eating disorders


Young Girls Afraid To Gain Weight And Get Fat, Study Finds



A smart, health-conscious mom I know just drew the line: she’s going to stop reading “Grain Brain” — the compelling, controversial, potentially crazy-making new book that details the evils of carbs in general and grains in particular. She, and so many others, initially loved the book, which argues that carbs, even the whole grain variety, can “destroy” your brain and “cause demential, ADHA, anxiety” and more.

The problem, says this mom (beyond the what-can-I-possibly-pack-the-kids-for-lunch-with-no-grains dilemma), is that all the chatter about “bad foods” around her daughters might possibly increase their chances of developing an eating disorder.

This rang true to me as I came across this recent U.K. study on eating disorders in early adolescence.

Researchers from University College London Institute of Child Health and the London School of Hygiene and Tropical Medicine found that “six in 10 13-year-old girls, compared to four in 10 boys the same age, are afraid of gaining weight or getting fat.” And it got worse when the young teenage girls got a bit older, notes the report, published online in the Journal of Adolescent Health.

The bottom line results, according to the study of more than 7,000 13-year-olds: “Extreme levels of fear of weight gain, avoidance of fattening foods, and distress about weight and shape were common among girls.”

Here’s more from the study, according to the news release:

•One in three girls (34%) and one in five boys (21%) were upset or distressed about weight and shape

•One in two girls (53%) and four in 10 boys (41%) avoided fatty foods

•A quarter of girls (26%) and one in seven boys (14.5%) had restricted their food intake (by fasting, skipping meals or throwing away food) in the previous three months Continue reading

‘Thigh Gap’: Reflections On Teenage Girls’ Latest Obsession

By Sylvia Pagan Westphal
Guest Contributor

A few weeks ago, my 13-year-old daughter brought up the issue of the “thigh gap.”

A thigh-what? I thought. I Googled it and was appalled by the latest teenage girl obsession: having ultra-skinny thighs, so much so that one can see a space in between them when feet are touching (hence, the gap) is a trait many teenagers now covet. Of course, for many, this idealized gap is physically impossible to attain. (Still, I must admit to checking in the closet mirror to see if I had one.)

topgold/flickr, creative commons

topgold/flickr, creative commons

I was relieved when my daughter said she found the trend unhealthy. At the same time, she said, it’s unavoidable.

“You hear about it from your friends, it just travels,” she says. “Usually when you first find out about the thigh gap, the normal instinct is to Google it and one of the things that comes up is Tumblr and you get these crazy blogs on how to get a thigh gap and how to diet so you get it.”

(It’s true, some of these sites are a parent’s nightmare, from Cara’s Thigh Gap on twitter, which I’m not even linking to it because of the inappropriate content, to less-bad-but-still-troubling Operation Thigh Gap. Even this level-headed wiki-how is anxiety-producing, in that it confirms the ubiquity of the trend.)

It’s a tough world out there for our teens. We bombard them with conflicting messages to stay fit and be healthy (see Michelle Obama) while at the same time asking them not to get too neurotic about their body image. Some of us mothers send mixed messages too. What matters is how beautiful you are on the inside, we tell them, yet we work out and order salads for dinner Continue reading

Family Meal Boost: Lower Depression, Eating Disorder Risk In Girls

The concept of “the family meal” remains elusive — more nostalgia than reality — for many modern families. But it’s still worth striving for, according to a recent analysis by public health researchers at Tufts, who found that frequent family meals can reduce the likelihood that teenagers, particularly girls, will develop problems ranging from alcohol and tobacco use to eating disorders and depression.



Despite the benefits, researchers report that less than 60 percent of children eat five or more meals with their parents each week.

I asked the lead researcher, Margie Skeer, an assistant professor of public health and community medicine at Tufts University School of Medicine, a little about her analysis, published in the Journal of Youth and Adolescence. Here, lightly edited, is what she said:

RZ: What happens at family meals that may be protective against risky behavior, like substance abuse, or other mental health problems?

