifically, many patients who develop a formal eating disorder often socially isolate from others and they are dissatisfied with their interpersonal relationships. In addition, building intimacy is very challenging and may create emotional distancing. Furthermore, one may often avoid important events such as high school reunions due to their shame and embarrassment about their body image. Similarly, one may avoid becoming sexually active with their partner due to body shame. This chapter encourages readers to adopt personal autonomy and to build positive self-esteem prior to the commencement of any type of a relationship.

Initially, if one partner fosters positive self-esteem it attracts another partner who also has positive self-esteem. However, if one partner has low self-esteem they may also attract a partner who has low self-esteem.  Once the relationship has developed and one partner begins to build their self-esteem, it often threatens the other partner and results in conflict. Moreover, self-esteem and body image are strongly correlated for women. For example, the higher one’s self-esteem, the more accepting one is of their body image. Therefore, if one day your jeans are too tight or your weight goes up on the scales, it does not affect your self-esteem as much if you have positive self-esteem.

Improving Body Image

Susan Justitz Ph.D

If you are among the millions of women who does not like the way her body looks, join the club. Over half of the American population doesn’t like what they see in the mirror but this does not have to mean you don’t like who you are. Our body image refers to everything about us; our physical appearance along with our emotions and how we feel inside ourselves is what makes up our body image. So although what you see in the mirror every day constitutes part of our body image, there are other things you will need to work on in order to improve your entire body image. Here are some body image improvement tips:

Comparisons are bad.

As women it is natural that we compare ourselves with the girl walking down the street or the neighbor next door. But just because it is natural does not mean we should do it. It begins to take its toll as you make comparisons with yourself and others; and in all reality it does not and should not matter. Every woman is different and should celebrate their differences. Every woman has her own strengths and weaknesses. Don’t focus on what you are not by comparing yourself with every other Jane on the block. Focus on what you are and what you can become.

Look for your strengths.

Everyone has strengths; even you. Try finding parts of you that are your strengths; your talents. Don’t just look at your physical features. There is much more to you than what is on the outside. Look deeper. Can you paint? Did you graduate from college? Do you make others happy? Are you a great mom? These are the things that make the difference; not whether or not you have great legs.

Positive self talk.

Take a moment and listen to the things you say inside your head. Are they nice things? Or are they destructive. Just like a small child loves it when you praise their good behavior, so does your mind. If you could record some of your self talk you may hear things like “why did you do that? You’re such an idiot!” You are what you think, so start thinking good things about yourself so you can begin to change your body image.

Be realistic.

Let’s face it, chances are you’re not going to ever look like that Victoria secret model hanging up in the mall; and why would you want to? Be happy with what you look like; you are unique. Stop pretending that you’d be happy if you just lost ten pounds; or if you could just fit into that size three. When you stop trying to be someone you are not and be happy with the here and now, you will begin to see a change. Don’t live in a fantasy world; embrace who you are and the great things about you right now!

Be Healthy.

The word healthy encompasses so many things. To have a healthy body there a many things you can do. Let’s look at two of them: Exercise and Diet. The recommended daily amount of exercise is 20 minutes; that’s it! Go for a walk, start yoga, or go on a bike ride. You will start to feel your body not only lose inches, but lose all the negative self talk. Your body will thank you for getting some physical activity by helping your brain feel better. Improve your body image by taking a good hard look at your diet. What are you eating? Or not eating for that matter. Are you getting your recommended daily doses of fruits and vegetables; milk products; etc? Changing your diet to improve your body image does not mean you have to cut out everything good. Moderation is the key; so watch your intake and moderate your serving sizes.

Strive for a Healthy Body

Make it your goal to become healthy through regular activity and proper nutrition. Don’t focus on weight, body size, and shape. Think about health, fitness and enjoying yourself.

Focus on Your Positive Points

Do not define yourself only by your appearance. Develop and nurture the many gifts, skills, and abilities that make you unique. Admire and accentuate the things about you that you feel good about. Remember that beauty is a state of mind that has infinite definitions.

Limit Your Exposure to Negative Images from Your Environment

Research shows that the acceptance of negative images (from media, friends, family, etc.) poses more risk than being exposed to those images. Try to reject negative images from the environment by limiting the amount of time you spend with them.(For example, people who judge you based on your appearance, magazines/television/movies focused on one standard of beauty, etc.)

