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Tag: anorexia

Generation Cleanskin: Part 1

I am excited to be able to share with you an outstanding article on teens and body image, for which Australian journalist Susan Johnson extensively interviewed leading experts and kids themselves. With thanks to the Courier-Mail’s QWeekend, which originally published it, I will be presenting this engaging and important piece in three instalments over the coming weeks. In Part 1 this week, Johnson investigates why girls and boys are both feeling unprecedented pressure to fit a narrow body image ideal . . .


Skinny and denuded of body hair if you are a teenage girl and “built” and “muscled up” if you are a teenage boy: welcome to a world in which children as young as eight feel anxiety about body image. If Western society is supposed to be more “equal” than ever before, then idealised notions of what a teenage girl should look like and what a teenage boy should look like tell a different story. In this tale, all the girls look like anorexic 12-year-old lingerie models and all the boys resemble the Incredible Hulk.

Once the province of starving teenage girls, “body dysmorphia” is the term used when anorexics look in the mirror and see a fat girl looking back. Now the term “muscle dysmorphia” – sometimes also colloquially known as “bigorexia” – is increasingly used in relation to the body image issues of teenage boys. Today, both sexes are feeling the pressure.

Dr Lina Ricciardelli, associate professor in psychology at Melbourne’s Deakin University, has researched and written a number of papers on children and body image. In a 2009 study of children aged between eight and 11, she and her team found that 25 per cent of girls compared their weight to their peers, while 26 per cent of boys compared their muscles. By the time these children are teenagers, body image pressure can seem overwhelming.

Ricciardelli found that worries about body image can develop at an early age. “Children regularly compare their height, weight and muscles with their peers and this is natural, but on the flip side it can have serious implications when children are still developing their self-perceptions and identities,” she says.

The study threw up some interesting differences between boys and girls: “Girls were more likely to focus on their peers who they felt had a better body, particularly on those features they wish they had or could change, whereas boys tended to focus on their strengths and used social comparisons to feel good about themselves, helping to build their self-esteem. While comparisons seem to help boys to feel more positive and confident, girls tend to show signs of lower self-esteem and feel more discontent with their figures.”

However, the most recent comprehensive national survey into young Australians and body image conducted in 2008 by Mission Australia found that body image was an issue of concern for a staggering 22.2 per cent of Australian boys and young men aged 11–24 years old. And, according to 2011 statistics by the Victorian Government’s Better Health Channel website (produced in association with Eating Disorders Victoria), about 3 per cent of Australian teenage boys now use muscle-enhancing drugs such as steroids.

In an article in InPysch, the journal of the Australian Psychological Society (APS), the largest professional association for psychologists in Australia, Steven Gregor noted that while women and adolescent girls have had to deal with pressures regarding body image for years, what is new is “that men and adolescent boys are now under the exact same pressures”.

He quotes Elaine Hosie, a registered psychologist and a director of counselling working with adolescent males, about the influence and role of the media: “The media promotes a certain idealised image of what it means to be a male. In regard to the body image debate, the media plays a large role in the idealised notion of what it is to grow from a child, to an adolescent, to an adult male.”

Hosie and Ricciardelli agree on the pernicious influence of the media as a major contributing factor to teenage body image anxiety. Ricciardelli says that “without question the media is completely saturated with images of thin, ‘ideal’ bodies, much more than ever before. Plus there are mass media of more kinds than ever before; the internet has thrown up such things as [social media website] Facebook and online videos and on and on and on. There are increasingly sophisticated technologies and marketing strategies now.”

It is not only the multiplication of media but its increased sophistication that has transformed the media into such a powerful tool of influence: where once a photograph was a recorder of images and the camera did not lie, now a photograph can cheat and distort and a photograph will never again be simply a photograph.

“The media is manipulating bodies much more,” says Ricciardelli. Between dangerously skinny models, boys with six-packs and Photoshop, the gap between ordinary flesh-and-blood girls and boys and idealised images of girls and boys has grown wider and wider.

There are no statistics on the numbers of young men and boys using private gyms in Queensland but anecdotal evidence indicates that the worship of the “built” male body, previously only seen in gay and bodybuilding cultures, has made its way into mainstream culture too, and particularly into teenage male culture. When popular young amateur Sydney bodybuilder Aziz Shavershian (known as “Zyzz”) died last year of a heart attack, probably brought on by his steroid use, he had 120,000 followers on Facebook, many of them teenage boys: now his page (maintained by fans) has 283,266 “likes”.

Dr Peter West, formerly of the University of Sydney’s Research Group on Men and Families and author of a landmark paper on boys, men and body image in 2000, says that in the 12 years since his study, body dysmorphia has only increased. “When I was growing up in the ’50s bodybuilders were regarded as weird; no-one went to the gym, unless you were doing boxing or something. Everyone just went to the beach or played cricket or football. It’s not like that today,” he says.

