Anorexia Nervosa ~Adapted from the National Eating Disorders Association web site

1. Anorexia Nervosa~Adapted from the National Eating Disorders Association web site

2. Bulimia Nervosa-A cycle of binging and compensatory behaviors (vomiting or laxative abuse) attempting to undo binge eating ~Adapted from the National Eating Disorders Association web site

3. Symptoms -Eating large quantities of food in short periods of time -Feeling out of control over eating behavior. -Feeling ashamed or disgusted by the behavior. -Behavioral indicators of BED: eating when not hungry and eating in secret. Consequences -The health risks of BED are most commonly those associated with clinical obesity. -High blood pressure -High cholesterol levels -Heart disease -Diabetes mellitus -Gallbladder disease About Binge Eating Disorder: -The prevalence of BED is estimated to be approximately 1-5% of the general population. -Binge eating disorder affects women slightly more often than men--estimates indicate that about 60% of people struggling with binge eating disorder are female, 40% are male (NIH, 1993). -People who struggle with binge eating disorder can be of normal or heavier than average weight. -BED is often associated with symptoms of depression. -People struggling with BED often express distress, shame, and guilt over their eating behaviors. Binge Eating Disorder An eating disorder not otherwise specified and is characterized by recurrentbinge eating without the regular use of compensatory measures to counter the binge eating.~ Adapted from the National Eating Disorders Association web site

4. What Causes Eating Disorders? Psychological Factors that can Contribute to Eating Disorders: Low self-esteem -Feelings of inadequacy or lack of control in life -Depression, anxiety, anger, or loneliness Interpersonal Factors that Can Contribute to Eating Disorders:-Troubled family and personal relationships -Difficulty expressing emotions and feelings -History of being teased or ridiculed based on size or weight -History of physical or sexual abuse Social Factors that Can Contribute to Eating Disorders:-Cultural pressures that glorify "thinness" and place value on obtaining the "perfect body" -Narrow definitions of beauty that include only women and men of specific body weights and shapes -Cultural norms that value people on the basis of physical appearance and not inner qualities and strengths ~ Adapted from the National Eating Disorders Association web site

6. How to Help a Friend: • Discuss your intentions with a counselor or family physician and get their advice. • Plan the intervention carefully: who should be there, what you'll say, what time and place • Be able to give specific examples of his/her behavior that concern you. • Don't criticize, accuse, or dwell on appearance/weight (you might inadvertently reinforce the disorder!) • Use "I" statements such as "I'm really concerned that you don't seem to eat during meals"  • You may notice resistance or denial of the problem. • Acknowledge his/her fears • Avoid giving simple solutions ("If you'd just stop, everything would be fine!") • Encourage professional help. You should have resource phone numbers ready. • Show caring and continued friendship (don't threaten to withdraw your friendship if they don't get help). • Keep trying. You never know at what moment they may be more receptive to getting help. • Educate yourself about eating disorders first, that way, if they have questions, you can help answer them. • Get support for yourself if you find yourself becoming stressed/upset in trying to help your friend. ~Adapted from the University of Florida’s Eating Disorder Website: http://www.health.ufl.edu/shcc/ed/friend.htm

7. University of Florida Campus Resources Student Health Care Center, Eating Disorders Medical Evaluation, 392-1161 Counseling Services, 392-1171 Nutritional Services and Health Education, 392-1161 ext. 4281 University of Florida Counseling Center, 301 Peabody Hall www.counsel.ufl.edu, 392-1575 Gainesville Community Resources Alachua County Crisis Center, 264-6789 Shands at AGH Emergency Room, 338-2111 Shands Hospital Emergency Room, 265-0050 Overeater’s Anonymous, www.oanortheastflorida.com, 491-5069 Websites Gurze Books, Eating Disorders Publications, www.gurze.com National Eating Disorders Association, www.nationaleatingdisorders.org Anorexia Nervosa and Related Eating Disorders, www.anred.com American Dietetic Association, www.eatright.org Something Fishy (Links and Resources on Eating Disorders and Body Image Issues), www.something-fishy.org National Eating Disorder Information Center, www.nedic.ca Caring Online, www.caringonline.com/eatdis/topics/bodyimage.htm HOPE-www.hopetolive.com Helpful Resources: Toll-Free hotline for NEDA: 1-800-931-2237

8. Eating Disorders - Statistics ~ Adapted from the National Eating Disorders Association web site

9. Eating Disorders – Statistics Continued~ Adapted from the National Eating Disorders Association web site The Drive for Thinness *42% of 1st-3rd grade girls want to be thinner. *81% of 10 year olds are afraid of being fat. *The average American woman is 5’4" tall and weighs 140 pounds. *The average American model is 5’11" tall and weighs 117 pounds. *Most fashion models are thinner than 98% of American women. Dieting *51% of 9 and 10 year-old girls feel better about themselves if they are on a diet *46% of 9-11 year-olds are "sometimes" or "very often" on diets, and 82% of their families are "sometimes" or "very often" on diets. *91% of women recently surveyed on a college campus had attempted to control their weight through dieting, 22% dieted "often" or "always" . *95% of all dieters will regain their lost weight in 1-5 years. *35% of "normal dieters" progress to pathological dieting. Of those, 20-25% progress to partial or full-syndrome eating disorders. *25% of American men and 45% of American women are on a diet on any given day. *Americans spend over $40 billion on dieting and diet-related products each year.

