Chapter Nine

1. Chapter Nine Body Image: Viewing Yourself

2. What Shapes Body Image? • Body Image is shaped by mental representations that a person has of his or her own body, including perceptions, attitudes, thoughts and emotions • Culture has a strong influence on one’s body image • Media and the advertising industry have a powerful influence in portraying images of an ideal body

3. Effects of Puberty upon Body Image • Eating disorders are most likely to develop during adolescence • Body fat increases in healthy girls from 12% to 25% during puberty which causes many girls to become concerned about their bodies given the cultural emphasis on being thin • By sixth grade, twice as many girls as boys consider themselves fat • Sixth grade boys are more likely to want to gain weight and have a desire to become more muscular

4. Ethnicity and Body Image • Body satisfaction is also affected by one’s ethnicity • Caucasian women have been found to have the most body dissatisfaction and highest rates of eating disturbances • African American women report less body dissatisfaction, fewer weight concerns, and more positive self image compared to Caucasian women • Asian American women tend to have similar views as Caucasian women • Native American and Hispanic women display similar rates as Caucasian women however Hispanic women indicate less concern about weight than do Caucasian women

5. Men and Body Image • Male body image is not as affected by the media compared to female body image • Historically, men have been judged by accomplishments and strength more than looks • Men are more satisfied with their body size and appearance compared to women • Lately a new trend is emerging where men are becoming increasingly conscious about their physical appearance

6. Eating Disorders • An Eating Disorder is a condition characterized by severely disturbed eating behaviors and distorted body image • Eating Disorders occur primarily among people in Western industrialized countries • They occur in every ethnic, cultural, and socioeconomic group • These disorders are more prevalent when food is abundant and has taken on symbolic meanings (i.e. comfort, love, etc.)

7. Anorexia Nervosa • Anorexia Nervosa is a eating disorder marked by the following diagnostic criteria: • Refusal to maintain body weight at or above a minimal normal weight for age and height • Intense fear of gaining weight or becoming fat • Disturbance in the way in which one’s body weight or shape is experienced • Amenorrhea (absence of at least 3 menstrual cycles) • Some people with anorexia control their weight by using the following: • Restriction of calories • Binge eating and purging behavior

8. Do you know someone with Anorexia? • Physiological Signs: • Large weight loss in a short period of time • Cessation of menstrual periods without an obvious reason • Unusually pale skin • Cold body temperature • Dizziness of fainting spells • Psychological Signs and Attitude Shifts: • Mood swings • Perfectionism • Insecurity about abilities despite competence • Tendency to judge self-worth by what he or she does not eat • Tendency to be withdrawn

9. Do you know someone with Anorexia? • Behavioral Signs: • Fasting or severe dieting • Cutting food into tiny bites, counting bites of food, or preparing food for others but refusing to eat • Expressing an intense fear of becoming fat despite being painfully thin • Staying away from situations where food is available, such as parties • Maintaining a harsh, no-excuses exercise regimen • Dressing in layers to hide weight loss • Binging or purging (vomiting, using laxatives, enemas, or diuretics)

10. Anorexia, it’s not just personal! • Studies by the National Association of Anorexia and Associated Eating Disorders indicate that 20% of people with anorexia will die prematurely as a result of the disorder • The death rate associated with anorexia is 12 times higher than the death rate for all causes for females aged 15-24 • Anorexia has the highest death rate of any psychiatric disorder, about 10%

11. Carmen: A Case of Anorexia Nervosa • What factors seemed to lead to Carmen developing anorexia? • What signs did Carmen display that indicated she was struggling with anorexia? • What would you have done if Carmen was a friend of yours and showed these signs?