Of course, for as long as there have been human bodies, there have been inventive ways to fashion them: from African and Amazonian peoples inserting clay plates into their bottom lips, to Indian women putting jewels into their nostrils. Fashions come and go, too: in ancient Greek and Egyptian cultures men regularly removed all body hair, possibly because the pre-pubescent and newly pubescent hair-free, androgynous male body (rather than the female body) was believed to be the embodiment of beauty.

Dr Ricciardelli of Deakin University’s other area of expertise is male beauty and body image throughout history. She argues that the male body has been evaluated and scrutinised as an aesthetic ideal since ancient times. What has changed, however, is that today many boys are internalising messages promoted by a powerful media. “[There is a] perceived pressure that women are expecting men to shape up to the media images,” she says. Her studies have found that leanness and youthfulness as well as a sculpted appearance have become important standards of male beauty. In pursuit of this ideal, Ricciardelli’s studies suggest that up to 60 per cent of young adult men in the US and Australia have removed body hair (below the neck) at least once.

Ricciardelli is one of an increasing number of academics and psychologists advocating preventative work with teenage boys. In the APS InPysch article, Elaine Hosie argues that more psychologists, medical practitioners and teachers need to work together to ensure better outcomes for teenage boys: “I would say it [body image dissatisfaction] is not something that’s in their [adolescent boys’] awareness. The reason for coming to a counsellor would be about more concrete issues such as: ‘I’m doing really badly at school’, or ‘my girlfriend has dropped me’, or ‘I can’t get a girlfriend’, or ‘I don’t like my teacher’ – they externalise things; they blame the world. [But] these are the presenting issues, which often mask more serious health concerns such as body image dissatisfaction.”

Ricciardelli believes treatment needs to take into account “cognitive adjustment of distorted views about themselves” – just like teenage girls with anorexia.


I am pleased to have contributed my voice to those of the experts quoted in Part 2 of this feature, which I’ll bring you next week. In it, Johnson delves into issues such as the pressure on girls to diet and remove all their body hair. 

Susan Johnson, a full-time journalist at Qweekend magazine, is the author of seven novels; a book of essays, On Beauty (part of the Melbourne University Press series Little Books on Big Themes); and a memoir about her experiences of motherhood, A Better Woman.

Welcome to the Wasteland

Warning – this special blog post may be a trigger for some people.

For those of us who have never had an eating disorder it can be hard to understand the grip that diseases such as anorexia and bulimia have on young women’s minds. This week I would like to share a piece of writing that brings clear insight. Written by a 20-year-old woman whose anorexia and bulimia have brought her to the brink many times, it takes us right to the heart of what it means to have an eating disorder. I first met this talented young Sydney woman through my work with Enlighten, and I feel fortunate to have developed a real connection with her since. She is soon to leave hospital after spending time in treatment, and everyone at Enlighten sends her love, health, hope and peace.

Welcome to the Wasteland

If you could read my mind you would know how we see ourselves. Pathetic. Stupid. Ugly. Disgusting. Worthless. Useless. Fat. Lazy. Gluttonous. I could go on.

Yet others, when asked, will describe us with words we never imagined to be synonymous with ourselves. Witty. Intelligent. Together. In control. Hard working. High achieving. Compassionate. Energetic. Creative. Enthusiastic. Happy.

Welcome to the wasteland of eating disorders – contradictory in almost every way, and the epitome of self loathing. It is a world where nothing makes sense, basic requirements for human life are marked with a scarlet “DENIED” stamp and having nothing means everything. Where going down means you go up, and going up means you go down – low. It’s a place where frightened children fall into a mirror which shatters before they can escape. And where “leave me alone” actually means “please help me.”

It’s a reality carefully denied by those in its grips, and carelessly denied by those without the knowledge, experience or desire to understand. It’s an illness which affects not only those it physically hurts but almost every single person who comes into contact with that person. It’s a parasite which infects our minds and reprograms them, before we can possibly comprehend what a monster we’ve unleashed.

It’s a place where you have to watch someone fall. And fall. And fall. And fall. And often, there’s very little you can do to help them. Watching someone collapse doesn’t guarantee they’ve had their fall yet and “looking well” is merely a sign that someone is hiding their disease well. Running on empty doesn’t necessarily mean they’ve run out of fuel.

Welcome to our show – stage makeup, false smiles and all – where you’ll hold your breath and be gripping the edge of your seat as you watch us teeter on the tightrope, playing chicken. However, it’s a disease where all too often we lose our footing and we do make our spectacular final descent to earth, ending up 6 feet under. It’s up to those left behind to wonder if they could have done anything different to catch us. It leaves those of us in the grips of this illness wondering if we’re going next, or completely denying that we’re even on the tightrope.

