February 24th through March 3rd is Eating Disorders Awareness Week. Its purpose is to draw national and public media attention to eating disorders and their prevention. Much attention has been focused on the manifestations of eating disorders, and the all-too-frequently tragic stories of those afflicted with them. An equally important but all too often overlooked aspect of awareness involves prevention.

It is rare today for people, particularly pre-adolescents and adolescents, to feel good about their bodies. The current emphasis on beauty and the incredible pressure to be thin in order to achieve desirability are unprecedented. A lot of blame has been placed on the media and the culture of thinness that it promotes. Certainly the current bombardment of these messages by television and magazines affects our young people. It holds out to them false promises of the happiness and success that will be theirs if they can only be thin enough, or firm enough, or muscular enough.

But in order to truly prevent the development of eating disorders, we need to look closer to home--to the environment in which our children and adolescents are raised. An eating disorder isn't just something that happens out of the blue to a young person, and the fact that eating disorders don't happen to everybody indicates there are multiple contributors involved. To some extent, the same problems and issues that lead youngsters to abuse drugs and alcohol can contribute to the development of an eating disorder. Problems such as low self-esteem, unhealthy family and peer pressures, feelings of lack of control, and an absence of healthy role models, can all play contributing roles. Lack of knowledge about body size and shape, food and nutrition are also predisposing factors. Genetics are another factor in the development of eating disorders; as well as determining the parameters of an individual's size and shape, there is increasing evidence in the scientific literature that suggests that a tendency toward eating disorders can run in families.

The most important protective factors against the development of eating disorders in children and adolescents are an identity based on inner strengths rather than appearance, accompanied by a sense of competence-the feeling that one is a worthwhile person who can have a positive effect in the world. People develop these positive feelings of self-worth by being loved and respected for who they are, not for what they can do or what they look like. Self-esteem and a positive body image are strongly linked. People with a negative body image have a greater likelihood of developing an eating disorder and are more likely to suffer from feelings of depression, isolation, low self-esteem and obsessions with weight loss.

As parents, we are the primary source through which our children learn about themselves, others, and the world. We are responsible for teaching our children through our actions as well as our words. They need to know that they are wonderful, perfect human beings who are worthy of love and respect…just as they are! They need to understand that people come in a variety of sizes, shapes and colors, and that this healthy diversity is a positive characteristic of the human race. There is no ideal body size, shape or weight that every individual should strive to achieve. Children need to know that good health is not defined by body size; it is a state of physical, mental, and social well-being. They also need a basic understanding of the importance of healthy nutrition and exercise. Simply presenting healthy food and snacks rather than junk food to children at appropriate times can encourage the development of good nutritional habits. Participation in some form of healthy exercise--active family games, sports, or dance--can enforce a child's natural love of movement and engender a life-long habit of healthful activity. Children also need an understanding of the natural process of growth and development, including the fact that weight gain is a normal part of puberty for many youngsters. This important information can help alleviate anxiety over increasing body fat during puberty. Children and adolescents need to be aware of the dangers of dieting, to be able to think critically about media messages and resist unhealthy cultural pressures regarding weight and dieting.

It is important for parents and other role models to understand the power their comments have over their children. Inappropriate comments or name-calling can significantly impact a youngster in a negative way and help generate poor self-esteem. In particular, an unkind comment about a child's size or shape can set up negative feelings about their body that can last a lifetime. In the same way, parents' negative comments about their own or each other's size or shape also impacts children. Parents who are obsessed with size and shape create children with the same unhealthy concerns. Children are especially vulnerable to social pressures to conform. One survey of 7- to 12-year-olds found that 45% of them wanted to be thinner, and 37% had already tried to lose weight. The more desperate children become in their efforts to achieve the "perfect body," the more susceptible they are to distorted eating.

The best preventatives against the development of eating disorders are the same preventatives against many of the other pitfalls of childhood and adolescence. A strong self of self---self-worth, competence and reliance---insulates children and adolescents against harmful peer and cultural influences. Helping our children feel good about themselves--their minds and their bodies, as well as their abilities to positively affect their world--can help motivate them to maintain healthy behaviors throughout their life.