Pro-Ana Websites - Teens and Eating Disorders

Source: Connect with Kids

“I would never want to look at one. I think that would be really depressing to tell you the truth.”

– Mary Hardin, 14 years old

What Mary doesn’t want to see, to millions others is just a few key words and mouse clicks away.

“Who’s the skinniest and how can they stay the skinniest (or) here’s how you can have only one thing to eat all day or how you can survive on water and gum,” explains Bryna Livingston, a licensed clinical social worker who specializes in eating disorders.

Livingston is referring to pro-anorexia websites – where girls are applauded for losing weight and surviving hunger – that are emerging on the Internet. On many such sites, anorexics journal thoughts and feelings and even post pictures of their thin celebrity idols.

“It’s a pseudo-support group, and the problem is you’re not really getting support,” says Livingston. “You’re feeding a competition. You’re feeding a disease, and you’re feeding what you want to hear so you don’t have to make any changes.”

For Mary Hardin, change was hard. She struggled with anorexia for three years. These websites, she says, spell danger. “I think (the websites) could have really made me worse and (made me) fall more into my eating disorder and encouraged me more,” she says. “That’s the last thing I needed was to be encouraged to be in an eating disorder.”

Experts say parents of anorexics have to show tough love, especially if their child is being enticed by these Internet sites. “I’d turn off the computer. I’d get it out of the house,” says Livingston.

Mary’s advice: “Listen to who you trust. Do you trust your family and your friends, or do you trust these people (on the Internet) that you don’t even know that are trying to give you lessons about your life?”

Luckily, Mary avoided the lure of anorexia websites when she was struggling with her illness. After years of therapy and family support, she says she is now healed. “It is possible to recover and to be a healthy girl with a happy life after it all,” she says. “There is hope to get through it.”

Tips for Parents

Many dangerous places exist in cyberspace, especially for those with body image difficulties. A quick, easy Google search can produce a long list of pro-anorexia and pro-bulimia websites – places where those who suffer from eating disorders (ED) support each other and establish a sense of community. There are at least 100 active pro-anorexia and pro-bulimia sites. Some statistics state that several of these sites have accumulated tens of thousands of hits. Many sites treat eating disorders as lifestyle choices, rather than the illnesses they truly are. Most personify anorexia (“Ana”) and bulimia (“Mia”) into companions – individuals one can look to for guidance and strength.

The medical community classifies eating disorders as mental illnesses. Experts say girls with eating disorders focus on their bodies in a misguided bid to resolve deeper psychological issues, believing that they can fix their inner troubles by achieving a perfect outside. Eating disorder specialists say pro-anorexia sites are particularly dangerous since those suffering from the disease are usually in deep denial and cling to the illness to avoid dealing with its psychological underpinnings. Websites that glorify eating disorders make treatment increasingly difficult.

Eating disorders have the highest mortality rate of any mental illness.
There are an estimated 7 million females and 1 million males suffering from eating disorders in the United States.
The Harvard Eating Disorders Center estimates that 3 percent of adolescent women and girls have anorexia, bulimia or binge-eating disorders.

Four-of-five 13-year-old girls have attempted to lose weight.

One study showed that 42 percent of first- through third-grade girls want to be thinner.

About 1 percent of females between 10 and 20 have anorexia nervosa. Between 2 percent and 3 percent of young women develop bulimia nervosa. Almost half of all anorexics will develop bulimia or bulimic patterns.

Without treatment, up to 20 percent of people with serious eating disorders die. With treatment, the mortality rate falls to 2 to 3 percent. The recovery rate with treatment is about 60 percent. Alas, only 10 percent of those with eating disorders receive treatment.

Pro-ED sites are just one reason why parents need to monitor children’s online behavior. In the web journals or logs (blogs) of these sites, users share near-starvation diets, offer tips for coping with hunger and detail ways to avoid the suspicions of family members. They post "thinspiration" – images from the media of their ideal celebrities, such as supermodel Kate Moss and the Olsen twins. They discuss extreme calorie restriction and weight loss through laxatives, diet pills and purging (self-induced vomiting).

