Prevention Tips for:
PARENTS, ADULT, PEERS | MEN & FATHERS | PROFESSIONALS

Basic Principles for the Prevention of Eating Disorders

Eating disorders are serious and complex problems. We need to be careful to avoid thinking of them in simplistic terms, like "anorexia is just a plea for attention," or "bulimia is just an addiction to food." Eating disorders arise from a variety of physical, emotional, social, and familial issues, all of which need to be addressed for effective prevention and treatment.

Eating disorders are not just a "woman's problem" or "something for the girls." Males who are preoccupied with shape and weight can also develop eating disorders as well as dangerous shape control practices like steroid use. In addition, males play an important role in prevention. The objectification and other forms of mistreatment of women by others contribute directly to two underlying features of an eating disorder: obsession with appearance and shame about one's body.

Prevention efforts will fail, or worse, inadvertently encourage disordered eating, if they concentrate solely on warning the public about the signs, symptoms, and dangers of eating disorders. Effective prevention programs must also address:

>Our cultural obsession with slenderness as a physical, psychological, and moral issue.
>The roles of men and women in our society.
>The development of people's self-esteem and self-respect in a variety of areas (school, work, community service, hobbies) that transcend physical appearance.

Whenever possible, prevention programs for schools, community organizations, etc., should be coordinated with opportunities for participants to speak confidentially with a trained professional with expertise in the field of eating disorders, and, when appropriate, receive referrals to sources of competent, specialized care. For personal information, contact us at speak@umich.edu or check out the resources link on this site.

TIPS FOR PARENTS, PEERS, AND ADULTS (top)

• Examine, explore, and if necessary, modify the appearance expectations you have about your child or unborn child (e.g., will she grow up to be pretty, etc.).
• Examine your own attitudes, beliefs, prejudices, and behaviors about food, weight, body image, physical appearance, health, and exercise.
• Replace unhealthy attitudes with healthy ones.
• Replace extreme eating and exercise habits with more moderate ones.
• Do not talk about or behave as if you are constantly dieting.
• Do not "model" or otherwise communicate the message that you cannot dance, swim, wear shorts, or enjoy a summer picnic because you do not look a certain way or weigh a certain amount.
• Encourage balanced eating of a variety of foods in moderation.
• Allow all foods in your home.
• Encourage eating in response to body hunger.
• Notice often and in a complimentary way, how varied people are -- how they come in all colors, shapes, and sizes. (Show appreciation for diversity and a respect for nature. Link respect for diversity in weight and shape with respect for diversity in race, gender, ethnicity, intelligence, etc.)
• Become a critical consumer of the media -- pay attention to and openly challenge media messages. Talk with your children about the pressures they see, hear, and feel to diet and to "look good."
• Convey to children that weight and appearance are not the most critical aspects of their identity and self-worth.
• Build self-esteem. The most important gift adults can give children is self-esteem. When adults show children that they value and love them unconditionally, children can withstand the perils of childhood and adolescence with fewer scars and traumas. Self-esteem is a universal vaccine that can immunize a youngster from eating problems, body image distortion, exercise abuse, and many other problems. Providing self-esteem is the responsibility of both parents. Girls especially need support and validation from their fathers.
• Encourage open communication. Teach children how to communicate. Encourage children to talk openly and honestly and really listen to them. Let them know that their opinions and feelings are cared for and valued. Being encouraged to assert themselves helps young people say no to pressures to conform. Feeling loved and confident allows them to accept that they are unique individuals.
• Encourage critical thinking. The only sure antidote to the tendency to conform to the powerful seduction of the media and peer pressure is the ability to think critically. Parents have to encourage critical thinking early, and educators have to continue the mission. We need to teach kids how to think, not what to think, and to encourage them to disagree, challenge, brainstorm alternatives, etc. Girls especially need to learn that men are not the ultimate authorities and that they themselves have something important to contribute.
• Develop a value system based on internal values. Help children understand the importance of equating personal worth with care and concern for others, wisdom, loyalty, fairness, self-care and self-respect, personal fulfillment, curiosity, self-awareness, the capacity for relationships, connectedness and intimacy, individuality, confidence, assertiveness, a sense of humor, ambition, motivation, etc.
• Help children accept and enjoy their bodies and encourage physical activity.
• Discourage the idea that a particular diet or body size will automatically lead to happiness and fulfillment.
• Don't use food as a reward or punishment. It sets food up as a potential weapon for control.
• Don't constantly criticize your own shape ("I'm so fat--I've got to lose weight."). Such self-criticism implies that appearance is more important than character.
• Don't equate food with positive or negative behavior. The dieting parent who says she was "good" today because she didn't "eat much" implies that eating is bad, and that avoiding food is good. Similarly, "don't eat that--it will make you fat" implies that being fat makes one unlikable.
• Be aware of some of the warning signs of eating disorders. Understand that these warning signs can appear before puberty. Watch for: refusing typical family meals, skipping meals, comments about self and others like "I'm too fat; she's too fat," clothes shopping that becomes stressful, withdrawal from friends, irritability and depression, any signs of extreme dieting, bingeing, or purging.
• Love, accept, acknowledge, appreciate, and value your children -- out loud -- no matter what they weigh.
• Trust your children's appetites. Never try to limit their caloric intake -- unless requested to do so by a physician for a medical problem.
• Learn about and discuss with your sons and daughters the dangers of trying to alter their body shape through dieting.
• Don't support pornography or other "institutions" that cast women as objects for the pleasure of men, objects without personal integrity.
• Give boys and girls the same opportunities and encouragement (in assignment of chores, choosing a sport, etc.) and avoid restricting children to gender-specific activities (boys can enjoy cooking and girls can fix cars). Take females more seriously for what they say, feel, and do, and less seriously for what they look like.
• Teach children about good relationships and how to deal with difficulties when they arise. Males and females alike may use food to express or numb themselves instead of dealing with difficult feelings or relationships. Because of messages that suggest that the perfect body will dissolve all relationship problems, young people often put energy into changing their bodies instead of their feelings or their relationships.
• Teach children about spirituality.

