Battling Eating Disorders - Social Studies School Service

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Battling Eating Disorders Battling Eating Disorders Teacher’s Guide Introduction This Teacher’s Guide provides information to help you get the most out of Battling Eating Disorders. The contents in this guide will allow you to prepare your students before using the program and present follow-up activities to reinforce the program’s key learning points. This program presents viewers with a general introduction to the topic by providing them with an understanding of the development, signs, and significant dangers of eating disorders. Additionally, the film stresses that an eating disorder is a serious illness, rather than a lifestyle choice or short-term solution. The program covers what eating disorders are, who they affect, the personal experiences of those struggling with and recovering from eating disorders, and the challenges of the treatment experience. Treatment is emphasized, as is the need to con- front someone exhibiting an eating disorder. Learning Objectives After viewing the program, students will be able to: • Understand that an eating disorder is a disease, not a lifestyle choice as portrayed in the many “Pro-Ana” Web sites that can be found on the Internet • Identify possible factors contributing and/or leading to eating disorders • Identify the primary physical, behavioral, and psychological signs of eating disorders • Recognize the importance of treatment of eating disorders • Be aware of the personal, painful, and dangerous experience of struggling with an eating disorder Educational Standards National Standards National Health Education This program correlates with the National Health Education Standards: Achieving Health Literacy from the American School Health Association. The content has been aligned with the following educational standards and benchmarks from this organization: • Students will comprehend concepts related to health promotion and disease prevention. • Students will demonstrate the ability to access valid health information and health-promot- ing products and services. • Students will demonstrate the ability to practice health-enhancing behaviors and reduce health risks. • Students will demonstrate the ability to use goal-setting and decision-making skills to enhance health. This represents the work of the Joint Committee on National Health Education Standards. Copies of National Health Education Standards: Achieving Health Literacy can be obtained through the American School Health Association, Association for the Advancement of Health Education, or the American Cancer Society. Reprinted with permission. 2 Copyright © 2006 Meridian Education Corporation® English Language Arts Standards The activities in this Teacher’s Guide were created in compliance with the following National Standards for the English Language Arts from the National Council of Teachers of English: • Students conduct research on issues and interests by generating ideas and questions, and by posing problems. They gather, evaluate, and synthesize data from a variety of sources (e.g., print and non-print texts, artifacts, people) to communicate their discoveries in ways that suit their purpose and audience. • Students use a variety of technological and informational resources (e.g. libraries, databases, computer networks, video) to gather and synthesize information and to create and commu- nicate knowledge. • Students use spoken, written, and visual language to accomplish their own purposes (e.g. for learning, enjoyment, persuasion, and the exchange of information). Standards for the English Language Arts, by the International Reading Association and the National Council of Teachers of English, copyright 1996 by the International Reading Association and the National Council of Teachers of English. Reprinted with permission. Technology Standards The activities in this Teacher’s Guide were created in compliance with the following National Education Technology Standards from the National Education Technology Standards Project. • Students use technology tools to enhance learning, increase productivity, and promote creativity. The National Education Technology Standards reprinted with permission from the International Society for Technology Education. Program Overview This program provides students with basic information on eating disorders, explores the person- al experience of struggling with one, and emphasizes the fallacy of embracing these diseases as lifestyle choices as portrayed on the many “Pro-Ana” (pro-anorexia) Web sites that can be found on the Internet. Through watching this program, students gain a general understanding not only of the possible causes and effects of eating disorders, but also of the risks in failing to face them as serious illnesses. Students also learn what steps they can take if they suspect they have an eating disorder, as well as how to respond to friends who have this concern. Additionally, this video educates students on the importance of a true support system when faced with serious problems, and what that support should be. This program promotes more than just eating disorder awareness; it educates students as to the complexity involved with understanding, facing, and treating these illnesses and the truly negative and sometimes irre- versible health effects associated with them. In this program, students meet actual peers who struggle with eating disorders and the effects of these illnesses on their lives. The reality of eating disorders is decidedly unglamorous, and this program stresses the truly dangerous and unappealing toll on health they take. This pro- gram is not a lecture, but rather an unflinching look at what it really means to battle an eating disorder. Students are left with the understanding that eating disorders are far from desirable or a “quick fix,” and should be addressed and treated as soon as possible. 