Presentation Outline: 10 Ways to Prevent an Eating Disorder

Kim Passmore, RD, CD, Melissa H. Smith, PhD, and Melissa Taylor, LMFT

Ten Preventions

1.            Learn the Truth about Eating Disorders

2.            Be a Critical Consumer of the Media

3.            Own Your Own Body

4.            Develop Your Identity

5.            Strengthen Spirituality

6.            Practice Positive Coping Skills

7.            Cultivate a Healthy Relationship with Food

8.            Be Moderate with Exercise

9.            Connect with Others

10.          Eating Disorder Proof Your Life

Prevention #1 - Learn the Truth about Eating Disorders

Eating Disorders

  • Diagnosable psychological, medical, and nutritional problems
  • Among the most difficult disorders to treat and overcome
  • Highest mortality rate of all psychiatric disorders
  • Serious, all-encompassing illness
    • Not about food
    • Not about vanity
    • Underlying emotional difficulties

Eating Disorders Defined

  • Anorexia Nervosa (AN)
    • Low Weight (< 85%)
    • Intense Fear of Gaining Weight
    • Body Image Disturbance
    • Amenorrhea
  • Bulimia Nervosa (BN)
    • Recurrent Binge Eating
    • Lack of Control
    • Recurrent Inappropriate Compensatory Behavior
    • Body Image Disturbance
  • Binge Eating Disorder (BED)
    • No Compensatory Behavior

What Eating Disorders Are:

An adaptive function that inappropriately comforts, soothes, nurtures, numbs, sedates, distracts, gets attention, cries for help, controls environment and others, gives structure, gives identity, discharges tension, relieves anger, rebels, punishes self & body, cleanses or purifies self, creates a large or underdeveloped body for protection, avoids intimacy, avoids responsibilities of life, and/or to prove "I'm bad" instead of blaming others .

  • A means of numbing the pain of feeling that one is defective, incompetent, bad, weak, frightened or ashamed
  • An unhealthy attempt at changing low self-esteem
  • A destructive method to fulfill a need for distraction
  • An indirect attempt to be special/unique
  • A by-product of polarized thinking
  • A vague method of expressing difficult feelings
  • A physical manifestation of a need to escape
  • An evidence of a lack of coping skills
  • Evidence of a lack of trust in self & others
  • A defense against fears of disapproval & rejection

What Eating Disorders Are Not

  • Cheap attempts at getting attention
  • Simply dieting gone wrong or "out of control"
  • A food problem
  • An attempt to become a "super model"
  • Deceitfulness or vanity
  • Selfish attempts to get back at others

The Truth about Eating Disorders

  • 90% of anorexics and bulimics are female; 10% are male
  • Anorexia has the highest fatality rate of any psychological disorder; up to 20% of those with AN die from it
  • Risk of death is 12 times greater than same age peers without Anorexia
  • 56% more likely to commit suicide
  • Between 4% and 20% of young women practice unhealthy patterns of dieting, purging, and binge eating
  • Eating Disorders affect most ethnic groups; Caucasians at greatest risk for Anorexia
  • 91% of college women diet
  • Severe health consequences & financial burdens throughout life

Emotional Consequences

  • Low self-esteem
  • Distorted thoughts & feelings
  • Loss of emotional equilibrium
  • Feeling under attack
  • Feeling of hopelessness & helplessness
  • Becoming numb & checking out of life

Social Consequences

  • Withdrawal & Isolation
  • Strained relationships with family
  • Loss of friends
  • Fear of being in public
  • Loss of activities & hobbies
  • Inability to successfully engage in school work

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Prevention #2 - Be a Critical Consumer of the Media

Be a Critical Consumer

  • Most fashion models are thinner than 98% of American women
  • The average American woman is 5'4" tall and weighs 140 pounds
  • The average American model is 5'11" tall and weighs 117 pounds
  • 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
    To convince you to buy a specific product or service, advertisers will often construct an emotional experience that looks like reality

Talk Back to the Media

  • Talk back to the TV when you see an ad or hear a message that makes you feel bad about yourself or your body by promoting only thin body ideals
  • Write a letter to an advertiser you think is sending positive, inspiring messages that recognize and celebrate the natural diversity of human body shapes and size buy their products
  • Make a list of companies who consistently send negative body image messages and make a conscious effort to avoid buying their productss send a letter of protest
  • Avoid pro-Ana websites

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Prevention #3  - Own Your Own Body

Negative Body Image

  • Distorted perception of body shape
    • perceiving parts of body unlike they really are
  • Convinced that only other people are attractive & that your body size or shape is a sign of personal failure
  • Feeling ashamed, self-conscious, and anxious about body
  • Feeling uncomfortable & awkward in body

10 Appearance Assumptions

  • Physically attractive people have it all
  • The first thing that people will notice about me is what's wrong with my appearance
  • One's outward physical appearance is a sign of the inner person
  • If I could look just as I wish, my life would be much happier
  • If people knew how I really look, they would like me less
  • By controlling my appearance, I can control my social and emotional life
  • My appearance is responsible for much of what has happened to me in my life
  • I should always do whatever I can to look my best
  • The media's messages make it impossible for me to be satisfied with my appearance
  • The only way I would ever like my looks would be to change them

