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Published on March 01, 2019

In Pursuit of Perfection: Distorted Body Image and Eating Disorders

In Pursuit of Perfection: Distorted Body Image and Eating Disorders

In this Fox 8 House Call series, Cone Health experts explain eating disorders and distorted body image, including:

In Pursuit of Perfection: What Parents Need to Know About Kids and Distorted Body Image

Everyone comes in different shapes and sizes. Left to their own devices, kids will grow into the shape they’re genetically supposed to. Unfortunately, our culture often emphasizes body image in unhealthy and unattainable ways, and children are affected by these messages. The American Academy of Pediatrics now recommends doctors don’t focus on body mass index (BMI), but instead on habits and behaviors that are more indicative of a child’s overall health.

Focusing on a child’s weight can be dangerous and increase dieting behaviors. Dieting is bad for a person’s BMI over time because it decreases their metabolism and increases fat storage. Dieting is also often a gateway to disordered eating. Try to incorporate a variety of nutritious foods in your child’s diet rather than forbidding certain foods. Make an effort to eat meals together as a family and incorporate physical activity regularly.

The media and social media can have a negative impact on kids’ and teens’ body image. When they see a body type that has been digitally altered, they might not know the image has been manipulated, and that image can make them feel bad about their bodies. Doctors are now seeing children as young as 7 with disordered eating.

Monitor your child’s social media use, and most importantly, talk to them about what they’re seeing on social media, what they’re worried about and who they’re talking to. Encourage your child to be their best self, and let them know they’re beautiful exactly the way they are. Emphasize overall wellness instead of appearances.

Cone Health Nutrition and Diabetes Education Services has an exceptional team of registered dietitians dedicated to educating families on nutrition.

Laura Watson, MS, RD, CSP, CDE, LDN, is a registered dietitian with Cone Health Nutrition and Diabetes Education Services in Greensboro. Watson received a Bachelor of Science in public health from the University of North Carolina at Chapel Hill in 2007 and earned a Master of Science in nutrition from the University of North Carolina at Greensboro in 2009.

In Pursuit of Perfection: How Eating Disorders Develop

The three main types of eating disorders are anorexia nervosa, bulimia nervosa and binge eating disorder. Anorexia is characterized by very restrictive – and inadequate – eating; bulimia by compensatory behaviors in response to eating, such as inducing vomiting or overusing laxatives. Binge eating disorder is when an individual eats more food than is normal and with a sense of being out of control.

Eating behaviors can also represent disordered eating, which doesn’t meet the criteria for diagnosis, but still indicates an abnormal relationship with food that can be detrimental to health and well-being.

Eating disorders signal emotional dysregulation; food and eating (or not eating) becomes a dysfunctional coping mechanism for dealing with difficult emotions.

There are many contributors to eating disorders, including genetics; and biochemical, psychological and cultural factors. There is no “eating disorder” gene, but a person who develops anorexia, for example, inherits a particular personality, which may put him or her at increased risk of the disorder. This risk can be heightened by trauma, such as sexual or emotional abuse, bullying, dysfunctional family dynamics, or simply not having important emotional needs met during childhood.

Culture is also a significant factor. This includes, for example, the high value we place on thinness, beauty ideals that are unattainable by the vast majority of the population and our notions of foods that are allowed or not allowed.

You should seek help for an eating disorder if you feel constantly plagued by thoughts about food, weight, body size or shape, and/or exercise, or you realize the extent to which these thoughts are ruling your life.

The first step in getting help is to see a registered dietitian and/or therapist who specializes in eating disorders.

It’s usually a good idea to make an appointment with your primary care physician as well, depending on the severity and duration of the disordered behaviors. Ideally, this health care team of physician, registered dietitian, and therapist or counselor will work closely together in care of the patient with one of these very difficult disorders.

Jeannie Sykes, PhD, RD, LDN, is a registered dietitian at Cone Health Family Medicine Center and a member of Cone Health Medical Group. She received a Bachelor of Science in nutrition from the University of Vermont in 1976, and a Master of Public Health Nutrition from the University of North Carolina at Chapel Hill in 1980. Sykes earned a PhD in nutrition from the University of North Carolina at Greensboro in 1986. She has worked at Cone Health Family Medicine Center since 1990.

In Pursuit of Perfection: It’s Not Just Kids … Adults, Distorted Body Image and Emotional Eating

We often see the onset of anorexia nervosa during adolescence, but it is certainly seen among adults, sometimes well into their 70s. Depending on the severity of the disorder, many sufferers don’t make it to that age. Anorexia nervosa has the highest mortality of any mental health diagnosis. Binge eating disorder and bulimia nervosa are more likely to start during late adolescence or in young adulthood, and can also continue into later life. Cone Health sees many patients with eating disorders who are in their 50s and beyond.

Only about 1 out of 10 patients diagnosed with anorexia nervosa is male, but there is a higher prevalence of binge eating disorder in males. Most men with eating disorders are heterosexual, but LGBT males are at higher risk of all types of eating disorders.

There is a perception that distorted body image always accompanies eating disorders. While it is a prevalent component of eating disorders, it is not universally true. There is also a difference between body distortion and body dissatisfaction. The latter is undoubtedly fueled by the unrealistic beauty ideals promoted in the media, where images that have been digitally altered for both thinness and shapeliness are pervasive.

Many people who are hypercritical of their bodies fall into the trap of believing that self-criticism will eventually make them so disgusted with themselves that they’ll start exercising or eating right. All that negative thinking can, in fact, be motivating, but only in the short term. The reality is that criticism makes us feel bad, and when we feel bad, there is a part of our psyche that wants to feel better. For some, that means reaching for comfort in the form of food, otherwise known as emotional eating.

Emotional eating is using food in response to emotions, usually negative ones, independent of physical hunger, and it often involves sweets.

To intercept emotional eating, you should first bring mindfulness to the food decision. Ask yourself if you feel hungry, angry, anxious, lonely, tired, bored or depressed. If you can answer yes to one of more of those, the next 2 questions are, “What do I truly want?” and “What do I truly need right now?” With this analysis, you may find a much more effective way of making yourself feel better rather than resorting to food. In practice, it is more complicated, of course, but this is a good starting point.

Jeannie Sykes, PhD, RD, LDN, is a registered dietitian at Cone Health Family Medicine Center and a member of Cone Health Medical Group. She received a Bachelor of Science in nutrition from the University of Vermont in 1976, and a Master of Public Health Nutrition from the University of North Carolina at Chapel Hill in 1980. Sykes earned a PhD in nutrition from the University of North Carolina at Greensboro in 1986. She has worked at Cone Health Family Medicine Center since 1990.

Fox 8 House Call

Fox 8 House Call

Cone Health experts appear Monday, Wednesday and Friday at 8:30 a.m. on the Fox 8 morning news.