10. University of Florida Research Study of 10,000 students: ~ 1% of students were identified as being anorexic ~ 12% of students were identified as being bulimic ~ 65% of students showed signs of disordered eating

11. No Weigh!- A Declaration of Independence from a Weight-Obsessed World - I, the undersigned, do hereby declare that from this day forward, I will choose to live my life by the following tenets. In so doing, I declare myself free and independent from the pressures and constraints of a weight-obsessed world. • I will accept my body in its natural shape and size. • I will celebrate all that my body can do for me each day. • I will treat my body with respect, giving it enough rest, fueling it with a variety of foods, exercising it moderately, and listening to what it needs. • I will choose to resist our society’s pressures to judge myself and other people on physical characteristics like body weight, shape, or size. I will respect people based on the qualities of their character and the impact of their accomplishments. • I will refuse to deny my body of valuable nutrients by dieting or using weight loss products. • I will avoid categorizing foods as either “good” or “bad.” I will not associate guilt or shame with eating certain foods. Instead, I will nourish my body with a balance of foods, listening and responding to what it needs. • I will not use food to mask my emotional needs. • I will not avoid participating in activities that I enjoy (i.e., swimming, dancing, enjoying a meal) simply because I am self-conscious about the way my body looks. I will recognize that I have the right to enjoy any activities regardless of my body shape or size. • I will believe that my self-esteem and identity come from within!! • SIGNATURE: _______________________ DATE:_________________

12. Get Real.Get Real Expectations. Get Real Information. Get Real Help.~ Adapted from the National Eating Disorders Association web site • Create a list of all the things you like about who you are - read it and add to it often. • Don’t let your weight or shape keep you from participating in activities that you enjoy. • 3. Become aware of what your body helps you do each day. Remember that it is the instrument of your life, not just an ornament. • 4. Think about all of the things you could accomplish with the time and energy you currently waste worrying about your appearance. Try one! • 5. Don’t exercise to lose weight or to fight your body. Do it to make your body healthy and strong and because it makes you feel good. • 6. Remind yourself: Life is too short to waste time hating your body! • 7. Consciously choose to avoid making comments about other people or yourself on the basis of body size or appearance. • 8. Enjoy your favorite meal without feelings of guilt or anxiety over calories and fat grams. • 9. Throw out the diet products in your house (e.g. fat-free cheese, diet pills, the scale). • 10. Eat when you are hungry. Rest when you are tired. Surround yourself with people that remind you of your inner strength and beauty. Get Real.

13. 1.Think of your body as the vehicle to your dreams. Honor it. Respect it. Fuel it. 2. Create a list of all the things your body lets you do. Read it and add to it often. 3. Become aware of what your body can do each day. Remember it is the instrument of your life, not just an ornament. 4. Create a list of people you admire: people who have contributed to your life, your community, or the world. Consider whether their appearance was important to their success and accomplishments. 5. Walk with your head held high, supported by pride and confidence in yourself as a person. 6. Don't let your weight or shape keep you from activities that you enjoy. 7. Wear comfortable clothes that you like and that feel good to your body. 8. Count your blessings, not your blemishes. 9. Think about all the things you could accomplish with the time and energy you currently spend worrying about your body and appearance. Try one! 10.Be your body's friend and supporter, not its enemy. 11.Consider this: your skin replaces itself once a month, your stomach lining every five days, your liver every six weeks, and your skeleton every three months. Your body is extraordinary--begin to respect and appreciate it. 12.Every morning when you wake up, thank your body for resting and rejuvenating itself so you can enjoy the day. 13.Every evening when you go to bed, tell your body how much you appreciate what it has allowed you to do throughout the day. 14.Find a method of exercise that you enjoy and do it regularly. Don't exercise to lose weight or to fight your body. Do it to make your body healthy and strong and because it makes you feel good. 15.Think back to a time in your life when you felt good about your body. Tell yourself you can feel like that again, even in this body at this age. 16.Keep a list of 10 positive things about yourself--without mentioning your appearance. Add to it! 17.Put a sign on each of your mirrors saying, "I'm beautiful inside and out." 18.Choose to find the beauty in the world and in yourself. 19.Start saying to yourself, "Life is too short to waste my time hating my body this way." 20.Eat when you are hungry. Rest when you are tired. Surround yourself with people that remind you of your inner strength and beauty. 20 Ways to Love Your BodyCompiled by Margo Maine, Ph.D.Don't Weigh Your Self-Esteem. It's What's Inside That Counts!!