3 After watching the program, viewers should have a clear understanding of basic eating disor- der signs, symptoms, possible causes, and treatment. The program emphasizes how to recog- nize eating disorders, how to seek help or help a friend who is seeking help, and why eating disorders demand serious concern and effective response. Additionally, the program provides students with enough information on eating disorders to enable them to discuss the topic with others and truly understand the significant health risks and effects involved. The program makes it clear that those who struggle with eating disorders have a serious illness and are not making a rational decision or choosing a certain lifestyle of their own volition. The viewer should find Battling Eating Disorders relevant, informative, and helpful in its explana- tions, descriptions, and discussions of eating disorders, their effects, and necessary treatment. Main Topics Topic 1: Introduction to Eating Disorders This section introduces viewers to basic information about eating disorders, such as defini- tions of different terms, and some powerful statistics. Viewers meet Bronwyn and get a glimpse into her daily life, a life consumed by a struggle with eating disorders. Topic 2: What Causes Eating Disorders and What Eating Disorders Cause Here, viewers learn what factors might contribute to the development of eating disorders, from the effects of the media to genetic elements to, often quite importantly, a lack of self- esteem. The audience gets to know Kate, Yona, and Hillary, three young women who candid- ly describe how and why their eating disorders developed and the physical effects they expe- rienced. Topic 3: Eating Disorders Don’t Discriminate There might be a stereotypical eating disorder sufferer, but the experiences of Michael and Hannah emphasize that these illnesses can affect anyone. From Michael the audience learns the importance of recognizing and acknowledging the symptoms of an eating disorder no matter who displays them, and Hannah’s experience with treatment illustrates just how con- suming the struggle with eating disorders can prove to be. Topic 4: Confronting a Friend Confronting a friend about his or her eating disorder is certainly intimidating and a challenge. Emily and Yona discuss how Yona’s eating disorder affected their relationship, and how Emily’s confrontation of her friend about the illness, no matter how it first angered Yona, ulti- mately was extremely helpful as Yona worked towards recovery. Topic 5: Signs and Treatment In this section, the viewer learns more of the signs that indicate an eating disorder: deliberate self-starvation with weight loss, fear of gaining weight, self-perception of being fat, refusal to eat, denial of hunger, constant exercising, tiredness and difficulty with normal activities, sensi- tivity to cold temperatures, stopped or irregular periods, going to the bathroom after meals, using laxatives and vomiting to control weight, anxiety, depression, obsessive behavior, per- fectionism, poor concentration, and missing school or work. Additionally, this section stresses the importance of seeking professional guidance and treatment. Finally, the program takes a close look at Bronwyn’s experience during treatment for her eating disorder, and the different issues—beyond ED—that her treatment forced her to address. 4 Fast Facts • Eating disorders are not a lifestyle choice—they are serious illnesses with significant health effects. • The hundreds of Pro-Ana Web sites on the Internet promote and support a dangerous and even life-threatening practice. • Some teens, believing they’ve made a lifestyle choice, sport bracelets of coded colors— easily available from Pro-Ana Web sites—that identify them as anorexic, bulimic, and so on. • Approximately 10 million women and 1 million men struggle with eating disorders. • Psychological, cultural/social, familial, and biological/genetic factors can all contribute to the development of an eating disorder. • 99% of images in magazines are retouched and altered, creating a false standard of beauty. • Between the ages of 15 and 25, women with anorexia are 12 times more likely to die from their eating disorder than from all other causes of death combined. • Health effects attributable to eating disorders include loss of bone density, decreased ability to concentrate, missed or irregular periods, development of fine hair all over the body, and loss of hair. • Bulimia involves binging on food and purging it from the body, while binge eating refers to frequent episodes of overeating without purging. • Men, people of color, and people of normal or average weight can all suffer from eating disorders. • Eating disorders are the number one mental health killer. • Seeking professional guidance is an important start to the eating disorder recovery process. Vocabulary anorexia: Deliberate self-starvation, resulting in failure to maintain a minimally normal body weight. Can be life threatening in severe situations. binge eating: Frequent episodes of overeating. bulimia: Repeated episodes of binge eating followed by purging the body of the food consumed, usually by self-induced vomiting. Bulimics can maintain a normal weight. eating disorder: Illness such as anorexia, bulimia, or binge eating. genetic factors: Development of eating disorders is possibly connected to excessive sero- tonin in the body and an autoimmune process related to multiple sclerosis. 