This brief piece from the Los Angeles Times has some good information, namely that puberty is a tremendously important time for adolescents to be accruing bone mass. Any disruption in puberty, such as from an eating disorder, can cause big problems down the road. Case in point: me. I've lost about half an inch in height from osteoporosis, and I had lost my period for just barely under one year between 20-21. This scares the bejeebers out of me.
Sayeth the Times:
Scientists aren't quite clear on why exactly a woman's fat content makes a difference. Some of that bone accrual is likely a response to the stress caused by the weight her skeleton is carrying; the study's authors also suggest a possible relationship with estrogen levels.
Whatever the underlying causes are, given the post-menopausal specter of osteoporosis, it's important to encourage a healthy body image. Not only is skin-and-bones an unflattering look, it's bad for your bones in the long run.
My problem with the piece is this: it kind of plays into the stereotype that people with eating disorders are a little bit dense, that they are sacrificing health in the name of some ethereal physical trait of beauty. If only they knew they were wrecking their bones, the logic goes, they would just snap out of it! Um, no. That's not how it works. Still, hopefully the knowledge will help discourage dieting (though the cynic in my doubts it...)
The German affiliate of ANAD designed a rather interesting public information campaign to raise awareness of eating disorders. In order to show how beauty ideals have changed over the years, an artist altered famous paintings of women to show how our "cultural ideal" has become essentially anorexic. A short YouTube video on the project is below (if you're easily triggered, don't watch the video. You can pretty much get the idea by using your imaginations).
Although this video helps explain just how messed up our cultural ideals are, I don't quite get how it's supposed to prevent eating disorders. I don't know that these ideals have made eating disorders more "popular." They serve to trivialize eating disorders, and make it hard as hell to recover, that's true. But it doesn't quite resonate with me.
Frankly, the work is great for showing people with "normal eating behaviours" how distorted perceptions of beauty have become. But those truly in danger — anorexics and bulimics — are perhaps less well-served by the shock factor.
For many of them, the contrast of exposed hipbones to the fleshiness of older muses is an improvement, not a travesty. As one YouTube commenter eerily put it:
“using irony to get your point across is lost on someone with anorexia. we will merely see skeletal bodies being displayed as art they way they should be. hope this made you some money.”
"The way they should be": those words ring louder than any intellectual accolade proffered by someone not suffering from an eating disorder. It’s a perspective worth keeping in mind when managing a similar type of client.
Symptoms of eating disorders tend to fluctuate over time, meaning that people can move rather fluidly between anorexia and bulimia and the EDNOS diagnosis. David Herzog's group at Harvard University tried to determine how to classify diagnoses of EDNOS after AN or BN: was it a separate diagnosis or part of the spectrum of illness and symptoms seen in anorexia and bulimia? This study indicates that it should be the latter.
Individuals with AN most often developed subthreshold presentations resembling AN; those with BN were more likely to develop subthreshold BN. Purging disorder was experienced by half of those with BN and one-quarter of those with AN binge/purge type (ANBP); BED occurred in 20% with BN. Transition from AN or BN to most subthreshold types was associated with improved psychosocial functioning...Subthreshold presentations in women with lifetime AN and BN were common, resembled the initial diagnosis, and were associated with modest improvements in psychosocial functioning. For most with lifetime AN and BN, subthreshold presentations seem to represent part of the course of illness and to fit within the original AN or BN diagnosis.