Size Acceptance

  • Educate yourself on your biases
    • Do you make jokes about your own fatness
    • Admire or approve of someone for losing weight
    • Admire rigidly controlled eating
    • Talk about being good/bad in reference to eating behaviors
    • Say or assume someone is looking good because they have lost weight

Positive Body Image

  • Clear, true perception of body shape--you see the various parts of your body as they really are
  • Celebrate & appreciate natural body shape & understand that a person's physical appearance says very little about their character and value as a person
  • Feel proud & accepting of your unique body & refuse to spend an unreasonable amount of time worrying about food, weight, & calories
  • Feel comfortable & confident in your body

Ways to Love Your Body

  • Don't compare
  • Focus on your accomplishments
  • Learn to take a compliment
  • Think of your body as a tool/instrument, not as an ornament
  • Affirmations-"I'm beautiful inside & out"
  • Watch infants enjoying their bodies
  • Focus on the positives
  • Look at family photos
  • If you had one year to live, how important would your appearance be?
  • Enjoy your body: stretch, dance, sing, get a massage, take a bubble bath

The Uniqueness of You

  • Take less time to look in the mirror; obsess less about the body
  • Appreciate the part of the body for what it does, not how it looks
  • Body awareness- explore the qualities of your body; which parts are ticklish, soft, firm

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Prevention #4 - Develop Your Identity

Self-Esteem & Identity

  • Internal Characteristics
    • Know your heart
    • Develop your inner qualities
    • Honor your uniqueness
  • Accomplishments
    • What you are capable of
    • Don't compare
    • Don't judge what you can't do

Improving Self-Esteem

  • Strive to understand your feelings
  • Cultivate positive self-talk & quiet the inner critic
  • Face your fears
  • Pursue your passions
  • Challenge perfectionism
Perfectionism VS. Excellence
Obsessive
Consistent
Rigid
Flexible
Unreachable Goals
Obtainable Goals
Secretive
Self-Disclosing
Productivity
Process
Guarded
Open
Sensitive
Approachable
Critical
Kind

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Prevention #5  - Strengthen Spirituality

Spirituality

  • Meditate
    • Find your meaning
    • Understand strengths
    • Don't judge weaknesses
  • Pray
    • Ask for help with struggles
    • Pray for guidance
    • Understand your relationship/worth
  • Service
    • Focus on others less fortunate
    • Know your needs and ask for help
    • Help others who need you

The Body And The Soul

  • "Your body really is the instrument of your mind and the foundation of your character" (Packer, 2001)
  • "Know ye not that your body is the temple of the Holy Ghost which is in you, which ye have of God, and ye are not your own? For ye are bought with a price: therefore glorify God in your body, and in your spirit, which are God's" (1 Cor 6: 19-20)
  • "Happiness comes from accepting the bodies we have been given as divine gifts and enhancing our natural attributes, not from remaking our bodies after the image of the world. The Lord wants us to be made over-but in His image, not in the image of the world, by receiving His image in our countenances" (Tanner, 2005)
  • "For the dead had looked upon the long absence of their spirits from their bodies as a bondage" (D&C 138:50)

To Each Part A Purpose

  • For as the body is one, and hath many members, and all the members of that one body, being many, are one body: so also is Christ.
  • For by one Spirit are we all baptized into one body, whether we be Jews or be Gentiles, whether we be bond or free; and have been all made to drink into one Spirit.
  • For the body is not one member, but many. If the foot shall say, Because I am not the hand, I am not of the body; is it therefore not of the body? And if the ear shall say, Because I am not the eye, I am not of the body; is it therefore not of the body?
  • If the whole body were an eye, where were the hearing? If the whole were hearing, where were the smelling? But now hath God set the members every one of them in the body, as it hath pleased him (1 Corinthians 12)

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Prevention #6  - Practice Positive Coping Skills

Emotional Regulation

  • Find ways to cope with emotions without using food or extreme exercise
    • Go on a walk
    • Take a bubble bath
    • Call a friend
    • Write in your journal
    • Hit the batting cages
    • Listen to music
    • Read your scriptures
    • Look at photos of friends and family
    • Meditate
    • Cry

Cultivate Positive Self-Talk

  • I don't need to prove myself to anyone-not even to myself-for I know that I am perfectly fine as I am
  • I make my own decisions and assume responsibility for any mistakes.  However, I refuse to feel shame or guilt about them.  I do the best I can, and that is 100% good enough
  • I am not my actions.  I am the actor.  My actions may be good or bad.  That doesn't make me good or bad
  • Whenever I am tempted to punish myself, I remember to be kind and gentle instead.  I know that in order to be the best I can be, I need forgiveness and understanding
  • I know that it is okay to need.  I try to keep in touch with my needs so that I can respond to them
  • I know that others cannot be expected to read my mind or to guess my needs.  In fairness to them and me, I ask for what I need
  • I deserve to be appreciated.  When others show their appreciation, I embrace it with open arms.  I never try to deny or diminish my value
  • I live one day at a time and do first things first

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Prevention #7 - Cultivate a Healthy Relationship with Food

The Dieting Myth

  • 90% of women diet regularly
  • 90% of diets fail after 1 year
  • 98% of diets fail after 5 years
  • Dieters regain all weight lost, plus another 10%
  • Diets Don't Work!