5 lifestyle choice: An active and reasoned decision about an aspect of one’s life, or about the manner in which one conducts one’s life. pro-ana: Misguided perception of anorexia as a lifestyle choice, offering encouragement for those with eating disorders to maintain this illness. purging: Ridding the body of food consumed, usually by self-induced vomiting and/or the use of laxatives. self-starvation: Deliberate refusal to eat, even to the point of experiencing serious health consequences. Pre-Program Discussion Questions 1. Have you ever learned about or discussed eating disorders? What did you learn or discuss? 2. Who can be affected by an eating disorder? 3. Do you have any personal experience (your own or someone you know) with eating disorders that you would be comfortable sharing? 4. What messages does the media (advertisements, magazines, television, movies) send about body image? If you believed only what the media says, what should you look like? Is this realistic? Why or why not? 5. Are eating disorders an issue or problem in our school or community? Why or why not? 6. If you suspected or knew that your friend was struggling with an eating disorder, what might you do? Why? 7. Do you think it is important to learn about and discuss eating disorders? Why or why not? Post-Program Discussion Questions 1. What is anorexia? What is bulimia? What is binge eating? 2. Why do people develop eating disorders? What factors might affect them? 3. What are some of the physical effects and health consequences connected to eating disorders? Why should we take these seriously? 4. Did this program change your mind or surprise you about who can suffer from an eating disorder? Why or why not? 5. Are eating disorders a lifestyle choice? Why or why not? What are some examples of lifestyle choices? 6. If you confronted a friend about his or her eating disorder, how do you think he or she would react? How might you be affected by his or her reaction? 6 7. Why can treatment for eating disorders be challenging? Why is treatment for eating disor- ders important? 8. What is one thing you learned about eating disorders from this program that you didn’t know before watching? Group Activities Knowledge from the Source Invite a guest speaker to your class or school to address students about eating disorders. This speaker may be a medical or psychological professional who works with those suffering from eating disorders, or perhaps someone who has recovered from an eating disorder. While the speaker should provide basic information and answer student questions, a focus of the talk should also be on emphasizing that eating disorders are illnesses, not lifestyle choices, and that they result in serious medical consequences. You should work with your students in advance of the guest speaker’s visit to prepare appro- priate questions. Questions might reflect personal inquiries of students, or continue some of the points made in this program. Later, have students write summary papers describing what the speaker shared and what students learned. Try It Out As a class, talk about what it might be like to bring up an eating disorder with a friend you suspect of struggling with one. Discuss word choice, the emotions involved, how the friend might respond, what effect the confrontation might have on the friendship, what the next steps would be after confrontation, etc. On the board, compile a list of words, conversations, and actions that students think might be helpful or useful in this situation. Divide students into small groups. Groups will create and present role-play situations based on the scenario of confronting a friend about an eating disorder. Encourage groups to be as creative—and as realistic—as possible. After each role-play, invite classmates to comment. What was realistic? What was challenging or difficult? How could the dialogue be improved? Remind students to offer constructive criticism. Checking out the Media Start a conversation about the role of the media in the way we feel about appearance and body image. You may want to bring in some advertisements or images from magazines to get students talking. What messages does the media send about the way we should look, or the kind of appearance that might make us happy? Are the bodies and appearances in the media realistic? Why or why not? Ask students to observe the media to which they are exposed for one week. You may want to have students keep a log, journal, or notes to detail their findings. Encourage students to consider: • What do many of the people in movies and television shows look like? What types of body images and appearances are generally presented? If someone is the lead character or hero, what