The prevention of eating disorders is fraught with difficulty, risky and has not been very 
successful. This has led many to question whether prevention should even be attempted. But can we afford to wait until all the answers are in? Not if we recognize that eating disorders occur on a continuum, treatment of established cases is not an effective control mechanism, and the clinical and subclinical incidence of eating disorders is high. A study of university students showed that none of those who met the criteria for eating disorders ever tried to get help, and women between the ages of 18 and 21, who had signs of bulimia but did not fulfil the diagnostic criteria, showed higher psychological distress. We cannot afford to wait, but we must tackle prevention with full awareness of the challenges involved.
Fighting the Thinness Model
Our culture sanctions the particular behaviours associated with eating disorders – restraint, dieting and even limited purging – giving a strong message that is difficult to counteract. Our culture also sanctions attitudes that contribute to eating disorders; for example, the emphasis on thinness instead of health. This could be destructive for a growing youth. There is also an intolerance of such changes in women’s bodies as water retention associated with menstruation or those that occur during pregnancy. Within this context, how do we expect the adolescent to accept the tremendous changes associated with puberty?
Building Self-Esteem in Girls
Eating disorders have been related to low self-esteem. How do adolescent girls deal with the lower status of women in our society, or perhaps seeing what little power their mothers may have in relationships? Research at the Stone Centre in Boston looking at women’s development shows that 11- and 12-year-old girls suppress aspects of their selves, and generally are more confused about who they are, their attitudes, values and opinions, and have low self-esteem.