Do you fit in?
Eating Disorders

Middle School Help
High School Reach Line

Fitting-In Fears
Maybe things seemed simple when you were a kid - you got dressed in whatever was around your room, played with whoever was fun to be with, and that was it. Now you may feel that if you don't look or act a certain way, you won't be cool. People may look at you like you're a freak if you wear unusual clothes or they may talk about you if you say or do something they think is weird.

It's completely normal to feel pressure to conform or fit in - no one wants to feel like they're on the outside looking in. People want to be liked; it's part of being human. But you should never have to dress, act, or think like other people to feel accepted. The things that make you who you are - like how you feel about stuff and what you believe in - are what truly matter. These things have nothing to do with trends, and they can't be measured from the outside.

"OK," you're thinking, "so I have great, fantastic thoughts inside. But what about my huge pimples/cheap jeans/ugly shoes/big nose that everyone sees on the outside?" The thing to remember is that these things all make up the wrapping of the package - and that some parts of that wrapping can't be controlled. No one gets to choose how he looks - we can't place an order for green eyes or perfect skin.

Superficial beauty and attractiveness don't reflect how valuable a person is - and society's standards of beauty change often. If you like the way other people in your school dress or act, that's completely OK. But if you have your own style, don't squash it to please someone else - you won't be happy, and you won't be changing for the right reasons.

Cliques and How to Cope
If you attend a large enough school, you probably get to see cliques every day. Jocks, straight-edge kids, rich kids, artsy types, freaks - whatever you decide to call them, they're close groups of friends who have certain things in common. Cliques aren't always a bad thing. When your identity is forming, it can be comforting to have people around who are interested in the same things as you. But cliques have downsides, too.

Although it's great to feel like you're part of a group, some teens may feel like they can't make decisions for themselves because they have to answer to a group of friends. But being able to speak your mind, form your own opinions, and stand up for what you believe in are important parts of becoming mature.

Another problem is that you might want to expand your circle of friends, but some groups don't welcome new people if they don't meet certain standards. If this is happening, it may be time to reevaluate your group of friends. Your friends shouldn't get in the way if you're ready for new or different experiences.

Finally, cliques can also contribute to feelings of peer pressure. If your friends pressure you to see a movie you know you'll hate, it's no big deal. But if your friends pressure you to do things like smoke, drink, do drugs, or have sex, they're not worth your time.

If you're involved with a group of friends and you're not happy, you can try a few things to make the situation better. Try suggesting activities your friends wouldn't ordinarily think of doing. If they're not into it or laugh at you for having your own ideas about things, try going out on your own to meet some new friends. This might seem hard, lonely, or challenging in the beginning because it takes a while to get to know new people and to feel comfortable with them. But making new (and maybe better) friends is worth it - you'll learn more about other people and yourself.

This information was reprinted from www.teenshealth.org
Contributed by: Jennifer Flatley, Psychologist, Commack High School Top of Page

What are Eating Disorders?

Anorexia Nervosa	Eating disorders are characterized by disturbed eating behaviors and are generally accompanied by a preoccupation with food and body image or shape. They include anorexia, bulimia and binge eating disorder.
Bulimia Nervosa
Binge Eating Disorder
Quick Facts
Body Image Survival Tips
How can I help someone who is suffering from an eating disorder?
Top Ten Reasons to Give Up Dieting
Eating Disorder Test

Anorexia Nervosa
Anorexia Nervosa is an emotional “weight loss” disorder characterized by physical, social and psychological symptoms. Weight loss is achieved by a variety of obsessive behaviors. Most individuals with this disorder strongly deny it. A feeling of control is gained by severely restricting the amount of food eaten and the ability to do without food is viewed as a successful way and effective way to cope with life’s stresses.

