BodyVVise
HOW ARE EATING DISORDER
Eating disorders and obesity are part
Depression, anxiety,
_ e • s.
These problems include anorexia
bulimia nervosa, anorexic
unhealthy dieting
nervosa,
disorders are associ
and other mood
'"
binge eating disorder,
'"
Adolescents who are
rCJe ..
and bulimic behaviors,
practices,
AND OBESITY RELATED?
depressed may be at an increased risk of becoming
obese. One recent study found that depressed
and obesity. Adolescent girls may suffer from
adolescents were two times more likely to become
more than one disorder or may progress from one
obese at the one year follow up than teens who
problem to another at varying
It is important
degrees of severity.
to understand this range of weight-
did not suffer from depression.?
people with eating disorders
related problems in order to avoid causing one
depression,
disorder,
disorders,
disorder.Iv
such as bulimia,
while trying to prevent
another, such as obesity.
1
Body dissatisfaction
and unhealthy
In addition,
many
suffer from clinical
anxiety, personality
or substance abuse
or in some cases obsessive compulsive
Therefore, a mental health professional
may need to be involved in treating on adolescent
dieting
practices are linked to the development
of eatin
I
High numbers of adolescent
reporting
that they are dissatisfied
who is obese or suffers from on eating disorder or
other weight-related problem.
e
girls are
The environment
may contribute
with their
The
bodies and are trying to lose weight in unhealthy
moss media, family, and peers may be sending
ways, including
children and adolescents
skipping
meals, fasting, and
mixed messages about
using tobacco. A smaller number of girls are
food and weight that encourage
even resorting to more extreme methods such as
eating.ll
self-induced vomiting,
stigmatizes
diet pills, and laxative use.?
fatness, yet high-calorie
widely available
These attitudes and behaviors
place girls at a
greater risk for eating disorders,
nutrition,
growth impairments,
problems such as depression.3
For example,
concerned
that overweight
about their weight,
obesity, poor
and emotional
girls are more
more dissatisFied
their normal-weight
peers.s
Binge eating is common among people
with <>'1 If
~ c
r ae <>
n
People with bulimia binge eat and then
purge by vomiting,
using laxatives,
Binge eating that is not followed
also be considered
or other means.
by purging
may
an eating disorder and can
lead to weight gain. More than one-third of obese
individuals
in weight-loss treatment programs report
difficulties with binge eating.5 This type of eating
behavior contributes to feelings of shame, loneliness,
poor self-esteem, and depression.6 Conversely, these
kinds of feelings can couse binge eating problems."
A person may binge or overeat for emotional
reasons, including
stress, depression,
and anxiety.8
foods are
At the
same time, levels of physical activity are at
record lows as television and computers replace
has replaced walking,
space for walking
with their bodies, and more likely to diet than
thinness and
and heavily odvertised.t?
more active leisure activities,
Research shows,
disordered
Today's society idealizes
travel by automobile
and many communities
and recreation.13
lack
HEALTH RISKS
Most teens don
It
suffer from
either anorexia or obesity.
Eating disorders
may lead to
• Stu nted growth
They are more likely to
engage in disordered eating
behaviors such as bingeing,
purging, and dieting. These
• Delayed
menstruation
• Damage
to vital
organs
such as the
heart and brain
• Nutritional
starvation
• Cardiac
deficiencies,
including
arrest
• Emotional
problems
such as depression
and anxiety
behaviors are associated
with serious physical and
Obesity
emotional health problems.
• High
increases the risk for
blood
pressure
• Stroke
We've got to get back to
• Cardiovascular
• Gallbladder
three square meals a day,
disease
disease
• Diabetes
healthy meal planning,
• Respiratory
problems
• Arthritis
nutritious snacks, and
• Cancer
regular physical activity.
-
RICHARD
KREIPE,
MEDICINE,
M.D.,
UNIVERSITY
CHIEF,
DIVISION
OF ROCHESTER
14
OF ADOLESCENT
MEDICAL
CENTER
• Emotional problems such
as depression
and anxiety
1
Changing habits is never easy, but switching
to a healthier diet and
regular physical activity
will bring children and their families
many benefits, including
improved
quality of life.
health, more energy, and a better
15
-
JONELLE
C.