Between the ages of 8 and 14, females naturally gain at least 40 pounds.
More than half of teenage girls are – or think they should be – on diets.
Websites were changing the very culture surrounding eating disorders, making them more acceptable to girls on and off the Internet.

Pro-ED sites thrive off the denial aspect of the illnesses while promoting the perceived benefits of having an eating disorder.

References
Anorexia Nervosa and Related Eating Disorders, Inc.
Harvard Eating Disorders Center
The National Institute of Mental Health
Reuters
Socialist Voice of Women
South Carolina Department of Mental Health

Obesity Top Concern for Kids

Source: http://www.connectwithkids.com/

“Do it as a family. Kick them off the couch, get your exercise, stock your house with all kinds of healthy things and try to establish good eating habits, good healthful behaviors.”

– Kathleen Zelman, American Dietetic Association

American kids are getting fatter.

Is it the food they eat? Fifteen-year-old Tony says his diet was definitely unhealthy. “Chips, popcorn, soda, you name it. If it was there, I’d eat it,” he says.

How much they eat? Eighteen-year-old Matt admits he used to go overboard. “I would eat whole bags of potato chips. … We’d have two-liter bottles of soda; I’d drink probably the whole two liters … in a night,” he says.

Is it lack of exercise? “It’s OK if we want to sit at home, and play video games, and eat all day, and do nothing. I mean, our society has kind of put us that way,” says Jonathan, 16.

Or too much stress? Pediatric dietician Marilyn Tanner says, “It’s very common for kids – and adults – to use food as sort of a coping mechanism.”

The answer? It is all of these.

And according to the C.S. Mott Children’s Hospital, for the first time this year, childhood obesity tops the list of concerns parents have for their children.

But how can parents turn the tide?

Kathleen Zelman of the American Dietetic Association says: “Do it as a family. Kick them off the couch, get your exercise, stock your house with all kinds of healthy things and try to establish good eating habits, good healthful behaviors.”

Brenda Johnson, mother of an overweight child agrees. “Then it becomes a part of your lifestyle, and that’s what we’re trying to do. We’re trying to change our lifestyle to not being sedentary, but being active and making better choices,” she says.

It isn’t easy. And television, cars and fast food don’t make it any easier, but making better choices means exercise and a healthy diet.

Fifteen-year-old Tony knows that it takes hard work to shed extra pounds. “I wish, wish, there was some kind of a magic pill you could take, but there isn’t. You just gotta struggle through it,” he says.

Tips for Parents

In the past 30 years, childhood obesity has doubled for children between the ages of 2 and 5 and tripled for 6- to-11-year-olds. More than 15 percent of children between 6 and 19 are considered obese. Countering that trend, child advocates say, will require nothing less than a multi-pronged national effort.

Today, less than 6 percent of high schools require juniors and seniors to take physical education. There is also an "enormous decrease" in the number of school playgrounds. And recess has disappeared in many elementary schools where principals, anxious about preparing students for high-stakes standardized tests, have deemed it "nonproductive."

Efforts are under way to reinstate physical education. Recommendations include a minimum of 150 minutes a week for elementary school students and 225 minutes for high school students.
The Council of Educational Facility Planners International dropped its recommendations calling for vast acreage for large school sites, which will give school districts more flexibility in locating schools on smaller sites in places accessible by walking and biking

By one estimate, 65 percent of students walked to school 30 years ago. Today only 10 percent do.

For more than 14 million children, accounting for 25 percent of students between kindergarten and 12th grade, no parent is home after school. The child must take care of himself or herself. Many receive strict instructions from parents: Lock the door and don't go outside. It's a recipe for inactivity and an opportunity to snack. Only 11 percent of students (6.5 million) attend after-school programs, where they are likely to get a nutritious snack and take part in fitness activities.

The reasons for childhood obesity are complex and cannot be pigeonholed in a single or few causes.

Among the reasons experts cite are:

Kids’ backpacks are too heavy for walking too school.
Children rely on school buses or family vehicles for daily transportation.
Parents are concerned for kids’ safety and no longer permit outside, unsupervised play.
More homework allows less time for play.
Many schools have stopped scheduling recess.
Toy vehicles of today are not kid-powered, but battery-powered.
Computer games stimulate sports, rather than kids actually playing the sport.
Kids often eat due to stress or boredom.

