Talking to young people about body image

feet-on-scalesBy trying to steer teens away from unhealthy lifestyles, we could well be pushing them into anorexia, bingeing or bulimia.

That’s what the research suggests. With soaring rates of obesity and eating disorders in kids, today’s young people are getting powerful messages targeted to help them make healthy choices. But at the same time, the prevalence of eating disorders has actually increased among young people.

Between 1995 and 2005, the number of males and females with disordered eating has doubled, and eating disorders are now the third most frequent chronic illness in adolescent females. More and more adolescents are resorting to bingeing and purging, whatever size or shape they are. The number of admissions to the Children’s Hospital at Westmead’s Eating Disorder Service has increased four times since 2000.

Researchers and psychologists are now suggesting that public and school-based health advice for young people could be driving this trend toward bingeing, purging and restricting. And that’s no small matter, considering almost 1 million Australians now suffer from eating disorders.

So how exactly do we bridge this gap of promoting health in young people, without pushing them into a different set of problems?

Anyone who’s dealt with disordered eating knows that it’s too complex to reduce to a single cause – genetics, perfectionism, trauma, or depressive/anxious symptoms (among other things) can all play a role. The truth is that people who are predisposed to eating disorders will have a number of triggers, and counselling is often the best help to untangle the threads of the disorder. I can attest to this as a former anorexic who began restricting myself at age 17.

More research and activism is needed to ensure that public messages are not harming young people. But, individually, we can each help to change the conversation to avoid harm. On the back of research from National Eating Disorder Collaboration into public health communications to young people, here are some key areas to consider in speaking about health and body image.

Focus on healthy lifestyle, not appearance or shape.

Our media does us no favours with those “before” and “after” shots, or stories of celebrities who couldn’t be happier now that they’ve lost that 5 kilos. What gets lost in translation is that being healthy is not about how you look.

There were many steps I could have taken to be more active and eat better, but as a teen, I didn’t understand what this looked like, and then felt a lack of control over my body which pushed me into extreme behaviour. Skipping breakfast seemed a good tactic for helping me lose weight – when actually, eating breakfast would have helped kick-start my metabolism and increase my energy.

The trouble was around my misplaced priorities (trying to be thin) and my ignorance of how to keep a healthy weight. How to live a healthy life was a mystery to me. Simple and concrete steps would have helped me – just daily healthy choices. Eating breakfast every day, working physical activity into routine, walking the dog, playing sport and regular family meals are basic ways of promoting a healthy lifestyle, without making a certain weight into the aim.

Try to avoid numbers.

It took me a long time to realise that the number on the scale means different things to different people. You can’t make a judgment on someone based on this number – especially not the increasingly discounted BMI measurement. This is important to remember for two reasons.

First, for teens who are prone to disordered eating, quoting how many kilos a person weighs or what their BMI is can be like a red flag in front of a bull. I remember knowing what an “underweight” number sounded like, thanks to BMIs and magazines – and when I hit that weight, it was an achievement. This is typical of eating disorders, which are hugely competitive. Hence why there are so many problems in eating disorder hospital wards with patients competing with one another.

Second, depending on your height and other factors, one weight looks and feels very different on different people. Your health is determined by other factors than weight or BMI, including height, genetics and physical activity, and is much more complex than what you happen to weigh. If you place too much emphasis on numbers, you get situations where otherwise sporty, healthy girls are told they are an unhealthy weight, all because BMIs don’t take muscle mass into account.

Numbers aren’t the story. So try to avoid numbers.

When talking about nutrition, it’s about moderation, not exclusion.

We get messages all the time demonising saturated fat, sugar, and carbohydrates. And it’s valid that some foods should be eaten rarely because of their high fat or sugar content, or just the fact they have no nutritional value.

But it’s important to emphasise to kids that it’s not healthy to cut out whole food groups. Child and adolescent psychologists point out that young minds tend to be more concrete, meaning they’re more likely to take nutrition advice to extremes. The result is that some kids can start avoiding fats and sugars altogether, when actually you need different types of these in balance to keep you healthy.

My story is typical of the research. As a 17-year-old, I would read food labels and screen out any foods with a certain number of grams of fat or sugar in them, and removing certain “bad” foods altogether. I still have an aversion to some of these foods. What I didn’t realise is that “fat”, “sugar” or “carbohydrates” aren’t evil. Not to mention that an occasional treat – like birthday cake or a packet of chips – is not a one-way ticket to bingeing or relapse.

In a sentence: Sugary, fatty and “junk” foods may be the smallest part of the food pyramid, but they’re still part of the pyramid.

Losing weight is not a virtue.

We congratulate people for losing weight, and it’s true that it can help your overall health. But being thin is not an indicator that you’re healthy. Someone out there may be lighter than you, but they’re not healthy if they don’t eat a balanced diet and have never exercised. Someone out there may be heavier than you, but they exercise daily, eating across the food groups and have muscle mass adding to their weight. Health is so much more complex than weight.

For teenage me, losing weight was a positive reinforcement for my lifestyle. It made me believe that big weight is bad, small weight is good, and gaining weight is a failure. This just isn’t true. My smallest weight was not healthy and actually caused me health issues, instead of solving them. I am a larger weight now, but have more energy and feel much healthier than I did then.

Losing weight can mean a healthier lifestyle, but it’s not the aim for its own sake. Motivation is key.

There are many body shapes.

As a society, we see only a limited number of body shapes portrayed by the media – and for teenagers, this is confusing when your body shape doesn’t fit that mould. Deconstructing media imagery and pointing out how diverse bodies are is important at this and any age.

Some people are naturally lighter or heavier for a variety of genetic, physical or emotional reasons, and we need to dispel the stigma around any point on the spectrum. It’s a vicious cycle that weight stigma can result in disordered eating, which then leads to more weight stigma.

This sounds obvious, but as a teen, I honestly thought I could be as skinny as a supermodel if I just tried. If I didn’t look that way yet, I just needed to lose more weight. It took me a year or two of dieting to realise that I will never be a waif. It took a while longer for me to realise that that’s okay. Whatever my size or shape, my body is worthy of care. I could have saved a lot of heartache by realising that bodies come in all types, that there’s no ideal type, and that mine was fine the way it was. Not because of anything about it, necessarily, but because all bodies have intrinsic value.

Model healthy body image

This is the key to all of the above. At the heart of it, positive body image is making a choice to nourish and care for your body, regardless of what you ate or how you’re feeling about it. It’s also a choice to see other people positively, whatever their shape or size, in a culture where we vilify people for their weight or lifestyle choices.

Appreciating your body for what it does is a powerful testimony to anyone, let alone an impressionable young person. And in so doing, it’s shown that one person’s positive body image promotes positive body image in others.

Public health promotions are important and valid, but it’s clear there’s a danger that they can push young people into further confusion. Disordered eating is a web of causes and effects, but positive conversation around the issue can make a huge difference.

If you’re concerned about yourself or anyone else who might have an eating problem, I’d encourage you to talk to a healthcare professional, or more specifically to get more information from National Eating Disorder Collaboration.

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