Q:

A friend of mine has a great body, but she's constantly dieting and picking at her "imperfections." How can I help her have a healthier body image?

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Answers (4)

EXPERT
Lisa Bograd, MA, MFT (Marriage & Family Therapist) answered

For many women in America, Eating Disorder Awareness Week (February 20- 27), will be spent much like every other week, counting calories and skipping breakfast in an effort to shed a few more pounds so that they can achieve that holy grail of happiness: thinness.

But I would like to invite your friend to pause some time before the week's end, even if it is just a split second before doing that next ab crunch, or downing that Diet Coke, to think about Isabelle Caro, a 28-year-old French model who passed away from complications due to anorexia nervosa on November 17, 2010.

Caro's emaciated body was photographed by the celebrated fashion photographer Olivero Toscani in an attempt to shock people into awareness of the dangers of dieting in a controversial European campaign. Despite eventually climbing to 93 pounds (from a low of 55 pounds), Caro's body had been so ravaged by her illness that she could not eventually save herself. Like your friend, Isabelle started out dieting (a seemingly harmless rite of passage for so many young women from Westernized cultures), only this turned deadly for her.

Sure, we like to think that eating disorders only happen to models or celebrities, who write about their recovery in People, or to people who are far more obsessed or disturbed than we are, but the truth is that up to 35 percent of those who diet will progress to "pathological dieting," a chronic cycle of restriction and weight loss followed by binging and weight gain. Another 20 to 25 percent of dieters will progress to full-blown eating disorders, which have the highest mortality rate of any mental illness (at about 10 percent of sufferers).

Even if we do understand that eating disorders can wreak havoc on the lives of sufferers, we still don't make the connection between what we are doing to our bodies when we go on the latest juice cleanse, or decide to forgo carbs for a year, and what happened to Isabelle Caro. That is why this week I invite your friend to stop thinking about the number on the scale, and to start thinking about the thousands of women whose lives were cut too short by an eating disorder.

For anyone with a disordered relationship with food and their body image, I also recommend reading Life Without Ed and/or doing one of the following on my list of Eleven Steps to a Healthier Body Image:

1) Begin to cultivate listening to your body and its hunger and satiety cues. Eat when you are hungry. Stop when you experience an internal sensation of fullness. Do not allow externally imposed guidelines, like diets, to override your internal cues.

2) Regard your body as the "instrument of your life" that enables you to do many important and gratifying things. Create an inventory of all the wonderful things you can do with your body.

3) Create a list of people you admire who have contributed in important ways to your life, your community, or to the world at large. Remind yourself of the qualities that these people had that enabled them to make such a valuable contribution. You will most likely find that their physical appearance had very little to do with why you admired them and why they were able to be so successful.

4) Decide how you want to spend your energy: pursuing the "perfect" body, or enjoying nurturing relationships with your family/spouse/partner/friends, pursuing your interests and hobbies, learning, exploring and so much more.

5) Put signs on your mirror, in your car, or any place visible that say things like, "I'm beautiful inside and out," or, "I love my body just the way it is." Make up a quote that is personally meaningful and useful to you and affirm it to yourself when you find yourself starting to get into negative self-talk.

6) Count your blessings, not your blemishes.

7) Ask for support and encouragement from friends and family when life gets stressful instead of taking your feelings out on your body and yourself.

8) Find a method of exercise that you enjoy doing and do it regularly, not to lose weight or to eliminate "excess calories," but because it makes you feel good.

9) Work towards self-acceptance and self-forgiveness as much as possible.

10) Every morning when you wake up, thank your body for resting and rejuvenating itself so you can enjoy your day. Every evening before you go to bed, thank your body for what it has helped you to do throughout the day.

11) Create your own "Body Positive List" and share it with your friends and your family!

 

Helpful Resources:
[email protected]
www.eatingdisordershope.com
www.oa.org
www.gurze.com (eating disorder and body image publications)
www.something-fishy.org

 

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EXPERT
Dr. Ramani Durvasula (Licensed Clinical Psychologist) answered
You may not be able to do this for her, and in fact it really isn't your responsibility.  The key to a healthy relationship is to be present, authentic, and answer questions honestly - but also communicate clearly.  It may be that the best thing you could offer her is a small nudge to considering a discussion of her issues with a licensed mental health professional.  I hate to say it - but sometimes ignoring it can work.  Not rudely, but you can answer these kinds of questions in a perfunctory way (you look fine) and then move the conversation to something else and not belabor it.  If her distortions about her body image are pronounced - no amount of reassurance from the outside will mitigate this.  Like with most friendships - just be there, and try and avoid the minefields when possible.
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EXPERT
Michelle Brock (Certified Life Coach & Hypnotist) answered
I applaud the caring and concern you show for your friend, and I can tell that your desire to help her is genuine. Unfortunately, as her friend you cannot really help her to stop this behavior. This struggle is hers and hers alone. It would be great if there were a magic thing you can do or say to change the filter by which she views herself and her body, to make her see that she is wonderful just as she is. These types of issues: body image, relationship with food, eating disorders, etc. are often deep psychological wounds that require intense inner work, the kind of real work you can only do yourself with the help of a professional.
The reason that you can't help her work through this stuff is simply that you are not objective. You love her, care for her, and have probably spent hours talking and hanging out. You may even know her family, and you are familiar with her patterns, habits, and quirks. A professional comes with a clean slate, and will provide the objectivity necessary to delve into the emotions surrounding it, discover the roots of the issue, and then formulate a plan to resolve it. But, she will only seek out a professional when and if she ever realizes that she has a problem. That won't happen from your telling her she does.
What you can do here is focus on trying not to feed into it. What I mean by this is that you can't control her, her thoughts, and what she says, but you can control your reaction to it. For example, you may have plans to go swimming, and when she puts on her swimsuit, she starts to complain about how she thinks she looks in it. You then get upset and spend several minutes talking her down off of it, telling her that she is crazy, that she looks amazing, etc. You attempt to convince her to see herself as you see her, and more than likely, you spend a whole lot of energy doing it. Instead, try to minimize your reaction to it. Perhaps when she puts on her swimsuit and starts picking at herself, instead of trying to change her mind about how she looks, simply tell her she looks great but if she is uncomfortable to put something else on or maybe even suggest you do another activity. 
Try not to let her issue formulate the dynamic in your relationship. When she starts to pick, change the subject. This doesn't mean ignoring her issue, you acknowledge how she feels, tell her politely that you disagree and then move on. Remember, this dynamic between the two of you works both ways. Sometimes people with these types of insecurities gravitate toward friendships and relationships with people who have personalities that allow them to play the role of the "helper", and many times a "helper" personality will attract people into their lives who they feel need their help.
I'm not suggesting that you are enabling her here, but rather that if you can disengage from it there will be a shift in the energy. When you can create that shift, it may create more clarity for her and help her to see herself more clearly. Her realization that she has body image issues, if she ever has it, needs to come from a place inside of herself. Take yourself out of it. You don't need to help her, you only need to love her and be her friend.
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Anonymous answered
I'm not sure how old your friend is, but she is showing some signs of an eating disorder. As some of the people above have mentioned, there is not a whole lot that you can do to help her other than being supportive, but it sounds like she should have an eating disorder evaluation and then perhaps some psychotherapy. Eating disorders are among the most difficult psycho-social-cultural disorders to treat, and in fact are one of the few psychological disorders that can lead to death. I am not suggesting that your friend is at risk for that or that she even had an eating disorder, but the sooner these can be identified and treated, the better outcome there is.
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