Positive Body Image

CHAPTER 1
Body image and eating issues
WHAT IS BODY IMAGE?

A fact sheet overview from the National Eating Disorders Collaboration
B
ody image is the perception that a person has Self-esteem levels
of their physical self, but more importantly the Self-esteem dictates how a person feels about them-
thoughts and feelings the person experiences as a selves and this can infiltrate every aspect of that person’s
result of that perception. It is important to understand life. The higher your self-esteem, the easier you will find
that these feelings can be positive, negative or a comb- it to stay on top of daily life, the more sociable you will
ination of both and are influenced by individual and be, leading to higher levels of happiness and wellbeing.
environmental factors.
Self-acceptance
THE FOUR ASPECTS OF BODY IMAGE The more positive a person’s body image, the more
1. The way you see yourself (perceptual) likely that person is to feel comfortable and happy with
The way you see your body is not always a correct the way they look. A person with positive body image
representation of what you actually look like. For is less likely to feel impacted by unrealistic images in
example, a person may perceive themselves to be fat the media and societal pressures to look a certain way.
when in reality they are underweight. How a person sees
themselves is their perceptual body image. Healthy outlook and behaviours
When you are in tune with, and respond to the
2.The way you feel about the way you look (affective) needs of your body, your physical and psychological
There are things a person may like or dislike about wellbeing improves. A positive body image will lead
the way they look. Your feelings about your body, to a balanced lifestyle with healthier attitudes and
especially the amount of satisfaction or dissatisfaction practices with food and exercise.
you experience in relation to your appearance, weight,
shape and body parts is your affective body image. WHAT CAUSES BODY DISSATISFACTION?
When a person has negative thoughts and feelings
3. The thoughts and beliefs you have about
about his or her own body, body dissatisfaction
your body (cognitive)
can develop.
Some people may think that parts of their body are
Environmental influences play a large role in how
‘too big’ and wish they were thinner and others believe
people perceive and feel about their body. A person’s
they will look better if they develop more muscle. You
family, friends, acquaintances, teachers and the media
may think your body looks good the way it is and like
all have an impact on how that person sees and feels
what it can do for example, run and dance. The way you
about themselves and their appearance. In particular,
think about your body is your cognitive body image.
when an individual is in an appearance-oriented
Copyright © 2014. The Spinney Press. All rights reserved.
4. The things you do in relation to the way environment or receives negative feedback about their
you look (behavioural) appearance, for example, by being teased, they are at
When a person is dissatisfied with the way they an increased risk of body dissatisfaction.
look, they may employ destructive behaviours such as People of all ages are bombarded with images through
excessive exercising or disordered eating as a means to media such as TV, magazines, internet and advertising.
change appearance. Some people may isolate themselves These images are often unrealistic, unobtainable and
because they feel bad about the way they look. Behaviours highly stylised, promoting beauty and appearance ideals
in which you engage as a result of your body image for males and females in our society. They send strong
encompasses your behavioural body image. messages which reaffirm that in our culture thin is
beautiful for females and lean/muscular is the ideal body
WHY IS POSITIVE BODY IMAGE IMPORTANT? shape for males and that when these body shapes are
People with positive body image will generally have a achieved that happiness, success and love will result. The
higher level of physical and psychological health, and better ideal demonstrated in these images has been fabricated
personal development. A positive body image will effect: by stylists, art teams and digital manipulation and cannot
1
Healey, Justin. Positive Body Image, The Spinney Press, 2014. ProQuest Ebook Central, http://ebookcentral.proquest.com/lib/bsu-ebooks/detail.action?docID=1676193.
Issues in Society | Volume 372
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be created or achieved in real life. If a person feels that beliefs about body image are frequently shaped
they don’t measure up in comparison to these images, during late childhood and adolescence so this is a
feelings of body dissatisfaction can intensify and have particularly crucial time.
a damaging impact on that person’s psychological and •• Gender – adolescent girls are more prone to body
physical wellbeing. image dissatisfaction than adolescent boys; however
the rates of body dissatisfaction in males is rapidly
Some people are more likely to develop a negative approaching that of females.
body image than others. This can be as result of the •• People who experience low self-esteem and/or
following factors: have depression
•• Age – body image problems can affect people from •• Personality traits – people with perfectionist
childhood across the lifespan and are as prevalent tendencies (e.g. people who feel a need for everything
in midlife as young adulthood in women. However, in their lives to be perfect), high achievers and people
What is an eating disorder?

Snapshot Eating disorders are serious mental illnesses; they
&
are not a lifestyle choice or a diet gone ‘too far.’
Body Eating disorders

occur in both men
and women, young
image
and old, rich and
poor, and from all
cultural backgrounds.
About one in 20
Eating
Australians has an
eating disorder and
the rate in the
Disorders
Australian
population is
increasing.
Body image is It is also the People of all ages are bombarded with
the perception thoughts and images through media such as TV,
that a person feelings a person magazines, internet and advertising.
body image?
These images are often

has of their experiences as
physical self. a result of that
perception.
highly stylised
unrealistic and
What is
These feelings They are
unobtainable.
can be positive, influenced by
negative or a individual and
combination of environmental
both. factors.
If a person feels that they don’t measure
up, body dissatisfaction can intensify and
impact psychological wellbeing.
Poor body image is a risk
factor for Eating Disorders
Getting help
improve your body image If you feel dissatisfied with your body or
if you feel like you are developing unhealthy
eating or exercise habits, it is important to
People with negative body image can become get professional help.
fixated on trying to change their body.
This can lead to people engaging Professional support can help guide you
in unhealthy practices with food and exercise. to change negative beliefs and behaviours.
There is no right or wrong when it comes to body Visit our website to find help in your area.
shape or appearance. Learning to accept your
body shape is a crucial step towards feeling
positive about your weight, shape, size and
appearance. nedc.com.au
2
Positive Body Image
Created from bsu-ebooks on 2018-03-18 21:28:05. Issues in Society | Volume 372
who cognitively are more ‘black and white’ in their
thinking, those who internalise and value beauty
ideals, and people who tend to compare themselves
to others, are at higher risk of developing body
dissatisfaction.
•• Appearance teasing – people who are teased for their
appearance, especially weight, regardless of actual
appearance or weight, are at a greater risk of devel-
oping body dissatisfaction than those who are not.
•• Having friends and family who diet for weight loss
and express high body image concerns – when a
person is in an environment in which central people
express body image concerns and model weight
loss behaviours, they are more likely to develop
body dissatisfaction themselves regardless of actual
appearance or weight.
•• Larger body size – In our weight conscious society,
larger body size increases risk of body dissatisfaction.
•• Sexual orientation in males – research shows that
homosexual men are more vulnerable to eating
disorders than heterosexual men.
In western society, dissatisfaction with the body has •• Avoid self talk that is berating or negative
become a cultural norm. •• Focus on what your body can do and has done – the
body is amazing; appreciating and respecting all the
HOW CAN YOU IMPROVE YOUR BODY IMAGE? things it can do will help you to feel more positively
People with negative body image can become fixated about it.
on trying to change their actual body shape. This can •• Set positive, health-related focused goals rather than
lead to people engaging in unhealthy practices with weight loss related ones – engaging in practices with
food and exercise with the hope that the change in body food and exercise that promote health over weight
shape will alleviate negative feelings. These practices do loss/management is more positive for your overall
not usually achieve the desired outcome (physically or wellbeing. Remember many people who are normal
emotionally) and can result in more intense negative or underweight are unfit and many physically fit
feelings of disappointment, shame and guilt, as well people (think about rugby players) are higher than
as place a person at greater risk of developing an average in body weight.
eating disorder. •• Avoid making body comparisons to others – everyone
It is important to remember that you cannot change is unique and differences are what makes a person
some aspects of your appearance. Your height, muscle special. Admiring the beauty in others can be positive
composition and bone structure are determined by your for your own body confidence but it is important that
genes; this is the way you are born. A person can change you appreciate the beauty and accept yourself as a
some things but is important to understand and believe whole in order to feel more comfortable in your skin.
that there is no right or wrong when it comes to body •• Make a conscious decision about what to read and
shape or appearance. This can be hard to accept if a look at – remember that the majority of images
person has negative body image; however, challenging presented in the media are unrealistic and represent
beauty ideals and learning to accept your body shape a minority of the population. Many of the images
is a crucial step towards feeling positively about your in magazines have been digitally altered and do not
weight, shape, size and appearance. represent what real people look like.
While changing your actual appearance may be
difficult and complicated, changing your body image GETTING HELP
is an achievable goal. We have the power to change the If you feel dissatisfied with your body or if you feel like
way we see, feel and think about our bodies. you are developing unhealthy eating or exercise habits,
professional help is a good idea. There are counsellors
Here are some tips to get started:
and psychologists who have specialised knowledge in
•• Focus on your positive qualities, skills and talents
the areas of body image. Professional support can help
– this can help you learn to accept and appreciate
guide you to change negative beliefs and behaviours.
your whole self. A person is much more than just a
physical being. Used by permission of the Australian Government.
•• Say positive things to yourself every day – when you National Eating Disorders Collaboration (2013). What is body image?
say something often enough you start to believe it. Retrieved from www.nedc.com.au on 24 September 2013.
3
4
BODY IMAGE
Your body image is the way you think and feel about your body. Guys have body image
issues too. One third of
Positive Body Image

Created from bsu-ebooks on 2018-03-18 21:28:05.
It can be positive or negative. males want to be thinner
and one third want to be
Poor body image can be bulkier.
associated with depression,
Most young women and girls anxiety, alcohol and other drug
abuse and eating disorders. More than 1 in 5
are worried about their body young men say
– in fact it’s their number body image is their
one concern. number one concern
Some warning signs that you
or someone you know might
have body image issues:
Of Australian high school girls: Tips for better body image:
Distorted eating habits • Focus on yourself as a person,

76% not just how you look
wish they were thinner Obsession with weight
• Aim to get healthier rather
and exercise
than lose weight
50% Being continually • Focus on the things you like

self-critical about your body
have tried to lose weight
Constantly comparing • Stop being critical about
body size others’ appearance
16% • Remember real bodies aren’t
are happy with their body weight perfect, and perfect bodies are
almost always airbrushed
.org.au/bodyimage

