Disordered Eating And Body Image Issues In Teenage Girls: Part 1

6a00d8341bf67c53ef014e8c0ffaab970d-800wi (1)Working in a high school with teenage girls, I come across teenage girls with body image issues regularly.

Take for instance, one of my 15 year old clients who is so convinced that she is fat that when I first met her she was only drinking water mixed with apple cider vinegar for breakfast and lunch.

For dinner she would have a very small meal. She was not overweight, but due to teasing about her “putting on some weight” by both her mom and peers, she see’s herself as fat and ugly.

Because of all this, her self-esteem is shot and it’s taken weekly individual therapy sessions and weekly support group sessions to get her to at least start eating a light breakfast and lunch, although she is still struggling with body image and self-esteem issues.

Society Creates Body Image Issues In Girls

Unlike boys, teenage girls are put under immense pressure to be beautiful, thin and feminine in most Western industrialized countries. However, biological changes and weight gain are natural parts of pubertal development.

Like the client I was talking about above, her weight gain seems to be more of a womanly weight gain. She seems to be filling out and taken on the body of a woman, compared to that of a prepubescent child. This natural weight gain that most girls experience during puberty, goes against our cultural’s  view of what being beautiful is, which for women includes extreme thinness.

These are conflicting messages for preteen and teenage girls.

On one hand, they are naturally developing and putting on weight, while on the other hand, they are getting messages from society that says their weight gain is unattractive.

Female identity in one part is defined in relational terms, society says they are supposed to be interpersonal and care about other peoples needs, feelings and interests which makes them more vulnerable than males to other people’s behaviors towards and opinions of them.

Another major part of female identity is beauty. In our culture, physical attractiveness contributes a lot to interpersonal success, which is one of the main reasons females strive to be beautiful, to assure popularity and respect.

Also, physically attractive girls are typically seen as more feminine compared to less attractive girls or girls who challenge our cultures traditional views on femininity through their political views such as feminist, or through their sexual orientation, such as lesbians.

Girls tell our society that they are feminine by being concerned with her looks and trying to achieve our culture’s ideal of beauty.

Because our culture demands that girls care about other people’s opinions and that they are defined by their physical appearance,  which society says includes being very thin, there’s no wonder girls are motivated to pursue thinness, at times by any means necessary including starving themselves to death.

Combine these issues with the natural weight gain of puberty and there’s no wonder many teenage girls develop body image issues.

Many teenage girls I’ve worked with who are physically perfect, not even slightly overweight, some were even underweight,  suffer from intense body image dissatisfaction.

A girl I’ve been working with since last year was naturally thin, yet wanted to be thinner so bad that she starved herself to the point of needing to be hospitalized. Like many of the girls I work with who have body image issues, her pursuit for thinness and beauty was so consuming that almost every other aspect of her life, including her education, goals and future took a back seat.

Eating Disorders

Not all girls with body image issues go on to develop an eating disorder like the young girl I just mentioned above, but many of them will.

Eating disorders are a major concern when it comes to the health of teenage girls with an estimated 1% to 3% likely to meet diagnostic criteria for either anorexia nervosa or bulimia nervosa.

Anorexia nervosa is when someone refuses to maintain a minimal average body weight and has body image disturbances such as feeling fat even when they are very thin, and in females who are menstruating, they may experience amenorrhea if their body weight is low enough.

Bulimia nervosa typically includes periods of binge eating, followed by drastic methods to compensate for the binge eating including excessive exercising, fasting, vomiting, using laxatives, etc., accompanied with body image disturbance such as thinking one is much more overweight or unattractive than they really are.

Besides these two eating disorders, there are some girls who have other patterns of eating that fall under disordered eating, such as laxative abuse, vomiting after eating some meals, extreme calorie restriction, and binge eating.

Eating disorders typically begin in early adolescence with much of it’s symptoms typically evident by the late teen years.

While not all girls with body image issues develop full blown eating disorders, there is little research into why some girls do and others don’t develop an eating disorder.

During part 2 we will look at some of the risk and protective factors for young girls to develop an eating disorder.

Understanding Teenage Girls: Motivations and Psychological Meanings in Relating to Males

The other night I happened to catch a television reunion of the reality show Love & Hip Hop Atlanta.

I stared at the screen in not so much as shock as pity as I watched four different women vie for the love and affection of two guys who treated them more as if they women were merely whores, and the guys were their pimps.

The guys seemed to think the heartache and embarrassment they caused these women by their ongoing cheating, lies and manipulations were funny, while the women basically said that no matter how bad they were being treated, they weren’t going to leave their “man”.

One said it was because of good sex, money and furthering her her music career. Another said it was for love and yet another said it was because she had a child with the guy.

To me, none of these were reasons to stay with a man who obviously saw them as being little more than sexual toys to be used and abused.

Still, this got me to thinking.

Working with teenage girls I am always keenly aware of some of the internal conscious and unconscious motivations that effect their decisions, especially in relation to dating, sex, and self-esteem.

As a girl learns about sex, she is also learning about other things such as giving and receiving affection, self-worth and what she means to others.

She also learns about trusting and honesty (or dishonesty) through the ways she is first introduced to sex, especially through the ways she is protected or not protected from being exploited.

“I learned about sex from my dad. I never had a chance for my first time with my boyfriend. Who knows, maybe I [would have] wanted to wait until I got married. But no, I never got to have that chance. I don’t even remember the first time… I feel it ruined my life.”  -Anonymous Teenage Girl, Young Poor and Pregnant: The Psychology of Teenage Motherhood by Judith Music

Shame, fear and guilt are also valuable lessons, as they will (if she is fortunate) help her learn how to keep herself from situations and feelings that may be too painful for her to deal with physically or emotionally.

When these life lessons are learned and experienced in ways that inappropriately shape her sexuality developmentally, they are likely to have far reaching consequences through out her life in the way she perceives her world and those in it.

This effects such a major part of who she is that it also effects who she thinks she can become, what she is capable of and her ability to show and receive love as well as her ability to take control of her destiny.

For girls who grow up in disadvantaged situations, inappropriate sexual socialization is usually the final breaking point to other risk factors such as poverty, unstable family environment, fatherlessness and lack of appropriate nurturing, that already have made this girl vulnerable to men (and teenage boys) looking to exploit her.

This added with social isolation from other people (outside of her family and community) and institutions, becomes a recipe for disaster (often disadvantaged girls are only exposed to people in their immediate communities where important social services are either absent or insufficient).

Social isolation and psychological vulnerability mean that many disadvantaged young women will be controlled by their relations to men not only in the bedroom, but also in the classroom, the street and eventually even the work environment.

“The adolescent female’s sense of self in relation to males is the internal representation of her past experiences with men and- perhaps equally important- of her mother’s roles and relationships to those and other men.”  -Judith Musick

It’s sad to see teenage girls who grow up with a damaged sense of self because of their past relationships to men either directly or vicariously.

These young girls often turn into teen mothers, get stuck in poverty, abused by men, single mothers with a multitude of children by different fathers, abuse drugs, or get caught up in one of various avenues of the sex world such as prostitution.

It’s important that we protect these young girls as much as possible from being exploited and abused, physically and mentally. It is also important that we help build their self-esteems, educate them and teach them the their value is priceless and doesn’t depend on a boy’s, a man’s, or anyone else opinion of her.