Eating Disorders
6 Ways to Grow A Teen’s Self-Esteem

Many people young and old, male and female, struggle with recognizing their self-worth and their true potential in life. Often we are our worst critics. Most of us would gasp in horror if we heard another person speak out loud the thoughts we tell ourselves because it would be considered abusive!
Recently, as I was speaking to a group of young people and their parents on the topic of self-esteem, we broke down the definition of what self-esteem truly means. This is an interesting concept and I think helpful to break down into segments.
- To esteem something is to hold it in high regard, to treasure it, to value it.
- The self is you, the individual
How amazing it would be to think of your self in this manner. Is it possible to hold yourself in high regard, to value yourself, and to treasure it – i.e. to treasure you, the real you?
Combating Teen Body Trends: Julie Hanks on HuffPost Live
There’s a new body obsession among some teen girls called “the thigh gap.”
I was invited to participate on this HuffPost Live panel and discuss how we can to combat this dangerous trend.
Here’s the link to the Segment
Ask A Therapist: I Hate Myself And I Don’t Know Why
I hate myself and I don’t know why. How do I learn to love myself? Even though I believe I’m a daughter of God, I feel like believing and knowing is different than feeling. I don’t FEEL like that. I have urges to cut myself and sometimes give in, and I make myself throw up off and on. I hate being like this. I was sexually abused by a family friend for about six years. Even though he stopped when I got older, I never said anything to anyone. I feel like this might contribute to my feelings of hatred toward myself. Sometimes, I even think that my life has no purpose and that the world would be better off without me. I hate myself for doing things like spending money on a nice haircut. Every time I treat myself nice, even if it’s something like a bubble bath or chewing a stick of gum, I feel guilty. I treat other people well. I give people more energy than I have and it’s not fair to them or me. I know that if I treat myself better, I’ll have more energy to not only give to myself, but to others too. However, every time I try to do this, I end up cutting or throwing up because the urge to do so is overwhelming. How do I learn to treat myself well? What is your advice? Is there something I can do without therapy? I don’t have a lot of money and am out of a job.
A: Thank you for writing in and trusting me with your story. I want to suggest to you that you look into the mental health resources at your college and so you can start on a path to healing. Many schools offer free or reduced fee counseling for students. I want you to know that you are not alone. You are not crazy. You have suffered years of sexual abuse. I’ve worked with many young adults who’ve been sexually abused and who’ve expressed similar feelings of self-loathing, cutting, eating issues, and emptiness. Watch the video for more suggestions on how to start healing from your trauma.
Take good care of yourself,
5 Ways to Help a Loved One with an Eating Disorder
Do you suspect that one of your friends or family members is struggling with an eating disorder, but don’t know how to reach out to them? If so, my heart goes out to them and to you, because I understand that it is a heart wrenching experience. It is very difficult to watch someone you care about go through something so difficult, and it is even more frightening when you don’t know how to help them. Here are 5 suggestions that might help you approach the situation:
Recognize the Problem
It is helpful to recognize the signs of an eating disorder. The following are some of the things you may notice if your loved one is truly struggling with this issue:
Anorexia Nervosa
• Dramatic weight loss
• Wearing baggy, bulky clothes to hide weight loss
• Preoccupation with food, dieting, counting calories, etc.
• Refusing to eat, especially certain foods, such as carbs or fats
• Avoiding mealtimes or eating in front of others
• Preparing elaborate meals for others, but refusing to eat them
• Exercising excessively
• Poor self-image/Making comments about being “fat”
• Stopping menstruating
• Complaining about constipation or stomach pain
• Denying that extreme thinness is a problem
Bulimia Nervosa
• Evidence of binge eating, including disappearance of large amounts of food in a short time, or finding lots of empty food wrappers or containers
• Evidence of purging, including trips to the bathroom after meals, sounds or smells of vomiting, or packages of laxatives or diuretics
• Skipping meals or avoiding eating in front of others, or eating very small portions
• Exercising excessively
• Wearing baggy clothes
• Complaining about being “fat”
• Using gum, mouthwash, or mints excessively
• Constantly dieting
• Scarred knuckles from repeatedly inducing vomiting
Ask A Therapist: How Do I Open up Emotionally to my Therapist?