BODY IMAGE AND HEALTH
A position statement from the Australian Medical Association
UNHEALTHY BODY IMAGE food restriction and starvation
B
ody image describes how an individual concept- associated with anorexia and
ualises his or her physical appearance.1 The body bulimia include impairment
image a person has results from the interaction of bone mineral acquisition
between the person’s thoughts, beliefs, feelings and leading to osteoporosis,
behaviours regarding their own body, and their fertility problems, kidney
perception of what counts as the ideal body within their dysfunction, reduced
own social and cultural setting.2 Unhealthy body image metabolic rate, cardiac irreg-
can affect men and women, children and the elderly ularities, muscle wasting,
from all backgrounds. oedema, anaemia, stunting of
While there is no single or standard definition, height/growth and hypoglycaemia
‘unhealthy’ body image can be taken to involve a and reduced mental functioning.7
dissatisfaction with one’s physical appearance leading Eating disorders are serious
to unhealthy responses which can include poor psychiatric illnesses. The prevalence
eating behaviours, changing levels of physical activity, of eating disorders among children
substance abuse or reduced social interactions. This and adolescents is rising.8 While it is
description emphasises that, from a health and medical difficult to assess exactly how common
point of view, the important difference between eating disorders are (as many cases
healthy and unhealthy body image is the nature of the may go undiagnosed) it is estimated
behavioural and health-related consequences of the that one in 100 adolescent girls develop
body image a person has. anorexia nervosa, and that it is the third
There is potential for body image issues to arise at an most common chronic illness in girls, after
early age. Evidence suggests that self-awareness starts obesity and asthma. The Royal Australian
to emerge around the age of eighteen months, though and New Zealand College of Psychiatrists
this remains an area of research and debate.3 The age or (RANZCP) states that eating disorders have
stage of development when a child begins to evaluate the highest mortality rate of any psychiatric
their body for acceptability is still being investigated. illness, with a death rate higher than that of
The onset of puberty is a period of both substantial major depression.
physical change and altered peer-relationships. It can be Cognitive Behavioural Therapy – a form of psycho-
a period of major transition in a person’s body image.4 therapy designed to change problematic thinking habits,
Body image satisfaction has been identified as the feelings and behaviours – has been shown to be an
greatest single predictor of self-esteem for adolescents.5 effective treatment for bulimia nervosa in the Australian
Mission Australia’s National Survey of Young Australians primary care setting. Long-term follow-up studies
has identified body image as one of the leading issues of indicate that many patients with bulimia nervosa have
concern to young Australians of both genders.6 Children good outcomes, with up to 50% being free of symptoms
and young people with physical and developmental at five years or more after treatment.9 Unfortunately
disabilities can also experience body image concerns. there is no evidence for a similarly effective treatment
Unhealthy body image affects lifestyle choices and for anorexia nervosa. A major contributor to the poor
negatively affects mental and physical health, and social prognosis for this illness is the high rate of relapse
functioning. It can lead to unhealthy dieting, eating following initial treatment. This has promoted interest
disorders, excessive exercise or under-exercise, substance in interventions aimed at preventing deterioration

use, and the desire for unnecessary surgical intervention. and relapse, which may in turn lead to more effective
Once established, an unhealthy body image can continue treatments in the future.10
through adult life.
THE INFLUENCE OF THE POPULAR MEDIA
EATING DISORDERS Research is continuing into the range of individual
Eating disorders can result from unhealthy body and social factors that might contribute to the
image. Such disorders include anorexia nervosa and development of unhealthy body image and eating
bulimia nervosa. The former is characterised by self- disorders. It is generally recognised that the popular
imposed starvation coupled with an intense fear of media is a significant social and cultural factor that
weight gain (despite continued weight loss). The latter influences the development of people’s self-perception
involves episodes of binge eating followed by purging and body image.11 Young people especially, are susceptible
(such as self-induced vomiting, laxative or diuretic misuse to social pressures to conform to ideal stereotypes.
and excessive exercise). The health consequences of the The public is constantly presented in the popular print
5
and electronic media with images of attractive, thin disorder, general practitioners are often responsible
women and athletic, handsome men. These idealised for coordinating referral to, and care by, consulting
images do not truly reflect the bodies of most people tertiary services and local dietetic and psychological
in the community, and can contribute to unrealistic services.18 In the management of eating disorders, doctors
perceptions about appropriate physical appearance recognise the potentially long-term nature of the illness
which may lead to body dissatisfaction and eating and the need for continuity of care and coordinated
disorders. Repeated exposure to these images could multi-disciplinary management. Because there are
have a cumulative impact on vulnerable individuals.12 often long-term care relationships between doctors and
There is no national system of regulation relating to patients, doctors will be aware of the adverse impacts
the portrayal of body image in the print and electronic of eating disorders on families, friends and colleagues,
media, nor the use of digital manipulation techniques and will often be a source of important support for
such as airbrushing. This is despite growing community patients and their families during a very disruptive and
concern and debate around issues such as the use in psychologically disturbing time.
advertising of very young and/or extremely underweight In some cases, people turn to medical procedures or
fashion models.13 The development of national industry cosmetic surgery to achieve their ideal body. Advertising
standards may be an effective step along the way to and other promotions which appeal to youth can
responsible body image portrayal in the media. encourage cosmetic surgery as an easy solution to
personal issues, including body image dissatisfaction.
THE ROLE OF MEDICAL PRACTITIONERS Doctors can provide impartial advice to people on
According to the World Health Organisation cosmetic procedures, including whether they are
Collaborating Centre for Mental Health and Substance medically indicated, and the potential health risks that
Abuse, medical practitioners have an important role in may be involved. This also applies to drugs and other
fostering healthy beliefs about body weight and shape substances that individuals may use to enhance or
by challenging unrealistic thoughts, beliefs and values, change physical appearance. Evidence-based medical
providing education and providing referral for therapy.14 counselling can help individuals develop realistic views
Medical practitioners play an important role in the early about their need for cosmetic procedures, and what can
detection and management of individuals at risk of be achieved by them.
developing unhealthy body image or eating disorders.15
Doctors can identify symptoms of eating disorders or THE AMA POSITION
body image problems which would otherwise appear The AMA believes that the following measures and
unrelated. Early intervention may lead to a more proposals will contribute to reducing the impacts of
complete recovery, and reduce the risk of an eating unhealthy body image and eating disorders.
disorder becoming chronic.16 Doctors have opportunities
to educate patients on the benefits of healthy eating A national approach
and appropriate physical activity, and to advise parents •• The AMA believes that a nationally coordinated
about healthy eating and healthy weight for children and approach is necessary in order to develop effective
adolescents. Doctors are aware of the complex processes and consistent practices in preventing and addressing
of behaviour change needed to establish and maintain the incidence of unhealthy body image and eating
a healthy weight, and can advise those with body image disorders. To achieve this, a peak national network
concerns about the risks and likely successes of various of researchers, educators, policy-makers and industry
weight control ‘diets’.17 stakeholders should be established to coordinate this
For those individuals who have an established eating national approach to body image and eating disorders.
6
Positive Body Image
Media portrayals of body image
•• While acknowledging the impact of other social
pressures to conform to idealised body types, the
AMA recommends that the ‘media industry’ (i.e.
publishers, programmers and advertisers) depicts a
more realistic range of body images and role models.
This should happen at a national and industry-
wide level, through conformity with appropriate
standards that are developed by industry in
conjunction with experts and stakeholders in the
area of body image issues. If the Australian media
industry can neither develop nor abide by such
standards, then the AMA believes that government
regulation should be considered.
•• The advertising and media industry should not
portray normal bodily changes, such as those
associated with ageing, as abnormal or problematic.
•• Direct to consumer advertising of pharmaceutical •• The AMA supports the need for measures to ensure
products designed to play on body image and weight safety and quality of practice in cosmetic surgery,
concerns is an unacceptable practice. and that the interests of the patient are always
paramount. It is essential for people considering
Schooling and public education cosmetic surgery to discuss the risks and potential
•• The school system can play a very important role benefits with their doctor.
in helping children and young adults build and •• The AMA recognises the importance of restorative
maintain a healthy body image. There is a need for surgery in cases where accident, injury or surgery
increased understanding of how school curricula has a significant impact on body image satisfaction.
and other aspects of school life can impact positively
and negatively on the development of body image Treatment services
and eating disorders. In particular, schools should: •• Services for eating disorder patients vary widely
–– Incorporate issues around development of healthy in their accessibility, availability and the type of
body image into its health curriculum programs care provided to patients and their carers. This
(including recognition of the impacts that bullying variability is most pronounced for those living in
may have on body image) rural and regional areas.20 A greater focus is needed
–– Develop programs in media literacy, and integrate on ensuring appropriate access to early intervention
media literacy skills into other curriculum areas and treatment services for young people in rural and
so that young people can critically evaluate media remote locations.
content and messages pertaining to ideals about •• A ‘one size fits all’ approach to the treatment of
body type, and develop realistic views of self and eating disorders does not adequately cater for the
society needs of all those who have eating disorders or body
–– Develop and monitor their physical activity programs image problems. Mechanisms need to be in place to
to be aware of the risk of unhealthy body image allow health and medical professionals to readily
developing, and associated excessive exercise. An access recent information about best-practice for
emphasis on team based sports can be an effective the identification, diagnosis and treatment of body
vehicle to promote healthy lifestyles and to deter image and eating disorder problems.
disordered eating and athletic enhancing behaviours19
•• There is a need for increased government commit- Fitness and health

