Body image and eating disorders among adolescents 3

body image 1

Prevention Strategies

In this our final article in the series we look at prevention strategies and some educational messages.

Prevention is better than cure and strategies to prevent disordered eating should be implemented early to avoid body image dissatisfaction. It is more difficult to change unhealthy eating behaviour and disturbed body image attitudes once established. It is therefore important to provide children with the tools to maintain body esteem. This can be done by motivating children to challenge social and cultural messages and norms. A variety of factors should be addressed in prevention programmes. These include:

  • Genetic influence and acceptance of diversity in weight, height and body fat
  • Developmental changes through puberty that affect appearance
  • Healthy weight loss through appropriate choices of a variety of wholesome foods and the dangerous effects of weight-loss dieting
  • Value of physical activity
  • Sceptical and critical thinking regarding mass media messages that contribute to body dissatisfaction
  • Protective factors such as self-acceptance, life skills and healthy coping mechanisms

Prevention programmes should address both individual and environmental factors. Parents should be educated on how to become a role model for their children by adopting healthier attitude towards eating and their own bodies. Adults should be educated, impassioned and empowered to join students in resisting and challenging a cultural environment that creates body image problems, unhealthy weight concerns and disordered eating. School personnel should be motivated to create an environment that reduces the contributing risk factors. Physical education teachers and coaches should be included in prevention programmes seeing that they are often in a position to observe the first signs of body image dissatisfaction and disturbed eating patterns.

Coaches should deemphasize the association between a lean body shape and performance and rather focus on education of athletes on sound nutrition principles for enhancing overall health and performance. Group weigh-ins and criticism (negative or positive) regarding weight should be avoided. Early identification of individuals at risk and early intervention can lead to a more successful treatment process. Children at risk or engaging in weight-loss activities should be referred to a trained and qualified professional.


Practical Tips for Educational Messages

  • Build self-esteem and positive body image: Remind athletes that their body shape/size or physical ability does not determine their self-worth or identity. Young athletes should be realistic about their goal weight – they may be striving to attain a weight lower than is appropriate for their genetic body type
  • Do not request weigh-in or measurements or discuss weight in an evaluation of a child’s ability and performance.
  • Educate athletes: Engage in frequent open discussions about positive body image and how good nutrition improves performance.
  • Spread the message that undernourishment and dehydration can cause loss of muscular strength and endurance, decreased speed, loss of coordination and poor judgment.
  • Continued poor nutrition and dehydration can result in impaired brain function, irritability and inability to concentrate, depression and social withdrawal.
  • If young athletes have weight to lose, ensure that they don’t crash-diet. Seek advice from a nutritionist or dietitian if you are struggling to help them balance food intake and exercise.
  • Aim to help them eat a balanced diet, including a wide variety of foods from each food group and adequate calcium to maintain bone density. Include three to four servings of dairy products or other calcium-rich foods daily.
  • If a young female athlete has suffered amenorrhoea for longer than six months, she should seek advice from her GP, to rule out medical causes of amenorrhoea.
  • If a female athlete’s periods stop or become irregular, her training frequency, volume and intensity should be reduced, or her current programme should be changed.
  • If a young athlete suffers from disordered eating, they will need help in overcoming this problem.

Ten Essential Lessons to Build Body Esteem by Kathy Kater

To begin, accept what is not in your control:

  1. Accept your body’s genetic predisposition. All bodies are wired to be fatter, thinner, or in between. This includes fatter in some places and thinner in others. Regardless of efforts to change it, over time your body will fight to maintain or resume the shape it was born to be. You may force your body into sizes and shapes that you prefer, but you can’t beat Mother Nature without a tremendous cost.
  2. Understand that all bodies change developmentally in ways that are simply not in your control through healthy means. You may positively influence changes of puberty, pregnancy and lactation, menopause, and aging by making healthy lifestyle choices, but you will not “control” these changes, no matter how much you try.
  3. Never “diet”. Hunger is an internally regulated drive and demands to be satisfied. If you limit the food needed to satiate hunger completely, it will backfire, triggering preoccupation with food an ultimately an overeating or compulsive eating response. You may lose weight in the short run, but 95% of weight that is lost through dieting is regained, plus added pounds. Dieters who go off their diets only to binge are not “weak willed”. They are mammals whose built-in starvation response has kicked in – both physically and psychologically, going after what has been restricted. Scientific evidence has been available on this since the early 1950’s, but most people are not aware of the biologically predictable, counterproductive results of “dieting”.

Then focus your attention and energy on what is within your power to achieve:

  1. Satisfy hunger completely with plenty of wholesome, nutrient rich foods chosen from the core of the food pyramid- eat well! In today’s world, surrounded by taste stimulating, cheap, cleverly advertised, readily available, low-nutrient entertainment foods, learning to fed your body versus merely “eat” is an essential difference.
  2. Limit sedentary entertainment. Move aerobically, if possible, on a regular basis. Everyone who is not medically inhibited, regardless of size, can and should develop a reasonable level of fitness and maintain it throughout the life cycle.
  3. Understand that if you eat well and maintain an active lifestyle over time, your best, natural weight will be revealed. Set a goal to eat well and be active. Don’t be swayed by whether or not this makes you thin. Healthy, well fed, active bodies are diverse in size and shape, form fat to thin and everything in between. Don’t let anyone tell you otherwise, not even your doctor, who may be caught in unhealthy cultural myths about weight.
  4. Choose role models that reflect a realistic standard against which you can feel good about yourself. If the “ugly duckling” had continued to compare herself to the duck she’d still be miserable, no matter how beautifully she developed.
  5. Maintain your integrity as a human being. In spite of advertisements seducing you to believe that “image is everything”, NEVER forget that how you look is only one part of who you are. Develop a sense of identity based on all the many things you can do, the values you believe in, and the person that you are deep inside.
  6. Become media savvy. Educate yourself about the hidden power of advertisements. Advertisers spend tons of money on strategies specifically designed to make you feel there is something wrong with you. Why? If they first advertise an unrealistic standard of beauty that leaves you feeling deficient by comparison, a product that promises to improve your condition is an easy sale. Don’t be “sold” this bill if goods.
  7. Encourage your friends and co-workers to join you in developing a healthy, realistic body image. Use the collective energy your group would have spent on hating your bodies to make the world a better place. Help the next generation to develop healthy body image attitudes and learn positive lifestyle habits too.


Kater, K. Real Kids Come in All Sizes; Ten Essential Lessons to Build Your Child’s Body Esteem (Broadway Books/Random House, 2004.

You can view part 1 and part 2 in the series.

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