DO YOU HAVE AN EATING DISORDER? · 6. Crossword Puzzle 17 7. Role Models 20 8. The “Perfect” Body 21 9. Role Play 22 10. Value ... look like the ultra-thin celebrities they see

8085DV

DO YOU HAVE AN EATING DISORDER?

DVD Version

ISBN-13: 978-1-55548-683-9 ISBN: 1-55548-683-5


CREDITS

HUMAN RELATIONS MEDIA DO YOU HAVE AN EATING DISORDER?

Executive Producer Anson W. Schloat

Producer Peter Cochran

Consultant Lynn Grefe, CEO

National Eating Disorders Association www.nationaleatingdisorders.org

Special Thanks To Jenni Schaefer

Author of Life Without Ed: How One Woman Declared Independence from Her Eating Disorder and How You Can Too

www.jennischaefer.com

Teacher’s Resource Book Bonnie Denmark

Donna Giachetti

Sara Schloat

Matthew Wollin

Copyright 2009 Human Relations Media, Inc.


TABLE OF CONTENTS

HUMAN RELATIONS MEDIA DO YOU HAVE AN EATING DISORDER?

DVD Menu i Introduction 1 Learning Objectives 3 Program Summary 4

Student Activities

1. Pre/Post Test 9

2. Know the Signs 11

3. A Cry for Help 13

4. The Media 14

5. Class Debate 16

6. Crossword Puzzle 17

7. Role Models 20

8. The “Perfect” Body 21

9. Role Play 22

10. Value Who You Are 24

Fact Sheets

1. What is Anorexia Nervosa? 25

2. What is Bulimia Nervosa? 26

3. Eating Disorders and the Media 27

4. How to Help a Friend 29

5. Developing a Positive Body Image 30

6. National Organizations 31

7. Internet Resources 32

8. Bibliography 33

Other Programs from Human Relations Media 34


DVD MENU

HUMAN RELATIONS MEDIA i DO YOU HAVE AN EATING DISORDER?

MAIN MENU

PLAY

CHAPTER SELECTION

From here you can access many different paths of the DVD, beginning with the introduction and ending with the credits.

1. Introduction

2. What are Eating Disorders?

3. Shame and Blame

4. Health Consequences

5. What Causes Eating Disorders?

6. Biology and Environment

7. Warning Signs

8. How You Can Help

9. Recovery

TEACHER’S RESOURCE GUIDE

A file of the accompanying Teacher’s Resource Guide is available on the DVD. To open the file you need to load the DVD onto a computer that has a DVD-ROM and Adobe Acrobat Reader. Right click on the DVD icon and then double click on the file titled “Teacher’s Resource Book.”


INTRODUCTION

HUMAN RELATIONS MEDIA 1 DO YOU HAVE AN EATING DISORDER?

Today’s young people are living in a world that is food and diet obsessed. On television, on the internet, in magazines and movies, kids are bombarded daily with the newest diet trends. These super-sleek bodies are often impossible for adults to achieve; for youth, aspiring to look like the ultra-thin celebrities they see in the media can be especially dangerous. The pressure to be thin affects millions of people every year, particularly teens. According to the National Association of Anorexia Nervosa and Associated Disorders, 11 percent of high school students in the United States have been diagnosed with an eating disorder. The term “eating disorder” comprises several psychological disorders such as anorexia or bulimia that involve insufficient or excessive food intake. These serious (but treatable) mental illnesses are often characterized by an abnormal preoccupation with body image, weight and food. Eating disorders may develop from many emotional and psychological factors, like depression or low self-esteem. Environmental and societal pressures also play a role. Often teens who are described as “perfectionists” will strive to achieve what they consider the perfect body. Many young girls are powerfully influenced by ads in magazines and on television that promote weight loss as the ideal road to beauty. These outside forces, in combination with low self-esteem, can lead to inaccurate self-image, unrealistic expectations and, for some teens, life-threatening disorders. Bulimia nervosa, anorexia nervosa, and compulsive binge eating are the most commonly diagnosed eating disorders—and they all carry serious consequences. Teens struggling with anorexia will restrict their food intake to an extreme in order to lose weight. Even when they weigh less than 85 percent of their expected body weight, teens struggling with anorexia still believe that they are fat. Bulimia nervosa is known as a binge-and-purge disorder, where a teen will eat a tremendous amount of food in a short period of time and then purge by vomiting, using laxatives and/or over-exercising. Someone suffering from bulimia may not necessarily be underweight, so it can be harder to detect than anorexia. According to the National Alliance of the Mentally Ill, girls between the ages of 12-25 make up 90 percent of the people affected by anorexia and bulimia. Similar to bulimia, someone suffering from binge eating disorder will eat excessive quantities of food. They do not purge, but they feel a lack of control and low self-esteem that is similar to bulimia. Up to 11 million people in the United States are currently suffering from anorexia nervosa and/or bulimia nervosa, and up to 25 million are binge eaters. It’s important to note that girls aren’t the only ones affected by the pressure to be thin. Young men are also at risk. According to Anorexia Nervosa and Related Eating Disorders (ANRED), 10 percent of people suffering from anorexia and/or bulimia are male. This means more than one million boys in the USA suffer from these symptoms and disorders.


