Eating Disorders and the Role of the Media

Abstract

Introduction

This paper provides a review of the role of the media in the development, maintenance, prevention, and treatment of eating disorders.

Method

The literature on gambling in youth on the internet was reviewed. It explores: (1) the role of the media in providing a social context for the development of eating disorders, (2) the role of the media in the etiology of eating disorder pathology, (3) the ways in which the media is used by patients suffering from eating disorders, and (4) the role that awareness of the media can have in the treatment and prevention of eating disorders.

Results

This review demonstrates that the media does contribute to the development of eating disorders.

Conclusion

This review highlights the need for media literacy and media activism to help change the current normative body discontent of women in the Western world.

INTRODUCTION

When one is treating patients who are afraid to eat and afraid of becoming overweight, it is difficult not to feel hostile towards the media, and to blame them for both causing and maintaining our patients’ eating disorders. But while we are all exposed to the mass media, we don’t all develop eating disorders. What role does the media actually play in eating disorders? There has been an enormous amount written on the topic, with increasingly sophisticated research into which individuals are most vulnerable to the media’s messages. The literature is best summarized by looking at 1) the role of the media in providing a social context within which eating disorders flourish, 2) the role of the media in the etiology of eating disorder symptoms, 3) the ways in which the media is used by patients to help maintain their illness and 4) the role that awareness of the media can play in the treatment and prevention of eating disorders.

1) The Role of the Media in Providing a Social Context for Eating Disorders

Early studies looking at the role of the media in eating disorders focused on the decreasing weight over time of the models, actresses and beauty pageant contestants who are held up as ideals of beauty. A number of studies have documented the trend of increasing thinness in Playboy centerfolds, Miss America Contestants, and fashion models between the 1950’s and the 1990’s (Garner, Garfinkel, Schwartz, & Thompson, 1980; Spitzer, Henderson, & Zivian, 1999; Wiseman, Gray, Mosimann, & Ahrens, 1992). During the same period there has been a significant increase in weight in American and Canadian women, thus creating an ever increasing discrepancy between the media ideal and the actual body size of North American women (Garner et al., 1980; Spitzer et al., 1999; Wiseman et al., 1992)

Magazine articles, television shows, and advertisements have also created a social context that may contribute to body dissatisfaction and disordered eating in girls and women. Wiseman and colleagues (1992) found a significant increase in advertisements for diet foods and diet products for the years 1973–1991. In comparing pressures on women and men, Anderson and DFomenico (1992) showed that women’s magazines contained 10.5 times as many diet promotions as men’s magazines. Overall, research has shown that as commercials for diet foods and diet products have increased, the body sizes of Playboy centerfolds, Miss America contestants, fashion models and female actresses have decreased, while the weight of the average North American woman has increased.

Not only do the media glorify a slender ideal, they also emphasize its importance, and the importance of appearances in general. Naomi Wolf argues that our culture disempowers women by holding them prisoner to an unattainable beauty ideal (Wolf, 1990). The multi-billion dollar beauty industry depends on a strong emphasis on the value of beauty and appearances for women, because this supports a consumption-based culture in which the answer for any problem can be achieved by purchasing advertised products for improving one’s appearance (Wolf 1990; Kilbourne 1994; Thomsen, McCoy, & Williams, 2001).

There is plenty of evidence demonstrating that the media glorify slenderness and weight loss and emphasize the importance of beauty and appearances. But what evidence is there that women are buying it?

Surveys suggest that 83% of adolescent girls read fashion magazines for an average of 4.3 hours per week (Levine & Smolak, 1996) and that “Seventeen” magazine has an estimated readership of 11,000,000 (Levine, Piran, & Stoddard, 1999). It appears that beauty and fashion magazines significantly impact the process of identity development in young women, especially with regards to gender-role learning, identity formation, and the development of values and beliefs (Arnett, 1995; Thomsen et al., 2001). In one survey, the number one wish of girls aged 11–17 who were given three magic wishes for anything they wanted was “to lose weight and keep it off”(Kilbourne, 1994). In another survey, middle-aged women were asked what they would most like to change about their lives, and more than half of them said “their weight” (Kilbourne, 1994). This pervasive body dissatisfaction and preoccupation with weight has become part of the female experience in North America; so much so that “psychologists have coined the term ‘normative discontent’ to explain the idea that it is normal if you are a female to be unhappy with your weight” (Oliver-Pyatt, 2003).

2) The Role of the Media in the Etiology of Eating Disorders

The epidemic proportions of drive for thinness, body dissatisfaction, and unsafe weight control methods among women have led theorists to posit the existence of mechanisms that are capable of reaching a large number of women (Levine & Smolak, 1996). The media is one such mechanism that has an ever-increasing influence and reach on women across North America and the world.

A recent naturalistic experiment conducted in Fiji provides strong evidence to support the hypothesis that the media has a significant role in the development of body dissatisfaction and eating disorder symptomatology (Becker, Burwell, Herzog, Hamburg, & Gilman, 2002). Until recently, Fiji was a relatively media-naïve society with little Western mass-media influence. In this unique study, the eating attitudes and behaviors of Fijian adolescent girls were measured prior to the introduction of regional television and following prolonged exposure. The results indicate that following the television exposure, these adolescents exhibited a significant increase in disordered eating attitudes and behaviors.