ment to appropriately targeted public education on •• The AMA advises against the use of fad or crash ‘diets’
the association between diet, physical activity and which make claims of dramatic weight loss, weight
health, and the health risks associated with eating gain, or performance enhancement.
disorders. •• The AMA recommends that individuals engage
in healthy eating habits and an active lifestyle in
Cosmetic and restorative surgery accordance with evidence-based dietary guidelines
•• Medical procedures to modify or enhance physical and physical activity recommendations.
appearance should not be provided to young people •• Safe and supportive environments should be available
under 18 years of age, unless those procedures are to facilitate access, increase participation, and a
in a person’s medical and/or psychological interests. willingness to engage in a range of healthy physical
•• The AMA discourages the marketing and advertising activities by people with body image concerns.
of cosmetic surgery as an easy solution to individuals’ Having an unhealthy body image can also limit
personal or social problems. physical activity, as those who feel self-conscious
7
about their body may be less likely to participate for in Preadolescent Children’. Journal of Applied Development
fear of exposing their body. Psychology. 17: 85-100.
•• The AMA encourages the fitness industry to actively 5. Wood K.C., Becker J.A. and Thompson J.K., ‘Body Image
promote participation in physical activity as a Dissatisfaction in Preadolescent Children’. Journal of Applied
Developmental Psychology. 1996 17: 85-100.
preventative health strategy rather than to achieve
6. Mission Australia. National survey of young Australians 2007:
the ‘ideal’ body. Key and emerging issues. Located at: www.missionaustralia.
com.au/document-downloads/doc_details /48-nat...
Research 7. Eating Disorders Foundation of Victoria Inc. Physical and
•• Adequate funding should be provided for further Psychological effects. Located at: www.eatingdisorders.org.au/
research into: content/view/18/37/
–– The impact of media on body image, particularly 8. Gonzalez, A., Kohn, M.R., Clarke, S.D., ‘Eating disorder in
among children and adolescents adolescents’. Australian Family Physician vol. 36. No. 8. 2007.
–– The risk factors for developing eating disorders 9. Hay, P.J., ‘Understanding bulimia’. Australian Family Physician.
Vol 36. No. 9. 2007.
–– The protective factors that may reduce the
10. Walsh T., Kaplan A.S., Attia E., et al., ‘Fluoxetine after Weight
incidence of eating disorders Restoration in Anorexia Nervosa: A Randomised Control Trial’.
–– The health impacts of unhealthy body image and JAMA. 2006; 2605-2612.
eating disorders across all population groups, and 11. The Bronte Centre.
the effective interventions and treatments for 12. Government Response to the Parliamentary Inquiry into Issues
them, particularly regarding anorexia nervosa. Relating to the Development of Body Image Among Young
People and Associated Effects on Their Health and Wellbeing.
REFERENCES (Victorian Government: Family and Community Development
1. Thompson, J.K., Body Image Disturbance: Assessment and Committee) – January 2006.
Treatment. 1990. New York: Pergamon Press. 13. For example, the 2008 Senate Standing Committee Inquiry
2. Cash, TF. ‘Body Image: Past, Present and Future’. Body Image into the Sexualisation of Children in the Contemporary Media
2004. vol. 1: 1-5. Environment.
3. Brownell, C.A., Zerwass, S. & Ramani G.B., ‘So Big: The 14. Treatment Protocol Project. Management of Mental Disorders.
Development of Body-Self-Awareness in Toddlers’. Child 2000. World Health Organisation Collaborating Centre for Mental
Development. 2007. vol. 78:142-1440. Health and Substance Abuse.
4. Wood, K.C., Becker J.A.,Thompson J.K., ‘Body Image Dissatisfaction 15. Gonzalez, A., Kohn, M.R., Clarke, S.D., ‘Eating disorder in
adolescents’. Australian Family Physician vol. 36. No. 8. 2007.
16. Abraham, S.F., ‘Dieting, body weight, body image and self esteem
in young women: doctors dilemmas’. MJA 2003; 178: 607-611.
17. Dieting is so prevalent in our society that Australians spend about
$1 million a day on weight loss attempts. Unfortunately, nine
out of ten weight-loss diets are unsuccessful or may actually
be harmful or eventually increase weight gain. Vic Health.
Parliamentary Inquiry into issues relating to the development
of body image among young people and associated effects on
their health and wellbeing. 2004 Vic Health Response.
18. Gonzalez, A., Kohn, M.R., Clarke, S.D., ‘Eating disorder in
adolescents’. Australian Family Physician vol. 36. No. 8. 2007.
19. Elliot D.L. et al., ‘Preventing Substance Use and Disordered
Eating: Initial Outcomes of the ATHENA (Athletes Targeting
Healthy Exercise and Nutrition Alternatives) Program’. Arch
Pediatr Adolesc Med. 2004;158:1043-1049.
20. Government Response to the Parliamentary Inquiry into Issues
Relating to the Development of Body Image Among Young
People and Associated Effects on Their Health and Wellbeing.
(Victorian Government: Family and Community Development

Committee) – January 2006.
Australian Medical Association (2009). Body Image and Health – 2002.

Revised 2009. Retrieved from http://ama.com.au on 28 August 2013.
8
Positive Body Image
What is body dysmorphic disorder?
ReachOut.com explains the causes and characteristics of body dysmorphic disorder,
and what to do if you are experiencing extreme self-consciousness about your body
Everyone has times when they feel •• Frequently checking out how you
self-conscious about their body, look in mirrors
but when it starts impacting on •• Constantly making sure you look
everyday life it can be classed as clean and well-groomed
body dysmorphic disorder. There •• Frequently touching the part of
are a number of characteristics of your body that you don’t like
body dysmorphic disorder as well •• Trying to hide or disguise the
as numerous causes. If you think body part or yourself
you might be experiencing body •• Avoiding going out or being with
dysmorphic disorder, there are heaps others because you feel so self-
of things you can do which can help conscious about your appearance
you feel better. •• Trying to ‘fix’ the body part –
through exercise, medication,
This might be surgery, and other sorts of
a problem if you ... treatment.
•• Hate a certain part of your body
•• Wish you could look different If you are concerned that these
•• Avoid going out because you behaviours sound familiar it is
don’t like the way you look important that you speak to a doctor
•• Try to disguise parts of your body or psychologist to find out more.
•• Think life would be better if you
looked a certain way. What causes body
dysmorphic disorder?
L
et’s face it – at one time or BDD does not have a single cause.
another you’ve wished a part It is often due to a variety of different counsellor from headspace,
of your body looked a little physical and mental health issues. www.eheadspace.org.au
different to what it does. It might •• Talk to a GP and find out more
be that you think your thighs are Some of the factors that may about treatment options
too big, your skin’s not perfect, or contribute to having BDD include … •• Find out more about cognitive
your nose has that little bump in the •• Having low self-esteem and behavioural therapy
middle that everyone can see. negative beliefs about yourself •• Try online tools like MoodGym
This kind of thinking is pretty •• Negative self-talk – for example, to train your brain and thoughts,
common and relatively normal, thinking that life would be so www.moodgym.anu.edu.au
whether it’s true or not. However, much better if you could ‘fix’ a
this kind of thinking becomes a certain part of your body If you feel like you might be
problem when it starts to rule your •• Media emphasis and fixation experiencing something different, like
life. You become totally preoccupied on the ideal body an eating disorder, have a look at some
with the part of your body that you •• Feeling a lack of control in of our fact sheets about eating disorders
think is not okay and these beliefs your life and where to seek help.
severely interfere with the quality •• Stress or coping styles
of your life. This kind of obsessing •• Relationships with family What can I do now?
over a part of your body is known as and peers •• Avoid conversations about
body dysmorphic disorder (or BDD). •• Genetics and chemistry body size if they make you feel
•• Sexual abuse or trauma. bad about yourself.
Characteristics of body •• Check out MoodGym and work
dysmorphic disorder What to do if this on training your brain and
There are many different types of sounds like you thoughts.
behaviours and symptoms that you If you think you might be dealing •• Find out about eating disorders
might experience if you have BDD, with body dysmorphic disorder, and their symptoms.
however not everyone experiences there are a number of things that
every one. might be able to help. Inspire Foundation (2013).
What is body dysmorphic disorder?
Some signs of body dysmorphic Some of these include: (Fact sheet). Retrieved from
disorder include: •• Chat online or by email to a http://au.reachout.com on 26 September 2013.
9
Body dysmorphic disorder puts
ugly in the brain of the beholder
Body dysmorphic disorder is less well known than anorexia, but has
around five times the prevalence, reports Ben Buchanan
W
hen people think of mental problems related social lives and experience high levels of anxiety and
to body image, often the first thing that depression. Body dysmorphic disorder is clearly a
comes to mind is the thin figure associated serious problem and should never be dismissed as body
with anorexia. Body dysmorphic disorder is less well dissatisfaction or vanity.
known, but has around five times the prevalence of
anorexia (about 2% of the population), and a high level But distinguishing between these can be difficult, so
of psychological impairment. the following questions are often used as a guide:
It’s a mental disorder where the main symptom is •• Do you think about a certain part of your body for
excessive fear of looking ugly or disfigured. Central more than two hours a day?
to the diagnosis is the fact that the person actually •• Does it upset you so much that it regularly stops
looks normal. you from doing things?
•• Has your worry about your body part affected your
NEITHER VANITY NOR relationships with family or friends?
DISSATISFACTION ALONE
People with body dysmorphic disorder think there’s If someone answers yes to these questions, further
a particular feature of their face (such as nose, lips or professional evaluation is needed. A full assessment
ears) or another body part (such as arms, legs or buttocks) would entail a few sessions with a mental health
that’s unbearably ugly. Many seek unnecessary cosmetic clinician to talk about these worries and an assessment
surgery or skin treatments – but sadly only a few receive of grooming behaviours.
appropriate psychological support.
In general, people with the disorder are very shy and
some choose to stay home out of fear of being judged or
Body dysmorphic disorder is a mental
laughed at because of the way they look. disorder where the main symptom is
Many people with the disorder spend hours every day excessive fear of looking ugly or disfigured.
looking at themselves in the mirror. Others have unusual
grooming habits to try and cover up their perceived flaw. BRAIN RESEARCH
These people have significant difficulties with their My research using brain imaging has shown there
are clear differences in the brains of people with body
dysmorphic disorder that lead to changes in the way
they process information. We found that people with
the disorder had inefficient communication between
different brain areas.
In particular, the connections between areas of the
brain associated with detailed visual analysis and a
holistic representation of an image were weak. This could
explain the fixation on just one aspect of appearance.
There was also a weak connection between the

the amygdala (the brain’s emotion centre) and the
orbitofrontal cortex, the ‘rational’ part of the brain that
helps regulate and calm down emotional arousal.
Once they become emotionally distressed, it can be
difficult for someone with body dysmorphic disorder to
wind down because the ‘emotional’ and ‘rational’ parts
of the brain simply aren’t communicating effectively.
People usually develop body dysmorphic disorder
during their teenage years, which happens to be an
important time for brain development. They also often
report childhood teasing about their looks, which may
act as a trigger that rewires the brain to focus attention
on physical appearance.
10
Positive Body Image
COSMETIC PROCEDURES prevention with the option of antidepressant medica-
Many people with body dysmorphic disorder seek tion. This helps patients modify unhelpful daily rituals
cosmetic procedures such as nose jobs, breast implants and safety behaviours, such as mirror checking or
or botox injections. The problem is that the vast camouflaging the perceived defect with make-up.
majority (83% in some research) experience either no Body dysmorphic disorder is under-diagnosed
improvement or a worsening of symptoms after it. And because those with it persistently deny they have a
most are dissatisfied with the procedure. psychological problem, preferring to opt for physical
This differs from people without body dysmorphic treatments instead. Evidence suggests that symptoms
disorder who are generally satisfied with cosmetic are underpinned by differences in the way the brain
procedures and even report psychological benefits on processes information and that psychological therapy
follow-up. can help people overcome the preoccupation with their
appearance.
Researchers estimate about 14% of people Ben Buchanan is a Psychology Doctoral Candidate at Monash
who receive cosmetic treatments have University. He is involved in research and treatment of body
dysmorphic disorder.
diagnosable body dysmorphic disorder. The brain research referenced in this article was funded by
a Monash Strategic Grant. Ben conducts research at MAPrc
Researchers estimate about 14% of people who (Monash Alfred Psychiatry Research Centre), School of
receive cosmetic treatments have diagnosable body Psychology and Psychiatry, Faculty of Medicine, Nursing and
Health Sciences, Monash University and The Alfred Hospital,
dysmorphic disorder, indicating that psychological

