New measures to prevent eating disorders

It is becoming much more common to hear about the development of eating disorders in increasingly younger people. However, young people themselves may hold the key to an important part of the solution. This is about body-image pressure and how one manages to take care of one’s self-image.

Young girl picking at food on a plate
“Most girls are affected by eating disorders, but many boys also experience a lot of body-image pressure in adolescence, among other things to build a ‘defined’ body. They have to learn ways to cope with the pressure”, says Kethe M. E. Svantorp-Tveiten. Ill. photo: Shutterstock

“The reasons behind young people developing eating disorders must be addressed”,

says Kethe M. E. Svantorp-Tveiten, who has spent the last five years studying young people and their relationship to the body, body image, body-image pressure, exercise and dietary supplements — which are also an important part of the picture.

“The ideal body still creates a lot of problems for young people, but this ideal has also changed. It used to be more about being slim or skinny, but now people are saying that strong is the new skinny. However, it just means that the ideal has become even harder to live up to”, she says.

Portrait Kethe M. E. Svantorp-Tveiten
Kethe M. E. Svantorp-Tveiten was a doctoral research fellow at the Department of Sports Medicine at NIH. Photo: NIH (Norwegian School of Sport Sciences)

Must learn what is normal

Kethe M. E. Svantorp-Tveiten has been conducting her work scientifically, and together with a group of others, she has tried out various methods in order to figure out ways of reducing risk factors that, in turn, can trigger eating disorders.

“A lot is about teaching coping strategies to young people. So simple — and yet so difficult”, she concludes.

Together with Christine Sundgot-Borgen, she has been in contact with over 2500 Year 12 pupils at 30 upper secondary schools in Oslo and the former county of Akershus. In addition to the risk factors, they were also looking for ‘protective factors’ that influence and strengthen self-esteem, self-image and body image.

“One major risk factor was young people’s concerns about body, weight and figure. We have tried to improve their ability to deal with negative emotions regarding their own body, what is normal and which variations are normal”, she explains.

One important measure turns out to be about social media. They need to learn to become more critical of what they see there. Young people are quick to compare themselves a lot with others. “Social media provides great opportunities for exactly that.”

Chasing the impossible

Slim cardboard female figure in front of mirror in which the figure is shown as being fat
‘A cliche’ of distorted self-image illustrates how one perceives oneself. Ill: Shutterstock

The young people have answered questionnaires and they have met with the researchers on three occasions, an hour and a half each time. They have discussed what affects body image and how to strengthen it.

Diet and dietary supplements were a separate, important part here; it turned out that very many young people focused on and used such things.

“The ‘strong is the new skinny’ ideal is much of the reason behind this; as well as being thin, one should also be in good shape”, says Svantorp-Tveiten. Boys should have sixpacks, well-developed chest muscles and large biceps. Girls should have muscular thighs and buttocks, a narrow waist, they should be thin, but still have breasts.

  • Eating disorders are the most common mental health disorders among girls aged 13-25, but boys are also affected.
  • They can cause excessive focus on weight and the body, weight loss or weight gain, stress, guilt, and abnormal eating habits, all of which impair quality of life.
  • The most common types are anorexia and bulimia, but there are also things such as binge eating disorder.
    Source: Store medisinske leksikon (Norwegian medical encyclopaedia) – see also com

“But it doesn’t make sense”, she says, rather dejected. She says that young people are chasing an ideal body that can at best be achieved as an adult. “It is difficult. Fat and muscle mass are physiologically related, so reducing the amount of fat and at the same time increasing muscle mass requires an extreme amount of effort.”

Many are using dietary supplements

In some ways, she thinks that boys have it a little easier than the girls, despite the fact that they are also chasing unrealistic ideals and often resort to dietary supplements in order to achieve their goal.

About 1/3 of boys in this age group use protein supplements at least once a week, 17 percent use creatine, and 7-9 percent of both boys and girls use slimming products, some also to make them better in sports.

However, hormones will help the boys in the right direction, they naturally become more athletic — while the opposite is true for the girls: They naturally put on fat as part of puberty.

“Many, especially boys, also resort to dietary supplements, even if they don’t work. The ones that do work, however, do so because they contain so-called undeclared substances, such as testosterone or even amphetamines. In short: If a dietary supplement works, steer clear.

Young man exercising with dumbbell in a fitness centre
A ‘ripped’ or defined body is so important to many young people that they resort to both weights and dietary supplements. Ill photo: Shutterstock


"They are willing to learn"

“Visiting classes the way we did, worked. We were able to build trust and we were able to make young people more aware of what actually matters: making them more critical of social media”, she says.

One measurable result was that most of the boys who were part of this study stopped taking the dietary supplements. Even one year later, only six percent in this group who had not used them before had started. In a so-called control group (which was not involved in any discussion programme), over four times as many (26 percent) started taking dietary supplements.

However, the researchers don’t know exactly what it was that made them so successful; it must be investigated in more detail. “Young people are willing to learn. They took on the knowledge”, she says.

Intimate topics

Nevertheless, she and her colleague have a clear sense of what worked, and thus what others can learn from their work in order to succeed.

“The meetings with the young people need to be organised in such a way that they can discuss things among themselves and listen to each other’s opinions. Their opinions are more important than ours. It is much better than adults lecturing them”, she stresses.

Furthermore, she believes that young people must be challenged to:

  • resist the ideals
  • take measures in terms of how they use social media and who they follow online.
  • become conscious of how they talk to each other about the body.

“In order to succeed, however, it is perhaps most difficult for some to be relaxed and confident when talking to young people. One quickly touches on rather intimate topics such as sex, menstruation and what happens to the body during puberty.”

Another thing that Svantorp-Tveiten thinks helped a lot is the fact that she and Sundgot-Borgen were both young researchers and also up-to-date on trends and what young people are interested in.

Wrong to lecture them

“And the discussions also revealed who was at risk regarding eating disorders?”

“We could see that some were at risk, but they didn’t have a diagnosis. That wasn’t our task either. Our goal was to reduce risk and thus indirectly reduce the number of young people who could develop eating disorders.”

She says it would therefore also be wrong to lecture them about eating disorders, about vomiting and weighing food. “Instead, we chose a different approach that enabled them to deal with body-image pressure in a better way and improve their body image themselves.”

Importance of parents

In order to reverse the trend where increasing numbers of younger people are –developing eating disorders , Kethe M. E. Svantorp-Tveiten believes one has to work in kindergartens, primary and lower secondary schools, and also involve parents.

“There will always be some people who develop an unhealthy relationship with their body, weight and food, but the important thing is to create awareness and reduce body-image pressure broadly and at an early stage. The attitudes of parents are particularly contagious; just think when they talk about their weight, that they are too big and so on. Parents need to be aware of how that might influence their children.”

She says that much of the foundation is laid before adolescence, but that young people also influence each other greatly.

“I think we should also ally ourselves with influencers, people that youngsters look up to. They can be good and important role models.”