does he or she look like? 7 • How often do advertisements refer to or include appearance or body image issues, even if the product being advertised isn’t necessarily connected to appearance? • When clothing, makeup, accessories, skin care products, and jewelry are advertised, what do the models and actors in the ads look like? Why? Have students report back after a week of observing the media around them. Point out that the constant barrage of unrealistic images surrounding them can make them feel inferior or feel they need to improve, even when that’s very far from the truth. It’s hard to always feel good about yourself when television, movies, magazines, and advertisements send a message that you should look better or different. You may want to show the black-and-white com- mercial that opened this program and ask students why young children would be asking these types of questions. As a class, brainstorm some of the different human traits on which the media could focus instead of looks. What about talents, skills, friendships, achievements in school, the arts, or sports, or healthy living? Together, choose a product that is typically advertised through an emphasis on appearance, such as a hair care product or a new clothing line. Challenge stu- dents to create a commercial for this product featuring only an emphasis on one or more of the different traits you discussed, and without any focus on appearance. Individual Student Projects Poster the School Take some time to review the warning signs of a possible eating disorder with your class. Make sure that all students have a good understanding of these signs. Record a list of these signs on the board. Distribute small pieces of posterboard, markers, and other art supplies to each student. Instruct students to each create a poster highlighting some of the warning signs of eating disorders. Encourage students to be creative—they should get their message across in an effective, colorful, and powerful manner. If you have identified any local resources for stu- dents struggling with eating disorders (such as a hotline number or school counselor) you may also suggest that students include this information. When students are finished, hang the completed posters around the classroom or the school. Allow students to walk around and view each of the posters—you may want to solicit stu- dent feedback about posters with particular impact. How does viewing these different posters help make students more aware of the signs of eating disorders they might witness? Alternatively, you may want to have students create these posters at home and then bring them in and present them to the rest of the class. If multiple classes or grades are utilizing this program, your grade or school might hold a poster contest and select winners in differ- ent categories. A Positive Log It’s not always easy to have self-confidence about body image, especially in a society that can appear through its media to value unrealistic standards of attractiveness. Start a class discus- sion about some of the great qualities your students possess apart from looks. If possible, try to highlight at least one strength or positive trait for each member of your class. Qualities 8 such as kindness and truthfulness, strengths such as being a good listener or excellent public speaker, and skills such as knitting ability or talent in spelling bees could all receive mention. Ask your students to keep a log for one week. For each of the seven days, students should write down at least three positive things about themselves. These should mirror the types of traits you discussed in class. Students should also take note if they receive any compliments or achieve any successes during the week and record these in the log as well. At the end of the week, students should report back at least two of the positive items they recorded (their choice) in their logs. As students share, record their affirmations on a large piece of paper or posterboard. When the entire class has contributed, hang the paper/poster- board in a prominent spot in your classroom. Reacting to the Program Invite students to share some of their personal reactions to the video, at the level with which they are comfortable. Was anyone surprised by the content of the program? Startled? Saddened? Felt a mix of different emotions? What was their response to the women and man who shared their personal experiences? Could students in your class have been so can- did on film? Why or why not? Encourage students to provide a range of feedback, and allow students to be honest about their reactions and to ask any questions they may have. After this discussion, ask students to spend some time writing quietly. They should each com- pose a reaction paper to the program. These will only be shared with the rest of the class if students choose to do so, so instruct the class to write their true feelings and reactions. If your class discussion sparked a lot of response, students may already have good jumping-off points to begin their papers. If the class needs some prompting to begin writing, questions such as the following might be helpful: • How did you feel/what did you know about eating disorders before watching this film? How did this video affect that knowledge/feeling? • What is your response to the young adults who spoke in the film? Why? • Why do you think