Category: Body Image

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Dangerous Eating Has Become a Problem in High-Level Sports

00Anorexia Nervosa, Body Image, Coaching, Diet, Eating Disorders, Featured news, Health, Sport and Competition July, 18

Source: Image Credits Feature: Thomas Wolter at pixabay, Creative Commons

As profiled by the media during the Summer 2016 Olympics and Paralympics in Rio de Janeiro, doping is a problem that continues to plague sporting events worldwide. For the past half-century, international sports federations, including the International Olympics Committee (IOC), have tried to stop the infiltration of illegal substances into sports.

Despite harsh punishments, some coaches and athletes persist in employing banned drugs, such as stimulants and hormones, to improve performance. Through periodic drug testing, these federations monitor the substances that athletes consume. Educational programs and medical treatment also help athletes address drug use and the pressures of high-performance sports.

But is anyone paying attention to what athletes are not consuming?

Disordered eating behaviours are another tactic used to heighten performance. Although highly controlled eating practices can cause serious health problems, dangerous eating among athletes is not heavily monitored by sports organizations.

Disordered eating is defined as a spectrum of harmful and often ineffective eating behaviours used to lose weight or attain a lean appearance. When defining disordered eating, the American College of Sports Medicine uses a behavioural continuum that starts with healthy dieting among athletes, proceeding to more extensive weight or dietary restrictions, to passive or active dehydration (e.g., saunas), and end at the onset of diagnosable eating disorders.

In an interview with the Trauma and Mental Health Report, Roy Cowling, Technical Director and Club Head Coach at North Toronto Soccer Club and volunteer for the Special Olympics Ireland and Special Olympics Great Britain, says that “involvement in organized and professional sports can offer a lot of benefits—improved self-esteem and body image, and encouragement to remain active throughout one’s life.”

But from his day-to-day interactions with clients who are training for professional sports, he thinks that athletic competition can cause severe psychological stress.

“The sports culture, with its emphasis on optimal or ideal body size or shape for best performance, is at many times an influencing factor in developing odd or abnormal eating patterns. Even extreme dieting or not eating at all.”

When the pressures of athletic competition are layered on top of an existing cultural emphasis on thinness, the risks increase for athletes to end up with disordered eating—a strong predictor that individuals may progress to an eating disorder (anorexia nervosa, bulimia nervosa, and binge-eating disorder).

In a study of Division 1 NCAA (National Collegiate Athletic Association) athletes, over one-third of female athletes reported pathological attitudes and symptoms toward eating, placing them at risk for anorexia nervosa. Although most athletes with eating disorders are female, males are not immune. Athletes competing in sports that tend to place an emphasis on diet, appearance, size, and weight requirements—such as wrestling, bodybuilding, running, and ‘anti-gravity’ sports (jumping sports where excess body weight is a disadvantage)—face more pressure to maintain a certain body weight.

Athletes are also at a higher risk than the general population of suffering harsh health consequences of eating disorders. According to Cowling:

“Athletes already exercise heavily, so their bodies and energy levels are depleted sooner and their health is heavily tested and challenged.”

Doping is deemed harmful to an athlete’s health by sports federations and is monitored. So why aren’t eating disorders carefully screened? This question is particularly crucial, given that pathological eating behaviours, specifically anorexia nervosa, have the highest mortality rate of any psychiatric illness.

Cowling, through his work at the Olympics, says that it often boils down to time, resources, and ultimately, athletes’ willingness to speak out.

“Testing for illegal substances is a fairly quick and standard process, whereas inquiring about someone’s eating behaviours or dieting leaves a lot of room for misinterpretation. There’s no guarantee that the athlete is even going to be honest, since that could risk them getting excluded from the team or competitions. Plus, a lot of resources and training would have to go into properly screening for abnormal eating behaviours—something that international, and even national or local sports organizations, can’t be bothered with.”

Unless sports federations pay closer attention to this issue, the onus is on coaches who work closest with athletes to help keep eating and dieting behaviour in check.

Despite the lack of screening and prevention on the part of international sports federations, the National Eating Disorders Association and the National Eating Disorders Collaboration have guidelines for coaches to enhance their awareness and ability to address and prevent problematic eating behaviours in athletes.

