Healthy Bodies Healthy Minds

By Catherine Steiner-Adair and Lisa Sjostrom

The following excerpts are from a new curriculum book called Full of Ourselves: AWellness Program to Advance Girl Power, Health, and Leadership by Catherine Steiner-Adair and Lisa Sjostrom. (Teachers College Press, 2006) The program, which began as part of the Harvard Eating Disorders Center, has been piloted in 40 sites around the country. It involves activities to counter media culture, develop healthy eating and activity levels, and celebrates the many sizes and shapes of the human body.
— the editors

Over the last few years, it has become increasingly clear that America’s children struggle far too often and far too early with disordered eating and eating disorders. Anorexia, bulimia, and obesity are all on the increase. Eating disorders rank as one of the most common chronic psychiatric illnesses among young women, and their prevalence among teenage and preteen girls is growing. On the other end of the spectrum, childhood obesity has reached troubling proportions.

This serious scenario makes evident the need for large-scale health education and eating disorders prevention efforts. It is imperative that we invest in effective ways to equip children — and the adults who can potentially make a significant difference in their lives — with tools to resist cultural directives toward body preoccupation, overeating, and disordered eating behaviors.

Girls are growing up in a popular culture and an economy that continue to send them the message that what they look like is more important than who they are. In some communities, being the “prettiest” girl means being the thinnest; in others, being the curviest; and in others, being the most “buff.” While the idea image may vary, what remains sadly consistent is just how many girls refer to their body as the ultimate measure of their worth: Many girls literally weigh their self-esteem. This focus on bodies as a primary source of identity predisposes girls to disordered thinking and to disordered eating, which can escalate into a full-blown eating disorder and serious health problems. Disordered eating also disrupts learning; when a girl diets, skips meals, or subsists mainly on junk food, she’s not getting the nourishment she needs to think and to perform at her best.

Warning Signs for Eating Disorders

Eating disorders are serious illnesses; the longer symptoms persist, the harder it is to successfully treat the disorder. The sooner warning signs and symptoms are recognized and responded to, the better the prognosis. That said, because many people are concerned with weight and diet at least occasionally, it can be difficult to tell what is normal behavior and what is a problem that may escalate to an eating disorder.

Below is a list of warning signs to help you identify the presence of an eating disorder. While it is rare for one person to display all of these warning signs, people with eating disorders often manifest several of them.

  1. Excessive preoccupation with weight/ weighing, food, calories, and/or dieting
  2. Excessive and/or compulsive exercise regimen: the need to “burn off” calories regardless of bad weather, fatigue, sickness, and/or injury
  3. Withdrawal from activities because of the presence of food and/or weight and shape concerns
  4. Evidence of self-induced vomiting or use of laxatives, diuretics, purgatives, enemas, or diet pills
  5. Evidence of binge-eating, including hoarding and/or stealing food
  6. Alternating periods of severely restricting dieting and overeating, often accompanied by dramatic weight fluctuations
  7. Other unusual eating behaviors: skipping meals, eating tiny portions, fear of eating in front of other people, ritualistic or secretive eating, cooking for others but not participating in eating/enjoying the food
  8. Abnormal weight loss of 25 percent or more, with no known medical illness accounting for the loss
  9. Distorted body image and/or anxiety about being fat/weight gain/obesity that does not diminish as weight is lost
  10. Loss or irregularity of the menstrual cycle or inexplicable problems with menstruation (in females)

