do you have an eating disorder - L.I.V.E.

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8085DV DO YOU HAVE AN EATING DISORDER? DVD Version ISBN-13: 978-1-55548-683-9 ISBN: 1-55548-683-5 DO YOU HAVE AN EATING DISORDER? CREDITS HUMAN RELATIONS MEDIA DO YOU HAVE AN EATING DISORDER? Executive Producer Anson W. Schloat Producer Peter Cochran Consultant Lynn Grefe, CEO National Eating Disorders Association Special Thanks To Jenni Schaefer Author of Life Without Ed: How One Woman Declared Independence from Her Eating Disorder and How You Can Too Teacher’s Resource Book Bonnie Denmark Donna Giachetti Sara Schloat Matthew Wollin Copyright 2009 Human Relations Media, Inc. DO YOU HAVE AN EATING DISORDER? TABLE OF CONTENTS HUMAN RELATIONS MEDIA DO YOU HAVE AN EATING DISORDER? DVD Menu i Introduction 1 Learning Objectives 3 Program Summary 4 Student Activities 1. Pre/Post Test 9 2. Know the Signs 11 3. A Cry for Help 13 4. The Media 14 5. Class Debate 16 6. Crossword Puzzle 17 7. Role Models 20 8. The “Perfect” Body 21 9. Role Play 22 10. Value Who You Are 24 Fact Sheets 1. What is Anorexia Nervosa? 25 2. What is Bulimia Nervosa? 26 3. Eating Disorders and the Media 27 4. How to Help a Friend 29 5. Developing a Positive Body Image 30 6. National Organizations 31 7. Internet Resources 32 8. Bibliography 33 Other Programs from Human Relations Media 34 DO YOU HAVE AN EATING DISORDER? DVD MENU HUMAN RELATIONS MEDIA i DO YOU HAVE AN EATING DISORDER? MAIN MENU � PLAY � CHAPTER SELECTION From here you can access many different paths of the DVD, beginning with the introduction and ending with the credits. 1. Introduction 2. What are Eating Disorders? 3. Shame and Blame 4. Health Consequences 5. What Causes Eating Disorders? 6. Biology and Environment 7. Warning Signs 8. How You Can Help 9. Recovery � TEACHER’S RESOURCE GUIDE A file of the accompanying Teacher’s Resource Guide is available on the DVD. To open the file you need to load the DVD onto a computer that has a DVD-ROM and Adobe Acrobat Reader. Right click on the DVD icon and then double click on the file titled “Teacher’s Resource Book.” DO YOU HAVE AN EATING DISORDER? INTRODUCTION HUMAN RELATIONS MEDIA 1 DO YOU HAVE AN EATING DISORDER? Today’s young people are living in a world that is food and diet obsessed. On television, on the internet, in magazines and movies, kids are bombarded daily with the newest diet trends. These super-sleek bodies are often impossible for adults to achieve; for youth, aspiring to look like the ultra-thin celebrities they see in the media can be especially dangerous. The pressure to be thin affects millions of people every year, particularly teens. According to the National Association of Anorexia Nervosa and Associated Disorders, 11 percent of high school students in the United States have been diagnosed with an eating disorder. The term “eating disorder” comprises several psychological disorders such as anorexia or bulimia that involve insufficient or excessive food intake. These serious (but treatable) mental illnesses are often characterized by an abnormal preoccupation with body image, weight and food. Eating disorders may develop from many emotional and psychological factors, like depression or low self-esteem. Environmental and societal pressures also play a role. Often teens who are described as “perfectionists” will strive to achieve what they consider the perfect body. Many young girls are powerfully influenced by ads in magazines and on television that promote weight loss as the ideal road to beauty. These outside forces, in combination with low self-esteem, can lead to inaccurate self-image, unrealistic expectations and, for some teens, life-threatening disorders. Bulimia nervosa, anorexia nervosa, and compulsive binge eating are the most commonly diagnosed eating disorders—and they all carry serious consequences. Teens struggling with anorexia will restrict their food intake to an extreme in order to lose weight. Even when they weigh less than 85 percent of their expected body weight, teens struggling with anorexia still believe that they are fat. Bulimia nervosa is known as a binge-and-purge disorder, where a teen will eat a tremendous amount of food in a short period of time and then purge by vomiting, using laxatives and/or over-exercising. Someone suffering from bulimia may not necessarily be underweight, so it can be harder to detect than anorexia. According to the National Alliance of the Mentally Ill, girls between the ages of 12-25 make up 90 percent of the people affected by anorexia and bulimia. Similar to bulimia, someone