February 11, 1999
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Creating A Curriculum To Help Girls Battle Eating Disorders

Harvard Eating Disorder Center strives to raise awareness of 'weightism' in our culture

By Sally Anne Giedrys

Special to the Gazette


Lisa Sjostrom (left) and Catherine Steiner-Adair of the Harvard Eating Disorders Center, located in Boston's Back Bay. Photo by Kris Snibbe.

"Full of Ourselves: Advancing Girl Power, Health and Leadership" is not your typical health curriculum. In fact, the curriculum, which is being piloted in 33 public and private schools in Massachusetts, Maine, Connecticut, New Hampshire, and Oklahoma, doesn't even mention what it aims to prevent -- eating disorders.

"Research shows that teaching about eating disorders can often backfire," said Catherine Steiner-Adair, who conceived the project and who is director of education, prevention, and outreach at the Harvard Eating Disorders Center (a division of Harvard Medical School). "It doesn't necessarily work, and it risks spreading the behaviors."

What she hopes will work is a concerted effort to sustain girls in their health as they approach the minefield of adolescence. Along with the basics of healthy nutrition and exercise, "Full of Ourselves" teaches seventh-grade girls to be media-savvy consumers and careful observers of the world around them -- and to speak up when they don't like what they see. Lessons are devised to raise girls' awareness of "weightism" as a social justice issue, and provide them with tools they can use to feel confident in handling the inevitable stress of growing up.

"There was a call for it, especially from health teachers, but also counselors," said Steiner-Adair. She and Project Director Lisa Sjostrom hope to see the curriculum become standard in schools across the country. What concerns both women -- and many counselors and classroom teachers -- is the time and energy that girls spend worrying about their looks, time that could be filled with academics, sports, hobbies, and other activities that develop girls' strengths.

"In their answers to the question, 'Girls my age worry most about . . .', girls were consistent across the board from New Hampshire to Oklahoma: Boys, weight, looks, and popularity," Sjostrom noted.

Steiner-Adair added, "They have the misguided notion that this [focus] will lead to success." When something is troubling them, she explained, they go on diets, say they are too fat, base their self-worth on externals. "Thinking like this leads to disordered eating and, in some cases, to a full-blown eating disorder. High- achieving, wonderful young girls are being stricken."

The project draws heavily on Steiner-Adair's work with Carol Gilligan on the Harvard Project on the Psychology of Women and Girls' Development from 1977 to 1983, when she was working on her master's and doctorate at the Graduate School of Education. Gilligan is the Patricia Albjerg Graham Professor of Gender Studies at Graduate School of Education. The project also proceeds from Steiner-Adair's own research and clinical experience with the psychological development of girls and the connections between gender equity issues and eating disorders. She has worked as a school psychologist and counselor at the Dana Hall School for Girls in Wellesley and Phillips Academy in Andover, and is currently a clinical psychologist in private practice in Lexington and a frequent consultant to school districts nationwide.

To write the curriculum, Steiner-Adair sought out Sjostrom, an educator and the co-author of Bullyproof, an elementary-level anti- violence curriculum, and Flirting or Hurting, a sexual harassment awareness curriculum for high schools, both projects of the Wellesley College Center for Research on Women. A lead writer for the Ms. Foundation's Take Our Daughters to Work Day initiative, Sjostrom taught English to middle and high school students before receiving her master's from the Graduate School of Education. She has recently completed a novel -- for preteen girls -- about a trio of girls who exemplify the leadership and self-confidence she'd like to see in all girls.

"Full of Ourselves" was field-tested last year in 15 Boston-area schools, with positive results. Public libraries, the Girl Scouts, Girls Inc., and the Unitarian Universalist Society have all expressed interest in using the curriculum. Last month, in schools across five states, small groups of 10 to 15 girls and two adult leaders began the series of 10 sessions, including "Dieting Dilemma," "Claiming Our Strengths," and "The Power of Positive Action."

Before leading sessions with girls, women leaders are asked to take a look at their own weight and body image issues. After an initial training, they communicate with one another through an Internet bulletin board, talking about the lessons and their own experiences. Parents, too, are asked to examine their experiences through questions and exercises in an accompanying parents' guide.

The girls are first asked to define what it means to be "full of ourselves," and often the answers are negative. In fact, some sites have balked at the name and have been allowed to change it, but Sjostrom points out it was chosen intentionally.

"We let girls know they can redefine this phrase for themselves," she said, reading from the leaders' guide. "A girl who is 'full of herself' might say: I know who I am. I know that I matter. I speak my mind. I make choices that are good for me."

Girls examine the ideal of thinness and the treatment of those who don't meet it. Before reaching for a snack, they learn to ask what they hunger for: Is their hunger physiological, or is it intellectual, creative, emotional? They also identify their own strengths and create a Tree of Strength, on which each leaf represents a woman they consider strong, from Hillary Rodham Clinton to "my mother, because she is amazing."

"We're not out to bash models or fashion magazines; we're telling girls: be discriminating," Sjostrom said. "We're saying you can take what is useful and leave the rest. Girls know how cruel it can be to judge someone by the color of their body. When we ask them if judging someone solely on the size or shape of their body is okay, they start to say, 'Wait a minute, that isn't fair.' "

The girls will be trained to serve as peer counselors to fourth- graders, devising their own lessons from a "Throw Your Weight Around" guide of possible activities. The aim is to create a mentoring cycle in which seventh-grade girls are training fourth- graders who are, in turn, anticipating their role as trainers.

In fourth grade, girls are already putting themselves on diets and equating feelings of insecurity with being too fat, Steiner-Adair said. Research suggests that 31 percent of 10-year-old girls are afraid of being fat, just at the moment when menarche requires weight gain. Researchers have also found that younger girls are more apt to listen to young teens, whom they admire, than adult authority figures, she said.

Although the pilot began in New England, 1,500 girls in public and private parochial schools in Tulsa, Okla., were added after the Junior League approached the Center, offering to co-lead sessions with Tulsa teachers and counselors. The addition of an Oklahoma city city also allows program developers to obtain feedback from a more politically conservative area.

"In some places, the program faces initial resistance," Sjostrom said. "And we welcome that kind of critical feedback. We need to know what adjustments need to be made to make this work in every community."

On site visits, Sjostrom's classroom experience is an asset, allowing her to see what is not working and to troubleshoot. So far, what she has seen bodes well for a national distribution.

"What I am seeing is a lot of enthusiasm from girls and leaders. I am hearing how important it is for girls to have their own space where they can talk with women and other girls about these issues," she said. "There is also a lot of relief from counselors, who have long been struggling with girls' disordered thinking and behaviors about body image, weight, and diet."

An extensive program evaluation will be completed over the summer by evaluator Seeta Pai, followed by final revisions to the three guides and any supporting materials. The curriculum is expected to be available in December 1999. Now that "Full of Ourselves" for girls is being tested, the educators plan to begin work on a parallel curriculum for boys.

Forum, Conference on Eating Disorders Scheduled

The Harvard Eating Disorders Center will hold a public forum titled "Culture, Media, and Eating Disorders" at the Graduate School of Education on Tuesday, Feb. 23, at 7 p.m. The Center will also hold a National Conference on Eating Disorder Prevention for K-12 educators at Brandeis University on Saturday, March 27. For information about either event, call (617) 236-7766.

 


Copyright 1999 President and Fellows of Harvard College