Melbourne, Australia.
screening practises are inadequate. Given the likelihood
of causing psychological harm, it may be wise for
cosmetic surgeons to assess all potential clients before
operating. Buchanan, B (13 June 2013). Body dysmorphic disorder
puts ugly in the brain of the beholder. Retrieved from
http://theconversation.com/au on 25 September 2013.
PSYCHOLOGICAL TREATMENT
It can be difficult to persuade someone with the
disorder to accept psychological help given the belief in
their physical defect is likely to be very strong. But once
someone receives psychological therapy, symptoms are
likely to reduce.
The first-line of treatment is cognitive behavioural
therapy (CBT), focusing on exposure and response
11
WHAT IS AN EATING DISORDER?
EATING DISORDERS ARE SERIOUS MENTAL ILLNESSES, EXPLAINS
THE NATIONAL EATING DISORDERS COLLABORATION
E
ating disorders are serious affect every major organ in the body. disguise or deny their behaviour,
mental illnesses; they are not •• About one in 20 Australians has or do not recognise that there is
a lifestyle choice or a diet gone an eating disorder and the rate anything wrong.
‘too far.’ in the Australian population A person with an eating disorder
Eating disorders are associated is rising (Hay, Mond, Buttner, may have disturbed eating behav-
with significant physical comp- Darby, 2008). iours coupled with extreme concerns
lications and increased mortality. •• Approximately 15% of Australian about weight, shape, eating and
The mortality rate for people with women experience an eating body image.
eating disorders is the highest of disorder during their lifetime. Find out more about the warning
all psychiatric illnesses, and over 12 signs from www.nedc.com.au/
times higher than that for people A person with an eating recognise-the-warning-signs
without eating disorders.
disorder may go to great
Eating disorders occur in both RECOVERY IS POSSIBLE
men and women, young and old, rich lengths to hide, disguise Eating disorders are serious,
and poor, and from all cultural back- or deny their behaviour. potentially life threatening mental
grounds. About one in 20 Australians and physical illnesses, however
has an eating disorder and the rate •• The mortality rate for people with appropriate treatment and a
in the Australian population is with eating disorders is the high level of personal commitment,
increasing. highest of all psychiatric illnesses recovery from an eating disorder is
There are three eating disorders and over 12 times that seen in achievable.
that are recognised by the Diagnostic people without eating disorders. Evidence shows that the sooner
and Statistical Manual of Mental •• Many people who have eating you start treatment for an eating
Disorders (DSM), which are anorexia disorders also develop depress- disorder, the shorter the recovery
nervosa, bulimia nervosa and eating ion and anxiety disorders. process will be. Seeking help at the
disorder not otherwise specified •• It is common for a person with first warning sign is much more
(EDNOS). There is a fourth eating an eating disorder to also present effective than waiting until the
disorder which is also recognised by with substance abuse problems. illness is in full swing. If you suspect
professionals and will be included in •• Approximately 58% of people that you or someone you know has
the next revision of the DSM, binge with eating disorders present an eating disorder it is important to
eating disorder. with personality disorders. seek help immediately.
Eating disorders defy classif-
Used by permission of
ication solely as mental illnesses as SIGNS AND SYMPTOMS the Australian Government.
they not only involve considerable Due to the nature of an eating
psychological impairment and disorder many of the characteristic National Eating Disorders Collaboration
distress, but they are also associated behaviours may be concealed. A (2013). What is an eating disorder?
with major wide-ranging and serious person with an eating disorder Retrieved from www.nedc.com.au
medical complications, which can may go to great lengths to hide, on 25 September 2013.
12
Positive Body Image
Eating disorders: key research and statistics
THE LATEST DATA ON EATING DISORDERS, FROM EATING DISORDERS VICTORIA
Overview of eating disorders today 0.1% and 0.5% in males.12
•• Between 1995 and 2005 the prevalence of disordered •• Approximately one in 100 adolescent girls develops
eating behaviours doubled among both males and anorexia nervosa.13
females.1 •• One in ten young adults and approximately 25% of
•• Eating disorders are increasing in both younger and children diagnosed with anorexia nervosa are male.14
older age groups.1 •• Anorexia has the highest mortality rate on any
•• Eating disorders occur in both males and females psychiatric disorder.3
before puberty, with the ratio of males to females •• 1 in 5 premature deaths of individuals with anorexia
approximately 1:10 during adolescence and decreas- nervosa are caused by suicide.3
ing to 1:20 during young adulthood.2 •• Among 15-24 year old females, AN has a standardised
•• At the end of 2012 it was estimated that eating mortality rate that is 12 times the annual mortality
disorders affected nearly 1 million Australians.1 rate from all causes.15
•• Prevalence of eating disorders is increasing amongst
boys and men.1
•• 90% of cases of anorexia nervosa (AN) and bulimia Between 1995 and 2005 the prevalence
nervosa (BN) occur in females.1 of disordered eating behaviours doubled
•• Approximately 15% of women experience an eating among both males and females.
disorder at some point during their life.1
•• An estimated 20% of females have an undiagnosed
eating disorder.3 •• The onset of anorexia usually occurs during adoles-
•• Younger adolescents tend to present with anorexia, cents with a median age of 17.16
while older adolescents may present with either •• The average duration is 7 years. Those who recover
bulimia or anorexia.4 are unlikely to return to normal health.17
•• Eating disorders are the 3rd most common chronic •• 40% of people with anorexia nervosa are at risk of
illness in young females.3 developing bulimia nervosa.18
•• Risk of premature death from an eating disorder is •• Many sufferers develop chronic social problems,
6-12 times higher than the general population.3 which can escalate to the extent experienced by
•• Eating disorders are ranked 12th among the leading schizophrenic patients.19
causes of hospitalisation costs due to mental health.1 •• Morbidity includes osteoporosis, anovulation, dys-
•• Eating disorders can be considered to exist within thymia, obsessive compulsive disorder, and social
a spectrum, with 10-30% of patients crossing over isolation.20
between anorexic and bulimic tendencies during the •• Although 70% of patients regain weight within 6
course of their illness.5 months of onset of treatment, 15-25% of these relapse,
•• Depression is experienced by approximately 45% to usually within 2 years.21
86% of individuals with an eating disorder.6 •• More than half of anorexia sufferers have been
•• Anxiety disorder is experienced by approximately sexually abused or experienced some other major
64% of individuals with an eating disorder.7 trauma.22
•• Approximately 58% of individuals with eating disor-
Bulimia
ders have a comorbid personality disorder.8
•• The incidence of bulimia nervosa in the Australian
•• Sufferers typically deny they have an eating disorder.9
population is 5 in 100. At least two studies have
•• According to the National Eating Disorder Assoc-

indicated that only about one tenth of the cases of
iation, in the United States, eating disorders are
bulimia in the community are detected.23
more common than Alzheimer’s disease (5-10 million
•• True incidence estimated to be 1 in 5 amongst students
people have eating disorders compared to 4 million
and women (NEDC).1
with Alzheimer’s disease).10
•• Based on international data, the lifetime prevalence
•• In 1998, 38 months after television first came to
in females is between .9% and 2.1%, and <.1% to 1.1%
Nadroga, Fiji, 15% of girls, aged 17 on the average,
in males.12
admitted to vomiting to control weight. 74% of girls
•• The onset of bulimia nervosa usually occurs between
reported feeling ‘too big and fat’ at least sometimes.
16 and 18 years of age.24
Fiji has only one TV channel, which broadcasts mostly
•• It is common for people suffering from bulimia to
American, Australian, and British programs.11
keep their disorder hidden for 8-10 years, at great cost
Anorexia to their physical and psychological health.25
•• Based on international data, the lifetime prevalence •• 92% of people with bulimia said that seeking help
for females is between .3% and 1.5%, and between was entirely their own choice whereas only 19% of
13
including diabetes, high blood pressure and
cholesterol levels, gallbladder disease, heart disease
and certain types of cancers.36
•• Potential risk factors include obesity, being over-
weight as a child, strict dieting, and a history of
depression, anxiety and low self-esteem.37
Eating disorders not

otherwise specified (EDNOS)
•• The clinical diagnosis of eating disorder not other-
wise specified (EDNOS) has been said to represent
the most common diagnosis made in outpatient
settings but the one most ignored by researchers
because of its status as a ‘residual diagnosis’ in the
DSM-IV, or a disorder of clinical severity where
the diagnostic criteria of bulimia nervosa (BN) or
anorexia nervosa (AN) are not met.38
•• Approximately 40-60% of people seeking treatment
for an eating disorder have EDNOS.39
Risk factors developing an eating disorder