Warning Signs
Because early detection is important to successful recovery, it is important to recognize common warning signs of Anorexia Nervosa:

Significant or extreme weight loss with no known medical illness.
Reduction in food intake.
Ritualistic eating habits, such as cutting up meat into extremely small bites or chewing every bite excessively.
Denial of hunger.
Criticism and intolerance of others.
Claims of being too fat, even when this is not true.
Practices of highly self-controlled behavior.
Hiding of feelings. Top of Page

Medical Consequences
Anorexia Nervosa is intentional starvation that deprives the body of protein and prevents the normal metabolism of fat. In an effort to protect itself, the body slows down:

The heart muscle changes and its beat becomes irregular.
Menstruation often stops, even before extensive weight loss. This is called Amenorrhea.
Dehydration, kidney stones and kidney failure may result.
A fine body hair, called lanugo, develops on the arms and can even cover the face. This is the body’s attempt to keep warm.
Muscles may atrophy, resulting in weakness and lost muscle function.
Delayed gastric emptiness caused by a lack of energy and slowed body function results in bowel irritation and constipation.
Loss of bone calcium may lead to osteoporosis.

Thompson, C. (2002, December). Anorexia Nervosa. [Online] Available:

http://www.mirror-mirror.org

National Eating Disorders Association (2002). [Online] Available: http://www.nationaleatingdisorders.org

Bulimia Nervosa
Warning Signs
Bulimia is an emotional “weight control” disorder characterized by episodes of binge eating followed by some form of purging or restriction. Binges are the secretive periods of rapid consumption of high caloric food over a discrete period of time. Most bulimics follow binge eating with self-induced vomiting. However, the purging may take the form of a laxative, emetic or diuretic abuse, excessive exercising or fasting. The binge-purge cycle is normally accompanied by self-deprecating thought, depression, and awareness that the eating disorder is abnormal and out-of-control. Because most bulimics are within a normal weight range, the illness may go undetected by others for years.

Bulimia should be considered when a person frequently:

Makes an excuse to go to the bathroom after meals.

Shows mood swings.

Buys large amounts of food that suddenly disappear.

Has unusual swelling around the jaw.

Eats large amounts of food on the spur of the moment.

Uses laxative, emetics, or diuretics.

There is an unexplained disappearance of food.

Medical Consequences Top of Page

Bulimia Nervosa is the consumption of excessive amounts of food followed by one or more methods of purging. Common medical complications that result from this binge eating and purging cycle are listed below:

Vomiting, laxatives and diuretics flush sodium and potassium from the body resulting in an electrolyte imbalance. Arrhythmia (irregular heartbeat) can result, which can ultimately lead to heart failure and death.
The stomach acids in vomit can erode teeth enamel, resulting in damage such as cavities and discoloration.
Self-induced vomiting can result in irritation and tears in the lining of the throat, esophagus and stomach.
Laxative abuse can create a dependence and result in an inability to have normal bowel movements.
Abuse of emetics to induce vomiting can result in toxicity , heart failure and death.

Resources: Thompson, C. (2002, December). Bulimia Nervosa. [Online] Available: http://mirror-mirror.org
National Eating Disorders Association. (2002) [Online] Available: http://www.nationaleatingdisorders.org

Binge Eating Disorder

Warning Signs

This disorder is characterized by episodes of uncontrolled eating. Most binge eaters are obese and have a history of weight fluctuations. Co-occurring psychiatric illness is also common, usually depression.

Warning signs of binge eating disorder are listed below. The binge eater:

Frequently eats an abnormal amount of food in a discrete period of time.
Eats rapidly.
Eats to the point of being uncontrollably full.
Often eats alone.
Shows irritation and disgust with self after overeating.
Does not use methods to purge.
Is preoccupied with food to avoid facing problems.
Eats to express a need to control circumstances.

Medical Consequences Top of Page
Binge eating disorder involves compulsive, uncontrolled eating and bingeing. Some of the medical consequences that often result from this behavior are listed below:

High blood pressure, elevated cholesterol levels and elevated triglyceride levels. These conditions cause hardening of the arteries, heart disease and heart attacks.
Overeating simple carbohydrates, particularly sweets and junk food, places stress on the pancreas. At first there is an abnormally low amount of glucose in the blood. Later in life, secondary diabetes can result.

