Category: Eating Disorders

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Friends of Teens with Eating Disorders Unsure Where to Turn

00Adolescence, Anorexia Nervosa, Bulimia Nervosa, Eating Disorders, Featured news, Friends, Health, Social Life January, 17

Source: Darren Tunnicliff on Flickr, Creative Commons

During my last year of high school, I tried to help one of my closest friends, Rebecca (name changed), through an eating disorder.  I found myself in the difficult position of guarding her secret, yet somehow trying to get her through a mental illness.

So I was eager to see director Sanna Lenken’s, My Skinny Sister at the 2015 Rendezvous with Madness Film Festival in Toronto, a film that captures the pain of a family coping with one member’s eating disorder.

The story is narrated by a young girl, Stella, who discovers that her older sister and role model, Katja, is suffering from anorexia nervosa. Through their complicated relationship, the viewer feels the struggle of wanting to protect a friend or family member from harm, while respecting the right to come forward only when ready.

Stella’s confusion and anxiety resonated with me. Like her, I felt I had to keep my friend Rebecca’s eating disorder a secret, scared of repercussions should anyone find out.

Rebecca’s condition escalated during senior year. She began over-exercising and restricting her caloric intake. At first, the disorder was hardly noticeable. But over time her weight dropped, her face appeared gaunt, her bones protruded.

At seventeen, I felt ill-equipped to handle this. Like Stella, I wanted Rebecca to seek help, but I didn’t know how to arrange it without betraying her trust.

Trying to aid a family member or friend with an eating disorder is very hard. Without resources at school, with no one to turn to, I didn’t know how to begin the conversation. As I struggled to support Rebecca, it became obvious I had no tools to help. One week of anti-stigma instruction that focused on body image and speaking inclusively wasn’t nearly enough.

Many adolescents are vulnerable to personal and friendship crises like these. And some websites help educate teenagers, such as the Canadian Mental Health Association’s (CMHA) site or the National Eating Disorder Association’s (NEDA) site.

But mental health education in high school? Not so much.

That’s unfortunate. Research shows the benefits of educating teachers on mental illness. In a 2014 study published in the journal Child and Adolescent Mental Health, Yifeng Wei and Stan Kutcher at Dalhousie University found that training teachers through a mental health program led to significant development in their ability to identify individuals with mental illness. And their attitudes toward mental disorders improved as well. Teachers were better able to support students, and link them to services.

The Youth Action Committee of Children’s Mental Health Ontario, in 2012, designed a project to identify where schools were deficient in educating mental health issues. The study found a lack of training and education for students, with 39.5% of participants saying they only learned about mental health in one class. There was also a lack of access to resources, such as a designated safe space for students who wanted to discuss these issues in school.

In the end, there wasn’t much I could do to help my friend. Over time, Rebecca sought treatment independently—she got the help she needed.

But not everyone struggling with an eating disorder will seek help on their own. Better education and resources for people coping with mental illness, as well as for those who want to help, would go a long way in providing support.

–Alyssa Carvajal, Contributing Writer, The Trauma and Mental Health Report

–Chief Editor: Robert T. MullerThe Trauma and Mental Health Report

Copyright Robert T. Muller

This article was originally published on Psychology Today

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“Normal Barbie” Challenges Body Ideals

00Body Image, Child Development, Eating Disorders, Featured news, Gender, Politics May, 16

Source: Laura Lewis on Flickr

The Lammilly doll, a more realistic version of the Barbie, is challenging body image ideals perpetuated by the children’s toy industry. Proportioned like an average American woman, the doll comes with accessories that represent realities of the human body: acne scars, stretch marks, and cellulite.

The development of the Lammilly doll, reflecting the average 19-year-old body, was a crowd funded venture, raising over $95,000 in less than a day and over $501,000 in total. But the project first came together when Nickolay Lamm, the creator of the doll, realized that the dimensions of Mattel’s Barbie doll were physically impossible for any woman to attain.

“I created an alternative to suggest that it’s okay to not look like a supermodel, it’s okay to look like a normal person,” Lamm told The Telegraph. He is quoted in the Huffington Post as well, adding: “If we criticize skinny models, we should at least be open to the possibility that Barbie may negatively influence young girls as well.”

The effects of playing with dolls depicting an unrealistic body type have been debated. A study by Helga Dittmar at the University of Sussex found that young girls showed decreased self-esteem and decreased body satisfaction after being exposed to images of Barbie dolls. A recent study conducted by Doeschka Anschutz and Rutger Engels at Radbout University in the Netherlands similarly found that young girls had a decreased appetite after playing with thin dolls.