•• Eating disorders may arise from a variety of different
causes and while they sometimes begin with a
preoccupation with food and weight they are often
about much more than food.40
•• Adolescents with diabetes may be at 4-times the risk.3
people with anorexia agreed.26 •• Females with diabetes and anorexia nervosa are
•• 83% of bulimic patients vomit, 33% abuse laxatives, at 15.7 higher risk of mortality than females with
and 10% take diet pills.27 diabetes alone.3
•• The mortality rate for bulimia nervosa is estimated
to be up to 19%.28 Weight loss dieting
•• People with bulimia may have had one or several •• Dieting is the single most important risk factor for
suicide attempts and there is a high incidence of developing an eating disorder. 68% of 15 year old
depression amongst bulimia sufferers.29 females are on a diet, of these, 8% are severely dieting.
•• 70% of individuals who undertake treatment for Adolescent girls who diet only moderately, are five
bulimia nervosa report a significant improvement times more likely to develop an eating disorder than
in their symptoms.30 those who don’t diet, and those who diet severely are
•• Bulimia can become a means of coping with stressful 18 times more likely to develop an eating disorder.41
situations, such as an unhappy relationship or a •• Research has shown that the traditional dieting
traumatic past event.31 approach of restricting both calories and food types
•• Impulsivity and substance abuse is correlated with shows poor results in achieving long-term weight loss.
bulimia.32 Within five years, many dieters regain any weight they
lose and often end up heavier than when they began.
Binge eating disorder They also tend to develop very unhealthy attitudes
•• Binge eating disorder is characterised by recurrent towards food and to lose their natural ability to
binge eating without using compensatory measures recognise when they are hungry or full.42
such as vomiting, laxative abuse or excessive exercise •• Young Australian women who start dieting before
to counter the binge.33 the age of 15 are more likely to experience depression,
•• Based on international data, the lifetime prevalence binge eating, purging, and physical symptoms
in females is between 2.5% and 4.5%, and 1.0% and such as tiredness, low iron levels and menstrual
3.0% in males.12 irregularities.43
•• The prevalence of binge eating disorder in the general •• Women who diet frequently (more than 5 times) are
population is estimated to be 4%. 75% more likely to experience depression.44
•• The incidence of binge eating disorder in males and •• A Victorian study of adolescents aged 12 to 17 years
females is almost equal.34 classified 38% of girls and 12% of boys as ‘intermediate’
•• The disorder often develops in late adolescence and to ‘extreme’ dieters (i.e. at risk of an eating disorder).45
early 20’s.35 •• A Sydney study of adolescents aged 11 to 15 reported
•• People with binge eating disorder are at risk of that 16% of the girls and 7% of the boys had already
developing a variety of different medical conditions employed at least one potentially dangerous method
14
Positive Body Image
of weight reduction, including starvation, vomiting •• A 2007 Sydney University study of nearly 9,000
and laxative abuse.46 adolescents showed one in five teenage girls starved
•• A sample of women from the general population themselves or vomit up their food to control their
aged 18 to 42 years found the point prevalence for weight. Eight per cent of girls used smoking for
the regular use of specific weight control methods weight control.55
was 4.9% for excessive exercise, 3.4% for extreme •• In a 2006 AC Nielsen survey conducted to judge
restrictive eating, 2.2% for diet pills, 1.4% for self- if current models were too thin, 94% of people in
induced vomiting, 1.0% for laxative misuse, and .3% Norway, 92% in New Zealand and Switzerland and
for diuretic misuse.47 90% in Australia said the models could do with more
•• 31% of young women surveyed between 18 and flesh.56
23 reported that at some time they had at least
experimented with unhealthy eating behaviours
including making themselves purge, deliberately Dieting to control weight in adolescence
abusing laxatives or diuretics, or fasting for at least is not only ineffective, it may actually
24 hours in order to lose weight.48 promote weight gain.
•• Dieting to control weight in adolescence is not only
ineffective, it may actually promote weight gain. A
study of adolescents showed that after 3 years of •• Beyond Stereotypes, the 2005 study commissioned by
follow-up, regular adolescent dieters gained more Dove surveyed 3,300 girls and women between the
weight than non-dieters.49 ages of 15 and 64 in 10 countries. They found that 67%
•• High frequency dieting and early onset of dieting of all women 15 to 64 withdraw from life-engaging
are associated with poorer physical and mental activities due to feeling badly about their looks.57
health, more disordered eating, extreme body
dissatisfaction, and more frequent general health Hereditability/personality
problems.50 •• Research on the genetic basis of eating disorders
•• Amongst 12 to 17 year olds, 90% of females and 68% suggests that genes may account for 31%-76% of the
of males have been on a diet of some kind.51 variance in anorexia nervosa, between 28%-83% of
the variance in bulimia nervosa, and 17%-39% of
Body image pressure on young variance in binge eating disorder.58
people (a socio-cultural risk factor) •• A twin study published in the American Journal of
•• In Australians aged 11-24, approximately 28% of males Psychiatry found that genetic factors have a significant
are dissatisfied with their appearance compared to influence on the development of anorexia nervosa,
35% of females.12 with an estimated hereditability of 58%.59
•• The Australian National Survey of Mental Health and •• Adolescents with anorexia are usually high achievers
Wellbeing, revealed that body image was identified and are often involved in a number of extracur-
as the number one concern of 29,000 males and ricular activities such as tutoring, volunteer work
females.12 and community leadership, as the driven focus
•• The Longitudinal Study on Women’s Health, found required to successfully maintain an eating disorder
that only 22% of women within a normal healthy extends to other areas of their lives. They tend to
weight range reported being happy with their be perfectionists, have internalising coping styles
weight. Almost three quarters (74%) desired to and obsessive behaviours, often with comorbid
weigh less, including 68% of healthy weight and 25% mood symptoms such as depression and obsessive
underweight women.12 compulsive disorder (OCD).60
•• Low self-esteem increases the chance of developing •• Patients with bulimia have been described as having
disordered eating.52 difficulties with impulse regulation.61
•• Poor body image is associated with an increased

probability of engaging in dangerous dietary practices Protective factors
and weight control methods, excessive exercise, •• Protective factors have been less studied in comp-
substance abuse and unnecessary surgery to alter arison to risk factors.62
appearance.12 •• Individual protective factors include high self-
•• A recent survey of 600 Australian children found esteem, emotional wellbeing, positive body image,
that increasingly, children are disturbed by the assertiveness, problem-solving skills, media literacy,
relentless pressure of marketing aimed at them. A good social skills and successfully performing
large majority (88%) believed that companies tried multiple social roles, academic achievement.63
to sell them things that they do not really need.53 •• Social protective factors include belonging to a family
•• A large number (41%) of children are specifically environment that does not overemphasise weight
worried about the way they look with 35% concerned and physical appearance, eating meals together on
about being overweight (44% of girls and 27% of boys) a regular basis.63
and 16% being too skinny.54 •• A longitudinal study into the associations between
15
family meal frequency and disordered eating Eating and Weight Disorders, 5, 52-61.
behaviours in adolescents found that regular family 9. Hillege, S., Beale, B. & McMaster, R. (2006). ‘Impact of eating
disorders on family life: individual parents’ stories’. Journal of
meals during adolescence play a protective role for
Clinical Nursing, 15 (8), 1016-22.
extreme weight control behaviours in adolescent 10. National Eating Disorder Association www.edap.org
girls but not boys.64 11. 1999 study published by Anne Becker, director of research at the
•• Socio-cultural protective factors include cultural Harvard Eating Disorders Center, http://archives.focus.hms.harvard.
acceptance of a diversity of body shapes and sizes, edu/1998/Nov27_1998/eat.html
sporting contexts that value performance and not
merely physical attractiveness and aesthetics, rel- Anorexia
ationships with others that are not highly concerned 12. The National Eating Disorders Collaboration (2010). Eating Disorders
Prevention, Treatment and Management: An Evidence Review.
with weight and shape, and social support.65
Retrieved from www.nedc.com.au/nedc-publications
13. Eating Disorders (1994). National Institute of Mental Health, NIH
REFERENCES Publication No 94-3477.
Overview of eating disorders today 14. Paxton, S. (1998). ‘Do men get eating disorders?’ Everybody Newsletter
1. The National Eating Disorders Collaboration. (2012). An Integrated of Body image and Health Inc., p. 41.
Response to Complexity – National Eating Disorders Framework 15. Sullivan, P. (1995). ‘Mortality in Anorexia Nervosa’. American Journal
2012. of Psychiatry, 153, 1073-1074.
2. Kohn, M. & Golden, N.H. (2001). ‘Eating disorders in children and 16. Steiner, H., Kwan, W., Shaffer, T.G., Walker, S., Miller, S., Sagar, A. &
adolescents: epidemiology, diagnosis and treatment’. Paediatric Lock, J. Ibid.’Risk and protective factors for juvenile eating disorders’,
vol. 12 Suppl 1, pp. I36-8.
Drugs, 3(2), 91-9.

3. The National Eating Disorders Collaboration. (2012). Eating 17. Ibid.
Disorders in Australia. Retrieved from www.nedc.com.au/ 18. Beumont, P.J.V. & Touyz, S.W. Ibid. ‘What kind of illness is anorexia
eating-disorders-in-australia nervosa?’ vol. 12, pp. I/20-4.
4. Gonzalez, A., Kohn, M.R. & Clarke, S.D. (2007). ‘Eating disorders in 19. Hamburg, P. & Werne, J. (1996). ‘How long is long-term therapy for
adolescents’. Australian Family Physician, 36 (8), 614-9. anorexia nervosa?’ in Treating eating disorders., Jossey-Bass, San
5. Ibid. Francisco, CA, US, pp. 71-99.
6. O’Brien, K.M.O., & Vincent, N.K. (2003). ‘Psychiatric comorbidity 20. Ibid.
in anorexia and bulimia nervosa: Nature, prevalence, and causal 21. Hillege, S., Beale, B. & McMaster, R. (2006). ‘Impact of eating
relationships’. Clinical Pyschology Review, 23, 57-74. disorders on family life: individual parents’ stories’. Journal of
7. Kaye, W.H., Bulik, C.M., Thornton, L., Barbarich, N., Masters, K., Clinical Nursing, 15 (8), 1016-22.
& Price Foundation Collaborative Group. (2004). ‘Comorbidity of 22. Hay, P. (2004). ‘Australian and New Zealand clinical practice
anxiety disorders with anorexia and bulimia nervosa’. American guidelines for the treatment of anorexia nervosa’. Australian and
Journal of Psychiatry, 161, 2215-2221. New Zealand Journal of Psychiatry, 38 (9), 659-70.
8. Rosenvinge, J.H., Martinussen, M., & Ostensen, E. (2000). ‘The
comorbidity of eating disorders and personality disorders: A Bulimia
meta-analytic review of studies published between 1983 and 1998’. 23. Sullivan, P.F. (1995). ‘Mortality in anorexia nervosa’. American Journal
16
Positive Body Image
of Psychiatry, 152 (7), 1073-4. weight control practices of young male and female adolescents’.
24. Grilo, C.M., & Masheb, R.M. (2000). ‘Onset of dieting vs. binge eating Australian Journal of Nutrition & Dietetics, 53 (1), 32.
in outpatients with binge eating disorders’. International Journal of 47. Mond, J.M., Hay, P.J., Rodgers, B., & Owen, C. (2006). ‘Eating Disorder
Obesity, 24, 404-409. Examination Questionnaire (EDE-Q): Norms for young adult women’.
25. Understanding Eating Disorders. (1997). The Eating Disorders Behaviour Research and Therapy, 44, 53-62.
Association Resource Centre. 48. Brown, W. (1998). ‘Is life a party for young women?’ ACHPER Healthy
26. Gaskill, D. & Sanders, F. (2000). The Encultured Body: Policy Lifestyles Journal, 45 (3), 21-6.
Implications for healthy body image and distorted eating 49. Field, A.E., Austin, S.B., Taylor, C.B., Malspeis, S., Rosner, B.,
behaviours. Faculty of Health Queensland University of Technology. Rockett, H.R., Gillman, M.W. & Colditz, G.A. (2003). ‘Relation
27. Cooke, K.(1997). Real Gorgeous. Allen & Unwin, Sydney. between dieting and weight change among preadolescents and
28. Grotheus, K. (1998). ‘Eating Disorders and adolescents: an overview adolescents’. Pediatrics, 112 (4), 900-6.
of maladaptive behaviour’. Journal of child and Adolescent 50. Kenardy, J., Brown, W.J. & Vogt, E. (2001). ‘Dieting and health in young
Psychiatric Nursing, 11 (4), 146-56. Australian women’. European Eating Disorders Review, 9(4), 242.
29. Management of Mental Disorders. (1997). World Health Organisation, 51. Patton, G. C., Carlin, J. B., Shao, Q., Hibbert, M. E., Rosier, M., Selzer,
Darlinghurst. R., & Bowes, G. (1997). ‘Adolescent dieting: Healthy weight control
30. Edelstein, C.K., Haskew, P. & Kramer, J.P. (1989). ‘Early clues to or borderline eating disorder?’ Journal of Child Psychology and
anorexia and bulimia’. Patient Care, 23 (13), 155. Psychiatry, 38, 299-306.
31. Lindberg, L .& Hjern, A. (2003). ‘Risk factors for anorexia nervosa:
a national cohort study’. International Journal of Eating Disorders, Body image pressure on young people
34 (4), 397-408.
32. Ibid.
(a socio-cultural risk factor)
52. Button, E.J., Loan, P., Davies, J. & Sonuga-Barke, E.J.S. (1997). ‘Self-
esteem, eating problems, and psychological well-being in a cohort
Binge eating disorder of schoolgirls aged 15-16: a questionnaire and interview study’.
33. Eating Disorders and Binge Eating Information Sheet (2006). The International Journal of Eating Disorders, 21 (1), 39-47.
Eating Disorders Foundation of Victoria. 53. Tucci, J., Mitchell, J. & Goddard, C. (2007). Modern Children in
34. Wilfley, D.E., Agras, W.S., Telch, C.F., Rossiter, E.M., Schneider, J.A., Australia. Australian Childhood Foundation, Melbourne.
Cole, A.G., Sifford, L. & Raeburn, S.D. (1993). ‘Group cognitive- 54. Ibid.
behavioral therapy and group interpersonal psychotherapy for the 55. O’Dea, J.A. (2007). Everybody’s different. ACER Press.
nonpurging bulimic individual: A controlled comparison’. Journal 56. The 2006 Nielsen company survey, covering 25,000 respondents in
of Consulting and Clinical Psychology, 61 (2), 296-305. 45 countries.
35. Paxton, S. (1998). ‘Do men get eating disorders?’ Everybody Newsletter 57. Beyond Stereotypes, a 2005 study commissioned by Dove.
of Body image and Health Inc., p. 41.
36. The Australian Longitudinal Study on Women’s Health. (1996).
Universities of Newcastle and Queensland. Hereditability/personality
37. Eating Disorders and Binge Eating Information Sheet. (2006). The 58. Wade, T.D. (in press). ‘Genetic influences on eating and the eating
Eating Disorders Foundation of Victoria. disorders’. In W. S. Agras (Ed)., Oxford handbook of eating disorders.
New York: Oxford University Press.
59. Wade, T.D., Bulik, C.M., Neale, M. & Kendler, K.S. (2000). ‘Anorexia
Eating disorders not otherwise specified (EDNOS) nervosa and major depression: shared genetic and environmental
38. Wade, T.D. (2007). ‘A retrospective comparison of purging type risk factors’. American Journal of Psychiatry, 157 (3), 469-71.
disorders: eating disorder not otherwise specified and bulimia
60. Gonzalez, A., Kohn, M.R. & Clarke, S.D. (2007). ‘Eating disorders in
nervosa’. International Journal of Eating Disorders, 40 (1), 1-6.
adolescents’. Australian Family Physician, 36 (8), 614-9.
39. The National Eating Disorders Collaboration. (2012). What is an 61. Kohn, M. & Golden, N.H. (2001). ‘Eating disorders in children and
Eating Disorder Not Otherwise Specified (EDNOS)? Retrieved from
adolescents: epidemiology, diagnosis and treatment’. Paediatric
http://nedc.com.au/ednos Drugs, 3 (2), 91-9.
Risk factors developing an eating disorder Protective factors