Although cafeteria menus are coming under fire, the problem goes beyond what children eat to include when they eat. Crowded schools must extend lunch hours to serve everyone. An early lunch hour may come when the kids aren't hungry, they may not eat a healthy meal, and then they'll snack later. With a late lunch hour, kids might snack first and not be hungry for a good lunch. Finally, students also have limited time to eat. We're trying to get them to eat healthier food, but that takes time to chew.

References
C.S. Mott Children’s Hospital
The Centers for Disease Control and Prevention
The Christian Science Monitor
KidsHealth
WebMD Health

Sue Scheff: Family Dinners and Eating Disorders

By Connect with Kids

“If you have dinner with your family, including your kids, five nights a week, you have amazing results. You seem to have less incidence of a lot of problems that parents worry about with their teens.”

– Nancy McGarrah, Ph.D., psychologist

The average American woman is 5’ 4” and weighs 140 pounds. The average American model is 5’ 11” and weights 117 pounds. For millions of girls, that difference translates into dangerous eating disorders and extreme diets. What can parents do to help protect their daughters?

Sometimes starvation diets, binging and purging, or overuse of diet pills are used to correct a flaw no one else can see.

“I just see myself as really fat and gross,” says Lauren, 16.

‘I started buying fitness magazines and they all said to diet. I just couldn’t see reality. I saw fat where there wasn’t any,” says Maggie, 17.

‘I think I’m really fat right now, and that’s why I want to lose weight,” says Shelby, 18.

A new study in the Archives of Pediatrics and Adolescent Medicine reports a positive way to reduce the risk of an eating disorder: having regularly-scheduled family dinners.

“If you have dinner with your family, including your kids, five nights a week, you have amazing results. You seem to have less incidence of a lot of problems that parents worry about with their teens,” says Nancy McGarrah, Ph.D., psychologist.

In fact, the study found that teen girls who regularly had dinner with their family were 30 percent less likely to go on extreme diets or develop an eating disorder. Why? For one thing, experts say parents who sit and eat a healthy meal with their kids are good role models.

“Studies show time and time again that children model parents’ behavior with food,” says Rachel Brandeis, American Dietetic Association.

But experts also say that eating disorders are emotional disorders, and a family meal is a chance for kids to be with those who love them the most. That can help counteract what causes eating disorders in the first place.

“You’re having time with the family, you’re showing your commitment to your kids, you are tailoring your day around your kids, you’re having them tailor their day around that important time, and you’re having open communication,” says McGarrah.

Tips for Parents

Shared family meals are more likely to be nutritious, and kids who eat regularly with their families are less likely to snack on unhealthy foods and more likely to eat fruits, vegetables and whole grains. (Nemours Foundation)

Teens who take part in regular family meals are less likely to smoke, drink alcohol or use marijuana and other drugs, and are more likely to have healthier diets as adults. (Nemours Foundation)

Girls who have five or more meals a week with their families are one-third less likely to develop unhealthy eating habits, which can range from skipping meals to full-fledged anorexia or abusing diet pills. (Substance Abuse and Mental Health Services Administration, SAMHSA)

The importance of regular family activities to share ideas and find out “what’s happening” is a great way for a parent to be involved, discuss rules, monitor activities and friends, and be a good role model. (SAMHSA)

The benefits of eating together will last long after your meal ends, especially if you make family mealtimes a regular activity. (SAMHSA)

References

Nemours Foundation
Substance Abuse and Mental Health Services Administration (SAMHSA)

Breakfast Reduces Obesity by Connect with Kids

“The kids get all their stuff ready at nighttime, including clothes and packing backpacks and all that, because if we don’t, in the morning there’s no way that we could have time for them to eat breakfast, ever.”

– Yvonne, mother

It’s an old adage: breakfast is the most important meal of the day. And yet, an estimated 25 percent of children regularly skip it. Now, there is new research showing that eating at the beginning of the day saves calories the rest of the day.

