The Dangers of Body Dysmorphic Disorder

How a Distorted Body Image Fuels Disordered Eating

Preoccupation with body image usually kicks in during adolescence. In the early teen years, kids suddenly become obsessed with what society has determined as “good looks.” Many will pore over fashion or celebrity magazines, identifying the physical traits of seeming perfection, and then begin comparing these “perfect” body parts to their own. The mirror may become a young person’s worst enemy if this interest in what our culture dictates as physical beauty becomes an unhealthy obsession.

Although most of us can quickly point out the body part we wish we could fix or change, this desire doesn’t usually occupy more than a passing glance in the mirror on a given day. However, when an individual becomes so preoccupied with their perceived flaws that they can no longer control their negative thoughts about themselves, often resorting to drastic measures to fix the imagined defect, they may suffer from body dysmorphic disorder (BDD).

About BDD

BDD is a mental health disorder characterized by extreme and persistent obsessive thoughts regarding some aspect of their appearance. Someone suffering from BDD may spend several hours a day performing rituals coping with or hiding their distorted body image.

Surprisingly, BDD affects males and females nearly equally, with the disorder typically developing during the adolescent and teen years. About 1-2% of the U.S. population grapples with BDD, with the majority zeroing in on their hair, skin, nose, chest, or stomach, although people with BDD can find fault with any part of their anatomy.

BDD is tightly associated with other anxiety disorders, such as obsessive-compulsive disorder (OCD), eating disorders (ED), and social anxiety disorder. Symptoms of BDD, however, are specific and include:

• Preoccupation with appearance. The individual is preoccupied with one or more nonexistent or slight defects in their appearance, thinking about the imagined defects for at least an hour a day. They may spend a great deal of time trying to camouflage the imagined flaw.

• Repetitive behaviors. The individual performs repetitive, compulsive acts in response to the perceived defect. The repetitive acts can be behavioral, as in mirror-checking, excessive grooming, changing clothes often, seeking reassurance from others, or skin picking. If weight is the primary issue, disordered eating, over-exercising, or unnecessary cosmetic surgery may result. Repetitive behaviors can also be mental, such as constantly comparing one’s appearance with others; tormenting themselves by feeling they come up short.

• Impairment. When the preoccupation causes significant distress or impairs areas of functioning such as social, academic, or occupational, then BDD is indicated. Their constant negative self-talk hinders their ability to function, causing them to miss work, skip school, avoid social events, and isolate themselves.

Treatment for BDD

Because the sufferer of BDD is often embarrassed and ashamed of their condition, they might not seek medical help. However, effective treatment is available for treating BDD, often with great success. A typical treatment regimen includes both psychotherapy, specifically cognitive behavioral therapy (CBT), and medication such as selective serotonin reuptake inhibitors (SSRIs).

Cognitive behavioral therapy
Cognitive behavior therapy has been shown to help someone with BDD identify the thoughts that trigger the disordered behaviors, and then to replace the response with a new, healthy thought and behavior pattern. By teaching the BDD patient how to manage their triggers without resorting to avoidance or compulsive behaviors, CBT can help them see the bigger picture and to respond in a more rational way. CBT has been shown to improve such symptoms as depression, low self-esteem, and social anxiety.

SSRIs are considered the first-line medication of choice for treating BDD. SSRIs are antidepressants that can help reduce obsessive thoughts and compulsive behaviors. The medication helps to control the distress that BDD can cause, including anger and suicidal thinking, as well as improve daily functioning.

Casa Serena Can Help

If you or your loved one struggles with irrational perceptions of their physical appearance that have culminated in disordered behaviors, we are here to help! At Casa Serena our caring, expert clinical staff understands that BDD is not just vanity gone wild, but is a serious and dangerous mental health condition that needs to be treated with understanding and compassion. Our treatment plans are individualized to the specific needs of each patient and to how their BDD has manifested itself. Contact us today and speak to our knowledgeable staff today at (925) 682-8252.