“-Veerpal Bambrah, Contributing Writer, The Trauma and Mental Health Report.”

“–Chief Editor: Robert T. Muller, The Trauma and Mental Health Report.” http://trauma.blog.yorku.ca/

“Copyright Robert T. Muller.” https://psychotherapytoronto.ca/

This article was originally published on Psychology Today

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Dangerous Eating Habits Enhance Sports Performance

00Anorexia Nervosa, Body Image, Coaching, Diet, Eating Disorders, Featured news, Health, Sport and Competition July, 18

Source: Image Credits Feature: Thomas Wolter at pixabay, Creative Commons

As profiled by the media during the Summer 2016 Olympics and Paralympics in Rio de Janeiro, doping is a problem that continues to plague sporting events worldwide. For the past half-century, international sports federations, including the International Olympics Committee (IOC), have tried to stop the infiltration of illegal substances into sports.

Despite harsh punishments, some coaches and athletes persist in employing banned drugs, such as stimulants and hormones, to improve performance. Through periodic drug testing, these federations monitor the substances that athletes consume. Educational programs and medical treatment also help athletes address drug use and the pressures of high-performance sports.

But is anyone paying attention to what athletes are not consuming?

Disordered eating behaviours are another tactic used to heighten performance. Although highly controlled eating practices can cause serious health problems, dangerous eating among athletes is not heavily monitored by sports organizations.

Disordered eating is defined as a spectrum of harmful and often ineffective eating behaviours used to lose weight or attain a lean appearance. When defining disordered eating, the American College of Sports Medicine uses a behavioural continuum that starts with healthy dieting among athletes, proceeding to more extensive weight or dietary restrictions, to passive or active dehydration (e.g., saunas), and end at the onset of diagnosable eating disorders.

n an interview with the Trauma and Mental Health Report, Roy Cowling, Technical Director and Club Head Coach at North Toronto Soccer Club and volunteer for the Special Olympics Ireland and Special Olympics Great Britain, says that “involvement in organized and professional sports can offer a lot of benefits—improved self-esteem and body image, and encouragement to remain active throughout one’s life.”

But from his day-to-day interactions with clients who are training for professional sports, he thinks that athletic competition can cause severe psychological stress.

“The sports culture, with its emphasis on optimal or ideal body size or shape for best performance, is at many times an influencing factor in developing odd or abnormal eating patterns. Even extreme dieting or not eating at all.”

When the pressures of athletic competition are layered on top of an existing cultural emphasis on thinness, the risks increase for athletes to end up with disordered eating—a strong predictor that individuals may progress to an eating disorder (anorexia nervosa, bulimia nervosa, and binge-eating disorder).

In a study of Division 1 NCAA (National Collegiate Athletic Association) athletes, over one-third of female athletes reported pathological attitudes and symptoms toward eating, placing them at risk for anorexia nervosa. Although most athletes with eating disorders are female, males are not immune. Athletes competing in sports that tend to place an emphasis on diet, appearance, size, and weight requirements—such as wrestling, bodybuilding, running, and ‘anti-gravity’ sports (jumping sports where excess body weight is a disadvantage)—face more pressure to maintain a certain body weight.

Athletes are also at a higher risk than the general population of suffering harsh health consequences of eating disorders. According to Cowling:

“Athletes already exercise heavily, so their bodies and energy levels are depleted sooner and their health is heavily tested and challenged.”

Doping is deemed harmful to an athlete’s health by sports federations and is monitored. So why aren’t eating disorders carefully screened? This question is particularly crucial, given that pathological eating behaviours, specifically anorexia nervosa, have the highest mortality rate of any psychiatric illness.

Cowling, through his work at the Olympics, says that it often boils down to time, resources, and ultimately, athletes’ willingness to speak out.

“Testing for illegal substances is a fairly quick and standard process, whereas inquiring about someone’s eating behaviours or dieting leaves a lot of room for misinterpretation. There’s no guarantee that the athlete is even going to be honest, since that could risk them getting excluded from the team or competitions. Plus, a lot of resources and training would have to go into properly screening for abnormal eating behaviours—something that international, and even national or local sports organizations, can’t be bothered with.”