40. CEED 2008, ‘What is an eating disorder?’ retrieved 7 August,
62. Steiner, H., Kwan, W., Shaffer, T. G., Walker, S., Miller, S., Sagar, A.,
database.
& Lock, J. (2003). ‘Risk and protective factors for juvenile eating
disorders’. European Child & Adolescent Psychiatry, 12, 38-46.
Weight loss dieting 63. National Eating Disorders Collaboration. (2012). Protective Factors.
41. Patton, G.C., Selzer, R., Coffey, C., Carlin, J.B. & Wolfe, R. (1999). ‘Onset Retrieved from www.nedc.com.au/protective-factors
of adolescent eating disorders: population based cohort study over 64. Neumark-Sztainer, D., Eisenberg, M.E., Fulkerson, J.A., Story, M.,
3 years’. British Medical Journal, 318 (7186), 765-8. & Larson, N.I. (2008) ‘Family meals and disordered eating in
42. Katzer, L., Bradshaw, A., Horwath, C., Gray, A., O’Brien, S. & Joyce, adolescents: Longitudinal findings from project EAT’. Archives on
J. (2008). ‘Evaluation of ‘non-dieting’, stress reduction program for Pediatrics & Adolescent Medicine, 162(1), 17-22. Retrieved from
overweight women: a randomised trial’. American Journal of Health http://archpedi.jamanetwork.com/article.aspx?articleid=378850
Promotion, 22, 264-74. 65. Shisslak, C.M., & Crago, M. (2001). ‘Risk and protective factors
43. Lee, C. (2001). Women’s Health Australia: What do we do? What do in the development of eating disorders’. In J.K Thompson &
we need to know?: Progress on the Australian Longitudinal Study L.Smolak (Eds), Body image, eating disorders, and obesity in youth:
of Women’s Health 1995-2000, Australian Academic Press Pty Ltd., Assessment, prevention, and treatment (pp.103-125). Washington,
Brisbane. D.C,: American Psychological Association.
44. Kenardy, J., Brown, W.J. & Vogt, E. (2001). ‘Dieting and health in young
Australian women’. European Eating Disorders Review, 9 (4), 242.
45. Patton, G.C., Carlin, J.B., Shao, Q., Hibbert, M.E., Rosier, M., Selzer, Eating Disorders Victoria (2013). Key Research and Statistics.
R. & Bowes, G. (1997). ‘Adolescent dieting: healthy weight control Retrieved from www.eatingdisorders.org.au on 13 September 2013.
or borderline eating disorder?’ Journal of Child Psychology and
Psychiatry and Allied Disciplines, 38 (3), 299-306.
46. O’Dea, J.A. & Abraham, S. (1996). ‘Food habits, body image and
17
EXPLAINER: ANOREXIA AND BULIMIA
Peta Stapleton explains the two most widely known eating disorders
in this article first published in The Conversation
not uncommon for women and
girls suffering from anorexia to stop
having their periods.
Globally about 1% of the pop-
ulation suffer from anorexia and, in
Australia, 2% to 3% of adolescent and
adult women satisfy the diagnostic
criteria for anorexia or bulimia.
Research suggests 8% of Australian
women have suffered a serious
eating disorder at some point in
their lifetime, and 23% of young
Australian women aged between 22
and 27 year have disordered eating
in their recent past.
Anorexia is a very serious con-
dition and the death rate is five
times more for sufferers compared
to others of the same age.
There’s no single cause for
eating disorders although family
and cultural pressures such as
E
ating disorders are an for the development of an eating the media promoting an ‘ideal’
increasing problem in child- disorder and, disturbingly, it’s weight, as well as emotional and
ren and adolescents. Recent thought about 70% of 15-year-old personality factors (such as being
Australian studies have indicated girls are on a diet. Out of these, 8% perfectionist, having very high
eating disorder behaviour has are severely dieting. standards, and suffering from
increased twofold in Australia in anxiety), are thought to play a role.
the last five years and 9% (men Eating disorders are not
and women) will suffer from one just a concern for girls BULIMIA NERVOSA
at some point in their lives. Bulimia is the more common
An analysis by the American but for boys as well. One eating disorder, and its sufferers
Agency for Healthcare Research and in four sufferers of eating are usually near average weight or
Quality shows that hospitalisations disorders are male. even slightly overweight. Bulimics
for eating disorders increased most engage in periods of binge eating
sharply (119%) for children aged 12 Adolescent girls who diet only (more food than most people
and younger between 1999 to 2006. moderately, are five times more would eat in the same time), and
Eating disorders are not just a likely to develop an eating disorder purging (to rid their bodies of the
concern for girls but for boys as than those who don’t diet at all. food). Purging includes intense
well. One in four sufferers of eating And those who diet severely are exercise, vomiting, fasting, and
disorders are male. 18 times more likely to develop an using laxatives.
Anorexia nervosa is the third- eating disorder. About 5% of the population
most common chronic adolescent suffer from bulimia but the true
problem and the psychiatric cond- ANOREXIA NERVOSA incidence is estimated to be as
ition that causes the most number Anorexia is a serious psycholog- high as one in five in the student
of deaths. While the incidence of ical eating disorder with ‘starvation population. The lifetime prevalence
bulimia nervosa is estimated to be symptoms’. Sufferers develop an in Australia is 2.9%.
as high as one in five in the student intense fear of becoming over-
population. weight, even if they are severely TREATMENT
The combined prevalence of underweight. Often, their percep- Eating disorders can be linked to
eating disorders in the Australian tion of their body weight or shape low self-esteem and psychological
community is estimated to be 7%. is skewed, or they deny the implica- issues can result from the practise
Dieting is the greatest risk factor tions of their low body weight. It’s of an unhealthy relationship with
18
Positive Body Image
food. Anorexia and bulimia are Unfortunately, there’s insuf- books based on this type of therapy,
very serious illnesses, not merely ficient evidence to make data-based which are considered effective.
fad diets gone wrong. They require recommendations regarding the Antidepressant medication may
specialised treatment for recovery. treatment of adults with anorexia also be useful for those suffering
although new therapies such as depressive symptoms.
There are three recommen- acceptance and commitment There are also strategies for
dations from the UK National therapy are showing promise. parents to help prevent the develop-
Institute for Clinical Excellence ment of eating disorders in children
(NICE) for the treatment of anorexia When sufferers are and teenagers.
in sufferers who are not yet adults: empowered to believe in First, avoid talking negatively
•• For children and adolescents about your body because as it
still living at home who’ve been themselves, recovering gives the message that it’s okay to
anorexic for less than three from an eating disorder dislike it. If you’re overweight and
years, a family-based treatment is possible. need to diet, let your child know
called the Maudsley Approach you are trying to lose weight to
is suggested. For bulimia, the strongest improve your health rather than
•• Outpatient services for those evidence for successful treatment to be a certain weight or shape.
going to see a psychiatrist or are the enhanced versions of cogn- If you must diet, do so by eating
a psychologist for individual itive behavioural therapy, which healthy, balanced meals, and avoid
counselling. helps sufferers by showing them fad diets, skipping meals or diet
•• Inpatient service which how to recognise negative thoughts pills. Finally, model good exercise
combines re-feeding and and feelings and how to change habits. Moderate, regular exercise
counselling interventions. them. There are also self-help will help you stay healthy and help
your child see an example of a
balanced lifestyle.
RECOVERY
About 45% to 50% of anorexia
and bulimia sufferers return to a
healthy weight with appropriate
treatment. Another 30% make a
partial recovery.
Of those who remain chronically
unwell, newer approaches, such
as mindfulness and acceptance
training, are being explored. Mind-
fulness meditation aims to focus
attention on the present moment,
helping people disengage from
habitual, unsatisfying behaviours.
Acceptance approaches aim to
increase psychological flexibility in
how people think.
When sufferers are empowered
to believe in themselves, recovering
from an eating disorder is possible.
Peta Stapleton is an Assistant Professor

