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NEDA TOOLKIT for Coaches and Trainers • Eating disorder behavior presents differently in males. Although the emotional and physical consequences of eating disorders are similar for both sexes, males are more likely to focus on muscle gain, while females are more likely to focus on weight loss. Can’t people who have anorexia see that they are too thin? Most cannot. Body image disturbance can take the form of viewing the body as unrealistically large (body image distortion) or of evaluating one’s physical appearance negatively (body image dissatisfaction). People with anorexia often focus on body areas where being slim is more difficult (e.g., waist, hips, thighs). They then believe they have “proof ” of their perceived need to strive for further weight loss. Body image dissatisfaction is often related to an underlying faulty assumption that weight, shape, and thinness are the primary sources of self-worth and value. Adolescents with negative body image concerns may be more likely than others to be depressed, anxious, and suicidal. I know someone who won’t eat meals with family or with friends. How can he/she not be hungry? Does he/she just not like food? Most likely, the person is overwhelmingly preoccupied with food. A person with an eating disorder does not like to eat with others, does not like anyone questioning his/her food choices, and is totally consumed with refraining from eating. Is the person hungry? Yes! But the eating disorder controls the person. Page  | 10