How do I open up to my therapist? I am constantly worried that he might think I’m trying to get attention. I have an eating disorder and I’m slightly overweight according to my BMI. I’ve overexercised, took laxatives, and most recently diet pills. I ended up giving my therapist one session because I was taking so many that it made me fell terrible. I’m just not able to be truly open and honest. He really is a great therapist, and I have a deeper connection with him than most others in my life. I have these feelings outside of therapy, but when I go in, I put on a face that everything is ok. How do I work on this to communicate better?
A: Great question! The emotional pattern of guarding your feelings is likely part of the reason you’re in therapy in the first place. Watch the video below for complete answer.
Take good care of yourself!
Julie Hanks, LCSW
80% Of Ten-Year-Olds Have Dieted: Holly Willard on ABC 4 News
Body-image issues are more widespread than ever and effecting children at a much younger age. 80-percent of American 10-year-old girls have been on a diet, according to a recent study from upworthy.com.
Ways to combat body obsession in young girls
1. Model a healthy body image
Be aware of your negative comments about your own body and the impact they could be making on your children. Acknowledge that your behavior and that you are working on focusing on the positive.
Ask A Therapist: Eating Disorder, Depression, Insomnia, & Cutting
Q: I have an eating disorder, depression, insomnia, and now I’ve started cutting. No one cares. My mom said things could be worse. My dad ignores it. My boyfriend says its in my mind and I can get over it on my own. I’ve started cutting and no one knows and it’s embarrassing. I need help. What should I do? (24 yr old female college student)
A: Click the arrow below to hear my response to your question…
Click here to find a therapist in your area
Take good care of yourself!
Ask A Therapist: I Deal With Abusive Boyfriend By Cutting And Binging
Q: Hi, I am 19 year old girl in my 2nd year of college. I currently live with my boyfriend of 4 years who is 25 years old. Our relationship used to be really good, but now all we do is argue. A few years ago I was flirting with other guys and he has never forgiven me for it. He constantly tells me he doesn’t trust me, and when he gets mad he tells me he hates me, that I should crawl in a hole in die, that he can’t stand to look at me, and many profanities. He spends no time with me so I spend the majority of time home all alone, which is the main issue because that gives me all the time alone I need to self-destruct.
I can’t stand myself, I hate everything about me. I’m fat and ugly, sometimes I don’t even know why I bother trying to make it through life nothing ever goes as planned. I feel like I am constantly starving myself or if not eating ridiculous amounts of food and then feeling guilty so that I either make myself puke or cut myself. I can’t control it, I feel like if I can
make myself attractive my boyfriend will love me again but I can’t even take care of myself. The worst was when he caught me binging and freaked out along the lines of “No wonder I’m always starving, you eat all the food. For once I wish you would save some for me instead of stuffing your face all the time.” And despite hearing that I still continue to stuff my face… I can’t help myself… maybe I deserve to be fat. I can’t even decide what is worse, the purging or the self-harm. Both cause me discomfort and to feel like a failure, but in the end neither make me prettier…they just make me uglier. This also causes me to spend way too much money on food…I am $20,000 in debt with my bank because of all the money I waste on food. I eat too much so now I cant even barely afford anything…which my boyfriend also blames me for…rightfully, it is my fault.
I just don’t know what to do. I have thought about trying to see a therapist regularly but I’m too embarrassed. I don’t want to make known just how disgusting I am. I don’t want anyone to know how much I eat. I don’t want anyone to know how my boyfriend treats me. I just want to be a normal person… I want to be happy, and loved…what do I have to do to be okay??
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A: Even though you’re embarrassed, please go see a therapist ASAP. Licensed therapists are trained to help individuals and couples in crisis resolve your problems and help you, not to judge you. Just by reading this letter I can sense the depth of your pain, I have empathy for you, and I want to help you. This is how your therapist will feel too when you meet with him or her face to face. If you’re not sure where to find a therapist in your area click the Find Help tab at the top of this page for a listing. There are likely earlier roots to your self-destructive eating patterns, cutting, and dysfunctional relationship that can be explored and healed in therapy and are beyond the scope of what I can offer here.
What you’re describing in relationship with your boyfriend is verbal and emotional abuse. No one deserves to be told by their lover “I hate you” or “You should just crawl in a hole and die.” That is heartbreaking to hear and needs to stop if you are ever going to gain self-esteem and confidence to change your life. Your therapist can help you to build relationships skills and to help you come up with a plan to stand up for yourself when your boyfriend becomes verbally abusive.