Take Notice of All the Cool Things that Your Body Can Do

Remind yourself of the many things that you can do with your body – walking, running, jumping, dancing, breathing, laughing, hugging, smiling, etc. Practice them daily! Involve yourself in activities that help you tune into your body, such as yoga, Pilates, Tai Chi, etc.

Develop a Positive Social Support System

Surround yourself with people who are confident and encourage you to be your best. Build a network of friends, family, and co-workers who enjoy life and participate in your healthy lifestyle. Get a walking buddy or a lunch partner with healthy eating habits. Limit time spent with and place limits on people with whom you feel self-conscious and inferior. In addition, try to avoid those who point you towards unhealthy habits.

Devote Time and Energy Towards Helping Yourself and Others

Have a plan of action for those times when you may feel low. Turn your focus on helping and not hurting yourself. What can you do for yourself that would be positive? Make your day better. Take a walk, catch up with an old friend, play with a pet, etc. You may even turn your thoughts to making someone else’s day better. Helping other people often makes us feel better about ourselves and our situations.

Keep in mind that this is not a complete list. There are many other things that you can do to boost your body image. In fact, most of us are already contributing to our own positive body images without even realizing it. How often do you focus on your actions and who you are as a person instead of how you look? Do you ever say, “Good job, self!” or compliment yourself during the day?

By no means does this list include everything you can do to improve your body image, but it can be a starting point for action. Use it as a guide for creating a new, positive, encouraging perception of yourself. If you already have a positive body image, this can reaffirm the healthy habits you already have.

Your body image defines who you are so make it more than just your physical appearance. It sounds so cliché but people love you for what they see on the inside. Improve your body image by starting with what matters most.

Body Image and Eating Disorders

What Colors Do You See?

Susan Parish-Walker MS, LPC

What do you see when you look into a full-length mirror? If you are like many men and women, it’s not what you would like to see. Instead, your mind’s eye reflects on a history of a collage of past and present experiences, of remembered critical remarks and unforgotten praises. Is the image reflected of a person who is too thin, too fat, or just right? Moreover, do you find yourself analyzing and criticizing specific body regions such as your arms, buttocks, stomach, hips, or thighs?  Some psychologists compare an unhealthy body image as being distorted or being colorblind? For example, if one is truly colorblind that may have difficulty differentiating between various color tones. Similarly, if one has a distorted body image they may have difficulty assessing an accurate picture of their body.

body-image-mirrorWhy are so many men and women prone to have a distorted or unhealthy body image? Clearly, we may have a few figure flaws and many of us will never look like Cindy Crawford or Michangelo’s David. Body image studies reveal many factors that often lead to body dissatisfaction. The following issues seem to be contributing factors: weight gain, paradoxical messages from the media, cultural pressures, perfectionism, drive for thinness and a relentless pursuit to become thin, low self-esteem, being in a relationship where a loved one is disapproving, mood swings, physiological changes such as hormonal imbalances or pregnancy, chronic illness, disfigurement, and sexual abuse.

In addition, other symptoms that are often correlated with poor body image are interpersonal distrust. In other words, one may experience difficulty in building trust in relationships and may keep others at a distance. As a young girl, my father would build the most beautiful fires that were mesmerizing. I would love to put on my bobby socks and  flannel granny gown and sip hot chocolate in front of the fireplace and experience the warmth of the fire. However, if I moved too close to the fire I would often feel the heat that was so intense and I would create some distance to cool my skin. It was always a delicate balance between being too close and too distant. Likewise, building trust and intimacy in relationships may be very challenging if one has been burned or hurt very badly.

More specifically, if someone has been molested, raped or an extramarital affair has occurred it may create what is known as the “fat pad of protection” and create emotional distance. On the other hand, if one has been sexually abused one may lose an excessive amount of weight to appear unattractive so that they will not ever be sexually abused again.