INTRODUCTION CONTINUED

DO YOU HAVE AN EATING DISORDER? 2 HUMAN RELATIONS MEDIA

Often people who develop eating disorders begin to manifest symptoms and behaviors at a very early age. These symptoms may include severe weight loss, distorted body image or excessive exercising. Even seven-year-olds can feel the pressure to be thin. Left untreated, an eating disorder can leave a person with serious health problems such as bone density loss, heart arrhythmia or organ failure. Others experience hair loss, tooth decay, malnutrition and dehydration. Up to 20 percent of those suffering from an undiagnosed eating disorder will die as a result of these deadly complications, according to ANRED. Young people need to understand that eating disorders are life-threatening conditions that won’t disappear on their own. By promoting awareness and understanding of the signs and symptoms, adolescents will have the tools to help themselves and their peers. It is important for kids to remember that eating disorders often appear along with other kinds of mental illnesses such as depression or anxiety disorders, which, without treatment, can also carry devastating consequences. Much like any other illness, early diagnosis and treatment are essential to make a full and lasting recovery. There are effective treatment programs that can help affected people return to a healthy weight and lifestyle. After watching the program Do You Have an Eating Disorder? and participating in the activities in this Teacher’s Resource Guide, your students will recognize that intervention and treatment for an eating disorder is a necessary part of the road to recovery. Even more importantly, those suffering from an eating disorder will understand that they are not alone.

NOTE: The program purposefully does not include images of dangerously thin people. Such images can provoke a “race to the bottom” among those struggling with or susceptible to an eating disorder (i.e., She is thinner than I am and she’s still alive. I should lose more weight.) According to the National Eating Disorders Association, a focus on physical descriptions of the body is not only dangerous, but can also be misleading, since individuals with eating disorders come in all shapes and sizes.


LEARNING OBJECTIVES


After viewing the program Do You Have an Eating Disorder? and participating in the activities presented in this Teacher’s Resource Book, your students will be able to:

understand the seriousness of eating disorders, including anorexia nervosa, bulimia and binge eating

recognize the root causes of eating disorders

recognize the warning signs of an eating disorder in a friend

identify many of the physical and psychological ng

understand how they may be able to help someone with

apply tools to develop a more positive self-image

gain the ability to keep the importance of body shape and

realize how important it is to build one’s self-esteem from within

hype thinness as the key to happiness

have an eating disorder

consequences of anorexia, bulimia and binge eati

an eating disorder

size in perspective

become critical viewers of media messages that implicitly

know where to go for help in case they


PROGRAM SUMMARY


“Eating disorders are not just about food,” a young woman tells viewers, “Eating disorders can be about anxiety. It can be about depression. It can be about obsessive-compulsive disorder.” Viewers then meet a diverse group of people, all of whom have had personal experience with eating disorders. “A person shouldn’t blame themselves,” says one boy. One girl talks about how isolating the illness was, while another says she felt like she “had no one to turn to.” Another woman explains that the worst part is realizing how much permanent damage her body has suffered as a result of her eating disorder. “We have an expression: everybody knows somebody,” explains one expert. “Just about everybody knows somebody who knows somebody who has this illness.” The video begins its first section: “Do I Have an Eating Disorder?” by introducing Jenni Schaefer, who suffered from anorexia and has now recovered with the help of her music. She tells viewers how her eating disorder actually began when she was four years old, as she compared her body with those of the other girls in her dance class. As she grew older, her thoughts intensified about her body and about food. Viewers see photos of Jenni as a child—in her dance class, at a performance—and are left to think about living with an eating disorder. A student, B. Charles, explains that he is an emotional eater, turning to food in times of stress or trouble. Another student, Christine Maccia, describes her own eating disorder, how she began by just cutting out snacks and it escalated from there: “I just couldn’t stop,” she says. Viewers then meet Lynn Grefe, the CEO of the National Eating Disorders Association. She defines eating disorders as biologically based illnesses which are fundamentally forms of mental illness. She defines two of the most common eating disorders, anorexia and bulimia: “When a person has anorexia it means they are not eating, they are basically starving themselves. Bulimia means they purge the food that they have eaten, and it could either be through vomiting, through laxative abuse, through exercise abuse.” Latria Graham, a student at Dartmouth College, describes how as a bulimic she both over-exercised and used laxatives. Lynn Grefe returns to describe the third major eating disorder: binge eating. “And then there’s binge eating disorder, eating so much food at one sitting, and bulimia often works together with binge eating disorder, where a person will consume an enormous amount of calories and then immediately get rid of those calories.” Jenni Schaefer describes how she lost control around food while she was anorexic; her body demanded to be fed after having been starved, resulting in binging. Lynn Grefe tells viewers that while an estimated 16 million people are affected by anorexia, bulimia or binge eating disorder, more concrete statistics don’t truly exist because of the secretive nature of the illness, and the shame felt by those who suffer from eating disorders. The next section of the video is introduced: “Shame and Blame.” Jenni describes how she didn’t know what an eating disorder was, thinking instead that “this was something that I came up with, that it was my fault.” B. Charles notes that guys often have more trouble admitting they have a problem, because eating disorders have traditionally been portrayed as