Our community is unlike any other. We band together in mateship, each strongly denying our own illness, only to turn around and engage in exactly what we are most afraid of our friends doing. We accuse others of being irrational, frustrating and even psychotic – yet simultaneously we delude ourselves into believing that “one more time won’t hurt,” when we are in fact swiftly killing our spirits, and ourselves, and it’s only by the grace of Someone who is watching over us – or sheer fortune – that we’re still here today. We bitch about how awful our friends’ treatment teams are, but silently pray they will save them. We inadvertently collude with a friend’s disease before realising that we don’t want anyone else to be up to their necks in our hot water. No doubt our disease has also asked, even expected, others to collude with us in our scheming, planning and plotting.

We have moments of clarity, followed by moments of despair, quickly followed by denial. In that order. We would sell our mothers, our children, our lovers, for there to be silence in our heads. We dream of food, think of food, are obsessed with and possessed by food, and at the same time wave plates away with our hands and hold our breath walking past McDonalds. We eat carrot sticks in public, spending our nights eating everything in the pantry then acting out gut-wrenching, throat-shredding compensatory behaviours, which rip our bodies and minds apart. Or we’ve got the “normal eating” in public down pat yet eat nothing but soy sauce and vegemite at home, or spit out our food when no one is watching.

In recovery we take baby steps, chastising ourselves for never being the “best” at recovery. We swing between believing we need help, not wanting help, denying we need help and not feeling as though we deserve help. And back. We get up and run, crash headlong into an obstacle and lie on the ground crying. If we pick ourselves back up, we crawl, tentative, scared, knowing that it’s safe but anxious to stand up lest we crash back down to earth. We give up. We stand up and fight again. We leave treatment centres and psychologists on a whim – and regret our decision the minute we’re out the door. We take a few adult steps. We crawl again. Then we learn that things need to be taken slowly and consistently, and that even if we fall, we have the practice and, after years of doing this, the muscle tone in our knobbly, wobbly legs to actually support us.

We get frustrated. We scream. We take our unrepentant rage out on ourselves. We temporarily forget all we know about the damage we so easily inflict on ourselves and, desperate for a moment of control, fall back to our own ways. We come to terms with the damage that we’ve done – with psychologists, doctors, psychiatrists, dietitians, dentists, friends, family – and then turn around and point blank deny it. Or the truth hits us square in the eyes, and we regret everything. We swear we’ll never do it again, that we won’t make it any worse. We think “I seriously didn’t expect that to happen” even though we can recite the complications of eating disorders backwards. We end up close to dying, with all evidence before us, and repeatedly deny that we are so much as ill.

We say sorry over and over. Sorry for taking up so much space. Sorry for getting in your way. Sorry for voicing an opinion. Sorry for saying no. Sorry for saying yes. Sorry for thinking. Sorry for eating. Sorry for breathing. Sorry. Sorry. Sorry. Sorry. Sorry. Yet we can change to our eating disordered selves and back without so much as a breath.

We cling to childish ideas of recovery, of finding a cure, of fairytale “and they lived happily ever after” endings. We acknowledge that we will have to work hard to achieve our idealised state of recovery, but when the going gets tough we baulk. We begin once again to listen to the voice in our heads that convinces us that we’re not sick, or, in times of negotiation, that we’re simply “not sick enough”. We pin up fairy wands in our hospital rooms and pretend to be positive when in reality we don’t feel like we will ever escape the chokehold of this disease alive.

We can remember every minute detail of our week’s food intake and the calorie content of food we’d never so much as touch, and can recite our meal plans in our sleep. Yet sometimes we can’t remember what day it is. We live in a world where intelligence is measured by how many people we can deceive, rather than what we achieve.

Welcome to the wasteland of anorexia and bulimia.

Early intervention is key to treating an eating disorder. If you are concerned that your daughter or a girl close to you may be at risk, a good starting point is your GP, who can refer her to a relevant specialist. For older teens especially, it may be easier said than done to seek professional help. If she does not accept treatment, try to keep the lines of communication open; let her know that you are there to offer support and help her get treatment if she changes her mind. 

You may find it helpful to know some of the signs that can point towards an eating disorder:

• Extreme dieting, such as cutting out entire food groups or skipping meals
• Overeating
• Weight loss or gain
• Obsession with appearance or weight
• Loss of menstrual periods or disrupted menstrual cycle
• Sensitivity to the cold
• Faintness, dizziness, fatigue
• Anxiety, depression, irritability or an increase in mood swings
• Withdrawing from friends and family
• An increased interest in preparing food for other people
• Food rituals such as eating certain foods on certain days
• Wearing baggier clothes
• Exercising to an excessive degree
• Frequent excuses for not eating
• Eating slowly, rearranging food on the plate or using other strategies to eat less, such as eating with a teaspoon
• Eating quickly
• Stockpiling food in her bedroom
• Food disappearing from the pantry
• Frequent trips to the bathroom after meals

For more information on eating disorders visit:

The Butterfly Foundation:

Eating Disorders Victoria:

or US site Something Fishy:

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