in Psychology at Bond University.
Stapleton, P (3 July 2012). Explainer:

anorexia and bulimia. Retrieved
from http://theconversation.com/au
on 2 September 2013.
19
EATING DISORDERS RISK FACTORS
There is no single cause of eating disorders, however, there are a number of known
contributing risk factors, explains the National Eating Disorders Collaboration
that may be present before, during, and after recovery

from an eating disorder.
These include:
•• Perfectionism
•• Obsessive-compulsiveness
•• Neuroticism
•• Negative emotionality
•• Harm avoidance
•• Core low self-esteem
•• Traits associated with avoidant personality
disorder.
Specific additional personality traits may be asso-

ciated with each type of eating disorder. It is also
important to include that prolonged starvation induces
change in cognition, behaviour, and interpersonal
characteristics. It can therefore be difficult to discern
the psychological causes from the psychological effects
WHAT CAUSES AN EATING DISORDER?
T
of eating disorders.
he factors that contribute to the onset of an eating
disorder are complex. No single cause of eating Socio-cultural influences
disorders has been identified; however, known In year seven they weighed me and then put all
contributing risk factors include: our weights up on the board. That was when I started
•• Genetic vulnerability thinking about seriously losing weight. Suddenly I was
•• Psychological factors comparing myself to others.
•• Socio-cultural influences. Evidence shows that socio-cultural influences play a
role in the development of eating disorders, particularly
Genetic vulnerability among people who internalise the Western beauty
There is some evidence that eating disorders have ideal of thinness. Images communicated through mass
a genetic basis. This means that a person can inherit media such as television, magazines and advertising
their likelihood to develop anorexia nervosa, bulimia are unrealistic, airbrushed and altered to achieve a
nervosa or binge eating disorder. culturally perceived image of ‘perfection’ that does not
The genes that are most implicated in passing on actually exist.
eating disorders are within biological systems that The most predominant images in our culture
relate to food intake, appetite, metabolism, mood, today suggest that beauty is equated with thinness for
and reward-pleasure responses. It has been shown females and a lean, muscular body for males. People
that this genetic influence is not simply due to the who internalise this ‘thin ideal’ have a greater risk
inheritance of any one gene but results from a much of developing body dissatisfaction which can lead to
more complicated interaction between many genes and eating disorder behaviours.
quite possibly non-inherited genetic factors as well. Like most other psychiatric illnesses and health
The biological causes of eating disorders are not conditions, a combination of several different factors
well understood. This could be because the majority may increase the likelihood that a person will experience
of studies are conducted during the acute or recovery an eating disorder at some point in their life.
phase of an eating disorder. At this time, there are
physiological changes occurring in the person as a result MODIFIABLE RISK FACTORS
of their eating disorder behaviours which can affect the It is possible to change some socio-cultural, psych-
findings of the studies. Studies conducted at the onset ological and environmental risk factors.
of an eating disorder could show different results.
The modifiable risk factors for eating disorders are
Psychological factors identified as:
Research into anorexia nervosa and bulimia nervosa •• Low self-esteem
specifically, has identified a number of personality traits •• Body dissatisfaction
20
Positive Body Image
•• Internalisation of the thin socio-cultural ideal Extreme weight loss behaviours
•• Extreme weight loss behaviours. Disordered eating
Disordered eating is the single most important
Self-esteem indicator of onset of an eating disorder. Disordered
Low self-esteem has been identified by many eating is a disturbed pattern of eating that can include
research studies as a general risk factor for the fasting and skipping meals, eliminating food groups,
development of eating disorders. Strong self-esteem restrictive dieting accompanied by binge eating and
has been identified as essential for psychological excessive exercise. Disordered eating can also include
wellbeing and for strengthening the ability to resist purging behaviours such as laxative abuse and self-
cultural pressures. induced vomiting.
Disordered eating can result in significant mental,
Body dissatisfaction or negative body image physical and social impairment and is associated with
Poor body image can contribute to impaired mental not only eating disorders but also health concerns such as
and physical health, lower social functionality and poor depression, anxiety, nutritional and metabolic problems
lifestyle choices. Body dissatisfaction, the experience of and weight gain.
feelings of shame, sadness or anger associated with the
body, can lead to extreme weight control behaviours Dieting
and is a leading risk factor for the development of While moderate changes in diet and exercise have
eating disorders. been shown to be safe, significant mental and physical
Body dissatisfaction is also linked to depression and consequences may occur with extreme or unhealthy
low self-esteem and has been found to be widespread in dieting practices.
adolescent girls in Australia. Dieting is associated with the development of eating
disorders. It is also associated with other health concerns
Internalisation of the including depression, anxiety, nutritional and metabolic
thin socio-cultural ideal problems, and, contrary to expectation, with an increase
People who internalise and adopt the Western beauty in weight.
ideal of thinness as a personal standard have a higher
risk of developing an eating disorder. Dieting and adolescents at risk
Puberty is a time of great change biologically,
physically and psychologically. Teenagers are often
vulnerable to societal pressures and can often feel
insecure and self conscious, factors that increase the
risk of engaging in extreme dieting behaviour.
The act of starting any diet increases the risk of
eating disorders in adolescent girls. Research shows
that young people who engage in unhealthy dieting
practices are almost three times as likely as their
healthy-dieting peers to score high on measures
assessing suicide risk.
Studies in Australia and New Zealand have found:

•• Approximately half of adolescent girls have tried
to lose weight and practise extreme weight loss
behaviours such as fasting, self-induced vomiting
and smoking
•• As many as 75% of high school girls feel fat or want

to lose weight
•• Young people who diet moderately are six times
more likely to develop an eating disorder; those
who are severe dieters have an 18-fold risk
•• Among girls who dieted, the risk of obesity is
greater than for non-dieters.
Used by permission of the Australian Government.
National Eating Disorders Collaboration (2013). Eating disorders risk

factors. Retrieved from www.nedc.com.au on 3 September 2013.
21
Eating disorders ‘nearly as bad for men’
The gap between women and men in relation to eating disorders prevalence
is less than first thought, according to a new study. Following is an ABC
News report from Anna Salleh
T
he impact of eating disorders on men’s health has been Overall, 28 per cent of women were
underestimated, say researchers. Deborah Mitchison at
affected by factors related to eating
the University of Western Sydney and colleagues report
their findings online ahead of print in the International Journal disorders whereas 18.5 per cent
of Eating Disorders. of men were affected.
“Researchers have thought eating disorders are the domain of women so a lot of the research has been biased
towards women and not really recruited men,” says Mitchison, a PhD candidate in the School of Medicine.
In the first study of its kind, Mitchison and colleagues surveyed a 3,000-strong representative sample of the
population from South Australia on factors related to eating disorders.
Participants were asked about such things as regular binge eating or strict dieting and the degree to which their
weight and shape affected their self-worth.
While the researchers found that more women were affected by these things, the number of men affected was
also considerable.
Overall, 28 per cent of women were affected by factors related to eating disorders whereas 18.5 per cent of men
were affected.
“That was surprising. It was thought that there was a bigger gap between men and women,” says Mitchison.
The researchers found that 23 per cent of women reported that their self-worth was ‘moderately’ or ‘extremely’
influenced by their body shape and weight, and 13.5 per cent of men.
“That percentage for men is quite high,” says Mitchison.
The study found 5.7 per cent of women reported binge eating large amounts of food with a loss of control at
least once a week over the past three months. 4.1 per cent of men reported this behaviour.
The researchers also found that eating disorders resulted in a much lower quality of physical and mental
health – for both men and women.
“Even though men may be less likely to “Even though men may be less likely to experience
eating disorder features than women, overall there is
experience eating disorder features than very little difference between men and women in the
women, overall there is very little difference impact of these on their physical and mental health,”
between men and women in the impact of says Mitchison.
these on their physical and mental health.” “We really need to focus on men as well as women in
prevention and treatment of eating disorders.”
Salleh, A (31 January 2013).

Eating disorders ‘nearly as bad for men’.
Retrieved from www.abc.net.au/science
on 2 September 2013.
22
Positive Body Image
BODY IMAGE AND DIETS
Better Health Channel explains the links between dieting and
body image dissatisfaction in this reproduced fact sheet
Y
our body image is how you think and feel about weight loss and weight gain is a
your body. Body image involves your perception, risk factor for the development of
imagination and emotions. It does not necessarily heart disease later in life. People
reflect what you see in the mirror or what other people who diet frequently have a much
see. Poor body image is often linked to dieting or higher risk of developing eating
eating disorders such as anorexia nervosa, bulimia and disorders.
binge eating, and to other mental health issues such as If you are concerned about your own or your child’s
depression or anxiety. weight, consult with your doctor, paediatrician or
Many people try a lot of different diets that do not dietitian.
work. Some people diet because they have a poor body
image, rather than because they want to be a healthy Women need fat on their hips and thighs
weight. While it’s important to maintain healthy eating It is normal for women to have fat on their hips and
behaviours, constant dieting can lead to physical illness thighs. Frequent dieting will not remove this fat. It is
and depression, especially if your weight goes up and vital for:
down after dieting. •• Fertility and breastfeeding
•• Prevention of osteoporosis
Body image and weight issues •• Healthy skin, eyes, hair and teeth.
Some people think they are overweight when they
are not. Here are some statistics: Men also worry about their body image
•• 45 per cent of women and 23 per cent of men in the Men are under increasing pressure to have an
healthy weight range think they are overweight. ideal body:
•• At least 20 per cent of women who are underweight •• 17 per cent of men are on some sort of fad diet
think that they are overweight and are dieting to •• An increasing number of men are undergoing
lose weight. cosmetic surgery
•• Body image has some cultural links – for example, •• More men are buying grooming products and
some research shows that Asian women, after cosmetics than ever before.
moving to Australia, take on body image and diet
habits that are not common in their own countries. Where to get help
•• Your doctor
Weight loss from dieting does not last
•• Maternal and child health nurse
Australians spend up to one million dollars a day on
•• Dietitians Association of Australia Tel. 1800 812 942
fad diets that have little effect on their weight. Even if
•• Paediatrician
you remain on a weight loss program, it is likely that
•• Psychologist or counsellor
you will regain:
•• Eating Disorders Victoria Helpline
•• One to two thirds of your lost weight within one year
Tel. (03) 9885 0318 or 1300 550 236
•• Nearly all of your lost weight or more within five years.
Dieting affects your health and mental state Things to remember

Women who diet frequently are more likely to: •• Our body image may not be accurate. Many people
•• Binge eat think they are overweight or underweight when
•• Purge food (vomit) they are not

