Self-image, self-esteem and eating disorders.jpg

Self-image, self-esteem and eating disorders

By: Dr Maria Alice

[email protected]

I’m fat. I’m too skinny. I’d be happy if I were taller, shorter, had curly hair, straight hair, a smaller nose, bigger muscles, longer legs.

Do any of these statements sound familiar? Well, you are not alone if you are putting yourself down all the time.

Self-esteem is all about how much people value themselves, the pride they feel in themselves and how worthwhile they feel. It is extremely important because feeling good can affect how people act. A person who has high self-esteem is more in control of their behaviour, will make friends easily and will enjoy life more.

Self “body” image is how a person feels about their own physical appearance.

For many, especially those in their early teens, body image can be closely linked to self-esteem. As kids develop into teens, they care more about how others see them.

Some teens struggle with their self-esteem when they begin puberty because the body goes through many changes. All these changes, together with the natural desire to feel accepted, makes them compare themselves to the people around them or to actors and celebrities they see on TV, in movies or magazines.

The changing image of “beauty”

It’s not just development that affects self-esteem. Lots of other factors (like media images of skinny girls and bulked-up guys) can affect a person’s body image too.

Self-image and self-esteem have always been related to “fashion” and is repeatedly “impressed” in our minds by the media. With the skin and bone models of the catwalks, the image of beauty went from one extreme to the other and health wise the evolution has been dangerously negative.

Most of the very skinny women we see now in the fashion world are not yet “women”, they are just teenagers, masquerading as grown up sexy women.

What is forgotten is that a perfect body is a healthy body

After a 21-year-old Brazilian model, who began her modelling career at the age of 13, died of anorexia, top French couturiers denied that the fashion world was responsible for the pressure on young models to become excessively thin.

Her death came after the organisers of a major Madrid fashion show banned excessively skinny models, with a body mass index (BMI) of less than 18 (BMI takes into account height and weight) from their catwalks in September, on the basis of legislation aimed at fighting anorexia, a sometimes fatal illness in which people starve themselves to be thin.

The World Health Organisation considers anyone with a BMI below 18.5 underweight. A BMI below 17.5 is one of the criteria for the diagnosis of anorexia nervosa and a BMI nearing 15 is usually used as an indicator for starvation. The Brazilian model’s BMI was just 13.5.

Anorexia nervosa, an eating disorder characterised by an abnormal fear of becoming obese, aversion to food and severe weight loss, is a sad reality, a real social problem and many times starts with the search for a perfect body.

Another Uruguayan model had recently died during a fashion show in Montevideo.

Eating disorders

Eating disorders have always existed, but they have expanded in a frightening way. Their cause-effect relationship with images of extreme female thinness that the media fires at young people has yet to be proved wrong, although the fashion world denies any responsibility.

Eating disorders are characterised by a preoccupation with weight that results in severe disturbances in eating and other behaviours. They include anorexia nervosa, bulimia nervosa and binge-eating disorder.

Most people with eating disorders are females. Males can also develop eating disorders, but do so less frequently. The exception is binge-eating disorder, which appears to affect almost as many males as females.

Treatments may involve nutrition education, psychotherapy, family counselling and medication.

• Anorexia nervosa: Essentially is self-starvation. It involves a refusal to maintain a minimally normal body weight. In severe cases, anorexia can be life threatening.

• Bulimia nervosa: This involves repeated episodes of binge eating, followed by ways of trying to purge the food from the body to prevent expected weight gain. People can have this condition and be of normal weight.

• Binge-eating disorder: This is characterised by frequent episodes of overeating without purging.

It is often difficult to distinguish between an eating disorder and the whims and fads of adolescence. Parents need to be alert to sustained changes in dietary habits, not the occasional quirks that are part of growing up.

Many teenage girls and some teenage boys, go on diets to lose weight and stop dieting after a short time. As a parent, be careful not to mistake occasional dieting with an eating disorder. However, dieting can be a problem when your child stops gaining weight during pre-adolescent years. Your child should be gaining as much as 10 pounds a year.

Other behaviours that may indicate your child has a potential eating disorder:

• Not wanting to eat meals with the family.

• Frequent, long visits to the bathroom during or just after meals. Your teenage child may run water to obscure the sound of induced vomiting.

• Excessive exercise or preoccupation with weight.

Eating disorder behaviour

It appears that a variety of factors are involved, including genetics, family behaviour and culture. In some instances, researchers have found that the biological systems in the brain that govern appetite and digestion are not functioning properly.

A very relevant part of the explanation may also be the “messages” sent by the media in modern, economically developed nations to young people, particularly females, that excessive thinness is attractive. To be as thin as some teen idols and models requires some people to achieve and maintain a weight that is not healthy. Although it is possible for some idols and models to be both thin and healthy, the trouble arises when some young people are no able to sustain those body shapes without, for them, an unhealthy amount of weight suppression.

For some young people, the media message of thinness contributes to a distorted body image. A bright, high-achieving 14-year-old, who is rational in every other way may come to strongly believe that her ideal weight should be something that is totally wrong for a girl that age and for her frame. Gradually, she may begin skipping meals, denying herself the fuel her body needs to develop normally. She may get thinner and thinner, but still believe herself to be fat. Eventually, she may become so undernourished that she will need to be admitted to a hospital for treatment of anorexia.

When to seek medical advice

If you have severe weight loss or if you find yourself alternating between binge eating and strict dieting, talk to your doctor to see if you have an eating disorder and they can then do all the necessary tests to check for any related physical problems. Denial is often part of eating disorders, seeking medical advice may come only at the insistence of a family member or friend.

People with anorexia have a greater variety of health complications and a greater risk of death than do people with bulimia. However, both eating disorders can result in serious health problems.

It is estimated that as many as one in 10 people with anorexia will die from complications of the disorder.

What does “pretty” mean?

Be realistic. Do not accept what some of the media portray about what is a normal weight and what is an ideal body image.

The concept of beauty has changed through the centuries with different civilisations, but I strongly believe that even in our world of “making everything alike” the value of “being different” is not lost. Create your own image from the melting pot of your body and mind and improve it with only one limit, good health. Never forget to cherish your self-esteem. Well-balanced self-esteem will bring the best in you into the light.

If you have a positive body image, you probably like and accept yourself the way you are.

If self-image is realistic, you can set attainable goals leading to overall satisfaction.

It is all a matter of perspective.

A positive attitude and a healthy lifestyle (such as exercising and eating right) are a great combination for building a healthy self-image and self-esteem.

In 2007, build your own realistic, positive and healthy, personal self-image.

I wish this would be everyone’s New Year resolution for 2007.

Drª Maria Alice