How many of us restrict our foods, count calories or talk about bad foods?
Another university reports that eating disorders are widespread among students. But there is more to this story. The professionals at the Eating disorders common on campus, experts say
Nearly 10 percent of the student population at UC Davis has an eating disorder or issues concerning body image, according to Katie Cougevan, a Counseling and Psychological Services clinical psychologist. That is roughly 3,200 students a year, Cougevan said. “Here at CAPS we see five to 10 new people each week dealing with body-image issues or eating disorders,” she said.
According to a Women's Resources and Research Center flier, an eating disorder is defined as “an intense and unhealthy preoccupation with food and body image.”
...Though eating disorders are more common for women, men are not excluded from issues surrounding body image and eating disorders at UC Davis, Cougevan said. “Men are the most underrepresented and underserved on this campus,” she said. “In order to aid the needs of the male population there are outreach programs geared towards men so they may feel comfortable discussing body issues also.”
One such group is headed by Michael E. Maley, a psychology fellow at CAPS. “Anorexia and bulimia are the most common eating disorders on campus, as well as others labeled as EDNOS [Eating Disorders Not Otherwise Specified],” Maley said....[C]haracteristics of EDNOS include body-image issues involving restricting one's intake of food in people who are below their normal body weight.
Maley and Cougevan said there are telltale signs of anorexia, bulimia and EDNOS. Losing a lot of weight or obsessing about caloric intake can clue one in to a possible eating disorder, they said. ..."Noticing how people talk about food -- if someone talks about food as negative or puts it into categories as 'bad' -- [that] can also be a warning sign," Cougevan said.
Maley added, “If a friend talks about how many calories they consume, if they have to measure, it may mean they are restricting themselves." ...
A related problem not mentioned in the article that they are also seeing in increasing numbers is “over exercising,” which accompanies today’s heightened pursuit of fitness. In a comprehensive paper by Carolyn Costin, MA, M.Ed., MFCC, available free on their website, Costin explains that it occurs when people control their bodies, alter their moods, and define themselves through their over involvement in exercise activity, to the point where they feel they can’t stop. They’ve also been called “obligatory or compulsive exercisers because they seem unable to not exercise, even when injured, exhausted, and begged or threatened by others to stop,” she says. Her paper describes the features of this growing problem, gives a fascinating description of the common thinking patterns among sufferers used to rationalize their exercise, and offers guidance for approaching someone in trouble and getting them help.
The California Aggie article includes a list of resources and describes a unique program on campus called ABIDE: Association of Body Image and Disordered Eating. It is dedicated to not only raising awareness about how our culture influences our relationship with our bodies and our food, but it offers friends, men and fathers, family, teachers, coaches and healthcare professionals the resources to do something about it. Don’t just sit back if you’re worried that a friend or young person is having eating problems, they advice. It’s important to speak up early on and get help. They offer flyers with tips on “What to say” and “How to help a friend.”
Another aspect of their proactive program addresses body image and dieting. “Challenge Dieting,” “How to Improve Body Image & Love Your Body” and “50 Ways to Lose the 3 Ds: Dieting, Drive for Thinness, and Body Dissatisfaction” are just a few of the pamphlets and posters available for students. And plans are already underway for this year’s Celebrate Your Body Week on February 26-March 1.
Eating disorders are extremely complex and challenging problems, yet there is a paucity of research to support effective preventive programs. Reviews of the evidence have not been encouraging. Professionals hoping to prevent and slow the growing problem of eating disorders are left to work from the best evidence to date, as ABIDE is attempting to do. Available research points to promise for programs that are proactive in identifying young people at risk and that work on an environmental level to promote positive body images, reduce thin idealization and stop dieting behavior. But it appears our society's larger milieu is not easily overcome. A Cochrane Library review in 2003 found insufficient evidence for any preventive program and stated the quality evidence “does not allow for any firm conclusions” about the impact of prevention programs for eating disorders, although there were no indications that any were harmful. They identified only 22 published studies that used randomized, controlled trial methodology. “Only one statistically significant result was found — a slight effect of media literacy and advocacy programs in reducing acceptance of societal body image ideals.” But the programs were of short duration. Norwegian researchers in a 2004 issue of Tidsskr Nor Laegeforen looked at eating disorders prevention and found no studies had shown major and lasting effects, mostly due to methodological flaws, errors in designs, and imprecise or unrealistic outcome measures. Those that stood out as more promising, they said, were programs focused on changing attitudes to “modify the culture of body dissatisfaction.” Professors Eric Stice and Heather Shaw at the Department of Psychology, University of Texas, Austin, conducted a meta-analysis in 2004 including a broader range of randomized controlled clinical trials of eating disorder prvention programs which had published results from 1980 to April 2003. They found 53 trials using 38 different programs. About half significantly but modestly reduced a risk factor for eating disorders — thin ideal internalization, body dissatisfaction, dieting, negative effect or weight. The best results were seen in programs focusing on high-risk girls over 15 years of age and including repeated interactions. But Stice and Shaw concluded more research was needed because it wasn’t possible to predict clinical benefits from proxy measures and that no clinical benefit has yet to be demonstrated or shown to have lasting effects. Last August, university researchers in San Diego and the San Francisco Bay Area showed modest favorable results with a preventive program among high-risk young women. They conducted a randomized, controlled, 8-week intervention with 480 college-age women that included moderated online discussion groups addressing thin ideal and weight concerns. In other words, promoting body acceptance. The participants were followed for up to 3 years and while the study found no overall difference in the onset of eating disorders between the intervention and control group, there were two exceptions. Young women who at the beginning of the program had risky weight control behaviors (vomiting, laxative use, diuretic use, diet pill use and driven exercise) had half the rates of eating disorders at the end of followup. And none of the fat women in the program went on to develop eating disorders, compared to 12% of the fat controls.
The mortality rate for anorexia nervosa ranges from 6-20%, increasing the longer patients have it. And mortality is even higher, 5-40%, among bulimics. In addition to high death rates, eating disorders can cause many health problems that surface later in life, including fragile bones and osteoporosis, damaged teeth from purging, heart murmur or heart failure, and liver and kidney disease. And Dr. Joy Armillay, Ed.D, R.D., LDN, a nutrition and eating disorder therapist in northeastern Pennsylvania, says eating disorders require an average of 5 to 10 years of treatment. The costs of our cultural fixation with being thin and fit and following “healthy” eating prescripts are great.
Benefits have yet to be demonstrated.
© 2007 Sandy Szwarc
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