•• Restrict food intake too much and not get the •• If you diet, you will almost certainly gain any
nutrients they require for good health weight lost back again once you stop dieting
•• Over-exercise •• Frequent dieting affects your health and can make
•• Have poor health you depressed.
•• Become depressed or anxious Better Health Channel material is Copyright © 2013 State of Victoria.
•• Develop an eating disorder. Reproduced from the Better Health Channel (www.betterhealth.vic.gov.
au) at no cost with permission of the Victorian Minister for Health. The
The weight loss seesaw information published here was accurate at the time of publication and
Research has shown that nearly every young woman is not intended to take the place of medical advice. Please seek advice
and nearly half of all middle-aged women have dieted to from a qualified health care professional. Unauthorised reproduction and
lose weight at least once. The ‘weight loss, weight gain’ other uses comprised in the copyright are prohibited without permission.
seesaw may put you at risk of heart disease and other health Better Health Channel. Body image and diets (Fact sheet).
problems. Some studies have shown that just one cycle of Retrieved from www.betterhealth.vic.gov.au on 28 August 2013.
23
COSMETIC SURGERY
Better Health Channel fact sheet, produced in consultation with
and approved by, the Australian Society of Plastic Surgeons
C
osmetic surgery aims contouring, dermabrasion, laser skin resurfacing,
to improve a person’s implants and liposuction. Injections of botulinum toxin
appearance. Techniques Type A (available in Australia as Botox or Dysport) or
and procedures used include soft tissue (dermal) fillers, such as collagen or fat, may
facelift, eyelift, body contouring, also be used.
implants, dermabrasion or laser skin resurfacing,
liposuction and injections of botulinum toxin Type A Facelift (meloplasty)
(often known as ‘Botox’) or soft tissue (dermal) fillers The skin is cut in the scalp and around the ear. It is
such as collagen or fat. Potential risks of cosmetic surgery then separated from the underlying tissue, pulled tighter
include scarring and infection. and stitched. Leftover skin is cut away. The operation
Cosmetic surgery is performed to reshape structures can be performed under local or general anaesthetic and
of the body and to improve a person’s appearance. Like may take anywhere from two to four hours. The face will
any form of surgery, cosmetic procedures need recovery be bruised and swollen for some weeks. Numbness or
time, healing and proper care. Risks include problems an uncomfortably tight sensation are common reactions
related to anaesthesia and surgery, excessive bleeding, and may continue for months after surgery.
infection, scarring and failure to heal.
Eyelift (blepharoplasty)
Choose a qualified surgeon The eyelids are cut along their full length to the ‘crow’s
Choose a qualified and reputable plastic surgeon. feet’ wrinkles at the outer corners. Excess skin and fat
Ask them about their specific training and experience are removed. Laser resurfacing may also be performed
in performing the procedure. You may want to ask your to treat remaining wrinkles. This operation may take
doctor for a referral to a suitable professional or hospital. one to two hours and can be performed under local or
Ask questions about possible side effects and general anaesthetic. The eyes will be bruised and swollen
complications. Think carefully about your expectations for a few weeks. Side effects include blurred vision,
– in some cases, the results are not what you might have overproduction of tears and changed shape of the eyes
anticipated. (usually only temporary).
Expectations of cosmetic surgery Chemical peel

Before you choose cosmetic surgery, it is important A chemical peel removes the surface layers of skin. A
to think carefully about your expectations and get a solution is wiped over the face, which may then be left
full explanation of the anticipated results. Ask about uncovered or masked with lotion or tape. The chemicals
possible side effects or complications and what you can burn the skin and the healing process promotes new
expect after the procedure. The technique or procedure growth. Deep burns remove the most wrinkles, but
may improve your appearance and self-confidence, but also increase the risk of complications such as scarring
it won’t necessarily deliver your ‘ideal’ body image or and infection.
change your life.
Don’t be swayed by advertisements that promise Dermabrasion
amazing results – if they sound too good to be true, they A device similar to an electric sander is applied to
probably are. Think about the impact on your financial the face under local or general anaesthetic. The rough
situation, as cosmetic surgery does not usually qualify surface of the rapidly rotating pad rubs off the skin
for rebates from Medicare or private health insurance surface. The healing process promotes new growth.
companies. You should have a ‘cooling-off’ period after Deep dermabrasion removes the most wrinkles, but
attending your first consultation. This will give you time also increases the risk of complications such as scarring
to think about your decisions. and infection.
It’s natural to feel some anxiety, whether it’s excite-
ment for your anticipated new look or stress about the Wrinkle reduction
operation. Don’t be shy about discussing these feelings Wrinkles can be reduced using friction or they can
with your plastic surgeon. If you don’t feel comfortable be ‘plumped out’ with a variety of technologies. Laser
with the surgeon, seek a second opinion. skin resurfacing uses a laser beam to burn the skin.
Injectable fillers can be used in small doses to paralyse
Types of cosmetic surgery the underlying muscles responsible for forming the skin
In cosmetic surgery, a variety of techniques and wrinkles. This can be a safe and effective temporary
procedures are used, including facelift, eyelift, body treatment for fine facial lines and wrinkles.
24
Positive Body Image
Injections of fat or collagen can be piped along the fat is sucked out with a powerful suction pump.
wrinkles to smooth them out. Botulinum toxin Type A The operation can be performed under local or general
(available in Australia under the brand names Botox or anaesthetic. A pressure garment needs to be worn for
Dysport) is sometimes used to treat frown lines between some months to help the skin to contract and contour.
the eyebrows. The area will be bruised and swollen for weeks or
months. Complications can include failure of the skin
Ear correction (otoplasty) to contract, causing a corrugated look. A lipectomy is an
Ears that stick out from the head can be repositioned operation that removes extra skin as well as fat.
any time after the age of five or six years. The fold of
skin behind the ear is cut and the excess cartilage is Tummy tuck (abdominoplasty)
reduced or remodelled. The operation takes around one Excess skin and fat from the abdomen are removed
hour. Bandages need to be worn for a few weeks to help and the underlying abdominal muscles tightened.
manage the bruising and swelling. Often, the navel will need to be relocated. Incisions
are generally made along the ‘bikini line’ to minimise
Nose surgery (rhinoplasty) the visibility of scarring. This operation is performed
In most cases, the surgery is performed through using general anaesthetic. Numbness and sensations of
incisions in the nostrils, leaving no visible scars. Bone uncomfortable tightness are common and may continue
and cartilage are trimmed and the nose reshaped. Nostril for some months after surgery. Complications include
packs and splints may be required. This operation takes infection and the formation of fluid pockets.
around two hours. Bruising and swelling may take
three or four months to fully subside. Complications Breast enlargement (augmentation mammoplasty)
such as bleeding or infection are comparatively rare. Enlarging the breasts requires the insertion of saline
Sometimes a chin implant is inserted at the same time or silicone implants. An incision is made under the breast
to balance the profile. or in the armpit and the implant is pushed through. It
may be positioned either behind or in front of the chest
Facial implants pectoral muscle. There will be bruising and swelling for
Implants are used to fill out a receding chin or flat a few weeks. Complications include the formation of
cheekbones. The implant is inserted through a small inci- hard scar tissue around the implant, deflation of the
sion in a concealed place – for example, inside the mouth. implant, and implants that move out of position.
Lip enhancement
Breast reduction (reduction mammoplasty)
Thin lips can be fattened with a variety of procedures
Incisions are made beneath each breast and around
that offer short or long-term results. Injections of
the areolae of the nipples. Excess skin and fat are
collagen or fat are both eventually reabsorbed by the
removed. The remaining breast tissue is remodelled and
body. A permanent implant similar to a small foam rod
the nipples repositioned and stitched in place. Scars can
can be threaded through the lip.
take up to one year to fade, but will remain visible for
Liposuction life. Complications include reduced nipple sensation.
Liposuction is a procedure that removes fat from the
abdomen, thighs, buttocks, arms and throat. A narrow Where to get help
•• Your doctor
tube (cannula) is inserted through a skin incision and
•• Australian Society of Plastic Surgeons Tel. 1300 367 446
Doctors seek a ban on Things to remember

cosmetic surgery for children •• Like any form of surgery, cosmetic surgery carries risks.
•• It is vital to choose a fully qualified and trained
I
n July 2013, the Cosmetic Physicians Society of
plastic surgeon.
Australasia proposed that stricter, government-
controlled guidelines be put in place, so that no health •• Get a full explanation of the anticipated results
practitioner can perform procedures such as liposuction or and think carefully about your expectations.
lip augmentation on people under 18 years of age, unless •• Consider a second opinion before proceeding.
there are compelling medical or psychological reasons.
Better Health Channel material is Copyright © 2013 State of Victoria.
A national ban would bring all states in line with Queensland
Reproduced from the Better Health Channel (www.betterhealth.vic.gov.
where physicians who operate on children without good au) at no cost with permission of the Victorian Minister for Health. The
reason can face two years’ imprisonment. Medical Council of information published here was accurate at the time of publication and
NSW guidelines require minors who are considering cosmetic is not intended to take the place of medical advice. Please seek advice
surgery to have a three-month cooling-off period, followed from a qualified health care professional. Unauthorised reproduction and
by a further consultation. They are encouraged to discuss other uses comprised in the copyright are prohibited without permission.
it with their GP, and, if necessary, a clinical psychologist.
Source: Doctors seek ban on cosmetic surgery for under-18s.
Retrieved from www.smh.com.au/lifestyle on 25 September 2013. Better Health Channel. Cosmetic surgery (Fact sheet).
Retrieved from www.betterhealth.vic.gov.au on 28 August 2013.
25

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CHAPTER 1

Body image and eating issues

WHAT IS BODY IMAGE?

What is an eating disorder?

Body Eating disorders

These images are often

These feelings They are

Distorted eating habits • Focus on yourself as a person,

50% Being continually • Focus on the things you like

Issues in Society | Volume 372

UNHEALTHY BODY IMAGE food restriction and starvation

disorders, excessive exercise or under-exercise, substance in interventions aimed at preventing deterioration

•• There is a need for increased government commit- Fitness and health

(Victorian Government: Family and Community Development

Australian Medical Association (2009). Body Image and Health – 2002.

There was also a weak connection between the

dysmorphic disorder, indicating that psychological

•• According to the National Eating Disorder Assoc-

Eating disorders not

Risk factors developing an eating disorder

•• Poor body image is associated with an increased

Drugs, 3(2), 91-9.

Risk factors developing an eating disorder Protective factors

from an eating disorder is possible.

Peta Stapleton is an Assistant Professor

Stapleton, P (3 July 2012). Explainer:

that may be present before, during, and after recovery

Specific additional personality traits may be asso-

Studies in Australia and New Zealand have found:

•• As many as 75% of high school girls feel fat or want

National Eating Disorders Collaboration (2013). Eating disorders risk

Salleh, A (31 January 2013).

Dieting affects your health and mental state Things to remember

•• Purge food (vomit) they are not

Expectations of cosmetic surgery Chemical peel

Doctors seek a ban on Things to remember

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