Unless sports federations pay closer attention to this issue, the onus is on coaches who work closest with athletes to help keep eating and dieting behaviour in check.

Despite the lack of screening and prevention on the part of international sports federations, the National Eating Disorders Association and the National Eating Disorders Collaboration have guidelines for coaches to enhance their awareness and ability to address and prevent problematic eating behaviours in athletes.

“-Veerpal Bambrah, Contributing Writer, The Trauma and Mental Health Report.”

“–Chief Editor: Robert T. Muller, The Trauma and Mental Health Report.” http://trauma.blog.yorku.ca/

“Copyright Robert T. Muller.” https://psychotherapytoronto.ca/

This article was originally published on Psychology Today

Robert T Muller - Toronto Psychologist

Models Face Routine Exploitation, Mental Health Problems

130Body Image, Career, Eating Disorders, Featured news, Health, Post-Traumatic Stress Disorder January, 18

Source: Richard George Davis, used with permission

Former model Nikki Dubose has graced the covers of fashion magazines from Maxim to Vogue to Vanity Fair. She’s modeled in Barcelona, Paris, London, and Tel Aviv, and has walked the runway for numerous fashion designers.

Despite the glamorous lifestyle, Dubose is also a sexual assault survivor, and has struggled with eating disorders and mental-health issues. The story is a common one for many in the modeling industry. In an article for the Huffington Post, Dubose describes her experience:

“There were regular pressures to sleep with the director of my agency, constant ‘model dinners’ he organized that involved the owner of the agency, the director and his friends, and select models. This led to [my] being drugged and raped. [I was] raped by a photographer at a lunch that was organized by the director of my agency. Later, when I confronted the director, I was shot down.”

A recent report from The Model Alliance shows that nearly thirty percent of models report being sexually harassed, while twenty-eight percent have been pressured into sex with someone in the industry. Most of the models surveyed said they never told anyone—over two-thirds of those who did report the harassment to their agents were essentially ignored.

In a 2014 Flare Magazine exposé, model Misty Fox also revealed being mistreated by a photographer. Fox said he took photos of her without consent as she was using the bathroom:

“He went to the next cubicle, leaned over like a kid in primary school and took my picture.”

When she asked for the film:

“He just sneered, ‘What are you going to do, tell your daddy?’”

When Fox reported this incident to her agent, the reply was:

“‘Honey, it’s [name redacted]; he’s a really big deal. You’re lucky to be there. Get some good shots. Gotta go.”

Stories of photographers preying on young models are commonplace, and there are few consequences. In an interview with the Trauma and Mental Health Report, Dubose said:

Education and legislation are critical here—talking about sexual abuse in workshops so that models can develop safety plans, know what organizations to reach out to, and who to call if something happens. Prevention is key. Plus, predators need to be held accountable. Adopting regulations is also important to change the way the industry currently runs.”

Recently, Dubose worked alongside California State assembly-member Marc Levine on Bill AB 2539, which addressed the need for “workplace protections and health standards in the modeling industry.” This proposal was based on the current French law that prohibits using models with a Body Mass Index (BMI) of 18 or lower. Disappointingly, the bill was not passed by the California state legislature. Dubose said:

“The government continues not to take the necessary measures to ensure the safety of models in an industry that puts them at risk.”

People often associate modeling with a luxurious lifestyle, but working in the industry can have an impact on mental health. Studies in the past decade have shown that models run a higher risk of developing psychological disorders and report lower life satisfaction compared to other occupations. The Model Alliance reports that sixty-eight percent of models surveyed suffer from anorexia, depression, or a combination of both.

Dubose recognizes how common mental health issues are in her industry. Her memoir “Washed Away: From Darkness to Light” recounts the painful struggles and abuses she suffered as a young, aspiring model. Success often comes at a great cost, with young hopefuls developing an array of dangerous disorders and unhealthy coping mechanisms in the pursuit of fame. She explains:

“Models are often forced into doing things that they don’t want to do, such as losing weight for jobs or sleeping with photographers and other people in the business, and are often victims of wage theft. Most of these girls and boys are minors. It is not acceptable for them to be subjected to abuse, rape, financial theft, and so on.”