suffering from binge eating disorder will eat excessive quantities of food. They do not purge, but they feel a lack of control and low self-esteem that is similar to bulimia. Up to 11 million people in the United States are currently suffering from anorexia nervosa and/or bulimia nervosa, and up to 25 million are binge eaters. It’s important to note that girls aren’t the only ones affected by the pressure to be thin. Young men are also at risk. According to Anorexia Nervosa and Related Eating Disorders (ANRED), 10 percent of people suffering from anorexia and/or bulimia are male. This means more than one million boys in the USA suffer from these symptoms and disorders. DO YOU HAVE AN EATING DISORDER? INTRODUCTION CONTINUED DO YOU HAVE AN EATING DISORDER? 2 HUMAN RELATIONS MEDIA Often people who develop eating disorders begin to manifest symptoms and behaviors at a very early age. These symptoms may include severe weight loss, distorted body image or excessive exercising. Even seven-year-olds can feel the pressure to be thin. Left untreated, an eating disorder can leave a person with serious health problems such as bone density loss, heart arrhythmia or organ failure. Others experience hair loss, tooth decay, malnutrition and dehydration. Up to 20 percent of those suffering from an undiagnosed eating disorder will die as a result of these deadly complications, according to ANRED. Young people need to understand that eating disorders are life-threatening conditions that won’t disappear on their own. By promoting awareness and understanding of the signs and symptoms, adolescents will have the tools to help themselves and their peers. It is important for kids to remember that eating disorders often appear along with other kinds of mental illnesses such as depression or anxiety disorders, which, without treatment, can also carry devastating consequences. Much like any other illness, early diagnosis and treatment are essential to make a full and lasting recovery. There are effective treatment programs that can help affected people return to a healthy weight and lifestyle. After watching the program Do You Have an Eating Disorder? and participating in the activities in this Teacher’s Resource Guide, your students will recognize that intervention and treatment for an eating disorder is a necessary part of the road to recovery. Even more importantly, those suffering from an eating disorder will understand that they are not alone. NOTE: The program purposefully does not include images of dangerously thin people. Such images can provoke a “race to the bottom” among those struggling with or susceptible to an eating disorder (i.e., She is thinner than I am and she’s still alive. I should lose more weight.) According to the National Eating Disorders Association, a focus on physical descriptions of the body is not only dangerous, but can also be misleading, since individuals with eating disorders come in all shapes and sizes. DO YOU HAVE AN EATING DISORDER? LEARNING OBJECTIVES HUMAN RELATIONS MEDIA 3 DO YOU HAVE AN EATING DISORDER? After viewing the program Do You Have an Eating Disorder? and participating in the activities presented in this Teacher’s Resource Book, your students will be able to: � understand the seriousness of eating disorders, including anorexia nervosa, bulimia and binge eating � recognize the root causes of eating disorders � recognize the warning signs of an eating disorder in a friend identify many of the physical and psychological ng � understand how they may be able to help someone with � apply tools to develop a more positive self-image � gain the ability to keep the importance of body shape and � realize how important it is to build one’s self-esteem from within hype thinness as the key to happiness � have an eating disorder � consequences of anorexia, bulimia and binge eati an eating disorder size in perspective � become critical viewers of media messages that implicitly know where to go for help in case they DO YOU HAVE AN EATING DISORDER? PROGRAM SUMMARY DO YOU HAVE AN EATING DISORDER? 