Eating disorders don’t discriminate, as we all know. They cross the age, gender, socioeconomic barriers. I was asked recently to give a presentation regarding the school-age victims of these illnesses that are in the minority, but unfortunately growing in numbers. These include the bullied, the younger victims, men, and members of the LGBTQ community.
First of all, eating disorders are not a choice. They are not a lifestyle. They are not a diet gone awry. They are not teenage girls’ diseases. They are not vanity-driven. They are mental illnesses that rob their victims of a full and vibrant life.
Some functions of eating disorders are:
- distraction and avoidance
- expression and communication
- self esteem
About 5.7 million children are bullied annually. Children who are overweight are targeted by bullies.
In a recent survey, 91% of youth with EDs had been bullied and 46% believed this contributed to their ED. These children often stand out as different in some way because of appearance, sexual orientation, intellect, and socio-economic background, cultural or religious background. All bullying lowers self-esteem, and low self-esteem is proven to raise the risk of eating disorders. Bullying about size, weight and shape is particularly toxic. Size, weight and shape are the last personal domain where stigmatizing behavior goes unchallenged and where derogatory comments go unremarked.
Fat teasing should become as socially unacceptable as negative comments about race, ethnicity, sexuality or religion.
Some teens find that eating disordered behaviors such as binging and purging provide a sense of relief from the stress and anxiety of being bullied. In these situations, eating disorders become a type of coping mechanism rather than an fixation with appearance or an issue of body image. Other teens find that eating disorders give them a sense of control at a time when life is spiraling downward. When bullies are threatening, attacking, spreading rumors online or engaging in other harassing behaviors, an eating disorder makes some teens feel empowered in one area of their lives.
A 2009 analysis found that in the last decade, hospitalizations for eating disorders more than doubled among children under twelve and now account for four percent of all such hospitalizations.
Disordered eating is now established as the third most prevalent chronic health condition among adolescent females; only asthma and obesity occur more frequently.
Children are exposed to more commercials for junk food and more ‘super-thin’ images and characters. They are being encouraged to eat high fat food and be thin – both at the same time! Magazines geared toward young teens and “tweens” utilize abnormally thin fashion models. The message is clear: “thin is beautiful”.
Lack of parental control, guidance and example are contributors as well. When Mom and Dad are overweight and/or constantly dieting or using laxatives, diet pills and so on, it’s difficult for teens to avoid copying their parents disordered eating and dieting habits.
More Moms and Dads are working. More kids eat and/or watch TV in their own rooms. These factors may diminish parental control over their kids eating habits. They may even weaken relationships between parent and child and may indirectly lead to increased psychological stress which is an important underlying cause of eating disorders.
In terms of interest in appearance, clothing, social behavior and sexualization, girls at twelve are experiencing what girls at fourteen were experiencing just a decade ago. Culturally, the messages to be concerned with appearance are being delivered to girls at younger and younger ages.
1 in 10 cases of eating disorders involve males. While it’s true that men and boys develop eating disorders for the same reasons women will — genetics, low self-esteem, trauma, and cultural influences, ED’s in males are harder to diagnose. It can be easier to diagnose females with eating disorders because their obsession with weight results in recognizable symptoms such as not eating, purging, and dramatic weight loss. With men it’s a different story. Men’s obsession with weight usually manifests itself in “normal male behavior” such as excessive exercise and/or steroid use. Instead of striving to be super thin, men will often strive to appear lean and muscular by dramatically decreasing their percentage of body fat.
Males may diet to avoid being teased about being overweight or to improve athletic performance in wrestling, track, swimming, and other sports. Males often try to achieve a better body image through shaping-bodybuilding, weightlifting, and muscle toning-in response to social norms for males, which emphasize strength and athleticism.
Certain risk factors for developing an eating disorder are specific to boys. Boys who were teased as children for being overweight and athletes who must maintain a certain weight for enhanced performance are more at risk for developing eating disorders.
LGBTQ adolescents are especially at risk for eating disorders, as they often struggle with accepting their identity, coming out, and fitting in with peers who can be blatantly cruel. LGBTQ people experience unique contributing factors such as trauma in the form of gay-bashing or harassment, losing social support, family, and potentially their home as a result of coming out (up to 42% of homeless youth are LGBTQ), or extreme anxiety or depression associated with their sexuality or gender expression.
While the data showed a strong association between gay teenagers and eating disorders, the cause of these eating disorders isn’t sexual orientation, but rather the pervasive societal rejection and abuse faced by lesbian, gay, bisexual and transgender teenagers. This kind of isolation and victimization can take its toll on a young person. The emotional stress of this repeated victimization – a stress that is often accompanied by less-than-supportive home environments and social circles – can inflict significant lasting emotional damage that can manifest as depression, anger, self-hatred and disordered eating. Transgender individuals often feel tremendous body dissatisfaction. They often feel like they were born into completely the wrong body.
What needs to be done about this ever-increasing “epidemic” of eating disorders?
- Schools need to have a “zero tolerance” for bullying of any kind.
- We need to continually educate parents, educators, coaches, and other professionals about the signs of eating disorders and associated mental health issues like depression and anxiety in all students, no matter what their age or gender.
- We need to educate individuals about diversity –in all areas, but especially in sexual preference and gender identity. Pervasive ignorance drives discrimination.
- Educational and treatment resources need to be readily available online and in other environments like schools and workplaces, and quality treatment needs to be provided for those in need.
There is so much more that needs to be done to create awareness and provide treatment for all those who suffer with eating disorders. We can all do our part by being supportive to all people and especially sensitive to the needs of those who may be different.
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