A movement for change is emerging in response to these problems. Dubose and many others like her are fighting to create a future where young models perform their jobs in a safe environment without worrying about sexual and financial exploitation, eating disorders, and mental-health issues. Dubose concludes:

“It’s only a matter of time before we see major, positive change. I’m confident.”

–Ty LeBlanc, 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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Branding Tattoos Use Ink to Violate Women

00Anger, Body Image, Bullying, Domestic Violence, Featured news, Gender July, 16

Source: THOR on Flickr

Latishia Sanchez was fourteen when she was attacked and raped by five men, including her boyfriend. During the assault, the men tattooed her boyfriend’s name across her neck using a needle and pencil lead.

According to the Canadian Women’s Foundation, fifty percent of all Canadian women will experience at least one incident of physical or sexual violence in their lifetime. This can take many forms; recently tattoo branding has become a popular form of violence against women.

As a weapon of domestic violence, perpetrators use ink to assert control and ownership over victims, either physically forcing them to get tattoos, or drugging and tattooing them while they are unconscious. The offender’s name is usually forced onto a visible part of the victim’s body.

Six years after she was attacked and branded, Latishia Sanchez continues to relive the painful memories of her rape. In an interview with CBS News, she describes that seeing the tattoo daily has devastated her self-esteem:

“I didn’t think that I’d get raped, let alone my boyfriend allowing it. Right now our mirrors are covered up because I can’t even look at myself.”

Jennifer Kempton, a survivor of human trafficking, remains traumatized from her experiences of branding violence in the human sex trade in Columbus, Ohio. In an interview with The Guardian, she recalls how a pimp tied her down and tattooed “Property of Salem” above her groin, marking her as his possession. Kempton explains that the shame and trauma associated with this incident caused her to spiral into a deep depression and attempt suicide:

“Every time I took a shower or tried to look at my body I was reminded of the violence and exploitation I’d suffered. I was so grateful to be alive, but having to see those names on your body every day puts you in a state of depression. You begin to wonder whether you’ll ever be anything but the person those tattoos say you are.”

Sanchez and Kempton are currently seeking tattoo removal treatment. Dawn Maestas, a tattoo removal specialist and domestic abuse survivor explains the horrors of tattoo violence in an interview with CBS News:

“I’ve had victims who have been drugged and tattooed, who have been physically held down and force tattooed, and I get angry. I get angry because I know what these tattoos mean. This is control. This is ‘you belong to me.’”

Maestas is not alone in the fight to end ink violence against women. Chris Baker, a tattoo artist in Chicago and owner of tattoo parlor Ink180, is known for offering free cover-up tattoo and removal services for survivors of domestic violence and sex trafficking.

Ink180’s mission is to “transform pain into something beautiful,” for survivors of branding violence. The tattoo parlor also has a clause on its website describing work it will not do, including tattoos that are gang related, satanic in nature, vulgar, or degrading to women.

Since the shop expanded its services to abuse survivors, Baker estimates that he has completed over 2,000 free cover-ups or removals. Though his shop offers regular, paid tattoos as well, over 80 percent of the work he does is pro bono.

One of the most common types of tattoos Baker sees is barcodes. These actually serve atracking system for pimps who brand victims with their contact information to monitor the behaviour of their sex workers. In an interview with The 700 Club, Baker describes the experience of removing barcode tattoos from a fifteen-year-old sex trafficking survivor:

“The relief on her face, you could feel the pain she had been through trying to get rid of old tattoos that defined her past.”

Baker’s shop features both a prayer wall and ‘Freedom Tree’ for survivors of abuse. Once their tattoos are removed, women can place a handprint on the tree symbolizing their newfound freedom and identity. Baker explains:

“They are very shattered people. I can’t even use the word broken, because their psyche is very fragile. We’ve had girls collapse on the floor in tears, because they no longer need to look in the mirror and see that barcode on their neck, or their abusive ex-boyfriend’s name on their hands.”