Eating disorders, such as Anorexia Nervosa and Bulimia Nervosa, have been frequently linked to the media depiction of the “thin ideal” for women, and are increasing in incidence among adolescent girls in North America and Europe. These disorders can lead to immune dysfunction, permanent physical damage, and death.

Lamm found the design of the original Barbie particularly disturbing for this reason. “There’s nothing wrong with being a supermodel but I just had the impression that the wall of supermodels suggests that something is wrong with you if you don’t look like one,” Lamm explained, referring to the Barbies stacked on the shelves of a toy store.

But Kim Culmone, the vice president of design for Barbie, defends the proportions.

“Barbie’s body was never designed to be realistic, she was designed for girls to easily dress and undress”, she said in an interview with Fast Co Design, suggesting that Barbie was meant to be unrealistic, a fantasy in a young girl’s play. “When they’re playing, they’re playing. It’s a princess-fairy-fashionista-doctor-astronaut, and that’s all one girl. She’s taking her Corvette to the moon, and her spaceship to the grocery store.”

But children’s fantasy doesn’t have to include fashionistas in Corvettes.

The Lammily doll comes with her own range of accessories. The “normalness” of the doll does not stop children from being imaginative. The doll can be accessorized with stickers of glasses, bandages, moles, scars, casts, grass stains, and tattoos, all of which promote creative storytelling.

But the Lammily brand may also have its shortcomings. The doll has come under criticism for trying to be too average. Despite Lammily’s popularity with fundraisers and parents, its performance may fall short on the toy store shelf. Many children, bombarded with ads and images of the tall, thin, ideal female, may not be so attracted to the average-looking Lammily doll.

In a story for The Guardian, writer Lionel Shriver describes the doll’s appearance as “downright dumpy”:

“…Has anyone asked the little girls if this is the doll they want to play with? Who pre-ordered these dolls? Parents. Who really wants these dolls? Parents. Are children quite so easily manipulated as this?”

Still, Lammily successfully sold over 22,000 dolls when it launched in November, 2014, and that number continues to grow as the doll becomes available at retail locations. A popular young icon and pop star, Demi Lovato, has voiced her support for the “normal” Barbie, contributing to its popularity.

With both feet firmly planted on the ground, the Lammily doll encourages acceptance. As Lamm states, “I see ‘average’ as inclusive of all of us, not a standard which excludes. I want to show that reality is beautiful.”

– Khadija Bint Misbah, Contributing Writer, The Trauma and Mental Health Report

– Chief Editor, Robert T. Muller, The Trauma and Mental Health Report

Copyright Robert T. Muller

This article was originally published on Psychology Today

“Pro-Ana” Websites Encourage Anorexia

“Pro-Ana” Websites Encourage Anorexia

10Body Image, Eating Disorders, Featured news, Loneliness, Self-Esteem, Social Life August, 15

Source: Wolfgang Lonien/Flickr

In 2013, 17-year old Grainne Binns came forward to the Daily Mail with her story of having anorexia nervosa, an eating disorder defined by a distorted body image, and intense fear of being or becoming fat.  Months of restricting food intake meant Binns’ weight plummeted to 84 pounds.

Her inspiration, she explained, was admiration of girls on pro-ana and thinspiration blogs and websites.

The sites claim not to promote eating disorders, yet pro-ana (pro-anorexia) websites provide diet plans with dangerously low caloric intake, and ways to eat less and burn more calories, as well as “inspiration” through images of very thin models and celebrities.  They advance the idea of anorexia nervosa as a lifestyle rather than a mental illness.

Researchers at the Department of Communication at Wayne State University assert that the biggest appeal of pro-ana websites is their ability to provide social support and a sense of self-expression.  Offline, people with eating disorders often face stigma when voicing anti-treatment views and eating habits to friends and family.  Online, the websites become a sanctuary where users are free to express their views and have them met with agreement and support.

Shared writing about issues of self-esteem or feeling misunderstood, in fact, may be therapeutic, often providing a sense of community.  Emotional support and validation from other users seem to be part of the appeal of pro-ana websites.

In a study by Professor Nicole Martins, and Ph.D. Candidate Daphna Yeshua-Katz at the Department of Telecommunications at Indiana University, interviews with regular pro-ana bloggers revealed that many felt the websites granted permission for them to continue with their eating disorder.  Bloggers also worried they would be seen as wanna-rexics (wannabe anorexics) by other online community members for not meeting their weight loss goals.

Binns knew this feeling well, describing her need to please other users when they would comment that she appeared fat in her photos.

Sonya Lipczynska, information specialist of the Institute of Psychiatry at King’s College, also describes how the cult-like nature of pro-eating disorder websites are enabling harmful behaviour.  Personifying anorexia nervosa, writers on some sites refer to the disorder as if it were a real person, “Ana,” who members must appease by following rules and dedicating attention to making “her” happy.  These rules, known as “Ana’s Laws,” reinforce the fixation users have with being thin.