Resources:
Thompson, C. (2002, December). Binge Eating Disorder. [Online] Available: http://www.mirror-mirror.org
National Eating Disorders Association. [Online] Available: http://www.nationaleatingdisorders.org

Quick Facts
According to the National Eating Disorder Association, it is estimated that 5-10 million girls and women and about 1 million boys and men are struggling with an eating disorder. In addition, there are hundreds of people that have poor body image and often adopt unhealthy forms of dieting.

42% of 1^st-3^rd grade girls want to be thinner.
81% of 10-year-olds are afraid of being fat.
51% of 9- and 10-year-old girls feel better about themselves when they are on a diet.
25% of American men and 45% of American women are on a diet on any given day.
Between 5 and 20% of individuals struggling with Anorexia Nervosa will die.
Anorexia Nervosa has one of the highest death rates of any mental health condition.
Bulimia Nervosa affects 1-3% of middle school and high school students.
80% of healthy-weight 17-year-old girls see themselves as fat.

Resources:
National Eating Disorders Association. (2002). [Online] Available: http://www.nationaleatingdisorders.org

Body Image Survival Tips Top of Page
To improve your body image, worry less about how you look, how much you weigh or what you eat:

Actively resist the stereotype that thin equals beautiful. This is a relatively recent notion, anyway. Marilyn Monroe was not a size 6; she was a size 14.
Throw away the scale. Beauty can’t be measured in pounds. The scale is a particularly poor measure of whether physical activity is improving your appearance. Lean muscle tissue weighs more than fat, but takes up less space.
Don’t buy into media images. Remember that ads are meant to sell you something. Be alert for mixed messages. For example, one slogan used to sell candy bars say, “You can never be too rich or too thin.”
Work to change your relationship with food. Many people eat when they feel stressed, angry, lonely, depressed or disappointed. Find other ways to nurture yourself when you feel down. Eat healthy meals at regular times.
Focus on what you like about yourself and your body. Value your body for what it can do, not just how it looks.
Consider seeing a counselor. Changing your relationship with food can be difficult. A counselor can help you learn to adapt a healthy attitude and lifestyle with regard to food.

Resources: Muller, M. (1998). “Getting What You Want From Your Body Image”. ETR Associates.

How can I help someone who is suffering from an eating disorder?

Let the person know you care and you are there to give him/her support. Reach out to the person, instead of focusing on the eating behavior.
Don’t nag about or spend time talking about food or weight-related issues. Talk about what the person is feeling, not what he/she is eating or not eating.
Encourage the person to seek professional help. Be prepared for your suggestion to be initially met with denial and hostility.
Find support for yourself. You can talk to a counselor, doctor, or other professional, or attend a support group for family and friends of someone with an eating disorder.
Avoid comments on weight or appearance. Even if you “compliment” someone on losing weight, you may be giving the message that you only like the person because of the weight loss.
Read as much as you can about eating disorders. It will help you better understand what the person is going through.
Be patient: overcoming an eating problem takes time and usually outside assistance and support. It is not just a matter of willpower.

Resources: National Eating Disorders Association. (2002) [Online] Available: http://www.nationaleatingdisorders.org

Top Ten Reasons to Give Up Dieting Top of Page

#10 DIETS DON’T WORK. Even if you lose weight, you will probably gain it all back and you might gain back more than you lost.

#9 DIETS ARE EXPENSIVE. If you didn’t buy special diet products, you could save enough to get new clothes, which could improve your outlook right now.

#8 DIETS ARE BORING. People on diets talk and think about food and practically nothing else. There’s a lot more to life.

#7 DIETS DON’T NECESSARILY IMPROVE YOUR HEALTH. Like the weight loss, health improvement is temporary.

#6 DIETS DON’T MAKE YOU BEAUTIFUL. Very few people will ever look like models. Glamour is a look, not a size. You don’t have to be thin to be attractive.

