• The introduction of western television in Fiji caused a dramatic increase in the rate of eating disorders.
• One in every four TV commercials puts out some sort of message about attractiveness.
• One study documented that watching music videos featuring thin women led to an increase in body dissatisfaction
• In a survey carried out by People magazine, 80% of those who took part responded that images of thin women on TV and in the movies make them feel insecure.
• Actresses Julia Roberts and Cameron Diaz, as well as singer Diana Ross all meet the Body Mass Index physical criteria for Anorexia.
• Model/Actress Elizabeth Hurley stated in Allure magazine “I’ve always thought Marilyn Monroe looked fabulous, but I’d kill myself if I was that fat.”
• Pamela Anderson is 5’7” and weights 120 pounds. She is supposed to be the voluptuous ideal yet she is 11% below ideal body weight. In contrast, Marilyn Monroe set the beauty standard for her generation at 5’5” and weighed 135 pounds. Today her agent would probably tell her she had to lose weight!

It is irrefutable that the media has had a major impact with regard to the increase in eating disorders such as anorexia and bulimia. The population is constantly bombarded with images of over-thin models and messages reinforcing the idea that, to be happy and successful, we must be thin. We are constantly told that fat is bad. Magazines, newspapers, television advertisements – everywhere you look you will find references to ‘thin’. Not only adults are affected – these images and messages are reaching our younger generation, with the result that many adolescents often feel flawed or disfigured if their weight and body shape does not conform to that of ultra-thin models and actors. Can you name 5 current female television personalities who are overweight?

Isn’t it about time that the media owned to a responsibility for the current trend?

Mention eating disorders to the majority of people and they will probably imagine someone who is ‘stick thin’ or emaciated. They cannot picture someone who is overweight or obese.

Admittedly, anorexics and bulimics will often present in this way – but not all eating disorder sufferers are obsessed with starving themselves.

Binge eating disorder, often triggered by stress or trauma, is a condition which, for most sufferers, means that eating has become something that they can no longer control. They are powerless to stop or even slow the rate at which they are ingesting food. Without the accompanying bingeing or purging associated with bulimia, sufferers experience rapid weight gain which, in turn, impacts on the individual’s physical health and mental well-being, as well as personal relationships and social development.

Binge eating disorder is not simply occasional overeating; nor is it having the odd extra slice of cake or pizza. Sufferers experience this problem on a regular basis and are often ashamed of their behavior, withdrawing from social life in order to hide their inability to control their eating habits.

• In one study, 3 out of 4 women interviewed said they were overweight, although only 1 out of the 4 actually was
• Four out of five women in the U.S. admit they are dissatisfied with their appearance
• 81% of ten year old girls admit to being afraid of being fat
• 42% of first thru third grade girls stated they wanted to be thinner
• One study found that adolescent girls were more afraid of gaining weight than of getting cancer or losing their parents
• Over half of normal weight, white, adolescent girls perceive themselves as being fat
• Pre-school children, offered dolls identical in every respect except weight, chose the thin doll in 9 out of 10 instances
• A study asking children to assign attractiveness values to pictures of children with a variety of disabilities found that participants found an obese child less attractive than a child in a wheelchair, with a facial deformity or missing a limb
• One study found that women overestimate the size of their hips by 16% and their waists by 25%, even though they could correctly estimate the width of a box
• A survey in Glamour magazine found that 61% of those surveyed said they were ashamed of their hips, 64% were ashamed of their stomachs and 72% were ashamed of their thighs
• In a survey, 30% of women chose an ideal body shape 20% underweight. An additional 44% chose an ideal body shape 10% underweight
• Poor body image is one of the first evidenced symptoms of an eating disorder

• One in three women and one in four men are on a diet at any one time
• 35% of occasional dieters move on to compulsive dieting
• Two in every five women and one in every five men would trade several years of their life to achieve their ideal weight.
• The diet products industry has a turnover of $33 billion a year
• In 1970 the average age for a girl to begin dieting was 14; by 1990 the average age had dropped to 8.
• One half of 4^th grade girls are on a diet.
• 51% of 9 and 10 year old girls stated that they felt better about themselves when they were dieting.
• Whilst only 10% of high school girls are overweight, 90% of high school juniors and seniors admit to dieting.
• Over 70% of girls who purge, or use diet pills, frequently read women’s health and fitness magazines.
• 95% of those who diet, as opposed to maintaining a healthy food regime, will regain their lost weight within 5 years.

People picture bulimia sufferers as individuals who consume enormous quantities of food and then induce vomiting to rid themselves of the unwanted calories. This is often an accurate description – but not always! Some elect to indulge in excessive amounts of exercise to counteract the effects of their bingeing.

In some instances over-exercising can have the desired effect of keeping weight down – bingeing twice a week and excessive exercise a day can maintain an even body weight; but reverse the behaviors and the individual will actually become overweight.

Extreme exercise regimes are dangerous and can result in various medical complications:

• Stress fractures of bones, typically in weight bearing areas such as the feet and legs, are more common in eating disorder patients who, because of their illness often suffer from osteopenia (bone loss) or osteoporosis (brittle bones).

• Bradycardia or low heart rate occurs in response to rapid weight loss, whereby the body attempts to protect itself from further weight loss by slowing the metabolism. This can be potentially fatal.

• Amenorrhea results from significant and rapid weight loss. It results in osteopenia and osteoporosis. These are dangerous losses of bone density that can result in other more serious complications.

• Endorphin levels are increased during excessive exercise, producing a sense of well being that remains even when an individual is seriously compromising their health. Studies are being carried out to better understand the possible addictive nature of exercise.

