by Stephanie Setliff, MD
Medical Director, Eating Recovery Center of Dallas
With the arrival of summer, our thoughts turn to poolside get-togethers, beach outings and barbecues. For some, summer is a more relaxed time of year, one where we enjoy the company of family and friends in the outdoors. For others, this time of year brings pressures to slim down or tone up in preparation for bathing suit and tank top weather. And it's no wonder.
Advertisements for diet and exercise products showcase ideal bikini bodies, and tabloids harshly rate appearances, with articles like the "Best and Worst Celebrity Beach Bodies."
As a psychiatrist specializing in the treatment of anorexia, bulimia and other eating disorders, I see how summertime presents a unique challenge for individuals who struggle with body image. Even for those with a healthy body image, beach "body ideal" can spark feelings of inadequacy and depression. In some cases, particularly among individuals with a family history of eating disorders and those with perfectionistic, people-pleasing and reward-dependent personality traits, seasonal pressures to lose weight can trigger unhealthy behaviors related to dieting and exercise.
In fact, many eating disorder treatment professionals observe an increase in patients and families needing eating disorder support as the weather heats up, and we shed our sweaters for shorts and swimsuits.
For youths and teens—and even young adults—the desire to lose weight to look good in skimpy summer fashions is not the only factor that can trigger an eating disorder. Young people who are more likely to develop eating disorders prefer structure and predictability, yet summertime's unstructured "down time" takes the place of normal daily routines.
Additionally, summer is filled with milestones related to adolescent separation, attachment and "launching"—spending the summer away from home at camp or on a trip, preparing to leave home for college in the fall or graduating from college and entering the "real world." These changes, transitions and new situations can result in anxiety and feeling out of control, triggering coping mechanisms in an effort to regain a feeling of control.
Dieting (including restricting calories, eliminating foods or whole food groups or purging calories) as well as excessive exercise helps alleviate this anxiety. Young people can easily control their calorie intake and energy output, oftentimes in secret and without drawing the attention of friends or loved ones. While these behaviors can be unhealthy and dangerous as a coping skill, they are difficult to identify in a culture that encourages and applauds dieting, exercise and weight loss.
To create a healthy summer environment, think beyond losing weight to achieve the coveted beach body and instead take steps to nurture your physical, emotional and spiritual health.
Consider these five tips for a healthy summer season:
- Get moving. Try a new activity—find a yoga class for relaxation, go dancing with friends or play volleyball on the beach—with the goal of finding joy and connection with yourself, others and nature, not losing weight. Identify physical activities that make you feel good—physically, emotionally and spiritually.
- Find your happy. If achieving a healthy weight or getting stronger is your goal, you're more likely to be successful and less likely to develop an eating disorder if you are nurturing your emotional health as well. For those people who struggle to disengage from the strong seasonal pressure to lose weight, consider this—studies suggest a correlation between a positive emotional status and healthy body weight.
- Take time to "stop and smell the roses." It's easy to get so caught up in our physical appearance or the appearance of others that we forget to enjoy the moment. At the beach, don't worry about how you or others look in a bathing suit. Instead, focus on the sun's warmth on your skin (protected by sunscreen, of course!), the salty sea air smells and the sounds of crashing waves and kids laughing as they build sand castles.
- Stay hydrated. The simple act of drinking sufficient water throughout the day supports overall health. In fact, research suggests a connection between proper hydration and a healthy body weight. And, adequate hydration allows us to engage meaningfully in summertime activities.
- Make time to check in. Especially for adolescents and young adults, summer brings changes to the standard routines. Make time to talk to the young people in your life and discuss feelings related to seasonal changes and milestones, such as fear, anxiety, depression or a perceived loss of control. Identifying unhealthy coping strategies early means you can get help early.
Eating disorders are complex illnesses that develop as a result of a combination of factors, including genetics, temperament and environment. Dieting and exercising to achieve a "beach-ready" physique can contribute to the development of an eating disorder, but wanting and working toward a thinner physique for summer does not cause an eating disorder. However, for those at higher risk for developing an eating disorder, seasonal pressure and resulting behaviors can trigger anorexia, bulimia or other food, eating and body image disorders.
Dr. Stephanie Setliff, Medical Director at Eating Recovery Center of Dallas, has specialized in the treatment of eating disorders for 20 years. She speaks frequently at eating disorder education, prevention and treatment programs in an effort to increase awareness about the growing epidemic of eating disorders. Eating Recovery Center of Dallas is a medically supervised treatment program serving female and male adults, children and adolescents. A multidisciplinary team of professionals oversees comprehensive outpatient levels of care, including a seven-day per week partial hospitalization program and an intensive outpatient program.