it was difficult for Emily to confront her friend Yona about Yona’s eating disorder? Would you confront a friend in a similar way? Why or why not? • Why might some people consider eating disorders a lifestyle choice? What information is there to show that eating disorders are not a lifestyle choice? After students are finished, invite any willing volunteers to share some or all of their writing. Internet Activities Beat Eating Disorders! Together with students (or with students under your supervision), conduct an Internet search for potential resources to utilize in addressing eating disorders. These might include Web sites, books, articles, hotlines, foundations, etc. For each resource you record, ask students to include some basic descriptive information as well (a brief summary of a Web site’s content, the author and publisher of a book, etc). As a class, pull together all of your compiled resources. Discuss some potentially effective ways to distribute this information to other students. Ideas might include putting together a guide to these resources in book form, building a Web site that lists eating disorder 9 resources, sending an email compilation of these resources to the school community, handing out flyers listing these resources, etc. Select the format that the class determines to be most effective and realistic for your school, and work together to distribute your resources in that format (or make plans to do so in the future). Build Your Own Web Page Let your class know that you are going to work together to create your own Web page pro- moting eating disorder awareness (you may either create an actual page, or just lay out a design for one). Brainstorm together the types of information you want to include on the site, such as statistics, definitions, testimonials, links to resources, links to coverage of eating disorders in the news, etc. Next, brainstorm where you might find this information (online, via library books, newspapers and magazines, etc.). Finally, work together to build your eating disorder awareness Web site, utilizing your selected design and incorporating the information and links you have compiled. A Possible Career Remind students that professional guidance and treatment is an important first step in addressing eating disorders and beginning recovery from them. Professionals working with those suffering from eating disorders can literally help save someone’s life. Ask your students to determine who actually treats people struggling with eating disorders. Look online to discover an accurate answer to this question (it involves both medical and psy- chological professionals). Research some of the many books addressing eating disorders— who are the authors? What are their educational and professional backgrounds? Work with students to determine the type of education and training that goes into a poten- tial career in working with eating disorder sufferers. Where might you attend college? What might you study? What are different careers you could pursue and still work on eating disor- der issues? Be sure to point out and research some possibilities students may not think of, such as a researcher compiling data or a staffer at a nonprofit organization committed to eat- ing disorder awareness. You may want to have small groups of students use the Internet to research different career paths and report back their findings to the rest of the class. Assessment Questions Q1: “Deliberate self-starvation; a refusal to maintain a minimally normal body weight” describes what eating disorder? a) Bulimia b) Binge eating c) Anorexia A1: c) Anorexia Note: Anorexia has very serious health effects—in severe instances it can be life-threatening. Q2: List some of the factors that contribute to the development of eating disorders. A2: Psychological; cultural/social; familial; biological/genetic Note: Often, a lack of self-esteem and feelings of low self-worth are important factors in the development of eating disorders. 10 Q3: True or False: Anorexia and other eating disorders are lifestyle choices. A3: False. Note: Eating disorders have serious medical consequences and are never a fast track to weight loss. When you do make choices about your lifestyle, make them healthy and positive choices. Q4: True or False: Some people suffering with eating disorders have a normal body weight. A4: True. Bulimics can be of normal weight, but they are still struggling with a serious illness. Note: It’s easy to make assumptions about what someone with an eating disorder looks like, but often those assumptions are incorrect. Being aware of the signs and symptoms of eating disorders will make you more aware of them, no matter who might be struggling with them. Q5: What is binge eating? A5: Frequent episodes of overeating without purging. Note: Bulimia can include binge eating, but also involves purging the body of food, usually by self-induced vomiting or use of laxatives. Q6: What is a good first step in addressing and treating an eating disorder? A6: Seeking professional guidance. Note: Treatment for eating disorders is challenging, and those suffering from an ED can often relapse. Starting with professional help gets treatment off to a strong start. Q7: Which of the following is a sign that someone might have an eating disorder? a) Refusal to eat b) Denial of hunger c) Missing school or work d) Tiredness