4 HUMAN RELATIONS MEDIA “Eating disorders are not just about food,” a young woman tells viewers, “Eating disorders can be about anxiety. It can be about depression. It can be about obsessive-compulsive disorder.” Viewers then meet a diverse group of people, all of whom have had personal experience with eating disorders. “A person shouldn’t blame themselves,” says one boy. One girl talks about how isolating the illness was, while another says she felt like she “had no one to turn to.” Another woman explains that the worst part is realizing how much permanent damage her body has suffered as a result of her eating disorder. “We have an expression: everybody knows somebody,” explains one expert. “Just about everybody knows somebody who knows somebody who has this illness.” The video begins its first section: “Do I Have an Eating Disorder?” by introducing Jenni Schaefer, who suffered from anorexia and has now recovered with the help of her music. She tells viewers how her eating disorder actually began when she was four years old, as she compared her body with those of the other girls in her dance class. As she grew older, her thoughts intensified about her body and about food. Viewers see photos of Jenni as a child— in her dance class, at a performance—and are left to think about living with an eating disorder. A student, B. Charles, explains that he is an emotional eater, turning to food in times of stress or trouble. Another student, Christine Maccia, describes her own eating disorder, how she began by just cutting out snacks and it escalated from there: “I just couldn’t stop,” she says. Viewers then meet Lynn Grefe, the CEO of the National Eating Disorders Association. She defines eating disorders as biologically based illnesses which are fundamentally forms of mental illness. She defines two of the most common eating disorders, anorexia and bulimia: “When a person has anorexia it means they are not eating, they are basically starving themselves. Bulimia means they purge the food that they have eaten, and it could either be through vomiting, through laxative abuse, through exercise abuse.” Latria Graham, a student at Dartmouth College, describes how as a bulimic she both over- exercised and used laxatives. Lynn Grefe returns to describe the third major eating disorder: binge eating. “And then there’s binge eating disorder, eating so much food at one sitting, and bulimia often works together with binge eating disorder, where a person will consume an enormous amount of calories and then immediately get rid of those calories.” Jenni Schaefer describes how she lost control around food while she was anorexic; her body demanded to be fed after having been starved, resulting in binging. Lynn Grefe tells viewers that while an estimated 16 million people are affected by anorexia, bulimia or binge eating disorder, more concrete statistics don’t truly exist because of the secretive nature of the illness, and the shame felt by those who suffer from eating disorders. The next section of the video is introduced: “Shame and Blame.” Jenni describes how she didn’t know what an eating disorder was, thinking instead that “this was something that I came up with, that it was my fault.” B. Charles notes that guys often have more trouble admitting they have a problem, because eating disorders have traditionally been portrayed as DO YOU HAVE AN EATING DISORDER? PROGRAM SUMMARY CONTINUED HUMAN RELATIONS MEDIA 5 DO YOU HAVE AN EATING DISORDER? a “girl’s disease.” Latria describes the shame felt by those with eating disorders, and Jenni remembers reading a brochure on eating disorders and realizing for the first time, “I have an eating disorder. It’s not my fault. This is an illness. Other people actually do what I do.” Lynn Grefe returns to say that no one is to blame for an eating disorder. She goes on, “The good news is that eating disorders are treatable. The bad news is they can kill you if you don’t get treatment.” The program moves on to address the health consequences of eating disorders. Viewers meet Marna Clowney Robinson, a member of the board of directors of the National Association of Anorexia Nervosa and Associated Eating Disorders. She describes all of the health consequences she suffered from her eating disorder: “I had a mild heart attack before I was twenty years old because of not eating and abusing my body with trying to eliminate food. Teeth are rotted out because of all of the purging. I cracked my esophagus from a lot of the purging. I also have problems with my colon because of the laxative abuse.” Jenni Schaefer drives home that an eating disorder affects every system in the body, revealing that at 22, she was diagnosed with osteoporosis—a weakening of the bones usually found in older women. The different subjects talk about their own experiences. Latria suffered from edema, a condition where the hands and feet retain water, making it uncomfortable for her to do things with her hands. Jenni’s hair fell out in clumps and she had very dry, brittle nails. When Christine first visited a hospital for her eating disorder, she was immediately admitted in intensive