Some patients get so addicted to the appeal of pro-ana websites that they use them in secret, despite being advised against doing so by their therapists or other mental health professionals.

Although these websites are active, certain efforts are being made to discourage use.  Social media sites such as Tumblr and Instagram have changed their terms of service to ban the posting of thinspo images.

And a growing number of pro-recovery websites promote optimistic thinking and positive self-image through the use of inspirational quotes, pictures, and community support.  Users get the message that they can successfully beat their eating disorder, along with recovery tips and referral information to get professional help.

Still, pro-ana websites should not be dismissed.  What we need to appreciate is that the support and understanding the sites give to users make them not only popular, but addictive.

And there may be a lesson or two here for family, friends, and those in the mental health community invested in recovery from eating disorders:  The best way to address concerns about pro-ana websites is to provide the same level of support and understanding offline as users now get online.  And, eating disorder websites devoted to recovery need to provide a similarly supportive community as well.

In the case of Grainne Binns, the road was difficult.  But, it was the support of family and friends that allowed her to delete her pro-ana blog and start a new one about healthy living, ultimately facilitating her recovery.

– Anjali Wisnarama, Contributing Writer, The Trauma and Mental Health Report

– Chief Editor: Robert T. Muller, The Trauma and Mental Health Report

Copyright Robert T. Muller

This article was originally published on Psychology Today

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Anorexia Affects More Men Than Previously Thought

10Bulimia Nervosa, Consumer Behavior, Diet, Eating Disorders, Featured news, Gender, Health, Psychiatry March, 15

Source: Federico Morando//Flickr

Zachary Haines was 16 years old when a physical examination put his 5’7”, 230-pound body within the obese range.  Soon after, Zachary began working out and watching his diet, entering his junior year at high school 45 pounds lighter.

But what started as a healthy lifestyle soon spiralled into a struggle with anorexia nervosa, an eating disorder characterized by severely restricting food intake.  Like many other men and boys, Zachary’s extreme weight loss was not identified as an illness.  In fact, it was ignored until he was hospitalized for malnutrition.  Despite having many of the telltale signs of anorexia, Zachary’s condition went untreated.

Anorexia and bulimia are traditionally seen as “female problems.”  But, recent studies show that approximately one third of people with anorexia and about one half of those with bulimia are men.

One of the  influences thought to impact these men are the shifting ideals in the media that are putting pressure on men to become thinner.

While there may not be a direct causal relationship between media portrayals of the ‘ideal’ man and the development of eating disorders, these depictions contribute to a cultural context that glorifies their apparent normalcy.   They may also influence males’ fears of becoming overweight, as male models face pressure to slim down and appear androgynous.

The thin ideal male image is also making its way into fashion.

In 1967, an average mannequin’s dimensions were a 42-inch chest and a 33-inch waist.  Today’s average dimensions are a 35-inch chest and a 27-inch waist.  With the average American man’s waist size being 39.7 inches, these changes represent a remarkably unrealistic objective.

For Zachary, fitting into smaller sized clothing after weight loss was a source of pride.

But during treatment this once enjoyable activity became emotionally painful:  In Zachary’s words, “The most anxiety-inducing part for me is trying on clothes.  If I go up a size, I think I’m going to be 230 pounds again.”

The signs that something was wrong were all there.

Despite working out for three hours per day while only consuming 1,400 calories, Zachary was continuously trying to lose more weight.  By relying on inaccurate results from the Body Mass Index (BMI), doctors missed his emaciation.  He had never fallen into the anorexic range because the BMI does not take into account the proportion of muscle to fat, even though his emaciation would have been evident if he were seen shirtless.

The growing number of stories like Zach’s has led to significant changes to how anorexia nervosa is diagnosed.

In the DSM-V (the most recent version of American psychiatry’s diagnostic manual), this change involved eliminating Criterion D, or amenorrhea (the absence of menstruation) to make the diagnosis gender-neutral.

Zachary recovered because he had support from his family and friends, private insurance, and access to physicians and psychiatrists, who he worked with closely.

To help his recovery, he had to change his wish to pursue becoming an athletic trainer to that of going into advertising.

Those without resources can also identify some of the signs of an eating disorder:  extreme exercise behaviors, compulsive thoughts of losing weight, constantly feeling cold, and extreme food restriction.

These signs don’t discriminate between men and women, neither should we.

– Contributing Writer: Danielle Tremblay, The Trauma and Mental Health Report

– Chief Editor: Robert T. Muller, The Trauma and Mental Health Report

Copyright Robert T. Muller

Photo Credit: Federico Morando//Flickr

This article was originally published on Psychology Today