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Visions Journal

A reminder that this article from our magazine Visions was published more than 1 year ago. It is here for reference only. Some information in it may no longer be current. It also represents the point of the view of the author only. See the author box at the bottom of the article for more about the contributor.

Healthy Attitudes

Youth body image and self-esteem prevention program

Sarah Thorsteinson, RN, BN

Reprinted from "First Responders" issue of Visions Journal, 2006, 3 (2), pp. 32, 34

Early intervention of disordered eating behaviours during the teen years is crucial. Eating disorders are associated with serious health risks, including death and impaired psychosocial adjustment.1 And young people who diet are seven times more likely to develop an eating disorder.2

The Healthy Attitudes Program (HAP) is a free, community-based eating disorder prevention program serving Vancouver and Richmond. The program is staffed by a team made up of a community health nurse, physician, dietitian and clinical counsellor.

KC’s story

KC’s story is typical of client participation in the program. KC, a 15-year-old 10th grade student, was referred to HAP by her school counsellor. Her friends had talked to the counsellor after noticing that KC was losing weight and not eating lunch with them any more. KC admitted to always being on a diet and expressed a desire to be thinner, even though her weight was within the healthy range.

The counsellor suggested to KC that she call the HAP team to see if they could help with her concerns around how she viewed her body and how she felt about herself. KC’s friends felt like they had done the right thing by contacting the school counsellor to get help for her. They wanted KC to feel like her old self again and were willing to support her in any way they could.

After some convincing from the school counsellor, KC called HAP and spoke to the intake nurse. After asking KC a few questions about her eating habits and how she felt about herself, the nurse set up an appointment for a face-to-face visit to fully assess KC’s situation.

In the one-hour face-to-face intake interview, the nurse and KC discussed KC’s recent weight loss and her body image.

KC’s weight was still in the healthy range, but she had lost weight on a low-carb diet. She was now counting calories to limit the amount she ate and was avoiding certain foods that were higher in fat and carbohydrates. She was also exercising more.

Most of KC’s thoughts were about food and she felt guilty about eating. KC wasn’t happy with her current weight and wanted to be lighter. She found it hard to relate to her friends, because they seemed to be able to eat chips and pop and chocolate bars without worrying about the consequences. As a result, she spent less time with her old friends.

KC was starting to spend more time with her new boyfriend and his friends. She really wanted to fit in with his more popular group of friends—and she thought the best way to fit in was to be thin.

The intake nurse listened to KC’s story and recommended that she be included in the program. The nurse explained to KC that she would see the doctor from the HAP team for a thorough medical exam. KC was also asked to inform her family doctor that she was participating in HAP.

KC’s next appointment was with the HAP counsellor. The counsellor was concerned that KC showed signs of anxiety and depression along with an unhealthy body image and a desire to be thin. The counsellor offered to see KC for help with these issues once a week. KC agreed to attend, and wanted to see the HAP dietitian for help with healthy meal planning.

After three months of regular attendance at HAP, KC decided she was feeling well enough to stop coming to the program for awhile. She was following her healthy eating plan and was feeling good about her body shape for the first time in years. She was still in the healthy weight range. KC was seeing more of her old friends who had helped connect her to the Healthy Attitudes Program. She realized that her friends truly cared about her, and that was why they had reached out to get her help. KC was grateful that the school counsellor was able to connect her with HAP and that her friends were so supportive.

KC was sure that her problems would’ve become a lot worse if she hadn’t connected with HAP. The team congratulated her on her progress and invited her to return to the program at any time.

About the author
Sarah is a community health nurse and member of the Healthy Attitudes Program team, which serves Vancouver and Richmond youth ages 12 to 24.
  1. 1. Herzog, D.B., Greenwood, D.N., Dorer, D.J. et al. (2000). Mortality in eating disorders: A descriptive study. International Journal of Eating Disorders, 28(1), 20-26.

  2. 2. Patton, G.C., Selzer, R., Coffey, C. et al. (1999). Onset of adolescent eating disorders: Population based cohort study over 3 years. British Medical Journal, 318(7186), 765-768.


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