Common Questions

Do I Contribute to Another's Eating Disorder?
 How can parents help prevent eating disorders?
Do eating disorders occur in males?
How do eating disorders affect diverse populations?
What Can You Do To Help Prevent Eating Disorders?
What is the connection between Athletes and Eating Disorders?
 How to Practice Radical Acceptance
How do I navigate the Holidays when I have an eating disorder?

 

Do I contribute to another's eating disorder?

The culture of disordered eating is pervasive in our society. The following are ways in which we might unintentionally encourage eating disorders:

  •  Praising or glorifying another’s appearance based on body size or attractiveness.
  • Complimenting someone when they lose weight or diet.
  • Encouraging someone to lose weight.
  • Talking negatively about our bodies.
  • Discussing measurements, weight, or clothing sizes.
  • Thinking of foods as “good” or "bad.”
  • Making fun of another person’s eating habits or food choices.
  • Criticizing your own eating.
  • Considering a person’s weight important.
  • Saying someone is “healthy” or “well” because he/she is thin.
  • Expecting perfection.
  • Encouraging more exercise than is healthy.
  • Assuming that a large person wants or needs to lose weight.
  • Allowing the media to dictate what body type is “in”.

How can parents help prevent eating disorders?

Do:

  • Examine your own beliefs and behavior related to body image and weight and consider how your children might interpret the messages they get from you.
  • Encourage healthy eating and exercise.
  • Allow your child to determine when he/she is full.
  • Talk about the variety of different body types and the face that they can all be acceptable and healthy.
  • Discuss the danger of dieting.
  • Tell your child you love him/her for what is inside, not because of how he/she looks.

 Don’t

  • Label foods as “good” or “bad.”
  • Use food for rewards or punishments.
  • Diet or encourage your child to diet.
  • Comment on weight or body types: yours, your child’s or any one else’s.
  • Allow teasing or making fun of anyone based on physical characteristics including size.

Do eating disorders occur in males?
While women are more commonly affected by eating disorders, more than a million men and boys battle the illness every day.

If you are seeking information on eating disorders, perhaps you are concerned about your own health, or the health of someone you love. We’re glad you are reaching out to learn more. It’s the first step in understanding the issues surrounding this serious illness and with some help and support – treatment and recovery are possible.

Information for men and boys:
Anorexia, Bulimia, & Binge Eating Disorder: What is an Eating Disorder?
Eating disorders such as anorexia, bulimia, and binge eating disorder include extreme emotions, attitudes, and behaviors surrounding weight and food issues.

Anorexia Nervosa in Males
Anorexia Nervosa is a severe, life-threatening disorder in which the individual refuses to maintain a minimally normal body weight, is intensely afraid of gaining weight, and exhibits a significant distortion in the perception of the shape or size of his body, as well as dissatisfaction with his body shape and size.

Binge Eating Disorder in Males
Binge eating disorder is a severe, life-threatening disorder characterized by recurrent episodes of compulsive overeating or binge eating. In binge eating disorder, the purging in an attempt to prevent weight gain that is characteristic of bulimia nervosa is absent.

Bulimia Nervosa in Males
Bulimia nervosa is a severe, life-threatening disorder characterized by recurrent episodes of binge eating followed by self-induced vomiting or other purging methods (e.g. laxatives, diuretics, excessive exercise, fasting) in an attempt to avoid weight gain.

Enhancing Male Body Image
Recognize that bodies come in all different shapes and sizes. There is no one "right" body size. Your body is not, and should not, be exactly like anyone else's. Try to see your body as a facet of your uniqueness and individuality.

Research on Males and Eating Disorders
Approximately 10% of eating disordered individuals coming to the attention of mental health professionals are male.

Strategies for Prevention and Early Intervention of Male Eating Disorders
Eating disorders do not discriminate on the basis of gender. Men can and do develop eating disorders.

How do eating disorders affect diverse populations?