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Eating Disorders among Teens and Adolescents

Understanding Teen Eating Disorders and Ways to prevent them

Eating disorders often take root during the early years of adolescence.  This is a time when young people become more aware of the social demands for a physical ‘ideal,’ and many may feel they fall short.  The teen years are a fertile ground for an eating disorder to develop, as various elements of this phase of life—stress, insecurity, societal pressures, athletic competition—may contribute to the teen’s eventual disordered eating patterns.

Eating disorders, such as anorexia, bulimia, and binge-eating disorder are serious health conditions that should not be ignored.  The exact cause of eating disorders is often a mystery, with complex factors at the root of the condition making it challenging to identify the origin.  The societal emphasis on being a certain size and shape can so color a young person’s sense of self that is can lead to disordered eating habits in the quest to meet that expectation.

In addition, personality traits like perfectionism, certain genetic or biological factors, or mental health disorders such as anxiety and depression are also possible risk factors for an eating disorder.  Also, a general sense of having no control over one’s life is a common trait among teens suffering with an eating disorder.

Does my Teen have an Eating Disorder?

Because there are different eating disorders with different symptoms, it isn’t easy to identify whether or not a child may be developing disordered eating patterns.  However, there are some common behaviors that may indicate an adolescent is struggling with an ED, such as:

  • Persistent worry about being “fat” and obsession with losing weight
  • Skipping meals
  • Obsession with celebrities’ physiques and wanting to emulate them
  • Eating in secret
  • Irregular menstrual cycles
  • Visiting the bathroom immediately after each meal
  • Excessive exercise
  • Using laxatives and/or diuretics
  • Eating large amounts of high fat or sugary foods
  • Expressing disgust at their eating habits
  • Eating more food at a meal than is considered the norm

These red flags should be addressed as possible symptoms of a serious problem and, if the behaviors persist, steps should be taken to get professional help for the teen.

How can Teen Eating Disorders be prevented?

If your teen is displaying some of the thoughts and behaviors that may precede the development of an eating disorder, open communication is key.  Because a young person’s self-worth is often tied up with their body image, talking about their concerns at an early stage is helpful in directing them to healthier thinking.

Some areas that can help promote a more balanced approach to ______ include:

  • Set a healthy example. Kids look to their parents for direction and emulate them to a large degree.  If parents are obsessing about weight and dieting, or constantly complaining about their shape or size it can set disordered thoughts in motion in an impressionable young teen.
  • Discuss media influence. Young people are not yet aware of how powerful an influence the media is on our thoughts and behaviors, and are more vulnerable to the messaging.  Teach your teen that celebrities’ photos are often photo-shopped and not natural.  Point out stars that are famous and talented who have curves and some extra pounds on their frames.  Explain how cultural preferences for the desired shape is ever changing and that one should not be a slave to them.
  •  Build self-esteem. Teens often are insecure about their changing bodies, so help them feel good about themselves by pointing out their special qualities and skills that have nothing to do with physical appearance.  By praising their accomplishments at school, in sports, and their areas of interest you will foster a healthy sense of self in your teen.
  •  Discuss the dangers of dieting. If your teenager is engaging in fad diets or fasting they could be compromising their health.  Teach them about the dangers of robbing the body of important nutrients and about the body’s nutritional needs while it is still growing.
  •  Discuss the consequences of emotional eating. A teen may attempt to work out their emotional issues through food.  Teach your teen that strict controls over diet or over-consumption of ‘comfort foods’ is not a healthy way to cope with negative emotions or stress.  Encourage open communication with your adolescent, or direct them to a counselor, pastor, or another family member to discuss the problems they may be experiencing.
  •  Discuss the negative impact of social media. While bullying is not new, teens tormented about their appearance on a social media platform is a relatively new phenomenon–one which can have devastating consequences.  A young teen being skewered publicly for their size or shape on a social media app may take drastic measures in response.  If your teen is being bullied online they need support.

 Treatment for a Teen with an Eating Disorder

When a teen begins to use food as a tool for managing emotional pain it is time to reach out for professional assistance.  Each teen suffering with an eating disorder has a unique set of factors that led to their condition; therefore the approach to treating them must be individualized in order to be effective.

At Casa Serena, our dedicated professionals treat each young person with the compassion they deserve, focusing on the individual, not the diagnosis.  Call us today (925) 682-8252 and let our expert and caring staff put your teen on the path to a full recovery, and a new, healthy beginning.

