Contributor: Stephanie Sands, BSc, writer for Eating Disorder Hope and Addiction Hope
Eating disorders are chronic, progressive, and sometimes fatal conditions affecting adolescent and adult women and men. Acknowledged to be grossly under-reported, research suggests prevalence estimates for anorexia nervosa range from 0.5 – 0.6% for American women, and 0.1% for American men. Rates of bulimia nervosa in adult women are noted to be higher, at 1.1 – 2.8%, while binge eating disorder may affect 3.3% of women and 0.8% of men in North America .
These statistics do not include those who fail to meet diagnostic criteria for clinical eating disorders; thousands of individuals experience periods of disordered eating or fall into the category of ‘eating disorder not otherwise specified (EDNOS; recently re-named in the DSM-V as ‘other specified feeding and eating disorders’). 
Unfortunately, many of those affected by eating disorders suffer in secrecy, so actual rates are likely much higher than those reported. Less than one-quarter of sufferers will seek treatment, while only one-third of those who complete treatment will remain symptom-free for longer than 4 weeks. 
Is an Ounce of Prevention Worth a Pound of Cure?
As treatment and success rates are so low, preventing eating disorders is the first line of defense against the multiple long-term health complications associated with eating disorders such as heart attacks, osteoporosis, obesity, depression, substance abuse, and increased risk of death. [3, 4]
Prevention programs targeted at adolescents between the ages of 14 and 19 have been shown to reduce eating disorder symptoms like dietary restriction, binge eating, and purging (through vomiting, misuse of laxatives or diuretics, or excessive exercise), and contribute to reductions in current or future eating disorder development. 
Aspects of Successful Prevention Programs
Preventing eating disorders before they start is key, but how do we go about this? An extensive review of eating disorder prevention programs suggested that interactive programs delivered by eating disorder experts tended to be more successful than educational programs or lectures given by teachers. Additionally, long-term multi-session programs showed more benefit than single-session interventions. 
A particular aspect of successful interventions is known as ‘dissonance-induction’, which is a technique targeted at increasing body satisfaction and letting go of idealizing thinness. Body dissatisfaction and idealizing thinness are known risk factors for eating disorders, so dissonance-induction helps participants to challenge the thin-ideal. [3, 4]
The aim of dissonance-induction is to ask intervention participants to break down the thin-ideal by teaching the importance of being healthy over being thin through a number of cognitive and behavioral interventions such as making a list of 10 positive aspects about their bodies while standing in front of a full-length mirror, or by brainstorming methods to help younger girls develop satisfaction and gratitude for their own bodies. 
Healthy as The “New” Skinny
Breaking down the thin-ideal is no easy feat amongst a society that glorifies weight loss and ridicules celebrities for gaining weight. The recent “body positivity” movement is a start towards improving body satisfaction, but is somewhat problematic. Teaching adolescents to love their bodies regardless of size ignores the health complications associated with obesity. Taking body positivity one step further by educating teens on the benefits of achieving and maintaining a healthy body weight (BMI between 18.5 – 24.9)  through a focus on balanced nutrition and exercise has shown to be effective for reducing eating disorder symptoms while improving body satisfaction. 
Calling all Mothers to the Frontlines
The researchers behind the Healthy Girls Project discovered that mothers may be influential in reducing some of the body dissatisfaction in their daughters. Extensive research shows that girls as young as 10 perceive flaws in their bodies upon hearing their mothers’ complaints of her own figure. Mothers who diet regularly often have daughters who engage in dietary restriction, which may impact weight control methods like purging or over-exercising. 
The Healthy Girls Project showed that when mothers participated in a workshop aimed at improving body satisfaction, the daughters’ reported satisfaction also improved. The mothers attended four sessions that focused on challenging negative body image beliefs and modeling positive behaviors for their daughters. Mothers were asked to initiate conversations with their daughters about body image concerns, and then work together to overcome the concerns through behavioral challenges.
This could be anything from wearing shorts despite negative beliefs about one’s legs, or by exercising in public. After the challenge, mothers and daughters would discuss their experiences and make a pact to continue to challenge other concerns. 
Walk the Talk
It is important to understand that eating disorders result from a combination of environmental and genetic factors. As parents, teachers, doctors – we are all role models for children and adolescents, and everything we do or say with respect to our own bodies may influence others, let’s be positive influences.
Consider reducing exposure to media images promoting extreme thinness or keeping negative body talk away from impressionable ears. Easier said than done, for sure, but every little bit helps.
Investing in your own health through following a healthy diet and regular exercise program allows children to see the benefits of living a healthy lifestyle. Regular exercise not only helps with improving physical health, but does wonders for mental health as well! Eating disorders tend to co-occur with other mental health problems like depression, anxiety, and substance abuse, so keeping your mind healthy is just as important as having a healthy body.
Lastly, express gratitude for what your body does for you, rather than focusing on what it looks like.
Community Discussion – Share your thoughts here!
What body positive affirmations do you tell yourself?
About the Author: Stephanie Sands is currently pursuing a Bachelor of Science degree in Kinesiology, majoring in Mind Sciences. She completed an Honors Degree in Psychology in 2012, focusing on eating disorders and personality. She intends to combine her educational background into a holistic wellness practice, to strengthen mental health through a combination of counselling, physical activity, and nutrition coaching.
References:: Hudson, J, I., Hiripi, E., Pope, H. G., & Kessler, R. C. (2007). The prevalence and correlates of eating disorders in the National Comorbidity Survey Replication. Biological Psychiatry, 61(3): 348-358.: Schaefer, J. (2013). Goodbye EDNOS, hello OSFED. Jenni Schaefer, Retrieved from http://www.jennischaefer.com/blog/eating-and-body-image/goodbye-ednos-hello-osfed-subthreshold-and-atypical-eating-disorders-in-dsm-5/
: Stice, E., Shaw, H., Burton E., & Wade, E. (2006). Dissonance and healthy weight eating disorder prevention programs: A randomized efficacy trial. Journal of Consulting and Clinical Psychology, 74(2): 263-275.
: Stice, E., Shaw, H., & Marti, C. N. (2007). A meta-analytic review of eating disorder prevention programs: Encouraging findings. Annual Review of Clinical Psychology, 3: 207-231.
: National Heart, Lung, and Blood Institute. (2016). Calculate your body mass index. National Institutes of Health, Retrieved from
: Corning, A. F., Gondoli, D. M., Bucchianeri, M. M., & Blodgett Salafia, E. H. (2010). Preventing the development of body issues in adolescent girls through intervention with their mothers. Body Image, 7(4), 289-295.
The opinions and views of our guest contributors are shared to provide a broad perspective of eating disorders. These are not necessarily the views of Eating Disorder Hope, but an effort to offer discussion of various issues by different concerned individuals.
We at Eating Disorder Hope understand that eating disorders result from a combination of environmental and genetic factors. If you or a loved one are suffering from an eating disorder, please know that there is hope for you, and seek immediate professional help.
Last Updated & Reviewed By: Jacquelyn Ekern, MS, LPC on April 13, 2016
Published on EatingDisorderHope.com