“Do you have everything you need for school?” asks Yvonne, mother.

In lots of families, mornings are chaotic. Share the bathroom, get the kids dressed, pack up the book bag -- which often leaves no time for breakfast. But not at the Gonzalez home.

“You just want one egg each, or you want two?” asks Yvonne.

“It gets you up and running, and has lots of nutrition in it,” says Victoria, 9.

“The kids get all their stuff ready at nighttime, including clothes and packing backpacks and all that, because if we don’t, in the morning there’s no way that we could have time for them to eat breakfast, ever,” says Yvonne.

Researchers at the University of Minnesota studied more than 2,000 teens for five years. They found that teens who eat breakfast on a regular basis weigh less and eat a healthier diet than kids who don’t eat breakfast. Experts say skipping that first meal makes youhungrierlater in the day.

“And when we finally eat, we are ravenous and we are craving. And now we want a quick fix. And we want sugar and we want carbs and we want fat, and that’s what we eat,” says Dr. Ranveig Elvebakk, bariatric physician.

And that, says the doctor, forces the body to produce more insulin.

“This insulin brings the blood sugar into the cell, and what does the cell say? It says ‘I cannot possibly deal with all this sugar; I need to transform it and store it somewhere.’ Then you slowly plump up,” says Elvebakk.

One solution, experts say, is not skipping breakfast, and instead, having something substantial such as eggs or toast or cereal.

“You ate it all? Oh my goodness!” says Mom

Tips for Parents

Children who eat breakfast tend to have more adequate nutrient intake than children who do not.
By eating breakfast, students also get more of the important nutrients, vitamins and minerals such as calcium, dietary fiber, folate and protein. (Food Research and Action Center)

A higher percentage of children who skip breakfast do not meet two-thirds of the Recommended Dietary Allowance (RDA) for vitamins A, E, D, and B. (Food Research and Action Center)

Adolescents who eat breakfast tend to have a lower body mass index (BMI). Higher BMIs can indicate overweight and obesity. Girls who eat breakfast are more likely to have a lower BMI than girls who skip breakfast. (Food Research and Action Center)

Adolescents with one or two obese parents who eat breakfast every day are more likely to have BMIs within a healthy range than those who tend to skip breakfast. (Food Research and Action Center)

Try to serve a balanced breakfast that includes some carbohydrates, protein and fiber. Good sources of these nutrients include: (Nemours Foundation)

Carbohydrates: whole-grain cereals, brown rice, whole-grain breads and muffins, fruits, vegetables

Protein: low-fat or nonfat dairy products, lean meats, eggs, nuts (including nut butters), seeds, and cooked dried beans

Fiber: whole-grain breads, waffles, and cereals; brown rice, bran, and other grains; fruits, vegetables, beans, and nuts

References

Food Research and Action Center
Nemours Foundation

Unpopular Girls Gain Weight by Connect with Kids

“There was nothing I could do about it and … as a result, when you feel that left out, you find comfort in other things. And I think one of the things I found comfort in is food.”

– Sarah, 14

Are girls bullied because they are overweight, or do they gain weight because they are bullied? The findings of a Harvard study may surprise you.

In the 4th grade, Sarah was bullied by several of her classmates.

“They just figured, ‘we’ll be cool,’ whatever cool is, and cool was not talking to me,” says Sarah, 14.

She felt hopeless and alone.

“There was nothing I could do about it and … as a result, when you feel that left out, you find comfort in other things. And I think one of the things I found comfort in is food,” says Sarah.

Researchers at the Harvard School of Public Health followed more than 4,000 girls for two years. They found that girls who ranked themselves at the bottom of the social ladder were 69 percent more likely to gain weight than girls who were perceived to have a higher social standing.

“That kind of chronic experience increases the risk of all kinds of unhealthy ways of coping with the negative experience,” says Dr. Randall Flanery, Ph.D., child clinical psychologist.

Unhealthy coping includes overeating.

“Pushing that emotion down with food … pushing that away from having to deal with it … and the comfort, the one thing that is a nice warm hug, is that food which calms them down and makes them feel like, ‘Okay, I’m alright,’” says Marilyn Tanner, pediatric dietician.