MS: If family meals are frequent and consistent, mealtime can serve as a conduit for open, ongoing communication, where people come together to not only eat, but to talk about their day. In this regard, mealtimes can provide for a baseline level of communication, whereby parents/guardians can learn about the everyday, ongoing aspects of their children’s lives — both important and ordinary. This can create an environment that allows for the development of three crucial features of the parent-child relationship. Continue reading

‘Skinny Jeans’ World: How Do We Protect Daughters From Eating Disorders?

By Katy Aisenberg, Ph.D.
Guest Contributor

 “Sometimes it is necessary to reteach a thing its loveliness” — Galway Kinnell

After years and tears spent treating girls with eating disorders, I found myself pregnant — in my 40s — with a daughter.

Penelope is now 10, and suddenly, everything I’d preached and chiseled and chipped and interpreted in my office is getting put to the test. How was I going to try to prevent my own child from having an eating disorder?  How would I prevail against a culture of young girls in short shorts, strappy tops and frankly lewd fashion, where my 4th grader must choose between “boyfriend jeans” and “skinny jeans”?  As I had told my patients:  “Many girls entertain diets — not everyone gets an eating disorder.”

Still, I reviewed the early dangers for developing such a disorder — flipping through my own brain for knowledge.

1. Genetics
We had some family history of mood disorders but nothing that seemed so severe it couldn’t be tempered by attentive parenting.

2. Home obsession with foods

I made absolutely sure that nothing in my house was low-fat, low-calorie and insisted that dessert was part of the meal if you ate your ‘growing foods” a useful phrase I learned from her pre-school teacher.



3. Range of affect (or, enough feelings)

Yup, no problem there. My house was never one where feelings were suppressed. In fact, I might have spent too much time inquiring what my child thought or felt. I was politely interrupted. “Mom,” she said, “I’m watching the cars outside” or “Making a friendship bracelet” or “Telling myself a story.”

4. Too much affect

Yes, I wanted to tone this down. She neded to learn resilience — that horrible feelings, the dementors of loneliness, sadness and intense anger can be survived. She needed to endure them and learn to soothe herself. I reminded myself of this as I clenched my nails into my hand while she hurled about in her crib.

5. Too much talk about appearance
I failed on this. I could not even try to stop my outpouring of sheer joy at her natural beauty. I was, as C.S. Lewis said, “surprised by joy” in this department. I craved her attention like a jilted suitor. But it amuses both of us — and possibly helped her — that I would joke about my “separation issues.” I believe I gave her the freedom to express those same feelings and a good many more.

6. A sense of purpose  

We are currently working on this. The most effective cure for the most recalcitrant eating disorders is — surprisingly — community service.  Continue reading

Knees, Food, Periods: Top 10 Medical Tips If Your Daughter Plays Sports

(AP Photo/Gerald Herbert)

(AP Photo/Gerald Herbert)

You could call this “Title IX Medicine.”

Title IX, of course, refers to the landmark 1972 anti-discrimination law that gave huge added impetus to school sports programs for girls, helping create cohorts of more athletic grrrrrrrls.

In Title IX’s 40-plus years, American girls’ participation in high-school and college sports has jumped more than 10-fold to well over 3 million. That means many stronger, healthier girls — but it also means more girls at risk for sports-related injuries and what’s known as the Female Athletic Triad, a worrisome mix of poor nutrition, menstrual dysfunction and danger to bone health.

This week, Boston Children’s Hospital announced the creation of its new “Female Athlete Program,” aimed at treating “the entire female athlete – not just a single injury.”

“We know that the build of girls — both their musculature and bone structure — is different than boys’, as is their hormonal milieu,” said the program’s co-director, Dr. Kathryn Ackerman. “We really need to start tailoring our care of these athletes in a slightly different way.”

Certain specific issues need extra attention among girl athletes, she said. They’re at a five to eight times higher risk of anterior cruciate ligament knee injuries. “Aesthetic” activities like ballet tend to be linked with higher risks of eating disorders. If menstrual cycles become abnormal, bone development could suffer.

Some articles suggest that girls’ soccer is second only to men’s football in terms of concussions.

The new program aims to contrast with the traditional piecemeal approach to girls’ injuries and other health issues, Dr. Ackerman said. For example, “A girl comes in having sustained multiple stress fractures, and no one has asked her about her menstrual status or her calcium or Vitamin D intake or her overall caloric intake.” Some studies, she said, suggest that up to 60 percent of girl athletes have at least one component of the Female Athlete Triad: eating dysfunction, loss of menstrual cycle or low bone density.