  • African American girls aged 11-14 consistently scored higher than white girls of the same age on all Eating Disorder Inventory (EDI) scales measuring features commonly associated with eating disorders except for bodydissatisfaction and drive for thinness (Striegel-Moore et al, 2000).
     
  • Black girls may be especially vulnerable to developing eating disorders with binge eating features (Striegel-Moore, 2000).
     
  • Browne (1993) reports that African-American women feel tremendous pressure as role models, and that as a result, feel they must be perfect in order to counteract negative stereotypes.
     
  • Hall (1995) reports that Asian and Asian-American women are becoming increasingly susceptible to eating and body image problems
     
  • Yoshimura (1995) documented that Asian-American females are not immune to developing eating disorders.
     
  • A study conducted by Robinson, et al (1996) found that among the leanest 25% of 6th and 7th grade girls, Hispanics and Asians reported significantly more body dissatisfaction than did white girls.
     
  • Numerous studies of various Native American populations have shown a high incidence of disordered eating symptoms among adolescents (Story, 1997).
     
  • One study of adolescents belonging to the Chippewa tribe and living on a reservation in Michigan found that 74% were trying to lose weight, and of those, 75% were using at least one pathogenic weight control method (Rosen, et al in Story, 1997).
     
  • In studying Native American teenagers, Story et al (1997) found that 48.3% of girls and 30.5% of boys in grades 7-12 had dieted in the past year, and 28% of girls and 21% of boys reported purging behavior.
     
  • In a study of Cuban American women, Jane, Hunter, and Lozzi (1999) found that close identification with Cuban culture was associated with lower EAT scores and may have a protective factor in the development of eating disorders.
     
  • Chamorro & Flores-Ortiz (2000) found that second-generation Mexican-American women-those born in the US to foreign born parents-were the most acculturated and had the highest disordered eating patterns.

LGBTQ

  • Contradicting the common assumption that lesbian beauty mandates guard against body dissatisfaction, Striegel-Moore, Tucker, and Hsu (1990) found no significant difference between lesbian and heterosexual female undergraduates on measures of body dissatisfaction (In Myers, Taub, Morris, & Rothblum, 1999).
  • Similarly, Beren, Hayden, Welfley, and Grilo (1996) found no significant differences in regards to body dissatisfaction between lesbian and heterosexual women, but did find more appearance dissatisfaction in gay men than in heterosexual men (In Myers, Taub, Morris, & Rothblum, 1999).
  • In a study measuring body-image, weight concern, and eating patterns among 263 lesbian women, Hefferson (1999) found that lesbians were generally more critical of social norms concerning the roles of women, but not in regards to women's weight and appearance. In addition, the author found that 48% of the participants had dieted in the past 3 months, almost half were dissatisfied with their weight, and self-esteem was strongly linked to body satisfaction. As eloquently stated by Hefferson, "lesbians are no less heterogeneous than heterosexual women…it cannot be assumed that all lesbians equally reject or accept these societal (beauty) norms" (pg.123).

 What Can You Do To Help Prevent Eating Disorders?