PROGRAM SUMMARY CONTINUED


a “girl’s disease.” Latria describes the shame felt by those with eating disorders, and Jenni remembers reading a brochure on eating disorders and realizing for the first time, “I have an eating disorder. It’s not my fault. This is an illness. Other people actually do what I do.” Lynn Grefe returns to say that no one is to blame for an eating disorder. She goes on, “The good news is that eating disorders are treatable. The bad news is they can kill you if you don’t get treatment.” The program moves on to address the health consequences of eating disorders. Viewers meet Marna Clowney Robinson, a member of the board of directors of the National Association of Anorexia Nervosa and Associated Eating Disorders. She describes all of the health consequences she suffered from her eating disorder: “I had a mild heart attack before I was twenty years old because of not eating and abusing my body with trying to eliminate food. Teeth are rotted out because of all of the purging. I cracked my esophagus from a lot of the purging. I also have problems with my colon because of the laxative abuse.” Jenni Schaefer drives home that an eating disorder affects every system in the body, revealing that at 22, she was diagnosed with osteoporosis—a weakening of the bones usually found in older women. The different subjects talk about their own experiences. Latria suffered from edema, a condition where the hands and feet retain water, making it uncomfortable for her to do things with her hands. Jenni’s hair fell out in clumps and she had very dry, brittle nails. When Christine first visited a hospital for her eating disorder, she was immediately admitted in intensive care with an IV because of dehydration. B. Charles describes the experience of being told by his doctors that he could die if he didn’t gain weight. “That was kind of an eye-opener for me,” he says. The program then addresses the question of what causes eating disorders. “With eating disorders, it’s not about the food,” says Lynn Grefe, “It’s about the person, and it’s about a mental disorder that’s making [that person] have behavior about food.” For B. Charles, his eating disorder was mostly about insecurities and building relationships with friends. For Christine, her issues stemmed from anxiety about starting high school. Jenni talks about how high school was the crucible for her eating disorder. Her obsession with perfection—straight A’s, the volleyball team, National Honor Society, student council—drove her to low self-esteem and to constant self-criticism. Lynn Grefe describes how eating disorders are sometimes characterized as affecting the best and the brightest. Anorexia in particular is often accompanied by a certain personality type. She says, “They feel like they’ve lost control of everything in their life but they can control this.” Marna says how her eating disorder came in part from feeling responsible for her parents’ divorce. She says that with her eating disorder, “I could control a lot of the feelings that I was showing people.”




The video moves on to discuss the effect of biology on eating disorders. Lynn Gefe describes how science is discovering more and more that eating disorders are biologically based illnesses, most likely a result of a combination of biological and environmental factors. Marna talks about how for her, it was likely both a genetic and a learned behavior; her siblings suffered from eating disorders, and as a child she saw her mother yo-yo diet all the time. From watching her mother, she learned that eating less was the way to deal with perceived weight problems. Jenni quotes a common researchers’ maxim about eating disorders: “Genetics loads the gun, environment pulls the trigger.” In Jenni’s case, her move to Nashville was the event that triggered her eating disorder to come to the surface. In addition to feeling the pressure to look like the unrealistic women presented in the media, moving to Nashville intensified her sense of competition with others. At the time, she describes how she thought “Maybe I’m not the best singer, but I can have the best body.” Lynn Grefe returns to detail the unrealistic and unattainable images of people produced by our society, which can lead to self-esteem problems, if not an eating disorder. B. Charles introduces viewers to a disease called body dysmorphia, in which people perceive their own body as flawed, creating flaws where there are none. Christine describes how she thinks of body dysmorphia: “I always think of body dysmorphic disorder as looking in a funhouse mirror. You have those wavy ones where your body looks all wavy and weird…focus in on that one piece of my body and be like “Oh my god, I hate it,” and the more I hated it, the worse it looked.” The program introduces the next section: warning signs. Lynn Grefe offers the first warning sign: a family history of eating disorders. With anorexia, the warning signs are fairly apparent: hiding food, not eating, and above all, significant weight loss. Christine illustrates this point with her own experience: “I was eating alone. I wouldn’t eat in front of other people…I was being very secretive.” With bulimia, says Lynn Grefe, a person doesn’t necessarily lose any weight. She details some of the warning signs of bulimia: “Excusing themselves after every meal immediately, trying to avoid meals.” Latria describes how she avoided throwing up in the bathroom because she was afraid she would get caught. For Jenni, her symptoms as a teenager were ones that people often don’t think to look for: isolation and moodiness. The video moves on to a new topic: how to help. Lynn Grefe tells viewers they should not criticize someone with an eating disorder: it’s not their fault. She explains how the best thing to do is to reach out as a friend and encourage them to talk to someone. She also emphasizes the importance of understanding the problem, and knowing that it is not your friend’s fault: they are sick. Latria describes her own experience with a friend who tried to help. “One of my friends in high school, she told me, ‘I’d rather have you alive and mad at me than have you dead, and be on my conscience that I didn’t say anything.’” She goes on to clarify: “Sometimes it takes a group of people saying ‘I care about you, and I worry about you’ in order for that person to realize that they’re worth something.”




Lynn Grefe returns to emphasize the importance of helping those with eating disorders. “People with eating disorders need treatment and they need it early, before they have some long-term health consequences,” she says. “To anyone who might have an eating disorder, don’t be the least bit ashamed.” B. Charles describes the experience of being helped: “It’s such a relief because you’re not alone anymore; you can share it with someone.” The program begins its final section: recovery. From Marna, we hear how recovery is possible, and how recovery means relearning one’s relationships to food and to one’s emotions. Christine describes the benefits of recovery, saying simply, “I’m at a much better place in my life. Life is so much better now.” Jenni talks to the viewers one last time, describing her experience of recovering from an eating disorder. Initially, she thought that she would always struggle with food and weight—but she now knows that it is possible for a person to recover completely. While viewers see Jenni sing in a recording studio, she explains how she recovered. For her, singing was one method of expressing herself, and she began to not only sing but to write her own songs. Another method was to personify her eating disorder. “My therapist taught me to treat my eating disorder as a relationship rather than an illness. So I actually learned to call my eating disorder Ed, which is an acronym for eating disorder, E.D. I learned that the negative thoughts I heard constantly came from Ed, thoughts like, ‘Jenni, you’re fat,’ ‘Jenni, you’re no good, you’re worthless.’” She describes how she learned to develop healthy thoughts, thoughts that she could call Jenni’s and not Ed’s. For her, it felt good to be able to fight for herself, against Ed. The program finishes by letting viewers listen to the song Jenni is recording:

“You don’t have to just pretend All the pain can really end You deserve more than the lies that you’ve been fed You can believe in life without Ed.”

NOTE: The song “Life Without Ed” was written and composed by Jenni Schaefer

and Judy Rodman.



This page left blank intentionally.

STUDENT ACTIVITIES

ACTIVITY 1A

PRE/POST TEST


Name: _____________________________________

Pre/Post Test Decide whether the following statements are true or false.