Sarah eventually did make friends at her school. What is her advice today for other kids?

“You have to tell someone because even if they don’t do anything about it, even if the situation isn’t helped, talking about it does wonders,” says Sarah.

Tips for Parents

Many people who use food as a way of dealing with emotions suffer from “binge-eating disorder.” Binge-eating disorder is characterized by recurrent overeating or binge-eating episodes during which a person feels a loss of control over his or her eating. (National Institute of Mental Health, NIMH)
Unlike bulimia, binge-eating episodes are not followed by purging, excessive exercise or fasting. As a result, people with binge-eating disorder often are overweight or obese. They also experience guilt, shame and/or distress about the binge-eating, which can lead to more binge-eating. (NIMH)

Obese people with binge-eating disorder often have coexisting psychological illnesses including anxiety, depression and personality disorders. In addition, links between obesity and cardiovascular disease and hypertension are well documented. (NIMH)
If you are overeating often, there are some things that might help you avoid doing so. For example, instead of eating when you're not hungry, find other ways to keep yourself busy, such as taking a walk or talking on the phone. Try not to snack while doing something else, such as watching TV or doing homework -- that's a set-up for overeating! (Nemours Foundation)
Know yourself and your reputation. Get in touch with your values, interests and beliefs. If you are encountering cliques and/or exclusion at school, it's a good opportunity to ask yourself what you and your true friends give each other. Do you want to be part of a group because you need to feel accepted or because you actually share their values? (Nemours Foundation)
Stay involved in activities that make you feel good about yourself. Keep your social circles open and diverse.
Speak out. If you feel your group of friends is turning into a clique, take a stand for your beliefs. Be prepared that the clique might go on without you (remember many girls feel threatened by someone else's strength). Have a mind of your own.
Be sensitive to others and don't go along with what you don't believe is right — even if others are doing it. You are the only one responsible for your behavior. True friends will respect your mind, your rights and your independent choices. (Nemours Foundation)

References

National Institute of Mental Health (NIMH)
Nemours Foundation

Sue Scheff: Binge Eating by Connect with Kids

“Sandwiches, cookies, candy bars -- I have no idea how many candy bars. Just everything I could get my hands on, and I’d just continuously eat until I went to bed.”
– Matt Wymer, 18

Anorexia and bulimia are the names that come to mind when we think of eating disorders. But there is another eating disorder more common than anorexia and bulimia combined, and some experts say it’s becoming a major health problem in America.

“As soon as I came home I’d throw down my backpack and just automatically start going through the refrigerator and cabinets and start eating. Sandwiches, cookies, candy bars -- I have no idea how many candy bars. Just everything I could get my hands on, and I’d just continuously eat until I went to bed,” says Matt Wymer, 18.

Matt was a binge eater. According to a new study from Harvard Medical School, 3.5 percent of women and 2 percent of men suffer from this eating disorder.

While these are small percentages, they translate into millions of people. Experts say that binging is a condition that often starts in childhood.

“You know we start at a very young age… you fall and scrape your knee [and someone says], ‘Oh, here, we’ll go get some ice cream, that’ll make it feel better.’ Or you go to the doctor, you get a lollypop; something bad happens, ‘Oh, here’s something that’s comforting,’” says Marilyn Tanner, R.D., pediatric dietician.

Matt looked for comfort because he was constantly teased about his weight.

“There’d be days when I’d come and pick him up from school and he’d get in the car and he’d start crying before I asked him anything,” says Cathy Wymer, Matt’s mother.

“I probably gave him whatever he wanted to try to make him happy, but it was the wrong way of doing it,” says Vernon Wymer, Matt’s father.

“I just felt better after I ate a lot,” says Matt.

Experts say the first line of treatment for binge eaters is to help them find other ways, besides food, to feel better.

“There are about five basic ways … that it just kind of boils down to. You write, you talk, you cry, you exercise, you laugh. Laughing also reduces the stress that lots of times people are feeling,” says Genie Burnett, Psy.D., clinical psychologist.

