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Dr. Juleen Buser’s first experience working with people who have eating disorders came before she was even considering a career in counseling. At the time, she was a student at the Princeton Theological Seminary, and as part of her clinical pastoral education, she spent a summer working in a local hospital’s eating disorder unit, offering spiritual guidance to patients.

“I saw up close the struggles these patients endured,” she recalls. “That experience actually propelled me to go into the counseling field, because I wanted to help people, and I felt I needed more mental health training to be able to do so.”

She went on to earn a doctorate in counselor education and supervision, and today is an assistant professor in ������ý����’s Department of Graduate Education, Leadership, and Counseling, where much of her research has been focused in the areas of body dissatisfaction and eating disorders.

“Body dissatisfaction is a very well-established, well-known risk factor for the development of eating disorders,” she explains. “It’s been proven that individuals who don’t like the way they look are much more likely to develop an eating disorder than people who are pretty satisfied with how they look. But not everyone who is dissatisfied with their body also develops an eating disorder. My research has delved into what factors may protect individuals who are unhappy with the way they look but are not engaging in destructive eating practices.”

In one qualitative study, Buser and co-authors Rachael A. Parkins and Victoria Salazar interviewed seven college-aged women who said they were dissatisfied with their bodies but did not engage in any kind of disordered eating, either in the past or currently. Participants were questioned about what had helped them manage to avoid doing so. Through this study, Buser identified four factors that could protect body-dissatisfied women from engaging in eating disorder symptoms.

The first of those factors was valuing health. “They seemed to have a clear value system where they really wanted to take care of themselves, and they felt that engaging in dieting or over-exercising or self-induced vomiting was not healthy. This value system was very different from the value system of an eating disorder, which is basically destroying your body in many ways.”

A second factor was the belief that engaging in injurious behavior would not be effective in helping them achieve their desired goal of losing weight or looking differently. Participants talked about lessons learned from people they knew who had struggled with eating disorders in the past. One woman cited the example of a former teacher whose own eating disorder had “ruined her metabolism.” It helped her realize that disordered eating behaviors do not promote long-term weight loss, saying that, “starving yourself isn’t the way to do it because it can backfire in the end.”

Participants also talked about their love of food and the role it played in their lives. One woman discussed how she grew up in an Italian-Jewish family and eating was a big part of her family culture.

“There was this idea that they had a value system, too. They valued health, but they also seemed to value and enjoy a good meal, and they didn’t want to give that up," Buser says. "Obviously, engaging in eating disorder symptoms would go completely against that.”

The fourth factor was having a support system — people who either gave them compliments or positive affirmations about their appearance, or encouraged them not to engage in eating disorder symptoms. One woman talked about how, when she would complain about her body, her mother would tell her she was beautiful and that, “You don’t have to think like that. Eat what you want.”

As Buser summarizes, “Being very positive and supportive can have a really big impact on children who are getting all these other negative messages from friends or the media about how they should look.”

In a separate study, Buser and co-author Dr. Sandy Gibson surveyed 733 college women about their own body dissatisfaction. For this study, they also looked at the effects of a construct called “I” position, which Buser defines as having a very secure sense of self and not caving to the pressures and expectations of others. What the study found was that among individuals who reported high levels of body dissatisfaction, those who also had high levels of “I” position were less likely have an eating disorder such as anorexia or bulimia than those with low levels of “I” position.

“It makes sense if you think about the ways in which eating disorders often develop,” Buser says. “Society is constantly telling us, ‘You should look this way, you should be thin and beautiful…’ and so someone who has this internal value system that is different than that, this internal identity that is not so easily swayed, would be less susceptible to those messages.”

Looking ahead, Buser hopes to use the findings of her research to write a book offering practical advice for counselors as well as non-professionals on how to help protect people from eating disorders.

“I want to break down some of that technical research language and say, ‘so high ‘I’ position is a good thing, let’s talk about how you might foster that, either with a client or in our personal relationships. Or if the value of health is important, how do you instill that in people?' I think that would be a nice next step in looking at this," she says.

Buser's research interests are important to her not only because of her formative professional experiences but because of their prevalence in today’s culture.

“Just being a woman in American society, and being aware of all the pressures from the media, and having friends who have struggled with body image and disordered-eating issues…it’s important that we try to find ways to help people not struggle with those things,” she says.

Studies show that between 46 and 66 percent of adult women report weight dissatisfaction. Furthermore, 57 percent of college-aged women participated in restrictive or restrained eating. Twenty-seven percent of young adult female participants in a study claimed that they had dieted for weight loss in the last week, and in the last year, 32 percent of college women said that they took at least one diet aid; these diet aids included things like laxatives, diuretics and/or diet pills.

According to Buser, eating disorders pose many serious risks. In addition to the high mortality rates among patients with eating disorders, studies have found that they can cause additional health complications, including tooth and bone damage. There are also many psychological issues.

“I’ve seen the emotional distress that people with eating disorders struggle with in terms of depression and anxiety,” she says.  “It’s just a really damaging physical and psychological problem.”