Similarly, interoceptive awareness is a term that is often used in the Eating Disorder Inventory to describe how one has difficulty recognizing and accurately responding to emotional states such as stress, depression, or anger. Moreover, it indicates some confusion the identification of certain visceral sensations related to hunger and satiety. Often times an individual who struggles with weight management issues or a formal eating disorder has difficulty with assessing emotions and responding appropriately. For example, if an individual becomes angry, this is similar to a bee sting that allows that person to recognize that an event occurred that offended that person and they can react in an appropriate way to address the emotion. Overeating or underrating has often been used to cope with various emotions. Thus, anger and jealousy are the two emotions that women deny the most and men would prefer that they express their anger in an assertive manner versus acting it out by being passive-aggressive.

Is It Worth Dying For?

A recent commercial including all males portrays an interesting perspective on how obsessed Americans have become with their body image. In essence, it conveys the message that one’s clothing size will not determine one’s self-worth. Americans in general long for a healthier and improved body image. As an example, a recent study showed that 56 percent of women and 43 percent of men were dissatisfied with their overall appearance, and two-thirds of the women and over half of the men were dissatisfied with their weight. Empirical research indicates that males have a more positive body image than females.  Adolescents were especially uncomfortable with their body image and as many as 62 percent of this population expressed body image dissatisfaction.

Moreover, women expressed the most dislike for their hips and abdomen; for men, their chest and abdomen. However, the number one concern was their weight. In fact, weight was so closely linked to personal happiness that when asked if they would trade years off their lives to be thinner, 24 percent of women and 17 percent of men said they would give up more than three years.

Psychopathological concerns with body image or becoming obsessed with one’s body, weight, or image may result in a formal eating disorder. Clearly, body image distortion or a drive for thinness are symptoms that develop with eating disorders such as anorexia nervosa or bulimia nervosa which are both recognized as psychological disorders in the Diagnostic and Statistical Manual  (DSM-1V), published by the American Psychiatric Association.

The diagnostic criteria for anorexia nervosa is as follows: a refusal to maintain body weight at or above a minimally normal weight for age and height, intense fear of gaining weight or becoming fat, even though underweight, disturbance in the way in which one’s body weight or shape is experienced, undue influence of body weight or shape on self-evaluation, or denial of the seriousness of the current low body weight, and in postmenarcheal female, amenorrhea, i.e., the absence of at least three consecutive menstrual cycles.

The diagnostic criteria for bulimia nervosa is as follows: recurrent episodes of binge eating which is characterized by  eating in a discrete period of time an amount of food that is definitely larger than most people would eat during a similar period of time and under similar circumstances or a sense of lack of control over eating during the episode, recurrent inappropriate compensatory behavior in order to prevent weight gain, such as self-induced vomiting, misuse of laxatives, diuretics, enemas, or other medications; fasting; or excessive exercise. In addition, the binge eating and inappropriate compensatory behaviors both occur, on average, at least twice a week for 3 months.

Self-evaluation is unduly influenced by body shape and weight and the disturbance does not occur exclusively during episodes of Anorexia Nervosa.

More recently the research criteria for binge-eating disorder has been addressed as well. The following issues are being explored as a diagnostic criteria: recurrent episodes of binge eating as described previously with bulimia nervosa, however, the binge-eating episodes are associated with three or more of the following:  eating much more rapidly than normal, eating until feeling uncomfortably full, eating large amounts of food when not feeling physically hungry, eating alone because of being embarrassed by how much one is eating, and feeling disgusted with oneself, depressed, or very guilty after overeating. A marked distress regarding binge eating is present. Lastly, the binge eating occurs, on average, at least two days a week for six months and is not associated with the regular use of inappropriate compensatory behaviors (e.g., purging, fasting, excessive exercise) and does not occur exclusively during the course of Anorexia Nervosa and Bulimia Nervosa.

Clearly, the aforementioned clinical diagnoses are more common in women than in men and at least 90 percent of the occurrences are actually in the female population. Death most commonly results from starvation, suicide, or electrolyte imbalance. In conclusion, would you actually die to have the perfect body? Get help for anorexia, bulimia and binge eating disorder. Call Walker Wellness today at 877-899-7254 to start your journey to wholeness.