Dr. Ackerman, herself a former national team rower, and the program’s co-director, Dr. Martha Murray, an orthopedic surgeon with a swimming background, kindly generated this list of their top 10 tips for parents of girl athletes. Dr. Ackerman expands in the comments below.

Dr. Kathryn Ackerman (Courtesy BCH)

Dr. Kathryn Ackerman (Courtesy BCH)

1. Your daughter can minimize her risk of ACL (anterior cruciate ligament) injury with a simple training program.

It would include hamstring strengthening, landing bio-mechanics, core stability and overall muscular balance. More details in the program’s ACL handout.

2. She needs to be getting good nutrition to play well, especially enough calories and the right amount of calcium and vitamin D.

Calorie counts depend on a girl’s level of activity and growth, but she should be getting 1,300 milligrams of calcium a day until she’s 19, then 1,000 milligrams a day until menopause, when calcium again needs an increase. Vitamin D recommendations vary, but many bone experts recommend at least 800 international units a day for a blood level of at least 30. More details on nutrition here. Continue reading

Did Sylvia Plath Have An Eating Disorder?

Sylvia Plath clearly had issues. Years of depression. Suicide attempts. And finally, death by carbon monoxide poisoning: she placed her head in the kitchen oven with the gas turned on as her children slept nearby.

But an eating disorder? That’s not a problem typically associated with the gifted, tragic writer and poet.

Sylvia Plath (victorismaelsoto/flickr)

Sylvia Plath (victorismaelsoto/flickr)

In a piece in The Huffington Post today, Boston psychotherapist Jean Fain, who specializes in eating issues, raises the question because, she says, she’s long wondered if Plath suffered from disordered eating. Fain searched, but didn’t find any concrete evidence to back her theory. Still, she learned that Plath was quite focused on food and, in general, insecure about her own body. Here’a bit of Fain’s Q and A with Elizabeth Winder, the author of a new book on Plath’s time at Mademoiselle magazine, in 1953:

“Q: …Sylvia occasionally binged. Do you have any suspicions that Plath had an eating disorder?

A. Certainly when you read The Bell Jar, Esther Greenwood, [her fictional character,] eats all this caviar and avocados. Unlike Sylvia Plath, she didn’t seem to be getting enjoyment from it. She was just eating to deal with emotional pain. Continue reading

Feeling Fat, Feeling Old: No Age Limit For Bad Body Image

(NCI/Wikimedia Commons)

(NCI/Wikimedia Commons)

By Jean Fain
Guest contributor

“Look at these wrinkles.”

“I would do anything to look younger.”

“Do you want to come to a Botox party?”

You don’t have to read scientific journals to know that bad body image plagues women of all ages. There’s no getting away from the fact that, even before girls develop curves, self-perceived “figure flaws” are a deep source of distress for the vast majority.

Of course, there’s no shortage of scientific evidence confirming this sad fact of modern life. Just this month, a new study in the Journal of Eating Disorders confirmed what has become painfully obvious: bad body image knows no age limit.

If you missed that study, here’s the research recap: Trinity University psychologist Carolyn Black Becker and colleagues asked more than 900 American, British and Australian women between the ages of 18 and 76 about “fat talk” and “old talk” — complaints about feeling fat and old. All ages complained of feeling fat, but, surprisingly, even the youngest women worried about looking old.

To make sense of this surprising finding, I tracked down Becker and asked her why so many young women engage in “old talk.” Here’s what the San Antonio eating disorders expert told me: Continue reading

Ultimate Eating Disorder? Lose Weight Instantly But Risk Death

(AP photo/Reed Saxon)

(AP photo/Reed Saxon)

You could say it began with a big bowl of chocolate pudding. After days on a starvation diet, 14-year-old Maryjeanne broke down and devoured the whole bowl, spooning the forbidden chocolate sweetness into her mouth straight from the fridge.

Then the regret hit, and the shame. She had failed her 600-calorie-a-day diet. What to do now? She’d had Type 1 diabetes since age 10, and knew she should take some extra insulin to counterbalance all the pudding she’d just eaten. Or she could make a darker choice. She writes in her recent memoir, Eating to Lose:

I skipped my insulin that night. It was my penance.