In an interview with Huffington Post, Baker urged other tattoo parlors to consider offering similar services and spread awareness of tattoo violence. For him, the rewards are worth the free work:

“I see the look on their faces when a domestic violence survivor doesn’t have to look down at their ex-husband’s name on their wrist or arm. I see that relief that he’s physically gone from their lives and they’re physically safe, but now they’re mentally safe as well.”

–Lauren Goldberg, 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

20Body 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

Cosmetic Vaginal Surgery Ignores Women’s Mental Health

Cosmetic Vaginal Surgery Ignores Women’s Mental Health

00Body Image, Ethics and Morality, Featured news, Gender, Health, Media, Self-Esteem October, 15

Source: summerbl4ck/Flickr

“I just thought I was so different from everyone else that I wanted my vagina to be changed,” said 21-year-old, Rosie, during her interview for The Perfect Vagina, a 2008 documentary on vaginal reconstructive surgery.

Rosie received a labiaplasty to remove the skin of her labia minora (internal genitalia). While the operation is relatively simple, the risks include bleeding, infection, permanent scarring, nerve damage, and a painful three-month recovery.

David Matlock, a cosmetic surgeon and director of the Los Angeles Laser Vaginal Rejuvenation Institute pioneered the vaginal surgery market in Los Angeles. He claims he can create “the perfect vagina,” a promise that brings in about 12 million (USD) a year.

But researchers at the UCLA Center for the Study of Women believe the concept of a “perfect vagina” arises from consistent exposure to homogenous images of women’s genitalia.  Pornography, medical textbooks, and sex shops show a similar vagina that is pink, hairless, with only the labia majora (external genitalia) visible.  Even the popular women’s health and sexuality book Our Bodies Ourselves shows only one image of the vagina.  Yet, the appearance of the healthy vagina is highly variable.

Why are more women opting for vaginal reconstructive surgery?  John R. Miklos, director of Urogynecology and Reconstructive Vaginal Surgery at the Atlanta Medical Center, found that most of his patients (on average 35 years of age) pursue the labiaplasty to improve sexual function, or to reduce pain during intercourse.

Other reasons for labiaplasty include alleviating discomfort from clothing or exercise, pressure from male or female sexual partners, reducing shame from having large labia minora, and boosting self-esteem.  And many labiaplasty patients are dissatisfied with the appearance of their genitalia and have lower sexual satisfaction.

Cosmetic surgeons state that women have the right to make decisions about their bodies. The American Academy of Facial Plastic and Reconstructive Surgery reported that women are the highest consumers of cosmetic surgery. In 2013, they accounted for 80% of all surgical (rhinoplasty, chin implants) and non-surgical procedures (BOTOX).

But many researchers take issue with that idea, arguing that vaginal cosmetic surgery patients often struggle with mental health.

Labiaplasty becomes problematic when young girls and women are looking for a self-esteem boost, as the surgery does not necessarily result in a positive outcome.  And for women struggling with low self-esteem, when one body part gets “fixed,” the dissatisfaction may shift rapidly to another.  This ongoing pursuit may be reflected in depression, anxiety, and even plastic surgery addiction.

However, Bruce Allan, an obstetrician-gynecologist from Calgary, Alberta, considers his patients to be very “well-adjusted people,” stating that a woman getting a labiaplasty is the same as a bald man getting a hair transplant.

Scientists at the Centre for Appearance Research at the University of the West of England have developed a psychological screening tool for all cosmetic surgery patients.  And specifically for labiaplasty candidates, there is the genital appearance satisfaction scale.

According to The American Society for Aesthetic Plastic Surgeons, psychological evaluations are not a mandatory procedure. Yet, most cosmetic surgeons are aware of body dysmorphic disorder, a chronic psychological illness characterized by obsessive, negative thoughts about one’s body and real or imagined flaws in physical appearance.  If patients opting for this surgery are doing so because they are suffering from a mental illness, one may ask whether it is indeed ethical to proceed?

Cosmetic surgeons would do well to consider the patient’s age when it comes to vaginal reconstructive surgery.  Young girls may prioritize a “quick fix” without understanding the surgery’s invasiveness.

