Peer Support Groups: Building Resilience Against Disordered Eating
It is well-known that individuals who are aware of and have internalized media messages regarding thinness and muscularity are prone to dieting and other weight control (or body change) behaviors. Evidence that children are influenced by these messages has been demonstrated by two recent Canadian studies. The studies revealed that 30 percent of girls and 24.5 percent of boys aged 10–14 years reported that they were dieting to lose weight, despite being within a healthy weight range.
Restrictive food intake and dieting (particularly unsupervised) by children is concerning because their growth necessitates increased amounts of nutrients. Dieting to lose weight can also set the stage for more serious eating problems and can trigger the onset of weight gain given that it is often followed by bouts of overeating or loss of control bingeing.
A High Risk Stage
The attitudes and activities of peers influence children and young adults. Some children experience direct pressures from their peers to diet or engage in unhealthy weight-control methods, while others imitate risky behaviors in an attempt to fit in. This desire for peer acceptance occurs in and around the same time that children are dealing with natural increases in weight and body fat associated with puberty.
Stress is common in this age group and many situations can trigger it. Examples of normative stressors include physical changes associated with puberty, a transition to middle school, increased academic pressures, and the onset of dating. Children who experience multiple stressors in the course of a year are prone to engage in more serious weight control behaviors than their peers who experience only one. For this reason, the early adolescent transition is a high-risk period for the development of body image concerns or disordered eating.
Peer Groups Demonstrate How to Cope
One way to help children navigate through this transition is to create a positive group setting as a way of demonstrating how to cope with stress and peer pressure. These groups can teach life skills, including media literacy training (e.g., critically analyzing unrealistic beauty and thinness messages), assertive communication styles, ways to build positive relationships, and self-esteem enhancement skills.
McVey and colleagues developed a peer support group model, entitled Girl Talk, which was carried out within the school setting. This 12-session once-a-week program provided an experience that left the majority of girls feeling
better about themselves and their bodies. During the peer group sessions, the Every BODY Is A Somebody curriculum was implemented, including topics such as positive relationships, stress management, media influences, and body size acceptance. The Girl Talk peer groups were facilitated by local public health staff trained within their communities.
Focus group sessions conducted with the Girl Talk participants revealed that most participants had obtained effective ways to deal with peer pressures to diet, and that they could apply those skills outside of the group. Additional research shows that this peer group model reduces silence in females. In other words, participants reported improvements in their ability to communicate more openly and assertively. Rather than keep feelings or opinions to themselves for fear that it might cause peer alienation, most girls felt more confident to express themselves. This prevention effect has the added benefit of boosting resilience against other risky behaviors such as sexual behaviors, smoking, substance use, and unhealthy relationships.
This program follows a recent trend in body image prevention. Namely, that implementing strategies for overall health and wellness can alter some of the predisposing risk factors related to disordered eating. This approach contrasts the traditional method of teaching adolescents the defining characteristics, behaviors, and dangers associated with disordered eating, which can lead some youth to glamorize those unhealthy behaviors.
There is also a growing need to investigate whether this peer support group model can also help boys cope with media and peer pressures. Evidence points to male youth also being troubled by their body size. Many adolescent males think they are too small or too fat, leading some to engage in unhealthy muscle gaining or weight loss.
Beyond the Classroom
There is also a need for prevention efforts to extend beyond the classroom. This speaks to the importance of examining the school ethos and its role in the development or maintenance of students’ unhealthy attitudes and behaviors.
Examples of school-wide initiatives include 1) sensitizing teachers, parents, and other school personnel about the influential role they play, 2) providing support to students about normal puberty changes, 3) implementing and acting on zero tolerance policies concerning weight-based teasing and discrimination, 4) providing opportunities for healthy eating and active living for all children, regardless of size or shape.
Pondering questions about your own body image is also important. Ask yourself: Am I dissatisfied with my body shape and do I talk about this? Am I a person who goes on diets? Do I think overweight people are out of control? These attitudes, whether expressed by parents, teachers or other school personnel, have a major effect on children.
Given the positive influence of the peer support group experience on feelings of assertiveness and self-esteem, participants are prepared to negotiate with peers and stand up to media messages. A positive peer group experience, such as Girl Talk, sets the stage for empowerment both in the classroom and out in the world.
By Gail McVey, PhD, C.Psych
Reprinted with permission from Eating Disorders Recovery Today
Spring 2005 Volume 3, Number 2
©2005 Gürze Books
About the Author
Gail McVey, PhD, C.Psych, is a Health Systems Research Scientist at Toronto’s Hospital for Sick Children, and an Assistant Professor of Public Health Sciences at the University of Toronto. She is also Director of the Ontario Community Outreach Program for Eating Disorders.