#5 DIETS ARE NOT SEXY. If you want to be more attractive, take care of your body and your appearance. Feeling healthy makes you look your best.

#4 DIETS CAN TURN INTO EATING DISORDERS. The obsession to be thin can lead to anorexia, bulimia, bingeing and compulsive exercising.

#3 DIETS CAN MAKE YOU AFRAID OF FOOD. Food nourishes and comforts us, and gives us pleasure. Dieting can make food seem like your enemy, and can deprive you of all the positive things you feel about food.

#2 DIETS CAN ROB YOU OF ENERGY. If you want to lead a full and active life, you need good nutrition and enough food to meet your body’s needs.

#1 LEARNING TO LOVE AND ACCEPT YOURSELF JUST AS YOU ARE WILL GIVE YOU SELF-CONFIDENCE, BETTER HEALTH, AND A SENSE OF WELL BEING THAT WILL LAST A LIFETIME.

Resources: Eating Disorder Resources (2003). [Online] Available: http://www.gurze.net

Eating Disorder Test

For yourself or someone you know, please rate the following questions: Top of Page

1- Often 2- Sometimes 3- Rarely 4- Never

____ I am proud of my thinness.

____ I weigh myself often.

____ I have fasted.

____ I fear becoming fat.

____ I feel fat, even though friends and family say that I am not.

____ I feel the need to exercise every day.

____ I enjoy preparing meals for others but eat little myself.

____ I’ve eaten in binges (lot at one time very quickly).

____ I like and anticipate eating alone.

____ I eat even when I’m not hungry.

____ I eat sensibly in front of others but not when I’m alone.

____I’ve made repeated attempts to diet or restrict my eating.

____ I feel self-conscious or embarrassed about my eating behaviors.

____ I sneak food when no one’s around.

____ I have lied about the amount of food that I eat.

____ I have made myself vomit after eating or binge eating.

____ I have used laxatives, diet pills, appetite suppressants or diuretics to control my weight.

____ I panic if I gain a couple of pounds.

____ I think about food frequently, deciding to eat or not eat.

____ I feel out of control when eating or binge eating.

____ I often feel depressed or anxious after eating.

____ I eat more when I’m upset or under stress.

TOTAL SCORE
42 + AVERAGE ATTITUDES TOWARD EATING, WEIGHT AND BODY IMAGE.

41-23 THERE MAY BE AN EATING DISORDER PROBLEM STARTING.

22 OR LESS THERE IS A STRONG POSSIBILITY OF AN EATING DISORDER.

à NOTE: EATING DISORDERS ARE POTENTIALLY LIFE-THREATENING DISORDERS THAT CAN BE TREATED WITH THE PROPER INFORMATION, SUPPORT, AND COUNSELING. THE EARLIER YOU SEEK HELP, THE BETTER, ALTHOUGH IT IS NEVER TOO LATE TO BEGIN THE ROAD TO RECOVERY.

Resources: Caring Online. (2003) [Online] Available: http://caringonline.com/eatdis/misc/edtest.htm

This article was written by Jessica Salvesen, a Social Worker at Commack Middle School.

FOR MORE INFORMATION CONTACT:

Commack High School Guidance Office: (631) 912-2121
Commack Middle School Counseling Center: (631) 858-3535

Top of Page

Warning Signs Because early detection is important to successful recovery, it is important to recognize common warning signs of Anorexia Nervosa:

Significant or extreme weight loss with no known medical illness.

Reduction in food intake.

Ritualistic eating habits, such as cutting up meat into extremely small bites or chewing every bite excessively.

Denial of hunger.

Criticism and intolerance of others.

Claims of being too fat, even when this is not true.

Practices of highly self-controlled behavior.

Medical Consequences Anorexia Nervosa is intentional starvation that deprives the body of protein and prevents the normal metabolism of fat. In an effort to protect itself, the body slows down: