Frances F. Conte
In preparing student activities for this curriculum unit it seemed appropriate to include the various aspects of this complex syndrome. To this end, I have associated each activity with a particular component or facet of Anorexia Nervosa and Bulimia. There are five Lesson Plans which can be used over a period of 1-2 weeks depending on the grade level and subject area in which this unit will be used.
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1. Lesson Plan I (The Survey) is designed to acquaint students with certain facts and manifestations of anorexia and bulimia.
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2. Lesson Plan II (Case Studies) presents vignettes and study questions relating to the precipitating factors of these disorders.
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3. Lesson Plan III (The Food Diary) enables students to become aware of the relationship between food and feelings.
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4. Lesson Plan IV (The Journal) identifies the patterns of family and social interaction which may lead to conflict and powerlessness which are major underlying factors of eating disorders.
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5. Lesson Plan V (The Media Survey) will help students to become more aware of the cultural influences on self-image as expressed through television, magazines and newspapers.
Lesson Plan I.
True or False Survey
Objectives
Students will be able to learn the facts about eating disorders.
Strategy
This survey may be given before the unit on eating disorders to determine what students may already know. It may also be used as a post test to assess how well they have understood the ideas presented.
Students may indicate a True or False response.
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1. Anorexia Nervosa (self-starvation) occurs most frequently in adolescent girls between 10-15 years old.
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2. The cultural message that “you can’t be too thin” is communicated to impressionable youngsters through the media, family and friends.
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3. Bulimics have a morbid fear of gaining weight; have episodes of binge eating, followed by purging through self-induced vomiting, or laxative abuse.
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4. The incidence of anorexia and bulimia has increased during the last 10 years.
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5. Bulimia is a secret addiction often undetected because bulimics usually are within 5% of their normal weight.
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6. Anorectics engage in strenuous exercises after every meager meal to burn up the calories they have eaten.
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7. Anorexia often begins innocently with a young person’s decision to diet.
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8. Eating disorders affect more women than men.
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9. Prolonged self starvation can lead to the loss of muscle tissue, cardiac arrest and/or brain damage.
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10. The binge/purge cycle can upset the body’s fluid balance.
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11. Anorectics are pleasers who use starvation to gain control of their lives.
*The responses are all true.
Lesson Plan II.
Case Studies
.
Objectives
These vignettes and the accompanying study questions will enable students to identify some of the causal factors and conflicts which are precursors to anorexia and bulimia.
Strategy
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1. Have students read each case study and respond to the study questions.
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2. Ask students to share their responses with the class.
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3. Encourage students to comment on their own experiences with dieting or conflicts.
Case Study—Irene (adapted from
The Golden Cage
by Hilde Bruch)
As a child Irene had not been preoccupied with her weight. When she was 11 years old several girls in her class talked about dieting and she found this peculiar because they looked all right to her; she felt lucky to like her own figure. However, a year later when she showed early pubertal development, her pediatrician made some casual remark about her getting too plump. This triggered a concern about growing up, dating and believing that her mother might become overly interested in her life. Irene suddenly began a rigorous weight-watching program, not permitting her weight to rise above 95 lbs. Though she kept on growing, she did not menstruate. She began to avoid people and stayed to herself. At age 15 her parents separated. At that time she began to starve herself and lost a dramatic amount of weight, striving to be as thin as possible and hating herself for gaining even an ounce.
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1. What prompted Irene to begin dieting?
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2. What effect on her healthy development did this loss of weight produce?
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3. Why do you think Irene turned to dieting again at age 15?
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4. What other aspects of her development was Irene avoiding?
Case Study—Sheila (Adapted from
The Art of Starvation
, by Sheila MacLeod)
At 14, Sheila attended an upper class boarding school on a government scholarship. Living away from home she felt out of place in the family and a misfit in school. She felt worthless, hopeless and empty.
At this point Sheila decided to go on a diet so as not to look “dumpy and ordinary.” Immediately, as the weight dropped off she began to feel exhilarated and more in control of those feelings of helplessness and self-loathing. She eventually lost so much weight that when she returned home she was mistaken for a young boy.