  • Be a model of healthy self-esteem and body image. Recognize that others pay attention and learn from the way you talk about yourself and your body. Choose to talk about yourself with respect and appreciation.
  • Learn all you can about anorexia nervosa, bulimia nervosa, and binge eating disorder. Genuine awareness will help you avoid judgmental or mistaken attitudes about food, weight, body shape, and eating disorders.
  • Discourage the idea that a particular diet, weight, or body size will automatically lead to happiness and fulfillment.
  • Choose to challenge the false belief that thinness and weight loss are great, while body fat and weight gain are horrible or indicate laziness, worthlessness, or immorality.
  • Avoid categorizing foods as “good/safe” vs. “bad/dangerous.” Remember, we all need to eat a balanced variety of foods. 
  • Decide to avoid judging others and yourself on the basis of body weight or shape. Turn off the voices in your head that tell you that a person’s body weight says anything about their character, personality, or value as a person.
  • Avoid conveying an attitude that says, “I will like you better if you lose weight, or don’t eat so much, etc.”
  • Become a critical viewer of the media and its messages about self-esteem and body image. Talk back to the television when you hear a comment or see an image that promotes thinness at all costs. Rip out (or better yet, write to the editor about ) advertisements or articles in your magazines that make you feel bad about your body shape or size.
  • If you think someone has an eating disorder, express your concerns in a forthright, caring manner. Gently but firmly encourage the person to seek trained professional help.
  • Be a model of healthy self-esteem and body image. Recognize that others pay attention and learn from the way you talk about yourself and your body. Choose to talk about yourself with respect and appreciation. Choose to value yourself based on your goals, accomplishments, talents, and character. Avoid letting the way you feel about your body weight and shape determine the course of your day. Embrace the natural diversity of human bodies and celebrate your body’s unique shape and size.

What is the connection between Athletes and Eating Disorders:
What Coaches, Parents, and Teammates Need to Know
Involvement in organized sports can offer many benefits, such as improved self-esteem and body image and encouragement fro individuals to remain active throughout their lives. Athletic competition, however, can cause sever psychological and physical stress. When the pressures of athletic competition are added to an existing cultural emphasis on thinness, the risks increase for athletes to develop disordered eating.

In a study of Division 1 NCAA athletes, over one-third of female athletes reported attitudes and symptoms placing them at risk for anorexia nervosa. Though most athletes with eating disorders are female, male athletes are also at risk – especially those competing in sports that tend to place an emphasis on the athlete’s diet, appearance, size, and weight requirements, such as wrestling, body building, crew, running and football.

Three factors have been thought to contribute to the odds that a person will be dissatisfied with his or her body: social influences, performance anxiety and the athlete’s self-appraisal.

Risk Factors for Athletes:

  • Sports that emphasize appearance or weight requirement. For example: gymnastics, diving, bodybuilding or wrestling – e.g., wrestlers trying to “make weight.”
  • Sports that focus on the individual rather than the entire team. For example: gymnastics, running, figure skating, dance or diving, versus teams sports like basketball or soccer
  • Endurance sports such as: track and field/running, swimming
  • Inaccurate belief that lower body weight will improve performance
  • Training for a sport since childhood or being an elite athlete
  • Low self-esteem, family dysfunction, families with eating disorders, chronic dieting, history of physical or sexual abuse, peer, family and cultural pressures to be thin, and other traumatic life experiences
  • Coaches who focus only on success and performance rather than on the athlete as a whole person 

Protective Factors for Athletes:

  • Positive, person-oriented coaching style rather than negative, performance-oriented coaching style
  • Social influence and support from teammates with healthy attitudes towards size and shape
  • Coaches who emphasize factors that contribute to personal success as motivation and enthusiasm rather than body weight or shape

The Female Athlete Triad
The Female Athlete Triad includes 1) disordered eating, 2) loss of menstrual periods and 3) osteoporosis (loss of calcium resulting in weak bones). The lack of nutrition resulting from disordered eating can cause the loss of several or more consecutive periods. This in turn leads to calcium and bone loss, putting the athlete at greatly increased risk for stress fractures of the bones. Each of these conditions is a medical concern. Together they create serious health risks that may be life-threatening. While any female athlete can develop the triad, adolescent girls are most at risk because of the active biological changes and growth spurts, peer and social pressures, and rapidly changes life circumstances that go along with the teenage years. Males may develop similar syndromes.

The International Olympic Committee had published recommendations for reducing the risk of the Female Athlete Triad, available at: http://multimedia.olympic.org/pdf/en_report_517.pdf

How to Practice Radical Acceptance
Radical acceptance is the practice of accepting life on its own terms and finding effective strategies to cope with whatever is happening. It doesn't mean being passive, but accepting "what is" with the understanding that you have the power of choice. Practicing radical acceptance is a choice that can ease stress and depression and enhance your overall quality of life.