and difficulty with normal activities e) All of the above A7: e) All of the above Note: Eating disorders can impact every area of life, robbing sufferers of goals, dreams, and good health. In the program, Hannah expresses disappointment that she was never able to return to college; dealing with her eating disorder took her energy and time. Q8: What kinds of messages does the media send about appearance? A8: Unrealistic ones—for instance, 99% of images in magazines are retouched or altered. Note: Find ways to feel good about yourself that don’t involve looks—concentrate on your talents, strengths, abilities, and interests. And don’t set expectations about your appearance based on what you see in the media—its standard of beauty is not based in reality, as the sta- tistic above indicates. Q9: What other mental health issues can be connected to eating disorders? a) Anxiety b) Depression c) Obsessive behavior d) All of the above A9: d) All of the above Note: Addressing other psychological factors may be necessary during treatment for eating disorders; for instance, during Bronwyn’s treatment for her eating disorders we see her con- fronting sexual abuse she experienced in the past. 11 Additional Resources Jamie-Lynn Sigler Foundation National Eating Disorders Association Eating Disorders Coalition for Research, Policy, and Action Something Fishy: Website on Eating Disorders Academy for Eating Disorders The Eating Disorder Sourcebook: A Comprehensive Guide to the Causes, Treatments, and Prevention of Eating Disorders By Carolyn Costin ISBN: 0737301023 McGraw-Hill, 1999 The Beginner's Guide to Eating Disorders Recovery By Nancy J. Kolodny ISBN: 093607745X Gurze Books, 2004 Additional Resources at Available from Films Media Group • • 1-800-257-5126 The Stockholm Solution: New Therapies for Eating Disorders • VHS/DVD-R/Digital On-Demand • Preview clip online • Recommended by Educational Media Reviews Online • Item # 34664 With a 75% success rate in treating anorexia and bulimia, Stockholm’s Karolinska Institute is in the vanguard of eating disorder therapy. This program follows patients through the Karolinska regimen as they relearn healthy eating behavior, gradually recognizing natural feel- ings of satiety with the help of a computerized biofeedback system. Closely observing the Institute’s counseling sessions, the video shows how the Karolinska approach counters tradi- tional clinical methods, which typically involve medication, family dynamics, and a high rate of recidivism. The Stockholm Solution portrays a medical revolution—and what is for many young women a new lease on life. (37 minutes) © 2004 12 Bridget’s Story: Fighting to Survive Anorexia • VHS/DVD-R • Item # 29888 All her adult life, Bridget Roath had struggled to hide her battle with anorexia nervosa. Finally, at age 32, the secret of this nurse and mother of three came out when she collapsed after 36 days of not eating. This program documents Bridget’s emotional odyssey as she attends an eating disorder clinic, relapses into abusing diuretics and laxatives, and is admitted to the live-in eating disorder program at the South Coast Medical Center in Laguna Beach, California. A Discovery Channel Production. (23 minutes) © 2001 Body Image for Boys • VHS/DVD-R/Digital On-Demand • Preview clip online • Correlates to national standards • Viewable/printable teacher’s guide online • Top Ten DVD/Video 2003, Young Adult Library Services Assn. (YALSA); Finalist, FREDDIE Awards; "Any young male would benefit from watching this tape."—Youth Today • Item # 29939 As the idealized male physique continues to be hyped in movies, on TV, in magazines, and on billboards, a rapidly growing number of men are becoming obsessed with appearance. Each year alone, they spend billions on gym memberships and home exercise equipment—and women are no longer alone in battling anorexia and body dysmorphic disorder. This topical program explores some of the issues facing young men today as they struggle to define themselves amidst the flood of media-generated images of male physical perfection. Experts including Divya Kakaiya, the visionary founder and clinical director of the Healthy Within treatment center; Leigh Cohn, co-author of the seminal Making Weight: Men’s Conflicts with Food, Weight, Shape, and Appearance; and UCLA Healthcare sports medicine physician Gary Green as well as a number of young patients grapple with problems such as steroid abuse, eating disorders, exercise addiction, and phony food supplements. A Cambridge Educational Production. (18 minutes) © 2002 Wasting Away: Anorexia Nervosa • VHS/DVD-R • Item # 11651 This emotionally charged program profiles four young women attempting to recover from anorexia nervosa. Ranging in age from 14 to 25, they struggle to gain weight while dealing with associated conditions such as osteoporosis and depression, family dysfunctionality, and a mindset that equates starvation with self-control. Filmed at the adolescent eating disorder unit of Westmead Hospital in Sydney and a private outpatient clinic, the program captures the complexities of a devastating psychological disorder that drives women to continuously lose weight—even if it kills them. (47 minutes) © 2000 13 2572 Brunswick Pike, Lawrenceville, NJ 08648 Toll Free: 1 800/727-5507 Fax: 1 888/340-5507 35200 For inf ormation on other pr ogra ms visit our web site at