Beauty and the Beach…

By: by Jennifer Passanante, LCSW

Preventing body image distortion from taking the joy out of swimsuit season …

During a recent conversation with my almost 6 year old daughter, she began listing all of the things she was looking forward to about summer.  They included things like popsicles, playing outside late, catching fireflies in a jar, and wearing my “swimmy suit”. The moment we walked in the door from school, both of my daughters flew upstairs and put on their new “swimmy suits” insisting that it was hot enough outside to turn on the sprinklers and take out the baby pool.  As I watched them play joyfully outside, I wondered to myself just when or what causes women to lose sight of the joys of summer and start to dread this time of year because there might be occasion to put on  a swimsuit.

Female dissatisfaction with appearance begins at a very early age. Infants begin to recognize themselves in mirrors at about two years old.  Females begin to dislike what they see only at just a few years old.  The latest surveys show very young girls are going on diets because they think they are fat and unattractive.  In one survey, 81% of ten-year old girls had already dieted at least once.

For a large percentage of females, puberty only makes things worse.  The normal physical changes, (increase in weight and body fat, particularly on the hips and thighs) take them further from the cultural ideal of unnatural slimness.  A Harvard University study showed that up to two thirds of underweight 12-year old girls considered themselves to be too fat.  By 13, at least 50% of girls are significantly unhappy about their appearance.  By 14, focused, specific dissatisfaction’s have intensified, particularly concerning hips and thighs.  By 17, only 30% of girls have not been on a diet and up to 80% will be unhappy with what they see in the mirror.

Among women over 18 looking at themselves in the mirror, research indicates that at least 80% are unhappy with what they see. Many will not be even seeing an accurate reflection.  Most of us have heard that women with anorexia see themselves as larger than they really are, but some recent research indicates that this kind of distorted body image is by no means confined to those suffering from eating disorders; in some studies, up to 80% of women over-estimated their size.  Increasing numbers of normal, attractive women, without weight problems or clinical psychological disorders, look at themselves in the mirror and see ugliness and fat.

Research confirms what most of us already know; that the main focus of dissatisfaction for most women looking in the mirror is the size and shape of their bodies, particularly their hips, waists and thighs.

More women struggle with liking the reflection in the mirror at this time of year more than any other as we are bombarded by images of “perfect” bikini bodies in magazines and on television.  We are encouraged to start various weight loss or exercise program to “get ready” for summer.  With all of this focus on getting our bodies “ready” for summer, is it any wonder that women view swimsuit shopping (or summer clothes for that matter) as a torturous experience to be avoided at all costs.  We become verbally abusive to our bodies and point out every perceived imperfection we can think of.  Some of us may even avoid certain places or events for fear that people might catch a glimpse of our “imperfect” bodies and know that we have not logged enough hours in the gym preparing for the warmer weather.

For people with eating disorders, this time of year can be especially challenging.  Even those who have been in recovery for awhile can find themselves allowing their inner critic to speak loud and clear encouraging them to “just drop a few pounds” or “run a few more miles” before considering wearing anything that might expose their “flaws”.  A well intentioned summer shape up plan can quickly result in relapse as we try to meet the medias standards for what women should look like.

So how can we take care of our bodies during this especially vulnerable time of year?  Take some time to enjoy some of the simple pleasures that come with warmer weather and longer days by:

  • Painting your toenails a new colornailpolish
  • Run barefoot in the grass
  • Find something cute and comfortable to swim in and enjoy floating in a pool, lake, or ocean
  • Enjoy a picnic with a friend
  • Watch the sunset
  • Go for an early morning walk

When we spend so much time focusing on our appearance, we can miss out on the experiences that make summer one of the best times of year.  So whether you choose to cover up, or show it all off, the most important thing is to live, really live in the body you have.  So get out there and enjoy the sunshine!

Negative Body Image: A Widespread Issue

Negative Body Image“I feel fat!” This is not only a comment made by individuals struggling with eating disorders, but one made consistently by countless women throughout America. Dissatisfaction with body shape and size is so prevalent in girls and women that it has been described as “normative discontent” (Tiggeman & Lynch, 2001). Recent studies have revealed that women’s desire to be thinner does not diminish across age spans, nor does the preoccupation with being overweight or dissatisfaction with appearance (Tiggemann & Lynch, 2001). Researchers have also found that people who are considered to be more physically attractive have an easier time getting jobs, have higher pay, are more socially competent, and are less lonely. Is it not surprising that many women suffer trying to fit the image of an attractive person?