FOR MEN & FATHERS (top)

• Develop a historical perspective on the politics of the control of women's bodies.
• Work toward and speak out for women's rights: to fair pay, to safety, to respect, and to control of their bodies.
• Demonstrate a respect for women as they age, in order to work against the cultural glorification of youth and a tightly controlled ideal body type. (Why is it that only men should become distinguished as they age, while women become wrinkled and need face-lifts?)
• Learn to and practice nourishing women's spirits, so they won't feel an empty hunger for beauty and for unhealthy amounts of food.
• Educate your children about the existence, the experience, and the ugliness of prejudice and oppression -- whether it is directed against people of color or people who are overweight.
• Devote yourself to raising non-sex-stereotyped children by modeling and living gender equality at home.
• Demonstrate respect for all people.
• Remain close to and supportive of your daughters as they experiment and struggle with body image, grooming and cosmetic issues, flirtatiousness and sexuality, etc.
• Talk to your sons about the way body shape and sexuality (for both boys and girls) are manipulated by the media and the struggle their sisters or girlfriends have in trying to conform or not to conform.
• Model patience, compassion, tenderness, fallibility, and most importantly, the capacity and desire to listen.

FOR MENTAL HEALTH PROFESSIONALS (top)

• Educate yourself about the warning signs of eating disorders.
• In your work with children, emphasize self-esteem, critical thinking, self-assertion, and communication skills. These strengths will inoculate children against pressures they experience to change and harm their bodies in the pursuit of "perfection, goodness, and happiness."
• Become political and socio-cultural advocates (i.e. volunteer with S.P.E.A.K.!) -- invite children you work with to challenge the ways in which our culture glorifies thinness. 43. Encourage the young men you work with to examine their own "weightist" attitudes and behavior toward females.
• Become knowledgeable about and able to discuss the scientific evidence concerning a variety of complex topics including: the physical development of boys and girls during puberty, "set point" regulation and defense of natural body weight, the futility and dangers of dieting, and the ways in which our culture has exaggerated the "risks" of being overweight.
• Develop systems whereby you can connect to teachers and coaches who can, in turn, reach out to help children who are expressing problems with their eating and body image. 46. Strengthen and support families so they are able to more effectively provide the security, acceptance, support, and direction that children need in order to inoculate them from negative media influences.
• Help parents reclaim their rights as experts. Empower parents to listen to their children and find solutions that will be best for them.
• Recognize how our changing world alters what children need from parents today. Socio-cultural pressures surrounding drugs, sexuality, body image, and perfectionism require great character strength, self-assurance, and decision-making in young children. Support parents to give more attention to children in these areas.
• Appreciate with families how we all use food for the wrong reasons at times. Help families understand the power and role of food in their own lives as it soothes, rewards, and punishes. Both parents should be actively involved in meal planning and preparations so that food and nurturing do not appear to be exclusive responsibilities or burdens for women. Encourage families to return to the traditional shared family meal in any way they can.
• Educate your community about the risks and the dangers of eating disorders while at the same time being careful not to promote or teach young people how to become eating disordered. In some ways, children are actually the highest risk audience. Audiences with less risk are school personnel, parent groups, athletic directors, and day-care personnel. Have a system in place if a child does have a problem and be supportive of family and friends of the person with the problem. You may work with the family while someone else is working with the identified patient. Give information and support. Reduce shame and guilt. Blaming parents guarantees treatment failure. Work with families to create and restore healthy eating and interaction patterns.

Be optimistic!! Together we can make a difference.

The above material was written by Linda Smolak, Ph.D. and Michael Levine, Ph.D. and presented at the13th National NEDO Conference. This material is copyrighted and may be reproduced or used for educational and non-profit purposes only, with acknowledgment of Dr. Smolak, Dr. Levine, and EDAP.