care with an IV because of dehydration. B. Charles describes the experience of being told by his doctors that he could die if he didn’t gain weight. “That was kind of an eye-opener for me,” he says. The program then addresses the question of what causes eating disorders. “With eating disorders, it’s not about the food,” says Lynn Grefe, “It’s about the person, and it’s about a mental disorder that’s making [that person] have behavior about food.” For B. Charles, his eating disorder was mostly about insecurities and building relationships with friends. For Christine, her issues stemmed from anxiety about starting high school. Jenni talks about how high school was the crucible for her eating disorder. Her obsession with perfection—straight A’s, the volleyball team, National Honor Society, student council—drove her to low self-esteem and to constant self-criticism. Lynn Grefe describes how eating disorders are sometimes characterized as affecting the best and the brightest. Anorexia in particular is often accompanied by a certain personality type. She says, “They feel like they’ve lost control of everything in their life but they can control this.” Marna says how her eating disorder came in part from feeling responsible for her parents’ divorce. She says that with her eating disorder, “I could control a lot of the feelings that I was showing people.” DO YOU HAVE AN EATING DISORDER? PROGRAM SUMMARY CONTINUED DO YOU HAVE AN EATING DISORDER? 6 HUMAN RELATIONS MEDIA The video moves on to discuss the effect of biology on eating disorders. Lynn Gefe describes how science is discovering more and more that eating disorders are biologically based illnesses, most likely a result of a combination of biological and environmental factors. Marna talks about how for her, it was likely both a genetic and a learned behavior; her siblings suffered from eating disorders, and as a child she saw her mother yo-yo diet all the time. From watching her mother, she learned that eating less was the way to deal with perceived weight problems. Jenni quotes a common researchers’ maxim about eating disorders: “Genetics loads the gun, environment pulls the trigger.” In Jenni’s case, her move to Nashville was the event that triggered her eating disorder to come to the surface. In addition to feeling the pressure to look like the unrealistic women presented in the media, moving to Nashville intensified her sense of competition with others. At the time, she describes how she thought “Maybe I’m not the best singer, but I can have the best body.” Lynn Grefe returns to detail the unrealistic and unattainable images of people produced by our society, which can lead to self-esteem problems, if not an eating disorder. B. Charles introduces viewers to a disease called body dysmorphia, in which people perceive their own body as flawed, creating flaws where there are none. Christine describes how she thinks of body dysmorphia: “I always think of body dysmorphic disorder as looking in a funhouse mirror. You have those wavy ones where your body looks all wavy and weird…focus in on that one piece of my body and be like “Oh my god, I hate it,” and the more I hated it, the worse it looked.” The program introduces the next section: warning signs. Lynn Grefe offers the first warning sign: a family history of eating disorders. With anorexia, the warning signs are fairly apparent: hiding food, not eating, and above all, significant weight loss. Christine illustrates this point with her own experience: “I was eating alone. I wouldn’t eat in front of other people…I was being very secretive.” With bulimia, says Lynn Grefe, a person doesn’t necessarily lose any weight. She details some of the warning signs of bulimia: “Excusing themselves after every meal immediately, trying to avoid meals.” Latria describes how she avoided throwing up in the bathroom because she was afraid she would get caught. For Jenni, her symptoms as a teenager were ones that people often don’t think to look for: isolation and moodiness. The video moves on to a new topic: how to help. Lynn Grefe tells viewers they should not criticize someone with an eating disorder: it’s not their fault. She explains how the best thing to do is to reach out as a friend and encourage them to talk to someone. She also emphasizes the importance of understanding the problem, and knowing that it is not your friend’s fault: they are sick. Latria describes her own experience with a friend who tried to help. “One of my friends in high school, she told me, ‘I’d rather have you alive and mad at me than have you dead, and be on my