1. TRUE or FALSE: Excessive exercising is one way that an eating disorder might manifest itself.

2. TRUE or FALSE: Laxative abuse is a form of purging.

3. TRUE or FALSE: Binge eating is a form of anorexia.

4. TRUE or FALSE: Only girls get anorexia.

5. TRUE or FALSE: A combination of genetics and environment are likely responsible for eating disorders.

6. TRUE or FALSE: Bulimics don’t necessarily lose weight as a result of their purges.

7. TRUE or FALSE: Eating disorders are fundamentally about losing weight.

8. TRUE or FALSE: If you know someone who has an eating disorder, you should force him or her to eat at least two meals a day.

9. TRUE or FALSE: Bulimics always use vomiting to get rid of the food they’ve eaten.

10. TRUE or FALSE: Most eating disorders will go away on their own, over time.

The Answer Key appears on the next page.

ACTIVITY 1B

PRE/POST TEST


Name: _____________________________________

Answer Key

1. TRUE or FALSE: Excessive exercising is one way that an eating disorder might manifest itself.

TRUE

2. TRUE or FALSE: Laxative abuse is a form of purging. TRUE

3. TRUE or FALSE: Binge eating is a form of anorexia. FALSE

4. TRUE or FALSE: Only girls get anorexia. FALSE

5. TRUE or FALSE: A combination of genetics and environment are likely responsible for eating disorders.

TRUE

6. TRUE or FALSE: Bulimics don’t necessarily lose weight as a result of their purges.

TRUE

7. TRUE or FALSE: Eating disorders are fundamentally about losing weight.

FALSE

8. TRUE or FALSE: If you know someone who has an eating disorder, you should force him or her to eat at least two meals a day.

FALSE

9. TRUE or FALSE: Bulimics always use vomiting to get rid of the food they’ve eaten. FALSE

10. TRUE or FALSE: Most eating disorders will go away on their own, over time. FALSE

ACTIVITY 2A

KNOW THE SIGNS


Name: _____________________________________

As a group, discuss what signs to look for in a peer who may be struggling with an eating disorder (i.e.: skipping meals, weight loss, etc.). Next, match the following symptoms with the number of the corresponding disorder. Keep in mind that a symptom may be related to more than one disorder.

Eating Disorders 1. Anorexia Nervosa

2. Bulimia Nervosa

3. Binge Eating Disorder

Symptoms 1. Lanugo, a downy layer of hair all over the body ______________

2. Overeating large quantities of food ______________

3. Malnutrition ______________

4. Yellow teeth ______________

5. Loss of menstrual cycle in females ______________

6. Restriction of certain foods ______________

7. Fear of weight gain ______________

8. Depression and anxiety ______________


ACTIVITY 2B

KNOW THE SIGNS


Name: _____________________________________

Answer Key

Eating Disorders

1. Anorexia Nervosa

2. Bulimia Nervosa

3. Binge Eating Disorder

Symptoms

1. Lanugo, a downy layer of hair all over the body 1

2. Overeating large quantities of food 2, 3

3. Malnutrition 1, 2

4. Yellow teeth 2

5. Loss of menstrual cycle in females 1

6. Restriction of certain foods 1, 2, 3

7. Fear of weight gain 1, 2, 3

8. Depression and anxiety 1, 2, 3

ACTIVITY 3

A CRY FOR HELP


Name: _____________________________________

Listed below are several scenarios in which a friend has come to you, asking for your help dealing with his/her eating disorder. In groups of two or three, discuss what you might do in this situation. Create a dialogue to describe how the scene would play out. You should write out your dialogue as a script, and perform it as a skit in class if time permits. If you prefer (and if you have permission from your teacher), you can write your own scenario in the space provided, or on the back of this page. You may want to consult the How to Help a Friend fact sheet before you develop your script.

1 Walter has been starving himself to make a lower weight class in wrestling. He allows himself only 500 calories each day, instead of the recommended 2,000 for a boy his age. He doesn’t want to tell his parents because he knows they will worry. Instead, he confides in you. What do you do?

2 Yesterday when you were walking through the hallway, you heard someone vomiting in the bathroom. You see that it was Katie, a girl from your math class. You ask her if she is okay, to which she responds, “I’m fine. Don’t worry about it.” You’re not good friends with her, but you notice that she has lost some weight lately. What do you do?

3 In gym class, you overhear Samantha bragging to her girlfriends that she has been using laxatives to lose weight. She doesn’t look thin or sick to you. What do you do?

4

ACTIVITY 4A

THE MEDIA


Name: _____________________________________

Part One: For a full week, keep a journal in which you note each time you see an endorsement on television or in a magazine that is hyping a new diet, weight loss pills, or exercise equipment. Monitor your reactions to the ads and take note of the words or images that you find most striking. In addition, cut out images from magazines and/or take notes on what kind of images and vocabulary are used to sell the products. Use the chart below to help keep track of what you see. You may need additional copies of the chart.

Product Being

Promoted

Type of Advertisement

(TV, magazine, etc.)

Key Images and

Vocabulary

This activity is continued on the next page.

ACTIVITY 4B

THE MEDIA


Name: _____________________________________

Part Two: At the end of the week, write a short essay below on how you felt about the images you noted. Were you surprised at how many you saw in a week? What kind of message do you think this sends to people your age? Is the message the same for males and females? Were certain key phrases used repeatedly? Were certain selling tactics in many different advertisements? Part Three: Compare your results with the rest of your class, and read the information presented on the Eating Disorders and the Media fact sheet. Discuss whether you feel that the advertising industry is manipulating young people’s self-perception.