And with adequate training to administer psychological screening tools, cosmetic surgeons could identify which patients should speak to a mental health professional before signing up for a labiaplasty.

Perhaps labiaplasty candidates can be given the opportunity to consider taking another route to address underlying body image dissatisfaction.  Patients might be better off if their doctors started tackling the problem from the top-down.

– Shira Yufe, 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

Abusing Your Body Through Exercise

Abusing Your Body Through Exercise

00Anxiety, Body Image, Diet, Featured news, Obessive-Compulsive Disorder, Sport and Competition June, 15

Source: Flickr/Mario Lazaro Delgado Marquez

Last year, a good friend of mine became obsessed with the gym. Preoccupied by the “small” size of his muscles, he would spend hours staring at himself in the mirror. Others commented on how great his body looked, yet he didn’t believe them. Sticking to a rigid exercise and eating schedule, he stopped socializing with friends, became secretive, and dropped out of school.

A sense of hatred toward a particular body part, hiding it, or using extreme measures to change it is commonly seen in people with Muscle Dysmorphic Disorder (MDD).

MDD is most common in men, especially professional body builders or frequent gym-goers, and individuals who work or live in an environment where weight and appearance are considered important. My friend was a kinesiology student and was surrounded by an MDD-conducive environment.

MDD is listed in the DSM-5 under the spectrum of obsessive-compulsive disorders(OCD) to reflect its similarities to both process and treatment of OCD. MDD is also a subcategory of body dysmorphic disorder (BDD), a pathological preoccupation with features that are perceived as defective or grotesque, which leads to persistent stress and obsession. In MDD, the emphasis is specifically on muscularity. My friend’s particular body part was his biceps; even though he had stretch marks from over-working them, he still complained they were too small.

MDD is also distinct from eating disorders. The concern is not with striving to be thin, but rather with their perceived underdeveloped muscle mass. At times I would see my friend eat three cans of tuna and four eggs in one sitting – he felt his body needed the protein to build mass.

Statistics on MDD are limited since it is categorized under BDD. The prevalence of BDD is approximately 2.4% of the general population which makes it more prevalent than schizophrenia or bipolar disorder.

Symptoms of MDD are deceptive. The trouble with diagnosing MDD is that patients often do not consider themselves ill or in need of help. The more my friend became involved in the gym, the more I would try and talk to him about my suspicion that he was suffering from MDD, but the conversations never ended well. To add to the complexity of the disorder, some individuals with MDD tend to wear baggy clothes to hide their bodies, while others wear tight clothes to show off their muscular stature.

But getting help is important, as potential long term effects include damaged muscles, joints, cartilage and ligaments due to inadequate rest from strenuous weightlifting. They are also more likely to have a poorer quality of life, show a higher frequency of anabolic steroid abuse, and even suicide attempts.

Criteria for diagnosis include repetitive behaviours caused by preoccupations with perceived body defect(s), excessive training, following a rigid diet, avoidance of social events to maintain diet and exercise schedules, and avoiding situations that include body exposure, which may lead to extreme anxiety. The individual’s body perception causes considerable impairment in daily functioning. The diagnosis requires two of these criteria to be met.

There are analytical tools to help diagnose MDD. Most common is the Muscle Appearance Satisfaction Scale developed in 2002 by Psychologist Stephen B. Mayville, which rates levels of muscle satisfaction, substance use, and injury. Or the Muscle Dysmorphia Inventory which is a six factor scale that determines body size, exercise dependence, supplement use, dietary behaviour, physique protection, and pharmacological use.

And there are psychological treatments as well. The most common of which is Cognitive Behavioural Therapy (CBT), which teaches an individual to identify and modify distorted thoughts (e.g., I am not muscular enough), and to replace unhealthy behaviours (e.g., exercising four hours a day) with healthier ones. Treatment with selective serotonin reuptake inhibitors (SSRIs) has also been used with MDD, but the most effective treatment is a combination of CBT and medication.

Despite recent awareness and treatments, with rising interest in fitness clubs and health supplements, as well as pressure on males to be unrealistically muscular and lean, a further rise in MDD wouldn’t be surprising.

– Jenna Ulrich, 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