Sheila was the eldest of three daughters. Her father was a school teacher; her mother had never reconciled her homesickness for the country. Sheila was bright and gifted. The family was extremely mannerly. Anger was not openly expressed, and conflicts were avoided. Sheila got the message that in going away to school she was expected to succeed—to become extraordinary—to make the family happy.
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1. What demands did Sheila perceive her family placed on her?
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2. What provoked Sheila’s decision to diet?
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3. What did Sheila gain from refusing food?
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4. What conflicts was Sheila experiencing?
Case Study—Cherry (Adapted from
Starving
for
Attention
, by Cherry Boone O’Neill)
At 16, Cherry, the eldest of four daughters, was slightly overweight at 140 lbs. Wanting to be a good role model for her younger sisters and anxious to please her parents, she began dieting. Cherry stole her mother’s diet pills to keep her appetite in check and exercised six hours a day. Eventually she got down to 90 lbs. She wore extra layers of clothing to hide her protruding bones. Her eating habits grew more bizarre. She began binge eating, followed by ingesting massive doses of laxatives. After a grim struggle over a period of 10 years, Cherry finally stabilized her life with psychiatric help and support from her husband and family. She now weighs 114 lbs. Cherry says, “I want my daughter to feel good about herself as she gets older because of who she is and not how she looks.”
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1. In trying to please her parents what was Cherry saying about her self image?
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2. What message did Cherry’s mother communicate in using diet pills herself?
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3. What do you think Cherry’s message to her daughter means?
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4. What do you think the title of her book,
Starving For Attention
, means?
Lesson Plan III.
Food Diary
Objectives
People need food in order to live. Food is a life-giving source and not something to be avoided or misused.
Strategies
Ask students to keep a record of their food intake for one week. (a sample food diary is provided) After completing the food diary students will be asked to share their eating patterns with the class.
Additional questions may prompt further discussion from students.
(Sample Food Diary):
Day & Time
/
What I Ate
/
Feelings Before and After Eating
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1. What did you learn about when, what and why you eat?
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2. Do you sometimes eat when you’re not hungry? What happened to make you think of eating?
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3. Do you ever each so much your stomach hurts?
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4. Do you eat junk food? Do you feel guilty and hate yourself when you do?
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5. Do you go without solid food for 24 hours or more? Why?
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6. Do you ever eat because you are lonely, upset or anxious?
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7. What do you think you learned about the relationship between food and feelings?
Lesson Plan IV.
Journal
Objectives
To help students identify personal and family interactions that may lead to conflicts?
Materials
Sample questions, folders, pencils, paper.
Strategies
Have students make entries in response to the questions found in their journal folders. Allow students to add or substitute comments or concerns.
Encourage students to talk about these issues in class, but respect the fact that some students may choose not to share comments.
(Sample Questions):
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1. What is the general emotional mood of your family?
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2. What are the rules in your family? Who sets up the rules? How are they carried out?
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3. How are decisions made in your family?
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4. What are the sources of trouble in your home?
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5. How is conflict handled in your family? Anger?
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6. How is affection expressed in your family?
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7. Who has the power in your family? How is it used?
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8. Who are you most like in your family?
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9. How are you different from others in your family?
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10. Who has influenced you most in your family?
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11. Name five things your parent(s) expect of you?
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12. How well do you think you are fulfilling these expectations?
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13. How often do you feel that too much is expected of you? If so, what do you do about it?
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14. How accurately does the following statement describe your own attitude:
I hate my life. It’s all messed up. I wish I could start over again and do everything right.
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Your teacher may ask you to share some of the feelings expressed in your journal. Sharing with others may help you see that you have many things in common.
Lesson Plan V. Media Survey
Objectives
To enable students to become aware of the role the media and advertising industry play in exploiting cultural trends.
Strategies
In preparation for class discussion on the influence of the media and the advertising industry, students will be asked to collect pictures from magazines and newspapers that advertise, glorify or exploit dieting, body image, and/or thinness.
Students will compile a list of television commercials and shows which promote external appearance, slimness and an “ideal body.”
The pictures may then be used for a class mural or collage.