ACTIVITY 5

CLASS DEBATE


Name: _____________________________________

Divide the class into two equal groups. Using one of the debate questions below, one group must argue yes, and the other group must argue no. Each side must support its position with researched facts and valid, respectful arguments.

1 Should weight loss television commercials be banned just as tobacco ads were banned?

2 The chicken or the egg: which came first? Did society want to be thin and so advertisers decided to market their products accordingly? Or has our perception of a healthy body become warped from seeing pin-thin models in every magazine?

3 Will our standard of beauty ever change? If so, under what conditions? Is there more than one standard of beauty? What does any culture’s concept of beauty tell us about that society?

4 Who bears the responsibility to use healthy bodies in their images: The magazine? The advertiser? The television network? Would a standard BMI (Body Mass Index) help to make sure that sickly models aren’t put on a pedestal?

5 In the past few years, the fashion industry has responded to criticism of using sickly-thin models by making an effort to use models that are somewhat more healthy-looking. Have you noticed any change in advertisements? Do you agree that a change needed to take place?

ACTIVITY 6A

CROSSWORD PUZZLE


Name: _____________________________________

Crossword Puzzle

1 2

3

4 5

6

7 8

9

1

0

1

1

1

2

1

3 1

4


ACTIVITY 6B

CROSSWORD PUZZLE


Name: _____________________________________

Clues

Down 1. Anorexia nervosa is often linked to

obsessive ___________ disorder. 2. Many people struggling with eating

disorders count the ___________ they consume every day.

5. There is no one ___________ for any eating disorder.

6. Other psychological problems may accompany eating disorders, like ___________ or anxiety.

7. A specialist in food and dietary needs.

8. An abnormal heart rhythm associated with malnutrition.

14. Downy hair that covers the body in an effort to keep it warm.

Across 3. ___________ factors also contribute

to an eating disorder, like genes, hormones and brain chemicals.

4. The need to obtain a “__________” body leads many people toward an eating disorder.

8. A disorder characterized by extreme food restriction.

9. Bulimia nervosa is characterized by binging on food followed by ___________.

10. It is necessary to seek ___________ for any eating disorder.

11. ____________ eaters will eat excessive amounts of food in one sitting.

12. Proper ___________ is necessary for anyone struggling with an eating disorder.

13. Lack of vitamins and minerals in the body can lead to ___________.


ACTIVITY 6C

CROSSWORD PUZZLE


Name: _____________________________________

Answer Key

1 C 2 C

3 B I O L O G I C A L A

M L

4 P E R F E 5 C T O

U U R 6 D

7 N L 8 A N O R E X I A E

U S R E E P

T I R S 9 P U R G I N G

R V 1 0

H E L P E 1 1

B I N G E Y S

T 1 2

T R E A T M E N T S

I H I

O 1 3

M A 1 4

L N U T R I T I O N

N I A N

I A N

S U

T G

O

ACTIVITY 7

ROLE MODELS


Name: _____________________________________

Good role models are an asset to any teenager’s life. Think about role models that you might have, whether they’re at home, at school or a famous historical figure. Now, think about what kinds of role models the media commonly presents, particularly toward young people like you and your peers. Use the quote below as a starting point. Do you agree with the quote? What do you think it means? In the space below, address these questions and any other thoughts you might have on the topic of role models. In particular, think about the difference between a healthy and an unhealthy role model, especially as they relate to a person’s self-esteem and satisfaction with body image.

“Your problem is your role models were models.”

—Jane Wagner (American writer), from her play “The Search for Signs of Intelligent Life in the Universe”

ACTIVITY 8

THE “PERFECT” BODY


Name: _____________________________________

Part One: For this activity, you’re going to examine the notion that there is one “perfect” body, or one “perfect” way to look. First, in each of the spaces below, write characteristics that you associate with a healthy person. Part Two: When everybody has finished their list of traits above, discuss the following questions as a group: Does everybody have the same list of traits? Why do you think each person’s list is different? Are there traits that are common to all healthy people? Does it seem like there is one single “perfect” body? Part Three: As a group, make a list of physical characteristics you associate with the fashion models and celebrities you see in the media. Part Four: Now, as a group, look at the list of physical characteristics of malnourishment below. Which of the lists from Part One and Part Two does this list have more in common with? What do you think that means? Discuss as a group.

sunken cheeks dry, brittle nails

tired eyes dry, shriveled skin

fine hair over the body unhealthy hair

extreme skinniness moodiness

ACTIVITY 9A

ROLE PLAY


Name: _____________________________________

Do you know how to reach out to offer help to a friend? Sometimes it can be hard to take the first step toward helping someone else. However, when it comes to a teen with an eating disorder, it is essential that you show your support as soon as possible. Take a look at the scenario below:

One of your friends is always trying to be the best at everything. Recently, you’ve noticed your friend has been eating less and often disappears into the bathroom right after eating. You can see your friend is getting thinner and seems to be tired all the time. When you ask your friend what’s going on, you never get a straight answer.

Part One: Act Out On the following page are several possible ways to help. Some of them are better than others. There is room for you to add your own options on how you might confront your friend. When you have added at least two of your own ideas, cut the page into separate cards for each solution. You may want to consult the How to Help a Friend fact sheet to come up with good ideas. Use the cards for a two-person role play. One student should portray the friend suffering from an eating disorder. Another student should draw one of the solution cards and use it to act out the scenario. Part Two: Discuss After each exchange is acted out, discuss what happened. Was your role play realistic? Do you think the solution would work? Why or why not? Are there any other possible solutions to the scenario that you think would work better?


ACTIVITY 9B

ROLE PLAY


Name: _____________________________________

Confront your friend directly but gently, telling him/her about the things you’ve noticed.

Show your concern, and encourage your friend to seek professional help.

Get angry at your friend for being so stupid, and critique what he/she has been doing wrong.

