Back to school means more than just new clothes, new classes and new friends. It can also mean worry about looks, image and weight. These worries can quickly turn into the nightmare of an eating disorder.
A new school year brings concerns to every youngster. She wants to fit in, be liked and feel accepted. She feels the pressure of performing up to standards expected of her by her parents, teachers and coaches. This can be a very stressful time even in a young life.
Part of fitting in these days, especially in New York where the fashion industry and theater play such a visible and influential role, is being thin. Messages to take it off and keep it off are not just heard by teenagers and adults, they create strong impressions and concern in children as young as five. The majority of 4th, 5th, and 6th grade girls have already been on at least one diet. This is during the growing years when restricting intake can severely affect the natural maturation of bones, muscles and hormonal processes.
Dieting too much and too early can lead to anorexia or bulimia, compulsive eating, weight problems, or an obsession with appearance at the expense of self-esteem. When ones focus on body image, thinness, weight and appearance becomes all-important, a young girl begins to define herself as likable or acceptable because of how she looks. This reinforces her need to stay thin at any cost. The next step is very easy.
She begins to starve herself by skipping meals, avoiding taboo foods, and denying her hunger. She loses more and more weight until her body thinness becomes alarming to others and threatens her health and ability to perform. She has become anorexic.
She may turn instead to purging calories by self-induced vomiting, fasting, over exercising, or taking laxatives after eating. She becomes hungry. She eats again and purges again. She has become bulimic. She feels horrible about herself, but her fear of gaining weight prevents her from keeping anything in. Her secret life is kept hidden from others at all costs
Her repeated dieting may also lead to weight gain. Her metabolism becomes confused about whether it will be fed each day or not, so it slows itself down to protect the body from starvation. This means every calorie has a higher impact.
If nothing else, this young girls obsession with body size and weight gets in the way of her hearing her bodys cues about when it is hungry and what it really wants to eat. Rather than sensing whether she is full or hungry, she decides when and what to eat based on her notion of what she should be or should not be eating. If her body really needs something else, she will still feel hungry and may continue to eat. This compulsive eating leads to a battle of willpower and usually a feeling of being out of control and at the mercy of ones body.
Preventing and treating weight and eating problems should begin early and with the family. Parents can help a lot by not emphasizing dieting and body weight. Avoid diet clubs, remarks about weight and teasing, which can damage a young girls esteem, especially if it comes from a father or brother. Create an atmosphere of acceptance. She needs positive remarks about the positive parts of her appearance, personality and abilities. Parents can also help by not getting involved in clothing choices. Allow the child to begin developing autonomy so she feels good about herself. Finally, do not make a big deal about what and how much she is eating.
If a weight problem or eating disorder develops, the parents should first see an eating disorder therapist to see if they can change the way food is handled in the family.
Once a child is in therapy for these problems, the focus will usually be to help her redefine her self-esteem in other terms than food and body weight. There are a variety of options in New York.
Education in the schools through special lectures and additions to curriculum is essential to help students develop a normal relationship with food. This is especially important in New York because of the unusual emphasis on thinness. Each young person ideally needs to find what body size is comfortable for her physically and emotionally.
______________
Joanne Gerr provides eating disorder counseling and group therapy in Manhattan and Central New Jersey.