12. Bulimia Nervosa • Bulimia Nervosa is an eating disorder marked by consuming large amounts of food, then using inappropriate means to rid themselves of the calories • People with Bulimia also have a disturbed perception of body size and image • Binge eating and purging are behaviors that are considered socially isolating • Purging can consist of self-induced vomiting, misuse of laxatives, diuretics, enemas, or other medications

13. Do you know someone with Bulimia? • Physiological Signs: • Swollen glands, puffy cheeks, or broken blood vessels under the eyes • Frequent sore throat without known causes • Fatigue and muscle aches without known causes • Unexplained tooth decay or erosion of tooth enamel • Yo-yo weight fluctuations within a 10-15 pound range • Psychological Signs and Attitude Shifts: • Mood swings that include depression, sadness, guilt, or self-loathing • Harsh self-criticism • Need for the approval of others • Self-worth based on weight

14. Do you know someone with Bulimia? • Behavioral Signs: • Binging • Being secretive about food; stealing or hiding food • Talking constantly about food or weight • Avoiding restaurants, planned meals, or social events with food present • Putting his or herself down for eating too much • Leaving the table and going to the bathroom right after a meal • Vomiting, using laxatives, enemas, or diuretics • Taking diet pills • Maintaining a harsh, no-excuses exercise regimen • Expressing an intense fear of becoming fat despite being normal weight

15. Bulimia, it’s not just personal! • An estimated 10% of college-aged women suffer from bulimia • Men make up about 10% of those who have bulimia • An estimated 10% of individuals with bulimia will die from complications of the disorder, including cardiac arrest

16. Lauren: A Case of Bulimia Nervosa • What factors might have lead to Lauren developing bulimia? • What signs did Lauren display that indicated she was struggling with bulimia? • What would you have done if Lauren was a friend of yours and showed these signs?

17. Binge Eating Disorder • Binge Eating Disorder has been recognized as a psychological disturbance that is associated with obesity • This disorder involves binge eating without vomiting or purging • About 10% of patients in weight loss clinics are believed to have binge eating disorder • ¼ of patients are male, although exact figures are still unclear • Depression is a symptom of this disorder that is not commonly seen from other obese people

18. Zach: A Case of Binge Eating Disorder • What factors might have lead to Zach developing a binge eating disorder? • What signs did Zach display that indicated he was struggling with a binge eating disorder? • What would you have done if Zach was a friend of yours and showed these signs?

19. Low Self-esteem Self-critical attitude Belief in the importance of thinness Black and White thinking Feelings of emptiness Desire to be special or unique Need for power and control Desire for respect and admiration Difficulty in expressing feelings Need for escape or a safe place Lack of coping skills Lack of trust in self or others Being terrified of failure Characteristics and Patterns of Thought Associated with Eating Disorders

20. Severe weight loss Imbalance of electrolytes Emaciated body Dry, cold, and discolored skin Bloated abdomen Swollen legs Immune system is compromised Abnormal heart function Lanugo develops (body hair) Bones become demineralized Decreased blood flow to brain and other organs Amenorrhea (in women) Lethargy Testosterone decreases (men) Health Effects of Anorexia Nervosa

21. Electrolyte imbalance Stomach enlarges Irregular heart rhythms Inflammation of the esophagus Tooth enamel erodes Calluses form on the hands Abnormal function of the intestines (laxative use) Fluid loss (due to diuretics) Effects blood pressure Possible severe internal bleeding Health Effects of Bulimia Nervosa

22. Cardio-respiratory disease Diabetes High blood pressure Gall bladder disease Osteoarthritis Sleep apnea Certain cancers Joint problems High cholesterol levels Health Effects of Binge Eating Disorder

23. Treating Eating Disorders • Aside from osteoporosis, most of the negative health conditions are reversible • The first step towards treatment is to recognize the problem • Effective treatment involves a multidisciplinary team of medical personnel, and possibly hospitalization • Once weight has been stabilized, the next phase is behavioral modifications through psychotherapy, education, and even medication

24. Body Dysmorphic Disorder • Body Dysmorphic Disorder is a pre-occupation with an imagined or exaggerated defect in appearance • This pre-occupation causes significant distress or impairment in social, occupational, or other important areas of functioning • Other concepts of concern related to this disorder are: • Muscle Dysmorphia (obsession with muscle building) • Use of Cosmetic surgery • Activity Disorder (excessive exercising)

25. Awareness and Prevention: Promoting a Healthy Body Image • Become more aware of your own attitudes about body image, body weight, and the role of men and women in society • Be a role model for your children by communicating your own healthy body image approaches and problem solving skills appropriately • Support community organizations and programs directed towards healthy lifestyle patterns • Become active in changing social messages

26. Chapter Nine Body Image: Viewing Yourself