Try to make your friend feel guilty for not thinking about the effects that his/her eating disorder has on others.

ACTIVITY 10

VALUE WHO YOU ARE


Name: _____________________________________

Many students do not feel comfortable talking about themselves, but getting to know more about yourself is an important part of developing self-esteem. If you can learn to value who you are now, it will be easier to make good choices in the future. Part One: Interview five people who are close to you. Ask each one to name five or more good qualities that they see in you. The people you choose might be family members, teachers, friends, classmates or other individuals who you think know you well. List those qualities below.

Person 1:

Person 2:

Person 3:

Person 4:

Person 5:

Part Two: On a separate sheet of paper, summarize the qualities that people described above and create a “portrait” of yourself. You can write down the qualities, or you may choose to create a visual collage. Consult the Developing a Positive Body Image fact sheet for further details.

You are a valuable person!

FACT SHEETS

FACT SHEET 1

WHAT IS ANOREXIA NERVOSA?


Name: _____________________________________

ormal weight

ng

d shape

the abdominal area

ing after

Possible Consequences of Anorexia Nervosa

depressi

away of muscles

or yellowed

h and gums ce

protein

insomnia kidney infection and failure cramps or bloating constipation or diarrhea incontinence (wetting one’s pants) DEATH: one in ten cases leads to

death from starvation, heart failure, other medical complications or suicide!

Profile of an Anorexic: A high-achieving, self-disciplined perfectionist who aims to please others and rarely disobeys. She is intelligent, thoughtful and demanding and critical of herself. She keeps her feelings to herself. She has a low opinion of her worth as a person. She decides that by controlling her body, she will feel more in charge of her life and will start to feel better about herself. Her whole life—her thinking, planning and dreaming—becomes focused on avoiding food and getting thinner.

Anorexia Nervosa is an eating disorder that involves extreme weight loss—at least 15 percent below the normal weight for an individual. Young people with anorexia starve themselves on purpose and may exercise excessively to control their weight. Anorexics see themselves as “too fat” no matter how thin they are. They view their weight loss as a badge of achievement, whereas weight gain is seen as an unacceptable loss of self-control. Anorexia can be fatal.

Symptoms of Anorexia Nervosa

experiences profound weight loss looks emaciated

exercises excessively wears baggy clothing refuses to maintain a n is withdrawn and isolated has an intense fear of gaini

weight or becoming fat is preoccupied with weight an

is preoccupied with food lies about eating

practices food rituals bruises easily has swelling in feels cold much of the time complains of nausea or bloat

eating small amounts of food has difficulty eating in front of others

on, loneliness delayed puberty fatigue

muscle weakness wasting loss of bone mass low blood pressure dry, thinning hair dry skin that is gray

chemical imbalances problems with teet lanugo or fine hair covering the fa

and body from lack of

stunted growth irregular heart rate

malnutrition

FACT SHEET 2

WHAT IS BULIMIA NERVOSA?


Name: _____________________________________

ed the Binge and Purge ycle—unts of food (often junk food by

miting, abusing laxatives or diuretics, taking en as or of anger, loneliness, fear, stress or anxi

is called the “secret intain a near-norm from others and continue to function in a tively normal way. Bulimics may develop feelings of hopelessness and in some severe cases

ay even consider suicide.

Symptoms of Bulimia Nervosa

ly to make up for a binge

swelling in face (a

rash or skin eruptions

bruised fingers (from repeated use of fingers to make

e eyes

ences Bu

e tract

dehydration

muscle sp

insomnia

low blood pressure

low body temperature

cramps, bloating

constipation or diarrhea

electrolyte imbalances, which roblems or

heart failure

Bulimia Nervosa—also call C is characterized by uncontrollable urges to eat huge amovo

) and then getting rid of the excess calories em exercising compulsively. Binges are

ety. Binge eating is done in secret and eating disorder” because bulimics

often tied to timescauses guilt and depression. Bulimiama al weight, hide their habitsrelam

recurring binge eating episodes

with a sense of lack of control during the episodes

making oneself vomit; misusing laxatives, diuretics, enemas or other medications; fasting; or exercising excessive

fear of gaining weight

depression, isolation and loneliness

low self-esteem

being a “people pleaser”

weight fluctuations

fter vomiting) callused or

preoccupation with food; hoarding, hiding or stealing food

oneself vomit)

broken blood vessels in th

Possible Consequ

sore throat

infected salivary glands

tearing of the esophagus

of limia Nervosa

acid reflux

problems with the digestiv

cancer of the esophagus

cancer of the voice box

erosion of tooth enamel, rotting teeth

asms can lead to kidney p

fatigue and

heart palpitations

malnutrition

dry skin and hair

hair loss

FACT SHEET 3A

EATING DISORDERS AND THE MEDIA


Name: _____________________________________

you on between the num er of young people ook at these facts, which have been reported in

edical and psychological journals. Sources are listed on the following page.

ollege students, media exp ure w

and ineffectiveness in wome

g college students, media exposure was correlated to orsement of personal thinness and dieting in men. [1]

Several studies have reported a correlation between exposure to beauty and fashion magazines and an increased level of weight concerns or eating disorder symptoms. Trying to look like women on TV, in movies or in magazines was predictive of 9- to 14-year-old girls beginning to purge at least monthly. [2]

In another study, both boys and girls aged 9 to 14 who were making an effort to look like media figures were more likely than their peers to develop weight concerns and become constant dieters. [1]

Exposure to images of thin, young, air-brushed female bodies is linked to depression, loss of self-esteem and the development of unhealthy eating habits in women and girls. [2]

Many teens choose fashion models or actresses as their role models, and some will resort to dangerous methods of weight control to try to look like their idols. [3]

A positive correlation was found between the frequency with which high school girls read beauty magazines and their use of appetite suppressants, skipping two meals a day, intentional vomiting and laxative use. [4]

This fact sheet is continued on the next page.