10 Tips for Schools — Create a Culture that Supports Student Well-Being

  1. Encourage faculty to model acceptance of diverse body shapes, sizes, and appearances — starting with their own. Create a protocol of acceptable topics of discussion; for instance, it is not appropriate for a teacher to comment on one another’s or a student’s weight, no matter how well-intentioned. Provide professional development on health, nutrition, and the signs and symptoms of eating disorders.
  2. Provide a range of affordable, fresh, nutritious foods. Work with food service to ensure greater consistency between food choices in the cafeteria and nutrition information taught in Health class. Eliminate vending machines — or stock them with healthier choices.
  3. Check out the visual images in your school. Do they promote well-being and acceptance of body size diversity? For example, do the posters, books, magazines, videos, and artwork displayed in the school reflect a range of body shapes and appearances?
  4. Don’t weigh kids publicly — ever. Don’t weigh kids on the first day of school. Avoid placing scales in public places (such as locker rooms) where students with body and/or weight preoccupation can ruin their ability to concentrate by getting on the scale.
  5. Review your school’s anti-harassment and anti-discrimination policies. Do these include injustices based on physical appearance and body size or shape? Provide students with both formal and informal avenues to report incidents of teasing, bullying, or harassment. Include information on “weightism” in all school diversity awareness campaigns.
  6. Don’t discriminate or play favorites on the basis of appearance. In particular, watch out for favoritism of girls who fit the cultural definition of “pretty.” Whenever possible, see that students of diverse body sizes are chosen as leaders for a variety of tasks (e.g., as school representatives, in theatrical productions, as team captains, etc.).
  7. Educate parents. Host an evening forum to inform all interested parents and other relatives about body image and eating disorder issues.
  8. Designate a school eating disorders resource team. This might include a school nurse, counselor, teacher, and other staff members who are interested in enhancing students’ health. Provide training about eating disorders and treatment. Develop a database of local counseling centers and medical practitioners that serve students with eating disorders and body image issues.
  9. Establish policies and protocols that relate specifically to eating disorders. Create a standard protocol for approaching and referring students with possible eating problems, as well as guidelines for contacting parents and liaising with outside health professionals.
  10. Refer at-risk students. If you are concerned about a student, share your concerns with the eating disorders research team or other staff members who know the student. Decide together on the best course of action — which may include referral to a qualified professional.

Sample Activity Face-Off: A Group Collage

This collage can be created in less than 10 minutes. You’ll need scissors, glue sticks, black pens, and one sheet of oaktag. Draw a circle on the oaktag, leaving some space around the edges where the girls can write.

Hand out scissors and instruct the girls to cut or tear out female faces from their magazines: large faces, small faces, no bodies, no necks, just faces and hair.

Have the girls glue overlapping faces inside the circle to create a collage.

While the girls are cutting and gluing, encourage conversation. Pose casual questions and comments to the group:

  • Funny how they look so similar. Any of these girls having a bad-hair day?
  • Anyone wearing glasses? Braces? Any pimples? Birthmarks? Moles? Bushy eyebrows? Runny noses?
  • Not many girls of color, Indian girls, Asian faces, or chubby faces, huh? Who’s left out?
  • The beauty industry rakes in $13 billion a year. How many college educations would that buy?
  • If these faces could talk, what would they be saying? Draw “talk bubbles” around the margins of the collage and have the faces “talk.”
  • Would you like to say anything to the fashion stylists who create these images? Write in the margins. (Exam-ples from past participants: Get real! No plastic surgery allowed! Don’t have her just look pretty, have her do something. Eat!)

Give girls black pens and challenge them to alter the faces so that they look more realistic. For example, add pimples, facial hair, glasses, and so on.

Display the “defaced” collage in a prominent place.

Discussion Questions

  1. Agree or disagree: Models look the same in person as they do on the cover of a magazine.
  2. Studies show that after just 15 minutes of reading fashion magazines, girls and women feel crummy and worse about themselves. Can anyone guess why?

Comment: Advertisers want us to believe that we have to buy something and change ourselves to be happy and valued. Advertisers want your money, and they’ll do anything to get it — including making you feel insecure.

Reprinted by permission of the publisher from Catherine Steiner-Adair and Lisa Sjostrom, Full of Ourselves: AWellness Program to Advance Girl Power, Health, and Leadership. (New York: Teachers College Press, © 2006 by Teachers College, Columbia University. All rights reserved.), pp. xi-xii, 41, 99-100,104. To order copies, please contact Teachers College Press at