September 4, 2001
Globe and Mail

More than one in four teenaged girls has symptoms of eating disorders such as binging and purging, according to a new Canadian study. It calls the number alarming.

More troubling still is that the behaviour is seen in younger and younger girls. Some as young as 12 turn to self-induced vomiting as a means of losing weight.

"The problem is really starting young," said Jennifer Jones, a researcher in the department of psychiatry at the University Health Network in Toronto.

"Young girls are now adopting the behaviours of those who were traditionally at risk of eating disorders; they are behaving like young women of college age."

Dr. Jones said there is no doubt that constant bombardment with media images of stick-thin models places tremendous pressure on girls and is creating unrealistic expectations.

"The ideal many girls are striving for is not achievable, and it's not healthy." Recent research shows that as many as 80 per cent of girls of normal height and weight want to lose weight. Many diet even before they reach puberty. The new study, published in Tuesday's edition of the Canadian Medical Association Journal, found that 27 per cent of girls aged 12-18 have "disordered eating behaviours."

Using standard testing measures, researchers examined the girls' "drive for thinness," body dissatisfaction and eating attitudes. While dieting was commonplace, the study found that girls engaged in a full range of activities to lose weight, even at a relatively young age.

Among 15-year-olds, 22 per cent engaged in binge eating and 11 per cent in purging (self-induced vomiting); 4 per cent used diet pills; 2.2 per cent used laxatives; 1 per cent used diuretics. Among 12-year-olds, researchers found 9 per cent of girls engaged in binge eating, 6 per cent in purging, 1.1 per cent used diet pills and 0.4 per cent used laxatives or diuretics to lose weight.

Dr. Jones said much of this behaviour is temporary but a significant minority of the girls will develop severe eating disorders, and existing programs are wholly inadequate to deal with the growing problem. There are long waiting lists for admission to eating-disorder programs, and the failure rate is quite high: Many girls with severe eating disorders die of organ failure or suicide.

Dr. Jones said the present approach of treating only serious cases is a failure and that public-health approaches must be developed to focus on prevention. "Children — and girls in particular — need to develop healthy attitudes toward food and exercise. They need to learn about their bodies and that the bodies they are seeing on billboards, in magazines and in rock videos are not normal."

Dr. Jones said the research shows that teaching about body image and nutrition should begin in primary school and continue through high school. Further, the teaching should involve students.

"Girls don't need someone to stand up and say: 'This is bad for you.' They need teaching that validates their experience; they need answers to their questions." Dr. Jones added that she was struck by how many of the girls in the study were eager to discuss their problems, and frustrated that they had no one to turn to. She said parents and family physicians should make a greater effort to "ask non-judgmental questions" about girls' diets and their body image. For example, many teenaged girls are not aware that it is normal to accumulate fat during puberty, and that doing so is important to normal development.

The new study was based on data collected from 1,739 teenaged girls in Toronto, Hamilton and Ottawa. The researchers did not question boys because about 95 per cent of eating-disorder cases treated by clinicians are among girls. However, Dr. Jones said teenaged boys have their own problems, and those need further examination.

"We're seeing boys with the opposite pressures: Instead of being stick-thin like girls, they feel a need to bulk up and have a six-pack," she said. "The root cause of the problem is the same: the media images they are trying to emulate."

reprinted with permission