The next day I lay in my hospital bed with five intravenous tubes connecting the insides of my arms, ankles, and neck to the stark walls of that room. There was not a single ounce of energy left in me. My mouth was drier than Arizona sand. My stomach felt as though it had expelled every morsel of food I had ever eaten. The muscles along my torso felt bruised from endless violent heaving; my insides now entirely evacuated. The combination of this torturous diet and the resulting chocolate pudding binge had cost me two collapsed lungs and nearly ten pounds of weight loss, consisting not of fat, mind you, but primarily of essential bodily fluids.

Maryjeanne had entered the world of “diabulimia,” an eating disorder specific to people with Type 1 diabetes, usually young women. The “bulimia” in the name refers to a diabetic method for purging calories: Instead of vomiting up food as typical bulimics do, someone with diabulimia skips or skimps on insulin, so that blood sugar is “purged” in urine instead of being absorbed and used for energy by the body’s tissues.

The effect can be instant weight loss. Also instant medical crisis, and devastating long-term damage.

Diabulimia offers perhaps the starkest example there is of the harsh “logic” of an eating disorder, an urge to lose weight so overwhelming that health no longer seems to matter. And young women with Type 1 diabetes are two to three times more prone to eating disorders than those without, research finds. The overall prevalence of diabulimia is estimated at up to 1.4 million Americans.

If a young woman is already at risk for an eating disorder, and then she experiences weight loss in a day or two from skipping insulin, “It’s outrageously reinforcing,” said Dr. Ann Goebel-Fabbri of the Joslin Diabetes Center. “That’s a more powerful and dangerous calorie purge than any other eating disorder symptom.”

The price is also exceptionally high. Continue reading

Call To Consider ‘Diabulimia’ As A Mental Illness

Insulin pump (mbbradford/Wikimedia Commons)

Insulin pump (mbbradford/Wikimedia Commons)

Diabulimia? At first I thought it might refer to purging with laxatives. But no, it refers to young women with diabetes who cut back on the insulin they need in order to lose weight. “Diabetes Health” offers some excellent background here, including the explanation that “when insulin is omitted, calories are purged through the loss of glucose in the urine.”

The BBC reports today that a British charity called Diabetics with Eating Disorders is now pushing to have diabulimia recognized officially as a mental illness. The report warns that side effects of not taking enough insulin can range from “eye sight loss to kidney damage and if left untreated can even kill.”

Leading doctors and psychiatrists say diabulimia is most common with young women who have type 1 diabetes…

Figures show, in the 12 months up to last March, more than 8,000 people were admitted to hospital in England and Wales, with symptoms of not taking enough insulin. Continue reading

Stomach-Pumping Machine As ‘Professional Bulimia Tool’

Stomach-Pumping Machine Makes Calories Disappear, yesterday’s Good Morning America headline reads. WBUR’s Rachel Paiste spotted it, and here, she reacts:

By Rachel Paiste
Guest Contributor

The AsipreAssist: It allows you to eat whatever you want, all day, without gaining a pound! (So its makers say.)

I find it disgusting, horrifying, and I’m sure other people would probably say it’s wonderful.  All at once!

The group of inventors behind the Segway have created what basically equals a professional bulimia tool.

(Ephemeral Scraps/flickr)

(Ephemeral Scraps/flickr)

The AspireAssist device allows you to eat what you want…then suck it right back out of your stomach. The ABC news report I stumbled upon says only about a third of the calories consumed are absorbed by the body after the machine sucks out all the icky, undigested bits.

If I reflect for a moment, I remember having similar feelings about the Segway when it was released. Can’t people just walk? Are we really on our way to being the fat globs that float about space in Wall-E?

Maybe we are. What happened to diet and exercise? Portion control? Healthy living? Now, I’m as guilty as the next person of occasionally overeating and regularly eating “dinner” foods at 8 am (though I do come to work at 4am, which is my personal justification…think: it’s dinner time somewhere).

And I know for some people losing weight can feel impossible; and desperate measures may be appropriate. I get that people have painful, lifelong struggles with losing weight. Continue reading