ROWE,
M.D.,
OFFICE
ON
WOMEN'S
HEALTH
HELP ADOLESCENTS DEVELOP HEALTHY EATING
ATTITUDES AND BEHAVIORS
Be a positive role model. Children look to parents
Be aware of your child's emotional health.
and other adult caregivers
Depression,
as they develop their
anxiety, and other mood disorders are
own attitudes and behaviors toward eating and
associated with obesity, eating disorders,
weight.
weight-related
For example,
children of overweight
are more likely to be overweight
parents
than their peers.
professional
if you think your child may be suffering
Also, daughters of mothers who diet are more
from a more serious emotional
likely to diet than other girlS.16 Teach young people
adolescent
how to eat healthily
complaining
problem than typical
mood swings.
through your own actions. Avoid
unhealthy habits such as skipping
weight,
and other
problems. Consult a mental health
meals to lose
about your body, or using food
as a reward.
Provide opportunities for children to
participate in sports, dance, swimming, or
other physical activities. Take your child regularly
to parks, beaches, and other places where he or she
Help children learn to control their own
eating. Parents and other adults can help children get
can be physically
active. Take walks, hikes, or bike
in touch with their feelings of hunger and fullness. For
rides as a family. Keep exercise clothing and equipment
available. limit and monitor time spent watching
example, encourage
television,
satisfied.
young people to stop eating when
Avoid forcing children to eat certain foods,
which encourages
sedentary
behavior
exposes children to junk food advertisements.
and
Remove
requiring that they "clean their plates," or forbidding
particular foods, as it may even increase their
televisions from kids' bedrooms.
preference
show that when mothers try to restrict their children's
Counteract harmful media messages about
body image. Watch television with children and
food, the children actually tend to eat more when they
talk about messages regarding
are not being supervised. IS
how advertisers
use thin models to market products
and manipulate
photos and other images to make
for and intake of those foods.17
Studies
body image. Discuss
Offer young people a variety of healthy foods
at meal and snack times. Plan meals in advance,
bodies look perfect. Praise the child for his or her
and make sure they include vegetables,
rather than on appearance.
whole grains,
talents and abilities,
and encourage
a focus on health
protein, and other foods that are low in sugar and
saturated fat. Pack a healthy school lunch for your
Don't be afraid to seek help. Take your child to a
child. Keep plenty of healthy snacks such as nuts and
family doctor if you think he or she has a weight-related
fruit available
problem.
at home.
A doctor can suggest ways to maintain a
healthy weight,
assess your child for any underlying
Eat dinner together as a family most days
of the week. Meals are an important social activity,
emotional
and help parents and caregivers
these programs include family members, so you may
young people are eating,
keep track of what
as well as their activities
and moods. Make mealtime a relaxed and enjoyable
occasion.
problems, or recommend a program that
promotes healthy food choices and exercise. Many of
benefit personally
from it too.
Did you know ...
•
In American
high schools,
30 percent of girls and
16 percent of boys schools
suffer From disordered
eating,
vomiting,
including
bingeing,
fasting, laxative
DEFINITIONS
Body image is how you see yourself when you look in the mirror
or picture yourself in your mind.
and diet pill use, and
compulsive exercise
•
Obesity means having an abnormally
19
Childhood obesity has more
than tripled in the last 30
years. By the year 2000,
15 percent of children and
adolescents ages 6 to 19
were obese.20
•
Studies suggest that about
high proportion
can also calculate
your BMI by going to an online BMI calculator
at www.fns.usda.gov/tnrockyrun/diff.htm
.
Overweight
refers to an excess of body weight compared
set standards.
The excess weight may come from muscle, bone, fat,
body water. A person can be overweight
and/or
adolescents will become
obese (for example, athletes who have a lot of muscle). However,
many people who are overweight
are considered
without being
obese due to
excess fat on their bodies. A person may be considered
A personal or family
history of obesity is a risk
if he or she has a BMI of 25-29.9.
factor for later development
Anorexia
of bulimia.22
•
to
70 percent of overweight
obese cdults.?'