In trying to evaluate whether exercise levels have gone from reasonable to excessive, the following questions can be asked:

1. Do you feel guilty if you miss your workout?
2. Do you still exercise when you are sick or hurt?
3. Would you avoid  going out with friends or spending time with your family, just to ensure you got your workout in?
4. Do you freak out if you miss a workout?
5. Do you calculate how much to exercise based on how much you eat?
6. Do you have trouble sitting still because you’re not burning calories?
7. If you’re unable to exercise, do you feel compelled to cut back what you eat that day?

Someone who answers ‘yes’ to one or more of these questions may be exercising too much and endangering their health as a result.

Family relationships are important to psychological health and as such the family is an integral part of the recovery process and a fundamental part of the solution.

Family Systems Therapy is a branch of psychotherapy, working with families and couples, to bring about change and development within relationships.

At Sovereign Health of California, all our programs include family therapy sessions and families and partners are included as an integral part of the patient’s treatment. All treatment programs are individually tailored to suit the particular needs of the patient, whether it is an eating disorder, alcoholism, addiction, dual diagnosis or any other form of disorder. That is why treatment at Sovereign Health of California really works. Our success rate speaks for itself!

Sovereign Health’s eating disorder treatment program also offers a transitional living program. The eating disorder transitional living program at Sovereign Health helps patients suffering from eating disorders continue their treatment in a less restrictive setting. Patients continue to have access to eating disorder treatment services whilst living in an apartment. The transitional eating disorder treatment program allows people to work or go to school, in a semi-structured setting, with help just around the corner should the person need it.

The Transitional Living Eating Disorder treatment program is designed to build upon what patients have learned in the primary eating disorder treatment program at Sovereign Health of California. Aftercare treatment is a key element in successful recovery from eating disorders and the transitional living program offers exceptional aftercare treatment services in an outpatient setting for those suffering from an eating disorder.

Bulimia nervosa is a psychiatric disorder focusing on food. Bulimics consume tremendous amounts of food – often thousands of calories – in a short space of time, subsequently purging it from their bodies by self-induced vomiting or laxative or diuretic abuse.

Bulimics may binge and purge 20 to 30 times a day. This is tremendously hard on the human body. Medical complications can include damage to the esophagus, stomach, intestines and teeth and gums. In extreme cases the kidneys and heart can sustain irreparable damage.

The emotional consequences of bulimia can be equally catastrophic. Unlike an anorexic, who is proud of the way she appears, a bulimic suffers shame and guilt over their behavior. Bulimics have also been known to steal food when they have insufficient funds to purchase the necessary huge volumes of food.

Professional care is realistically the only way to overcome bulimia. Typically commencing with outpatient therapy, it is not unusual for inpatient care, with a higher degree of monitoring, to be needed to achieve long term recovery.

From:  A Therapist’s Notes: Self-Esteem, Relationships, Guilt and Other Messy, Complex Stuff Made Simpler

Mirror, Mirror on the Wall…

Sarah Steinmeyer, Ph.D.

A recent issue of The New Yorker features a cartoon in which a woman shopper, with an armload of garments, complains to the sales clerk, “I want that dressing room mirror fired!”  If only it were that easy!

Almost everyone has trouble with what he or she sees in the mirror. In response to our image on that silver surface most of us immediately adopt a critical mode: our thighs are too thick; our stomach is too big; our arms look awful; we have the beginning of a double chin and new bags and wrinkles seem to have sprouted over night. A few moments of this kind of self-punishment make it very difficult to face the day with much enthusiasm.

We go to the mirror with hopeful expectations. We don’t want to see what we ‘look like’, because we are pretty sure that it’s not good enough. We want to see what we want to look like. I’m just as vulnerable as the next person to this phenomenon. For example, I go to the mirror wanting to look 20 pounds lighter and 10 years younger. Every morning there’s a secret part of me that says, “This is going to be the day when the mirror says what I want to hear.” Of course, every day my mirror says, “Are you serious?” I am always disappointed.

Not everyone has this ‘reflection’ reaction. My granddaughter, aged four, was checking herself in the mirror as she tried on a skirt she hadn’t worn in some time. Her mommy commented that it looked a little tight. “I know,” said my granddaughter, “but I sure look good!” It is sad to think that perhaps in a few years the fit of the skirt will define her for the day.

How does the mirror come to have such power? Well, we start with the belief that the mirror image is ‘accurate’. We assess what we see against what we believe is some socially acceptable standard and we are instantly and inevitably struck with such an assortment of inadequacies that our very membership to society seems likely to be revoked. “I’m too ___ to be acceptable. Nobody is going to like… want to be around …someone like me,” a mindset that makes it impossible for anything positive to sneak in. After all, anyone who looks like we do in the mirror couldn’t deserve nice things from others.

Let’s agree to approach the mirror with a different attitude. Like I said, I am no less vulnerable than any other adult woman when it comes to feeling uncomfortable about what I see there. But the advantage I have is the absolute confidence that nobody on the face of the planet can see what I see in my mirror. Those with whom we interact throughout the day do not expect us to suddenly appear in our ideal form. They would in fact be shocked out of their socks if we did. They expect to get exactly what they get—the ‘us’ of the moment. We all do. It’s not only enough ? it is in fact reassuring. “What I see in the mirror stays in the mirror,” might be an appropriate mantra as we leave the bathroom.

But of course, there will always be those moments when we have to address ourselves in those dreadful dressing room mirrors. Perhaps we could mandate that they be embossed with the following warning: “Caution: Objects in the mirror will appear to be larger and older than is actually the case.”