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Athletes with Eating Disorders

How the Demands in Athletic Competition Fuel Disordered Eating

Athletes with Eating Disorders

It’s easy to grasp how an athlete may develop an eating disorder.  Competition among athletes is fierce, and the pressure to meet the perceived physical appearance standards or weight requirements of a sport can be unrelenting.  In fact, according to a 2004 study from Norway, athletes are far more likely to develop an ED than the general public.  The study found that 14% of the 1,620 athletes evaluated had an active ED, versus 5% of the general population.  In addition, the study showed a higher incident of ED in female athletes, with a prevalence among athletes in leanness-dependent and weight-dependent sports.

Although eating disorders do occur in every sport, athletes who participate in what are referred to as “lean sports” tend to be more susceptible to acquiring an eating disorder.  Those sports include gymnastics, wrestling, cycling, running, ballet, diving, rowing, jockeying, and martial arts.  These particular sports tend to have a weight-class requirement, such as wrestling, or a standard that promotes low body weight for peak performance, such as cycling.

Why do Athletes Develop Eating Disorders?

Along with the stringent demands involved in being a competitive athlete that may drive some toward disordered eating habits to accommodate the physical standard for the sport, personality traits also factor in.  “The traits found in those with anorexia are also often found in high-performing athletes,” states Dr. James Greenblatt, chief medical officer at Walden Behavioral Care in Waltham, Massachusetts.  Greenblatt continues, “These traits include high self-expectations, perfectionism, competitiveness, hyperactivity, preoccupation with weight and dieting, and a tendency toward depression.”

Disordered eating among athletes, as in the general population, is caused by complex factors, including psychological, behavioral, environmental, and genetics.  In sports, some participants may go to unhealthy lengths to control their weight, influenced by such factors as:

  • Demands for peak performance, including speed and agility
  • Aesthetic demands, such as grace and beauty in dance or gymnastics
  • Pressure from coaches, judges, peers, and teammates to have a certain body size and shape and who emphasize only performance and success
  • Form-fitting athletic attire
  • Training for a sport from a young age
  • Public weigh ins
  • Media images of top athletes that present a stereotypical body image for a sport

The Consequences of ED among Athletes

These pressures can cause an athlete to go to any means necessary to shed pounds in a short period of time.  Binging and purging or starving oneself of important calories and nutrients becomes a de facto method to achieving the weight or physical appearance required by their sport. By engaging in such unhealthy dietary practices, the athlete may become more prone to injury, having the net result of a shortened career.

In female athletes, the lack of appropriate nutrition can cause detrimental health effects, referred to as the Female Athlete Triad.  This includes disordered eating, amenorrhea, and osteoporosis.  The process begins with the disordered eating, which can result in a female athlete ceasing to menstruate (amenorrhea), which in turn may cause calcium and bone loss that can lead to stress fractures of the bones (osteoporosis).  Male athletes battling an ED may have an increased incidence of co-morbid depression and substance abuse.

How Can Eating Disorders be prevented in the Sports Community?

Those with key roles in the athletic community have a responsibility to be proactive about addressing the dangers and prevalence of eating disorders.  Many turn a blind eye, considering disordered eating as part and parcel of participation in competitive sports.  In some instances, the coaches themselves are to blame for triggering an ED by belittling comments toward their athletes about body size and shape, or by public weigh-ins where peers can humiliate a fellow athlete.

Those in power positions, like a coach, have the opportunity to address the ED and to influence the athlete back to healthy eating habits.  Effective coaches exhibit responsible eating habits themselves, and emphasize health and wellbeing over the destructive success-at-all-costs mantra.  In doing so they provide positive examples to their young athletes that promote healthy lifestyles in addition to athletic performance.

We Can Help

At Casa Serena our expert treatment specialists are available to treat athletes who are battling an eating disorder.  These compassionate professionals are trained in treating the specific issues related to participating in competitive sports, helping the athlete to reclaim a balanced and healthy approach toward the demands of their sport.  Call today for a discreet consultation at (925) 682-8252.

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