•
of body
fat. A person is considered obese if he or she has a body mass
index (BMI) of 30 or greater. BMI is calculated by dividing a
person's weight in kilograms by height in meters squared. You
People with this disorder
eat very little even though they are thin. They have on intense and
overpowering
The overage child in the
U.S. watches
nervosa is self-starvation.
overweight
10,000
television advertisements
for
food each year, 95% of
which are for foods in one
of four categories:
sugared
fear of body fat and weight gain.
Bulimia nervosa is characterized
and purging,
either by vomiting
by cycles of binge eating
or taking laxatives or diuretics
(water pills). People with bulimia have a fear of body fat even
though their size and weight may be normal.
cereals, candy, fast foods,
and soft drinks.23
Binge eating disorder means eating large amounts of food in
a short period of time, usually alone, without being able to stop
when full. The overeating and bingeing are often accompanied
by feeling out of control and followed
by feelings of depression,
guilt, or disgust.
Disordered
eating refers to troublesome eating behaviors,
such as restrictive dieting,
frequently
criteria
bingeing,
or purging,
which occur less
or are less severe than those required to meet the full
for the diagnosis
of an eating disorder.
!
THE DIET TRAP
• The risk for obesity
greater
may be 324 percent
for adolescent
girls who describe
themselves as dieters than girls who do
... the potential consequences
not diet.24
• Up to one in four ll-year-old
already
girls have
of body dissatisfaction
and
tried to diet at least once.25
unhealthy weight control
• Children
who diet may actually
up gaining
more weight
than children
who do not diet. This is
because dieting
•
restrictive
eating,
or binge
eating.26
may cause a cycle of
followed
by overeating
becoming
obese are more likely to use
unhealthy
weight
loss practices,
eating and dieting
linked to serious risk-taking
such as drug, alcohol
delinquency,
have been
because these negative
are associated with the
development
of both eating
disorders and obesity.
29
behaviors
and tobacco
unprotected
public health significance,
such as
and using diet pills or laxatives.27
Disordered
behaviors are of considerable
cognitions and behaviors
People who are obese or at risk of
vomiting
•
end
in the long term
use,
sexual activity,
-
DIANNE NEUMARK,SZTAINER, PH.D.,
M.P.H.,
R.D.,
DIVISION OF EPIDEMIOLOGY, UNIVERSITY OF
dating
violence,
and suicide otternpts.»
MINNESOTA SCHOOl OF PUBLIC HEALTH
Elld Notes
1 Neumoric,sztoinor,
RESOURCES
D. -0be5ity end Eating DilOt'dot Preventi.on;
Ado/esconf
Approoch~"
MfKlfclne,
The National
Information
Women's
Health
Center (NWHIC)
American
Nutrition
end Non-Ovorweisht
Malesan,!kd;ano, Feb;156121:171-8, 2002.
hotline: (900) 225·5267
3 Neutnati:-Smioor,
O. ·Obesity and Eeting Disorder Prevention:
Publications: (800) 877·1600
TDD: (888) 220·5446
Web site: www.4womon.gov
www.4girls.gov
Web site: www.eatright.org
Markey, CN., Birch, LL "Etio$ogy
0(
operates a nutrition hotline thot provides
Among .$.yeor--oJdGIrl,."
0cJ;35(2): 143-151,
NWHIC is a federal government Web
site and toll-free call center that provides
free, reliable women's health information.
Sponsored by the Department of Health
and Humon Services' Office on Women's
Health, NWHIC features special sections
the public with nutrition information for
a small fee. The association also offers
publications and other resources to the
general public, health core providers and
other professionals, teachers, and parents.
J.S., Thelen, M.H. ·Eoftng and
on body image and girls' heolth. The
National Eating Disorders
Association (NEDA)
ext. 5000
4 Burrows, A., Cooper, M. ~Pouible Risk Foctors
Institute
The American Dietetic Association
and Digestive
(NIDDK)
of Diabetes
and Kidney
Disease
educational information on its Web
site and manages The Weight·control
Information Network (WIN), which
provides resources on obesity, eating
disorders and other weight.related issues.
Heart,
NEDA is the largest eating disorders
prevention and advocacy organization
prevention programs for a wide range
of audiences, publishes and distributes
educational materials, conducts an annual
of
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'Teen
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13 Frencn, S.A. Story, M., Jeffery, R. "ErrvironmenkJ!lnfluonc;:es
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{);JOfden, anti Obesity
A..oc.mon,
17
The Body Positive is a non.profit
organizotion that educates people
to think about self·esteem, health and
in
E.• Whitaker, R.C. "A Prospective Study of the R~ af Depression
in the Developmenr and Porsbtence
Sep;IIOI3):497.5Q4,2002.