With the help of his doctor, Matt started a diet and a daily workout. He’s lost more than 150 pounds, he’s healthier and he says he’s more confident.

“I guess you’d say I’m happier than I used to be,” says Matt.

Tips for Parents

Most people don’t even recognize they are engaging in emotional eating until they’ve gained a lot of weight. Parents should learn to recognize the warning signs – being overweight, having a history of weight fluctuations, eating alone, hoarding food, eating rapidly, eating until uncomfortably full, and having feelings of guilt or depression after eating. (The American Dietetic Association)

Experts say encouraging kids to express their feelings can lower a child’s need to binge. Have younger kids draw pictures of how they are feeling. Afterward, discuss the drawings. (The American Dietetic Association)

When older children feel the need to binge, distractions may help. Find other things to do such as walking, riding a bike or playing with the dog. (The American Dietetic Association)

Keep the kitchen stocked with plenty of fruits and vegetables. If children feel like binging, encourage them to have a small, healthy snack instead. (The American Dietetic Association)

References

The American Dietetic Association

Connect with Kids: Anorexia and Eating Disorders

“It was definitely an obsession and giving that up was incredibly hard, it was like asking me not to breathe.”

– Kathryn, 17

Hundreds of thousands of girls in the U.S. struggle with anorexia, which is an obsession to be thin. According to the National Institutes of Health, as many as one in 10 will die from the disease.

How does this obsession begin in a young girl’s mind?

When she was 15, Kathryn was desperate to be thin.

“It was definitely an obsession and giving that up was incredibly hard; it was like asking me not to breathe,” says Kathryn, 17.

Kathryn developed anorexia; she may have inherited from her mom.

“I think I clearly had some sort of eating disorder as an adolescent,” says Kathy, Kathryn’s mother.

One study of anorexic women found that many of them shared a propensity for perfection, a trait experts think could also be genetic.

Along with genetics, experts say sometimes parents unintentionally encourage eating disorders. What do experts advise? Avoid the “d” word. “I never like to hear it, especially when kids are involved with the word diet. That’s kind of a restrictive word. You shouldn’t restrict your kids from having different types of food.

What I do recommend is making sure that they have healthy options at home,” says Sara Price, personal trainer.

Next, remember that parents are role models and your children are watching.

“Moms who are so ultra-concerned about weight and size because of their own struggles, even with a child who doesn’t have a problem, may be putting undue concern and focus on this. Creating a fear, creating an anxiety,” says Paige Love, registered dietician.

Non-stop diets, weighing and measuring food, counting every calorie, and constantly weighing yourself can all send a message.

“You don’t want to trigger eating disorders, which you really can. You can get obsessive with food and calories and exercise; you can create a monster that you will regret,” says Kathleen Zelman, registered dietician.

Experts say that the best advice is also the most obvious: focus on who your child is, not how much he or she weighs.

“Listen to your daughter. If you actually hear who she is, what she thinks, what she feels, what her true self is, then that’s what you value more than how she looks. Then she’ll start to believe that that’s sufficient,” says Rick Kilmer, Ph.D., licensed psychologist.

Kathryn is better now, but it took months of love and support and therapy.

“I’ve come a long way physically, but more so mentally. I was lucky, definitely lucky,” says Kathryn.

Tips for Parents

Warning signs of Anorexia: (Nemours Foundation)
Drops weight to about 20% below normal
Denies feeling hungry
Exercises excessively and feels fat
Withdraws from social activities

Therapy or counseling is a critical part of treating eating disorders and in many cases, family therapy is one of the keys to eating healthily again. (Nemours Foundation)

The most critical thing about treating eating disorders is to recognize and address the problem as soon as possible like all bad habits, unhealthy eating patterns become harder to break the longer a person takes part in them. (Nemours Foundation)

Carefully consider comments you may make, about other people’s appearance and weight. (Bellott Clinic, Eating Disorder Clinic)

Eating disorders can be triggered by a major life change or trauma for a child. Be particularly attentive after such events as a divorce or moving to a new city. (Bellott Clinic, Eating Disorder Clinic)

References

Nemours Foundation

Bellott Clinic, Eating Disorder Clinic