Wednesday, March 21, 2007

Eating disorders and self-esteem

The question I've been chewing on lately is this: What's the connection between eating disorders and self-esteem?

Does low self-esteem lead to, contribute to, or cause eating disorders? Conversely, does boosting self-esteem make one less susceptible to e.d.s?

I started thinking about this after following a link to an interview on Studio 2B, which bills itself as "a site for teens." The interview is with Scarlett Pomers, a 17-year-old actress who was treated for anorexia in 2005 and is now involved with the National Eating Disorders Association. In it, Pomers reinforces the link between positive body image, self-esteem, and health. She quotes some scary statistics--half of all girls between ages 12 and 14 say they're unhappy because they're too fat--and offers earnest suggestions for teens who may know someone with an e.d. or who may themselves be struggling with one.

All to the good. I do believe the more we talk about eating disorders, the less stigma is attached to them. But I'm not sure about the connection with self-esteem.

Before anorexia (and now again, as she's in recovery) I would have described my daughter as confident, smart, funny, outgoing, and emotionally astute. Her descent into anorexia did not seem connected with low self-esteem. On the contrary, she seemed to develop low self-esteem--along with a slew of other problems--only after becoming anorexic.

I don't want to knock efforts like NEDA's and others to try to boost girls' self-esteem. It's not a bad thing in this post-Reviving Ophelia culture. I'm wondering, though, if efforts like this are enough, or speak to the right point.

At the very least, shouldn't they be paired with education around nutrition--not the deluge of anti-obesity propaganda that now passes for "wellness education" but a clear, matter of fact explanation of what teens need to eat in order to be healthy? It wouldn't hurt to have a unit on, say, how and why diets don't work, too.

I don't know that this will prevent anorexia and bulimia in those who are susceptible. Maybe it would be a good start, though.

I would really like to hear what other people think on this subject.

7 comments:

Another Maudsley Mom said...

Have you seen this site? It's worth a look
http://www.healthyweight.net/

Laura Collins said...

I think this is a classic case of society being too eager to confuse correlation with causation.

Raised self-esteem during recovery seems to me to be a sign of recovery, not a cause.

As lovely as a crocus is: it doesn't cause spring.

Harriet Brown said...

Well put.

CARRIE ARNOLD said...

Laura,

An epidemiologist in the making! So often correlation *is* confused with causation, and I think both you and Harriet are spot on here. I think it's perfectionism that's linked with eating disorders, and self-esteem does tend to go along with that. Maybe not in all respects, but typically in some.

As well, it depends on how you measure self-esteem. I don't think any teenage girl just adores herself. Ergo, there will be some overlap. Lots of girls (sadly) don't like themselves because of how they look. Most of them will not develop an eating disorder. Though I never particularly liked my weight when I was growing up, I don't know that it exactly caused huge problems (no pun intended).

Raising self-esteem in our children is good, especially as basically all media out there tell us we're not good enough. But I don't know if improving self esteem will necessarily decrease eating disorders.

Harriet Brown said...

I'm a big believer in the power of therapy. Good therapy. But I have to say that the self-esteem thing seems to verge on psychobabble to me, certainly when it comes to e.d.s and causality. I think you are both right--low self-esteem is definitely a symptom of an e.d., and may or may not predate it. And it seems to be widespread among adolescent girls.

I'm sure a helping of self esteem can't hurt during recovery. But I'd serve that with a gold fork and a milkshake, myself.

CARRIE ARNOLD said...

I think a better term might be self-worth. I do agree with you (to some extent) about self-esteem being babble, but I think self-worth is more about valuing yourself as a person, and accepting yourself from the inside out.

I am a whole-hearted believer in *behavioral* therapy. Not discussing the past ad libitum, rather developing specific tools to deal with your problems in life. I have never suffered from penis envy...except perhaps in gas station bathrooms, but that's a different story. ;)

I'm glad you brought this up, though. It's sparked quite an interesting line of thought.

Erin said...

As a recovering bulimic, I can attest to the fact that my disorder was never, ever about self-esteem. I was/am a class president, prom queen, accomplished equestrian, smart, and well-liked person who had a wonderful family and great friends. For me, it was, and always has been, about perfection.

I knew that if I just worked hard enough and was diciplined enough with my (not) eating, I could eventually have the body type that I wanted, and not the athletic body that I've always had.

It is as simple as this -- most clothes today (and the ideals they represent -- models, actresses) are cut long and lean. I like to look fashionable, and I wanted to be able to buy those clothes and have them fit me like they were supposed to. I couldn't get the body I needed just by working out (I tried that first), so I took the next steps.