What exactly is body image? Body image refers to an individual’s evaluations and affective experiences regarding their physical attributes. Body image has three components: a) physiological component, or the brain’s ability to detect weight, shape, size, and form; b) the conceptual component, including formation of a mental picture of one’s body; and c) the emotional element, or perceived feelings about one’s body, shape, and size.

Physiological Component of Body Image

The brain’s processing of female body shapes engages a distributed neural network, parts of which are underactive in women with eating disorders. Results of a divided visual field experiment supported a theory proposed by Smeets & Kosslyn (2001) that the distorted perception of one’s own body in patients with Anorexia Nervosa is mediated by a failure to integrate the general body schema in the left hemisphere with the concrete examples coded in the right hemisphere. For women in particular, all the biological development milestones of puberty, pregnancy, and menopause have the potential to increase body fat.  The physiological changes associated with these milestones create an increase in the number of individuals who develop eating disorders or experience relapses in the recovery from an eating disorder during the aforementioned times.

Conceptual Component of Body Image

Formation of attitudes about body image begins early in life; children show preferences for thinness at increasingly younger ages. A research study showed that five-year-old girls expressed a desire to be thin and preschoolers exhibited aversions to overweight individuals. Hoyt and Kogan reported that women who are underweight were no more satisfied with their body appearance than were normal or overweight women, suggesting that it is one’s perception of body size that is of greatest importance.  Most people are set to maintain weight within what is considered to be a normal range; this “normal” range; however, may not be what an individual considers an ideal or desired range.

Emotional Component of Body Imagenegative-body-image

The affective component of body image includes feelings of anxiety, distress, and other emotions associated with the body. Research has revealed that women feel more guilty, anxious, and depressed after viewing thin models in the media. Body dissatisfaction is associated with increased depression as well as low self-esteem.

Body Image Disturbances Do Not Discriminate

While body image has been repeatedly identified as an important factor in the development of eating disorders, body image dissatisfaction does not only exist in the population of individuals struggling with eating disorders. Women who perceive themselves as overweight often engage in cyclic binge eating and fasting, characterized by a loss of control and eating in times of stress. The methods used by women who have poor body image are similar to the methods used by those with an eating disorder, only to a lesser extent.

Where do we go from here?

A multiphasic approach can be highly effective in treating body image dissatisfaction; this includes educational, socio-cultural, cognitive, emotional, behavioral, and familial components. Cognitive work helps patients accept their own bodies and accentuate the function the body serves rather than its appearance. Because body image dissatisfaction is laden with emotions, such as fear, anxiety, and depression, patients must be assisted in identifying, expressing, and coping with the intense emotions. The behavioral component of therapy strives to help patients express positive attitudes about their bodies by changing the self-defeating behaviors that lead them to disapprove of their bodies in the first place. Walker Wellness Clinic offers a body image and self-esteem group as part of the treatment for formal eating disorders.

 

The Freshman Fifteen

By Susan Parish-Walker

Although we have begun to conquer the Age of Anxiety, we still are faced with many challenges in the rat race of life. However, researchers have made tremendous progress, but stress is clearly winning the race at this time. Approximately 60-90 percent of physical health problems are related to stress. The onset of eating disorders such as anorexia nervosa which is a mental disorder characterized by a refusal to maintain a normal body weight is often associated with a stressful life event, such as leaving home for college. Unfortunately, many changes occur such as learning how to get along with your roommate, doing your own laundry, not eating mom’s cooking, and trying to avoid the freshman 15.

Falling into the habit of drinking excessive amounts of alcohol will slow down the metabolic rate and possibly cause a weight gain.Freshman Fifteen

Rational approach to eating minimizes a weight gain such as implementing frequent feedings every 4-5 hours to regulate blood sugar levels and avoid binge eating.

Emotional eating often leads to binge episodes as well as avoidant behaviors such as coping with stress.

Share only your other personal belongings with your friends, but not your clothes because it may trigger preoccupation with your body image.

Have a dessert or incorporate your favorite foods into your food intake to avoid deprivation, which is the number one reason that one binges.

Make an effort to remain active and incorporate an exercise prescription into your lifestyle to improve stress, body image, and minimize depression and anxiety.