Do think there’s a connecti b suffering from eating disorders, self-image and the media? Take a lm

Among cto disordered eating, a powerful drive for thinness, body

os as correlated

dissatisfaction n. [1]

Amonan end

FACT SHEET 3B

EATING DISORDERS AND THE MEDIA


Name: _____________________________________

image among adolescents there. [5]

of eating disorders in males, who represent approximately 10 percent of eating disordered individuals coming to the attention of mental

Sources: [1] “The im scents,” Anne M.

Morris , Official Journal of the C . www.p

[2] “Media, Self-Esteem and Girls’ Identities,” Media Awareness Network website.

w.m irls/women_girls.cfm [3] “Teena

www.m [4] “Body Image 1996,” D.M. Garner and A. Kearney-Cooke. Psychology Today, 29(2),

to Adolescent Female .htm

[5] “Adolescents and the Media: Why Don’t Pediatricians and Parents ‘Get It’?” Victor C.

Strasburger. The Medical Journal of Australia, 183 (8), 2005. w.m

[6] “Resea tional Eating Disorders

Association. www.edap.org/p.asp?WebPage_ID=316&Profile_ID=41154

A recent study found a cause-and-effect relationship between the introduction of American TV programs into Fiji and the development of new eating disorders and abnormal body self-

Body image concerns may be important predictors

health professionals. [6]

pact of the media on eating disorders in children and adoleand Debra K. Katzman M.D. Pediatrics and Child Healthanadian Pediatric Society, June 2003, Volume 8, Number 5

ulsus.com/Paeds/08_05/morr_ed.htm

ww edia-awareness.ca/english/issues/stereotyping/women_and_g

gers and Eating Disorders,” Colleen Thompson, 1996. irror-mirror.org/teens.htm

1996. Cited in Debbie Naigle, “Literature Review of Media Messagess.” www.usask.ca/education/coursework/802papers/naigle/index

ww ja.com.au/public/issues/183_08_171005/str10407_fm.html

rch on Males and Eating Disorders,” Tom Shilts, Na

FACT SHEET 4

HOW TO HELP A FRIEND


Name: _____________________________________

eep in mind that you cannot force an anorexic to eat or keep a bulimic from purging. You must not conce rs are emotional problems; the e tempt to control, hide or forget e

If you suspect someone has anorexia or bulimia…

Approa .

Begin by telling your friend how much you care.

Express your concern. Share what you’ve noticed in a calm, direct way. Point out things that make you worry about your friend’s health, happiness and safety.

age the person to express his or her feelings.

p. Medical and psychological help are needed to treat anorexia and bulimia. No one should try to treat this disease

idance situation is so severe that your friend’s

“You dI believe in you.”

utside“I don’t care if you’re mad at me. Friends don’t let friends suffer in a dangerous situation.” “I won’t stop caring.” “I’m worried that you’re trapped and not seeing your situation clearly.”

“You are acting irresponsibly.”

“Would you just eat already?” “It’s not healthy to throw up all the time.” “I don’t understand why you don’t just eat.” “Why are you doing this to yourself and everyone who cares about you?”

K

ntrate immediately on the issue of food because eating disordeating behaviors are only a symptom. Refusing to eat is an atmotional pain, stress or self-hate.

Learn as much as you can about the eating disorder.

ch the person when you can talk in private without interruptions

Encour

Give your friend enough time to respond. He or she may deny there is a problem, be furious at you for uncovering the secret or feel threatened by your caring.

Encourage the person to seek professional hel

entirely on his or her own.

Avoid conflicts. If your friend refuses to acknowledge that there may be a problem, restate your feelings and be open to listen when your friend is ready to talk.

Tell a responsible adult, such as the school nurse, a doctor, a teacher, a gucounselor or a parent. Don’t wait until the life is in danger. Many young people refuse to get help until a parent forces them into treatment.

Avoid placing shame, blame or guilt on your friend.

Things to say: eserve to get help and get better.”

Things NOT to say: “You just need to eat.”

““I think you’re really struggling and need

help.” “Are you sick?” “You look like a corpse.” o

FACT SHEET 5

DEVELOPING A POSITIVE BODY IMAGE


Name: _____________________________________

ational Eating Disorders Association

How can you develop a more positive body image? not related to appearance.

orth as a person.

erstand that a person’s physical value as a person.

s.

5.

6.

7. ghing,

8. o your e truly important to their success and accomplishments?

10. our body.

.

12. r inner qualities shine through.

. verly concerned with appearance.

14. Don’t put yourself down in your own m nd.

15. Wear clothes that are ak

e people shown have realistic body types? e you feel like you don’t measure up?

’t center around your body image.

s to their fullest.

ps with friends and family.

s for yourself and carry them out in stages.

“People with a negative body image have a greater likelihood of developing an eating disorder and are more likely to suffer from feelings of depression, isolation, low self-esteem, and obsessions with weight loss.”

— N

1. Focus on the qualities you like about yourself that are

2. Remember that your body size and shape have nothing to do with your w

3. Bodies come in all different shapes and sizes. Undappearance says very little about their character and

4. Refuse to spend excessive amounts of time worrying about food, weight and calorie

Don’t allow your body size and shape to become your entire identity.

Learn to feel comfortable in your own unique body.

Make a list of all the things you are thankful for your body’s ability to do: laudancing, etc.

Create a list of people you admire—people who have contributed to your life or tworld. Was their appearanc

9. Be your body’s friend and supporter, not its enemy and detractor.

Count your blessings, rather than focusing on what you believe are flaws in y

11 Demonstrate confidence in yourself by walking with your head held high.

Remind yourself that true beauty is a state of mind, not a state of body. It has to dowith letting you

13 Surround yourself with positive people who are not o

i

comfortable and m e you feel good about yourself.