Instructions
Step 1
Love and be gentle with yourself. Understand that real love must come from within. Radical
acceptance means treating yourself as you would treat someone that you truly love.
Step 2
Praise yourself. Tell yourself how well you are doing and stop criticizing yourself. Write down
things you have done that make you feel proud and refer to it when you're experiencing feelings
of self-doubt.
Step 3
Accept yourself. Don't listen to the little voice in your head that says you aren't good enough.
Accept the way you are, right now, without judgment.
Step 4
Find ways to support yourself. Practice radical acceptance by reaching out to friends and loved
ones and allowing them to support you.
Step 5
Forgive yourself. Have compassion for yourself and where you are in your life. Acknowledge
any real or perceived wrongs that you may have perpetrated in the past. Apologize if you have
wronged others, and then let it go.
Step 6
Lend a helping hand to others. Not only will it make a difference in their lives, but you will feel
better and more positive about yourself.
Step 7
Take care of your body, and accept it lovingly. Learn about exercise and nutrition and get
adequate rest. Nurture yourself and allow yourself to feel good.

How do I navigate the Holidays when I have an eating disorder?
Holidays Don’t Have to be Difficult for People with an Eating Disorder

Many people equate the holidays with food – big meals equals big times. Americans, especially, attach a lot of social and personal value to what, and how, we eat, often through family rituals or attitudes. For many, family gatherings are positive events, but for the 11 million men, women or young people who have an eating disorder, the holidays, without proper planning, can feel like nightmares.

Three out of four American women have “disordered eating” behavior, and 10 percent have an eating disorder such as anorexia or bulimia nervosa or binge eating disorder, says Cynthia Bulik, Ph.D., the William and Jeanne Jordan Distinguished Professor of Eating Disorders in the UNC School of Medicine’s department of psychiatry and director of the UNC Eating Disorders Program. Her latest book is Crave: Why you binge eat and how to stop.

If you have an eating disorder, plan ahead. Bulik recommends the following suggestions to navigate the food minefields of the holidays:

  • Have a “wing man” or “wing woman” – someone you trust to help run interference at family get‐togethers or office parties. This should be someone who knows your triggers and can help you handle the stress, even if that means being a quiet presence of support.
  • Make up a code signal or phrase with the wing man or wing woman before going to the holiday party. If you start to feel overwhelmed give your friend the signal so that you can both step out of the room and they can offer you some support.
  • Keep your support team on speed dial and call them at any time during or after a party.
  • Talking relieves the pressure. You're not overburdening them. They will undoubtedly have stories to share, too.
  • Potlucks are your friends. Don’t hesitate to take a food you prepared that feels safe enough to you so that you will have at least one manageable entrée.
  • Lavish holiday spreads don’t have to be the enemy. Before stepping in line, and before getting a plate, evaluate the options. Mindfully consider which foods you'll sample, portion sizes and whether you feel comfortable trying a “feared food.” Make a decision and do your best to stick with it.
  • If your treatment team has given you a meal plan, stay on track.
  • Listen with your heart, not your head. Hear the happiness and caring in a person’s tone when they tell you that you look “so much better.” They are saying they care about you. Don’t let the eating disorder lead you to misinterpret those words in a way that deprives you of hearing that people really care about you.
  • People too often have a fantasy about how “perfect” the holidays are going to be. When family members fail to live up to unrealistic expectations, it might be tempting to restrict or overeat in an effort to feel better temporarily. Try to anticipate some of the possible emotional traps in advance so you can cope (and maybe even laugh) when you encounter them.
  • The well‐known HALT slogan works for any type of recovery. Don't let yourself get too hungry, angry, lonely or tired. This is especially important over the holidays.
  • 'Tis the Season to Forgive, so forgive yourself if things don’t go as planned.
  • Try your best not to skip appointments with your treatment team. It’s an important time to stay in touch with people who can help.