Analyze your nutrition by completing a resting metabolic rate test as well as a nutrition assessment.

Never compare your body type, food intake, or exercise to others due to the difference in genetic predispositions, metabolic rates, body types and diet history.

 

Focus on foods that you enjoy eating within balance and do not eat foods that you dislike.

Initiate conversations with others that avoid topics about your food intake and body image issues.

Fad diets do not work: Incorporate the concept of “down with dieting.”

Talk to a professional such as an exercise physiologist or a registered dietician about healthy weight management.

Enjoy the eating process because one does receive the endorphin effect from eating and introduce colorful food groups to make your dining experience psychologically pleasing to your palate.

Educate yourself on intuitive eating which allows one to eat when they experience hunger sensation and stop when one reaches satiety.

Never pursue the chronic dieting and do not use the compensatory behaviors.

Research shows that compensatory behaviors such as fasting, excessive exercising, diuretics or laxative, or binge-purge episodes due to the fact that it is not an effective way to manage one’s weight and the longitudinal studies show that it actually results in a potential weight gain.

Generally speaking, one may have an increase or decrease in their appetite when they are experiencing increased stress. However, each gender manages their stressors differently. As an illustration, studies indicate that happily married males reported less stress and fewer contacts with physicians, hospitals, and psychologists. Moreover, stress often manifests itself as a physical health problem for men. For example, heart disease, high blood pressure, strokes, cancer, and impotence are correlated to stress.

In women, stress correlates to fatigue, increase or decrease in the appetite, hair loss, bad complexion, insomnia, disruption of menstrual cycle, low libido, and lack of orgasms. Some studies show that women are at a higher risk for increased blood pressure and heart disease. As an illustration, stress hormone readings may remain high for women throughout the day and evening whereas they decline for men after work hours. Furthermore, unhappily married women reported a higher incidence of stress than single women.

We cannot erase all our stressors, but we can learn stress management and coping skills. A comprehensive understanding of how to not allow your stress level to affect your weight will prevent one from dramatic weight changes. Click here for more information on how to manage an eating disorder in college.

The Barbie Doll Body Image

“The first problem for all of us, men and women, is not to learn, but to unlearn.” Gloria Steinem

Barbie just turned 47. She simply has not aged a bit and she still has that fabulous figure. Get real! We are living in the age of reality TV. Let’s get a dose of reality with our own expectations for our body image. A distorted body image is analogous to being colorblind. If you take a look into the mirror, what do you see? Perhaps forgotten compliments and condescending remarks such as your face is too round or you have an awesome six-pack stomach!  Do you read the latest trends about weight loss and what celebrities do to lose or maintain their beautiful bodies? Do you attempt to incorporate this into your lifestyle? It is simply a waste of your time because no two bodies are alike and will not respond in the same manner to the weight loss.

Who are our role models for having the perfect body?

Barbie Doll Body Image and Eating DisordersOver the years women have compared their body types to professional models, actresses, and Miss America pageant contestants. Maybe that is why Cindy Crawford once said, “I don’t even look like Cindy Crawford.” Comparing body types is like saying that you would like for your lovely brown eyes to turn blue. Of course one may purchase colored contact lenses and change the color of their eyes.

However, no matter how much one compares their body types, food intake, and/or exercise regimen to others, their body will not adapt or become their role models. A patient who suffered from an eating disorder once said that she wanted her body to look just like Paris Hilton’s body. The patient’s body was beautifully toned with muscle development due to the years of dancing and her percentage of body fat indicated that she was in a healthy and normal range. Regardless of her nutrition and exercise habits, due to her genetic predispositions and muscular body type she will never have a body like Paris Hilton. Unfortunately, many formal eating disorders or disordered eating actually begins with someone comparing their food intake, body type, or exercise habits to another persons. It is very irrational and one may always become frustrated because they will not be able to adapt to their role models body type.

For example, as girls and women began to age our metabolism slows down about 2 to 3 % every decade but we may not be changing our food intake, exercise regimen, or behaviors. Chronic dieting and restricting leads to a significant weight gain for most individuals. It slows down the metabolic rate and makes one very vulnerable for a significant weight gain. Furthermore, deprivation typically is the number one reason why most people have binge episodes. If you go for a very long period of time and omit some of your favorite foods that can be eaten in moderation such as pizza or chocolate chip cookies you may find that you will began to overeat these foods.

