Amanda Elliott told her mom she’d "rather die than be fat." But as her life spun into anorexia nervosa and later into bulimia, Elliott remembers looking in the mirror and seeing something no one else saw.
"To me, all I thought of were the tiny pieces of skin I could pinch with my fingers," she says.
She was just 13.
Elliott’s story is not uncommon. All the talk about the obesity epidemic spreading the nation and focus on weight begs the question, what about the girls who are dying to be thin?
Society bombards us with how we should look, what size we should wear and how much we should weigh. Young girls’ minds are flooded with images of perfection, leaving many feeling bad about their bodies and risking their health trying to reach perfection through starvation or extreme exercise.
The Robert Crown Center for Health Education in Hinsdale studied the impact of negative body image on grade-schoolers. The research focused on sixth-graders—when puberty generally strikes—and showed a gap between fourth- and fifth-graders and seventh- and eighth-graders in making good decisions and feeling comfortable in their bodies.
In addition to the media’s influence on how kids feel about themselves, Kathleen Burke, who led the body image-based research, says families also play a huge role in body image. For instance, if a girl’s mother or older sister hates her thighs or shows disgust with her body, the girl is likely to act the same way.
"Middle school years are difficult because there are a lot of changes because your body’s changing and it’s very difficult to manage all that," says Burke, CEO of the Robert Crown Center. "The results of that are a lot of teasing and being mean to each other."
The ‘I hate my body’ syndrome
Body image is how you see yourself, how you feel about your body and how you feel in your body, according to author Abigail Natenshon on www.empoweredkidz.com. A negative body image is a distorted perception of your shape and feeling awkward in your body. Young girls with negative body images are likely candidates for eating disorders. The Web site teaches kids that "liking how you look has less to do with your weight and shape and more to do with self-acceptance and holding yourself in high esteem."
"I think it was a matter of perfectionism," Elliott says. "It does consume your thoughts."
Unfortunately, instead of an emphasis on healthy eating and exercise, there’s pressure today for girls to try the latest diet.
Looking back, Elliott says she hated her body. She’d compare herself to the girls at school who she thought had better bodies. Elliott, now 27 and a support group coordinator for the National Association of Anorexia Nervosa and Associated Disorders, struggled with anorexia and bulimia until she was 15. She relapsed in her early 20s.
Using over-the-counter laxatives, she induced vomiting and obsessively exercised with workout videos.
"I went to the doctor and he didn’t say anything, so it just reinforced it," she says.
At the height of her bulimia, she would eat and purge thousands of calories at a time that today she "wouldn’t even consider a meal." For example, instead of eating a package of oatmeal, she would eat the whole box of oatmeal. When her mom found out she was taking laxatives, she thought it was just a phase Elliot was going through.
It wasn’t until Elliott saw a picture of herself that she noticed something wrong—her mind’s image didn’t match the image the camera caught.
She met with a therapist and learned that "seeing your eating disorder as an entity or separate from you" is crucial for recovery.
"Come at the person with concern instead of a confrontational attitude," says Elliott on how to approach a teenager who may have an eating disorder. "Or the person feels ostracized, which can make the eating disorder worse."
Her advice to parents with daughters displaying signs of an eating disorder comes from personal experience.
"Any sort of comment about the body can be triggering," she says. "Try not to focus on the body. When you honor who you are on the inside, the eating disorder is lessened. Just validate them as a person. Self-esteem is a major part of the eating disorder."
Parents can help by showing kids it isn’t that important to be thin, just healthy. Help them eat healthy, while teaching them to appreciate their bodies and recognize the things they like about themselves.
The negative impact
Dr. David Rosen, professor of pediatrics at the University of Michigan and director of the Teenage and Young Adult Health Program, says complex eating disorders like anorexia and bulimia are relatively uncommon. Only about one in 100 girls develop them, but about one in 10 girls have an "eating disorder not otherwise specified," which is classified as having quirky, obsessive eating habits.
"The largest single factor of eating disorders is genetic," says Rosen. "It is the number one psychiatric disorder."
Fortunately, progress has been made within the past 20 years in understanding body image and dysfunctional eating. According to www.bodyimagehealth.org about 75 percent of adolescent girls feel bad about their bodies and 70 percent report feeling "fat." Studies report that, regardless of size, almost half of third- through sixth-grade girls want to be thinner and become preoccupied with their body sizes.
"It’s a pretty sure thing in this situation, girls will deny it," says Rosen about girls who try to hide abnormal eating habits from their doctor or parents.
Elliott did. "I had a very strict plan of what I would eat every day," she says.
Who’s at risk?
Rosen says about 5 percent of people with eating disorders will die and, although they can affect anyone, eating disorders are most prevalent in upper to middle-class white girls.
The National Association of Anorexia Nervosa and Associated Disorders reports that eating disorders have reached epidemic levels. Ten percent of girls experience the onset of an eating disorder at age 10 or younger.
The association says on its Web site that girls who participate in highly competitive sports such as gymnastics, swimming and running also tend to suffer from body dismorphia—an extreme dissatisfaction or uncomfortable feeling with their bodies.
Girls who are perfectionists, controlling, high achievers and very hard on themselves are most likely to develop an eating disorder, says the Robert Crown Center’s Burke.
"Eating is one thing they can control," she says.
Our society portrays fat as an extremely negative quality, so kids tend to feel they’re "bad" if they’re overweight. But kids need to accept the diversity of different body shapes, or they risk developing poor self-esteem.
Rosen’s advice for girls with poor body image is to engage in physical activity because it’s good for self-image and to "teach kids to eat a wide variety of foods." There are no foods you should eat a lot of, but don’t limit yourself, he says. So, that means you can eat a slice of chocolate cake, but just be sure to eat your carrots, too. There are no forbidden foods.
"Parents need to set good examples and be good role models," says Rosen. "Eating disorders happen to everybody."
This means parents shouldn’t show their kids they worry about their size if they’re at a healthy weight. After all, weight is just a number.
"We forget the most important things are who we are inside," says Burke."
Julie Liotine, a senior at Roosevelt University, is an intern at Chicago Parent.