16. Be a critical Do they mak

viewer of the media: Do th

17. Take up new hobbies and activities that don

18. Develop your unique gifts and talent

19. Develop meaningful relationshi

20. Set realistic goal

FACT SHEET 6 Name: _____________________________________ NATIONAL ORGANIZATIONS

elated Eating5102

www.anred.com Eating Disorders Coalition for Research Policy and Action

611 Pennsylvania Avenue S.E. #423 Washington D.C. 20003-4303 (202) 543-9570 www.eatingdisorderscoalition.org

Eating Disorder Referral and Information Center

2923 Sandy Pointe, Ste. 6 Del Mar, CA 92014-2052 (858) 792-7463 www.edreferral.com

National Association of Anorexia Nervosa and Associated Disorders

P.O. Box 7 Highland Park, IL 60035 (847) 831-3438 www.anad.org

National Eating Disorders Association

603 Stewart Street, Ste. 803 Seattle, WA 98101 (206) 382-3587 www.nationaleatingdisorders.org

National Institute of Mental Health (NIMH)

Office of Communications and Public Liaison (301) 443-4513 www.nimh.nih.gov

Anorexia Nervosa and R Disorders, Inc. (ANRED)

P.O. Box Eugene, OR 97405(503) 344-1144


FACT SHEET 7

INTERNET RESOURCES


Name: _____________________________________

Centewww.m

“Beauty...and the Beast of A

www.medialit.org/reading_room/article40.html

w je M iawww.m

www.media-awareness.ca/english/issues/stereotyping/

N owww.m

National Eating Disorder

65

n-

e.html

.ki

ody_image.html

r for Media Literacy edialit.org

dvertising” by Jean Kilbourne

Jenni Schaefer’s website

ww. nnischaefer.com

ed Awareness Network edia-awareness.ca

“Media, Self-Esteem and Girls’ Identities”

women_and_girls/women_girls.cfm

ati nal Institute on Media and the Family ediafamily.org

“Media’s Effect On Girls: Body Image And Gender Identity” www.mediafamily.org/facts/facts_mediaeffect.shtml

s Association (NEDA)

www.nationaleatingdisorders.org

“Tips for Becoming a Critical Viewer of the Media” www.nationaleatingdisorders.org/p.asp?WebPage_ID=286&Profile_ID=411

“Enhancing Male Body Image” www.edap.org/p.asp?WebPage_ID=316&Profile_ID=41161

Tee Matters.com www.teen-matters.com

“Body Image”

www.teen-matters.com/textonly/bodyimag TeensHealth, Nemours Foundation www dshealth.org

“Body Image and Self-Esteem”

www.kidshealth.org/teen/your_mind/body_image/b

FACT SHEET 8

BIBLIOGRAPHY


Name: _____________________________________

ines for th atients with eating disorders.” American Journal of Psychiatry, 2000; 1

Berg, F to Eat: Children and Teens in Weight Crisis. Hettinger, ND: H rnal, 1997.

herin, Kim. The Obsession: Reflections on the Tyranny of Slenderness. New York:

Clarke, erstanding Weight and Depression. New York: R

Costin, Is She Dying for Your Attention? New York: Brunner/Mazel, 1996.

d, and Its Power.

Gay, K Anorexia, Bulimia, and Binge Eating. Berkeley Heights, NJ: Enslow Publishers, 2003.

oodno isorders: A Hot Issue. Springfield, NJ: Enslow Publishers, 1999.

Publishers, 1998.

Kirkpa ll. Eating Disorders: Anorexia Nervosa, Bulimia, Binge Eating and Others. Buffalo, NY: Firefly Books, 2001.

eone, David A. (ed.). Anorexia. San Diego, CA: Greenhaven Press, 2001.

en’s Bodies. Gurze Books, 2000.

Malone Straight Talk about Eating Disorders. New York: F

Nationa ng Disorders: Facts about Eating Disorders and the Search for Solutions.” Bethesda, MD: NIH Publication No. 01-4901, 2001.

g and Defeating aving Guide. Warner Books,

2

Schaefe ut Ed: How One Woman Declared Independence from Her Eating Disorder and How You Can Too. New York: McGraw-Hill, 2004.

Stanley, Debbie. Understanding Sports and Eating Disorders. New York: Rosen Publishing Group, 2000.

Vander Hook, Sue. Eating Disorders. Mankato, MN: Smart Apple Media, 2000.

American Psychiatric Association Work Group on Eating Disorders. “Practice guidel

e treatment of p57 (1 Suppl.): 1-39.

rances M. Afraidealthy Weight Jou

CHarper Collins, 1981.

Julie M., and Ann Kirby-Payne. Undosen Publishing Group, 2000.

Carolyn. Your Dieting Daughter:

Eliot, Eve. Insatiable: The Compelling Story of Four Teens, FooD Communications, 2001. eerfield Beach, FL: Health

athlyn. Eating Disorders:

G ugh, David. Eating D

Harmon, Dan. Anorexia Nervosa: Starving for Attention. Philadelphia, PA: Chelsea House

trick, Jim, and Paul Caldwe

L

Maine, Margo. Body Wars: Making Peace with Wom

y, Michael, and Rachel Kranz. acts on File, 1991.

l Institute of Mental Health. “Eati

Sacker, Ira M., and Marc A. Zimmer. Dying to Be Thin: UnderstandinAnorexia Nervosa and Bulimia — A Practical, Lifes001.

r, Jenni. Life Witho

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Documents

DO YOU HAVE AN EATING DISORDER? · 6. Crossword Puzzle 17 7. Role Models 20 8. The “Perfect” Body 21 9. Role Play 22 10. Value ... look like the ultra-thin celebrities they see