conscience that I didn’t say anything.’” She goes on to clarify: “Sometimes it takes a group of people saying ‘I care about you, and I worry about you’ in order for that person to realize that they’re worth something.” DO YOU HAVE AN EATING DISORDER? PROGRAM SUMMARY CONTINUED HUMAN RELATIONS MEDIA 7 DO YOU HAVE AN EATING DISORDER? Lynn Grefe returns to emphasize the importance of helping those with eating disorders. “People with eating disorders need treatment and they need it early, before they have some long-term health consequences,” she says. “To anyone who might have an eating disorder, don’t be the least bit ashamed.” B. Charles describes the experience of being helped: “It’s such a relief because you’re not alone anymore; you can share it with someone.” The program begins its final section: recovery. From Marna, we hear how recovery is possible, and how recovery means relearning one’s relationships to food and to one’s emotions. Christine describes the benefits of recovery, saying simply, “I’m at a much better place in my life. Life is so much better now.” Jenni talks to the viewers one last time, describing her experience of recovering from an eating disorder. Initially, she thought that she would always struggle with food and weight—but she now knows that it is possible for a person to recover completely. While viewers see Jenni sing in a recording studio, she explains how she recovered. For her, singing was one method of expressing herself, and she began to not only sing but to write her own songs. Another method was to personify her eating disorder. “My therapist taught me to treat my eating disorder as a relationship rather than an illness. So I actually learned to call my eating disorder Ed, which is an acronym for eating disorder, E.D. I learned that the negative thoughts I heard constantly came from Ed, thoughts like, ‘Jenni, you’re fat,’ ‘Jenni, you’re no good, you’re worthless.’” She describes how she learned to develop healthy thoughts, thoughts that she could call Jenni’s and not Ed’s. For her, it felt good to be able to fight for herself, against Ed. The program finishes by letting viewers listen to the song Jenni is recording: “You don’t have to just pretend All the pain can really end You deserve more than the lies that you’ve been fed You can believe in life without Ed.” NOTE: The song “Life Without Ed” was written and composed by Jenni Schaefer and Judy Rodman. DO YOU HAVE AN EATING DISORDER? DO YOU HAVE AN EATING DISORDER? 8 HUMAN RELATIONS MEDIA This page left blank intentionally. STUDENT ACTIVITIES ACTIVITY 1A PRE/POST TEST HUMAN RELATIONS MEDIA 9 DO YOU HAVE AN EATING DISORDER? Name: _____________________________________ Pre/Post Test Decide whether the following statements are true or false. 1. TRUE or FALSE: Excessive exercising is one way that an eating disorder might manifest itself. 2. TRUE or FALSE: Laxative abuse is a form of purging. 3. TRUE or FALSE: Binge eating is a form of anorexia. 4. TRUE or FALSE: Only girls get anorexia. 5. TRUE or FALSE: A combination of genetics and environment are likely responsible for eating disorders. 6. TRUE or FALSE: Bulimics don’t necessarily lose weight as a result of their purges. 7. TRUE or FALSE: Eating disorders are fundamentally about losing weight. 8. TRUE or FALSE: If you know someone who has an eating disorder, you should force him or her to eat at least two meals a day. 9. TRUE or FALSE: Bulimics always use vomiting to get rid of the food they’ve eaten. 10. TRUE or FALSE: Most eating disorders will go away on their own, over time. The Answer Key appears on the next page. ACTIVITY 1B PRE/POST TEST HUMAN RELATIONS MEDIA 10 DO YOU HAVE AN EATING DISORDER? Name: _____________________________________ Answer Key 1. TRUE or FALSE: Excessive exercising is one way that an eating disorder might manifest itself. TRUE 2. TRUE or FALSE: Laxative abuse is a form of purging. TRUE 3. TRUE or FALSE: Binge eating is a form of anorexia. FALSE 4. TRUE or FALSE: Only girls get anorexia. FALSE 5. TRUE or FALSE: A combination of genetics and environment are likely responsible for eating disorders. TRUE 6. TRUE or FALSE: Bulimics don’t necessarily lose weight as a result of their purges. TRUE 7. TRUE or FALSE: Eating disorders are fundamentally about losing weight. FALSE 8. TRUE or FALSE: If you know someone who has an eating disorder, you should force him or her to eat at least two meals a day. FALSE 9. TRUE or FALSE: Bulimics always use vomiting to get rid of the food they’ve eaten. FALSE 10. TRUE or FALSE: Most eating disorders will go away on their own, over time. FALSE