In addition to meeting with a therapist regularly, I suggest you start seeking out books, blogs, and other resources and start arming yourself with more knowledge and tools to help you feel stronger and more competent. Here are some excellent resources right here at Psych Central to help you get started:
Weightless Blog
Eating Disorder & Binge Eating Info
Self-injury Forum
Relationship & Communication Forum
Eating Disorder Community Forum
Take good care of yourself!
Ask A Therapist: How Do I Know If I Still Need Therapy?
Q: I am a married woman of 24 years with 3 grown children. I have had a pretty rough past and struggled with mental illness most of my life. I grew up in a very dysfunctional violent family with an alcoholic parent. I was abused and neglected. I attempted suicide at the age of 17. Through the years I buried my past and attempted to live a normal life. I did not have an identity, I did what everyone wanted of me, and even believed the beliefs of the people around me. I was an empty shell being filled up by other people. I had another breakdown in 1999 and attempted suicide again. That is when I began therapy. It took me a realy long time to open up to my therapist. It seemed I got much worse before I got better. I began cutting and binge eating became a huge problem. I had always coped with food but now it brought my weight up to 322lbs.
As the years went by, and with medication I began to slowly deal with issues and start to rise out of my depression. I trusted my therapist and told her things I would never tell another soul. I was getting better and I decided to improve my life. I had gastric bypass to lose weight and in the past year I have lost over 120lbs. I was using good coping skills and having more rational thoughts. Unfortunately my bones suffered from the weight and degenerative bone desease. This past October I had a total hip replacement and this past February I had a total knee replacement. It has not been 2 months yet and it has been a slow painful recovery.
My therapist retired this past December. I do not have a regular one yet, although I did meet with one just one time to feel it out. I am unsure if I need to stay in therapy. I have been in it for a very long time and although I am better than ever before, I still have depression and dysfunctional thoughts. I am still on medication, Wellbutrin, Lexapro and Neurontin for mood disorder. I have been labeled as PTSD and BPD. I am starting to binge eat again and I am afraid the gastric bypass will be worthless to me someday. I do not want to gain all that weight back as I could hardly move then. I feel very sad that my therapist retired and I feel pretty lost right now. Is it normal to be in a therapy program for as long as I have been? Do some people stay in therapy all of their life? I feel that I will never get out of this dysfunctional rut. Is there hope for me? I am very tired and very afraid to live this way. I just want relief and to feel a bit of satisfaction in how I live. I appreciated any input.
Thank you![]()
A: What a brave women you are to have faced your past trauma and to have actively sought treatment to move toward a healthier and happier life. I can’t imagine how difficult it must be to have your therapist retire after working so hard to develop enough trust to open up and share things you’ve never shared with anyone else. It is very normal to feel lost, sad, and to grieve the loss of this therapeutic relationship, just as you would if you said goodbye to a close friend or family member. I imagine that finding a new therapist and developing that trust again is a scary thing to consider, but a necessary one.
Some health problems, like diabetes, are chronic and require lifelong attention, management, and treatment, while others are acute, like strep throat, and generally require one course of antibiotics. Mental illness can be conceptualized in a similar way. Your mental health history, your history of abuse and neglect, and your psychological symptoms seem to fall in the chronic category. It is common for individuals with severe childhood abuse and neglect to be in treatment on and off throughout life to help manage the emotional and psychological consequences of the early experiences.
Your continued struggles with dysfunctional thoughts, depressive symptoms, and binge eating suggest that you need to get back into therapy to maintain the progress you’ve made and to continue to develop coping skills and insight. You may in be in treatment throughout the rest of your life. If that’s what you need to continue to move forward, to manage your symptoms, and continue to create the life you want, then that is nothing to be ashamed of. You deserve to have nurturing and support.
Take good care of yourself!

make myself attractive my boyfriend will love me again but I can’t even take care of myself. The worst was when he caught me binging and freaked out along the lines of “No wonder I’m always starving, you eat all the food. For once I wish you would save some for me instead of stuffing your face all the time.” And despite hearing that I still continue to stuff my face… I can’t help myself… maybe I deserve to be fat. I can’t even decide what is worse, the purging or the self-harm. Both cause me discomfort and to feel like a failure, but in the end neither make me prettier…they just make me uglier. This also causes me to spend way too much money on food…I am $20,000 in debt with my bank because of all the money I waste on food. I eat too much so now I cant even barely afford anything…which my boyfriend also blames me for…rightfully, it is my fault.