Body Mass Index

  • "Although BMI is a generally convenient measure, it lacks theoretical foundation and may be compromised by ethnic, cultural or lifestyle differences"
    • QJM, Association of Physicians in Great Britain, 2000, Sep:93(9):589-96
  • "BMI was found to be a very poor predictor of cardiovascular disease or total mortality"
    • Association of bodyweight with total mortality and with cardiovascular events in coronary artery disease: a systematic review; Romero-Corral, et. Al, Lancet 2006
Name BMI Weight Status
George W. Bush 26.3 Overweight
Will Smith 27 Overweight
Yao Ming 27.7 Overweight
George Clooney 29 Overweight
Johnny Depp 29.8 Overweight
Matt LeBlanc 30 Obese
Tom Cruise 31 Obese
Shaquille O'Neil 31.6 Obese
Arnold Schwarzeneggar 33 Obese
Normal Eating
  • Being able to eat when you are hungry & continue eating until you are satisfied
  • Being able to choose food you like & eat it & truly get enough of it-not just stop eating because you think you should
  • Being able to use some moderate constraint on your food selection to get the right foods, but not being so restrictive that you miss out on pleasurable foods
  • Giving yourself permission to eat sometimes because you are happy, sad, bored, or just because it feels good
  • Leaving cookies on the plate because you know you can have more tomorrow, OR eating more now because they are so good when fresh.  You feel free to choose
  • Overeating at times; feeling stuffed and uncomfortable
  • Under-eating at times; wishing you had more
  • Trusting your body to make up for mistakes in eating
  • Taking up some of your time and attention, but not to the exclusion of other important areas of your life
  • Flexible:  varies relative to mood, schedule, hunger, and proximity to food

Tips for Emotional Eating

  • Ask "Am I really hungry, or just eating because food is here?"  To be sure, wait 5 minutes before eating
  • Plan times for meals and snacks
  • Never use food as a "pick me up"
  • When you feel anxious or nervous, do something nice for yourself
  • Rely on people, not food for companionship
  • Celebrate without food
  • Be prepared.  Stock cupboards with a variety of food choices

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Prevention #8  - Be Moderate with Exercise

Signs of Compulsive Exercise

  • Scheduling life around exercise
  • Missing class, work, parties or other appointments to exercise
  • Working out with an injury or while sick
  • Significant guilt or depression if unable to exercise
  • Working out for hours at a time each day
  • No rest or recovery days
  • Lack of enjoyment in exercise

Danger of Excessive Exercise

  • Injuries such as stress fractures, strains and sprains
  • Low body fat
  • Amenorrhea
  • Fatigue
  • Dehydration
  • Osteoporosis
  • Arthritis
  • Reproductive problems
  • Heart problems

Exercise as Eating Disorder Behavior

  • Exercise as form of purging
  • Exercise to compensate for calories consumed
  • Exercise to relieve guilt from eating
  • Exercise in order to "give permission" to eat
  • Exercise to meet underlying needs:  power, control, self-respect, avoidance of emotional needs or stress
  • Exercise as punishment
  • Exercise as addictive process

Moderate Exercise

  • Exercise for health & enjoyment
  • Average individual:  20 to 30 minutes of athletic activity (walking, slow jogging, weight training, aerobics, bicycling, etc.) 4 or 5 times per week
  • Non-athlete:  more than 45-60 minutes of these types of activities at a time, for more than 5 days a week can be dangerous
  • Athlete:  unhealthy exercise depends on sport, level of activity, personal achievement goal, & overall fitness
  • Athlete:  regular medical check-ups; caloric & fluid intake should reflect activity level & age

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Prevention #9  - Connect with Others

Connect with Others

  • Reach out to others; don't isolate
  • Appreciate & cultivate relationships
  • Understand your importance to others
  • Seek acceptance, not approval
  • Let go of expectations
  • Maintain family relationships
  • Plan time for recreation, leisure & relaxation
  • Get involved in activities of interest

Learn to Trust

  • Healing happens in relationships
  • Determine those who may be trustworthy
  • Trust is contextual and gradual
  • Take people at their word
  • Stop second-guessing
  • Let go of biases

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Prevention #10 - Eating Disorder Proof Your Life
  • Have food in your house that you enjoy eating
  • Enjoy positive books, music, magazines that encourage your interests
  • Do talk about emotions, especially ones that revolve around food or body
  • Become aware of your own biases towards body image and food
  • Buy products that encourage unconditional love for self (Dove, Nike)
  • Eating Disorder Proof Your Life
  • Don't keep scales in the house
  • Get rid of all clothing that is too small
  • Eliminate diet talk from your conversations
  • Do not buy supermarket tabloid magazines or fashion magazines
  • Don't talk about others' bodies or your own
  • Don't look up internet sites that encourage eating disorders

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Courtesy of Center For Change, Orem, Utah