16
conference, and operates a tall·free
The NHLBI Information Center and
the Obesity Education Initiative prOVide
adults that encourage healthy lifestyle
choices to reduce the risk of obesity and
heart disease.
Wallor, G, 'The
Vandor Wal,
K.D. (em) EatinS Ofsord"tl and Obesity, 2nd ed. New York: Guilford Press.
9(1.102.2002.
10 Notional Mentol Health
and weight issues. NEDA also develops
The Body Positive
Telephone: (510) 548·0101
Web site: www.thebodypositive.org
E·mail: [email protected]
Recreation and Parks Association, which
helps provide activities for kids and
K.O. lads), fallng DjJOl'Clersand
403.407, 2002.
6
and Welehl Ccocems
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8elxmor. Sep-Oct;25(5):77'>778,
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AJJIctNe
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Body Image Concern. Among Obese and
Vonovs.ki, S.l. '"Bingo Ealing in
5
11
onorexia, bulimia, binge eoting disorder
and to those concerned with body image
Blood Institute (NHLBI)
Telephone: (301) 592·8573
Web site: www.nhlbi.nih.gov
E·mail: [email protected]
also operates 0 program called Hearts
N'Parks, a partnership with the Notional
Appoflle,
in chjld!en.~ PecJlalrK;s. 2003 Nov;11215J:1138-45.
Lung, and
information obout weight control, including
tools such as an online BMI calculator
for adults and a menu planner. The NHLBI
AVMoge-We+ght
8 Goodmon,
eating disorders helpline.
The National
of Eating
Dcw!topmenl
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Sep;110I3J:497..504.
Lumeng JC, Gannon K. Cobral HJ, Fronk OA, Zuckerman
B. "A5.WCiatlon between clinically meaningful behavior problems cnd overweight
Telephone: (206) 382·3587
Information and Referral Helpline:
(800) 931·2237
treatment referrals to those suffering from
NIDDK offers stotistics, research, and
me
7 Fairburn, C., O\t-efcomlng Bmge fating. New York: The Guilford Press, 1995,
pp.8().99.
in the world. The association provides
Telephone: (877) 946·4627
Web site: www.niddh.nih.gov
In
Di:sorden in CNorwoight ProAdobcent Girls. ~ Inlf.trnoliOflOI.1cumo1 of Obesity
and Fleloted A-1cl"boIic DiMJfOou., Sopt;26(9): 1268.1 273, 2002; Davison, K.K.,
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National
Integrated
An
App<oach?" 2003.
Telephone: (800) 994·9662
4girls.gov Web site gives girls between
the ages of 10 and 16 reliable, current
health information designed to motivate
them to choose healthy behaviors.
Concerns
AdoleSCents:
for Prcvonfing VVeight-Reiated Disorders." Archi'IeJ of PecJj'oIriC$ond
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Dietetic Association
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High School Studonts lor Eati~ DiKX'ders: Rc:uulls01 a Not)onollnitiotivc.·
Jou,"o/ 01 Male",,,,,,
body image in a new way. Their
resources include a gUidebook on how
Dietz., W.H. ".v.edicol Coosequel'lCM of Obesity in Chi'dren ond Adolc!oCcnh.
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21
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BodyWise ond BodyWorks are initiotives of the U.S. Deportment of Health and Human Services
Office on Women's Health. BodyWise provides school personnel and other adults who interact with
•• Field, AE., Au,';n, S.B .• Taylor, C.8., MoIspei •• S" R"",er, B" Rock .. , H.R"
Gmmon. M. w., Cold .. , G.A. ·RoIon"" Beiwoon D"~ng arC We;ght Change
Among P'eodole""",,,
students ages 9 to 12 with information to help prevent disordered eating and eating disorders.
BodyWorks is a toolkit on physical activity and nutrition for porents and other adult caregivers of
girls ages II to 13. Print copies of BodyWise and BodyWorks are available at www.4woman.gov.
27
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