Therefore, the good news for those blues about weight gain is that if we continue to exercise and eat moderately throughout our life span, it is more likely that we will maintain a healthy body weight. Therefore, learning to normalize your dietary intake and exercise regimen is one of the healthiest ways to avoid dramatic weight changes and establish a healthy body image. The first step is to complete your resting metabolic rate test to determine how many calories your body needs to maintain, lose, or gain weight.  It may be important to establish the diagnostic criterion of the difference between a formal eating disorder and disordered eating.

Altering Body Image Distortions as Part of Eating Disorder Treatment

Early in their treatment most patients with formal eating disorders have a gross misunderstanding of the meaning of “body image”. These patients are aware that the term refers to how the body is viewed, but the method for altering poor body image is imagined to be changing the body. When patients understand that it is the distortions in the mind that require change they often feel discouraged. Anything contrary to a loathsome view of their bodies is what these patients view as distorted. Patients experience such negativity as objective truth that negates competing sources of self-evaluation.Body Image Distortion

Worsening their dilemma is the cycle of futility created by patients’ belief in an inferior body co-existing with, and reinforced by an obsessive pursuit of impossible physical perfection. This cycle is difficult to interrupt because both the pursuit of perfection and the belief in physical inferiority are driven by a deeply held assumption that appearance, weight, and shape are inextricably linked to self-worth. Patients’ self reports often indicate acknowledgment of accomplishments, talents, intelligence, creativity, compassion, and other aspects of personal value. However, these are seen as inconsequential compared to the value of appearance. Multitudinous evidence of personal value is summarily dismissed because the patient believes her true standard of worth (her body) is sub-standard. She believes that her worth would be proven if only her body were perfect; and because that perfection is hopelessly elusive, her value is unalterably undermined.

Images of idealized female beauty are marketed as the normal and desired standard, and are virtually inescapable in our media saturated culture. Exposure to this relentless urging to pursue unreal physical perfection and thinness is thought to detrimentally influence the self-esteem of most girls and women. Indeed, evidence suggests that the non-clinical population experiences significant and persistent body dissatisfaction. A research summary from the Social Issues Research Centre cites a study indicating that 81% of girls had already dieted by the age of ten. The centre also cites recent research indicating an increase in body dissatisfaction among adolescent and middle-aged males, attributed in part to increased presentations of unrealistic images of male beauty.

Among the clinical population, most, but not all patients with eating disorders suffer from distorted body image, according to a study in the American Journal of Psychiatry. The authors suggested that, if replicated, their findings might indicate a need for revision of the DSM diagnostic criteria for formal eating disorders, which currently include body image distortion. That said, while many women with normal eating habits adopt a critical stance toward their bodies, and not all persons with eating disorders suffer from extreme body image distortions, it is rare in our clinic to see a patient who does not suffer more than the average person from distorted body image. Rita Carter in her book Mapping the Mind states, “anorexics…may have impaired hypothalamic function”, positing that “limbic area dysfunction is increasingly seen to play a part in eating disorders”. Carter also names cultural influences as culpable in patients’ distorted body images.  “An anorexic’s ambition to be thinner-than-thin, or the bulimic’s determination to prevent their body from absorbing what they have eaten, are conceived in the conscious part of the brain and clearly have a lot to do with the way that a person thinks.” Carter suggests that eating disorders are open to interventions that address both physiological disturbances and mental distortions.

Mental distortions are addressed in Walker Wellness Clinic’s body image groups for adolescents and adults with evidence-based interventions based on Cognitive Behavioral Therapy methods and Dialectical Behavioral Therapy. Patients are shown how to reduce anxiety and loosen the grip of negative beliefs by distancing themselves from distorted thoughts and overwhelming emotions. Patients then become more open to exploring and disputing negative self-talk and other self-defeating habits. The resulting glimpse of a more affirming relationship with the body introduces a sense of hope; and hope becomes the patient’s strongest ally in exchanging a sense of futility for the will to continue the arduous process of body image alteration.

photo credit: by Janine via photopin cc

 
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Walker Wellness Clinic - An Eating Disorder Treatment Center
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