A number of studies have examined the correlation between the use of mass media and body satisfaction, eating disorder symptomatology, and negative affect. The majority of the studies have demonstrated a direct relationship between media exposure and eating pathology, body dissatisfaction and negative affect (Stice, Schupak-Neuberg, Shaw, & Stein, 1994; Stice & Shaw, 1994; Utter, Neumark-Sztainer, Wall, & Story, 2003). However, the strength of the correlations have varied within and between studies and with type of media exposure (Tiggeman, 2003; Vaughan & Fouts, 2003).

Thus, in an effort to better understand the direct or causal relationship between media exposure and body dissatisfaction and disordered eating, a number of controlled experimental studies have been conducted. Researchers have experimentally examined the role of the media in causing eating disorders by exposing young women to images of slender models in fashion magazines, and measuring body satisfaction, drive for thinness, eating pathology, mood, and self-esteem before and immediately after exposure (Martin & Kennedy, 1993; Pinhas, Toner, Ali, Garfinkel, & Stuckless, 1999; Stice & Shaw, 1994). The results for these controlled experimental studies have been mixed with some studies demonstrating that females exposed to thin media images experience an increase in body dissatisfaction and emotional distress (Pinhas et al., 1999; Stice & Shaw, 1994) and others finding no immediate effect (Champion & Furnham, 1999; Martin & Kennedy, 1993).

These mixed results from the controlled experimental studies led Groesz and colleagues (2002) to conduct a meta-analysis of 25 controlled experiments that evaluated the immediate effects of images of the “thin-ideal”. The meta-analytic results demonstrated that body satisfaction for females is significantly lower after viewing thin media images than after viewing control images. The omnibus effect size from this meta-analytic review supports the sociocultural theory that the mass media creates and promotes a standard of beauty that leads many adolescent and adult females to experience significant body dissatisfaction (Groesz, Levine, & Murnen, 2002). It also supports the theory that the mass media promotes and maintains the “normative discontent” that females experience about their bodies.

Perceived pressure to be thin from the media is theorized to lead to body dissatisfaction and eating pathology. Prospective research studies suggest that perceived pressure to be thin is a causal risk factor for body dissatisfaction, negative affect, and eating pathology (Ricciardelli, McCabe, Holt, & Finemore, 2003; Stice, 2002). A recent study even demonstrated that the media may have an indirect effect on females’ body image through its influence on boys’ expectations of females’ appearance (Hargreaves & Tiggemann, 2003).

The evidence that exposure to slender media images of women and perceived pressure from the media to be thin negatively affects female body image and emotional well-being, has led researchers to evaluate factors that may lead some girls and women to be more vulnerable to the messages and images portrayed in the media. The current evidence suggests that the negative effects of the media are more pronounced for individuals who are already at-risk or vulnerable (Stice, 2002). The meta-analytic review by Groesz et al. (2002) indicated that females who have already internalized the thin beauty ideal and/or who already have high levels of body dissatisfaction are most vulnerable. A meta-analytic review by Stice (2002) further indicated that adolescent girls with initial deficits in social support and elevations in perceived pressure to be thin are also more vulnerable to the effects of the media messages. Recent research has also demonstrated that social comparison mediates the relationship between media exposure and body dissatisfaction and eating pathology (Durkin & Paxton, 2002; van den Berg, Thompson, Obremski-Brandon, & Coovert, 2002). Thus the impact of the media is mediated by individual characteristics of the girls and women exposed to it.

The research on the impact of the media on body dissatisfaction, eating pathology, and negative affect indicates that the media is a causal risk factor for the development of eating disorders and negative affect (Groesz et al., 2002; Stice, 2002). Controlled experimental studies, prospective studies on perceived pressure, and naturalistic studies support the theory that media messages directly contribute to the extensive body discontent experienced by girls and women today in Western society.

3) The Role of the Media in the Maintenance of Eating Disorders

Just as young women with weight and shape preoccupation, body dissatisfaction, internalization of the thin ideal, and tendency for social comparison are most influenced by the media, so are they also more likely to use the media. Women with anorexia nervosa engage in heavy media use and describe their consumption of fashion magazines as an “addiction,” with many saying that their greatest media dependency occurred after their eating disorders had begun to take control of their lives (Thomsen et al., 2001). Qualitative results supported this suggestion by demonstrating that the relationships were consistent with an interactive, circular model as used to explain other compulsive and addictive processes (Williams, Thomsen, & McCoy, 2003). Beauty magazines become ‘how-to’ manuals to help women suffering from eating disorders in their attempts to obtain an elusive and impossible standard of physical thinness (Thomsen et al., 2001). Fashion magazines support the anorexic desire to restrict, and counterbalance dissonance-creating comments from friends and family (who tell them they are too thin) by promoting and endorsing messages that encourage thinness and dieting (Thomsen et al., 2001).

4) The Role of the Media in the Treatment and Prevention of Eating Disorders

Much of the literature on the role of the media in the treatment and prevention of eating disorders has focused on media literacy, activism, and advocacy (Levine et al., 1999; Levine, Smolak, & Schermer, 1996; Posovac, Posovac, & Weigel, 2001; Steiner-Adair & Vorenberg, 1999). Media literacy training involves teaching people to think critically about different forms of the media, increasing awareness of media use, and analyzing the content and intentions of the media producers. Through media literacy, adolescent girls learn how to decode and discuss the visual images and the messages in the media; they learn that all media images are constructed, that what they see is not necessarily reality, and that all media creations represent a point of view (Steiner-Adair & Vorenberg, 1999). Media literacy usually emphasizes that all forms of media are created through very deliberate, well-researched processes that are primarily profit-driven (Groesz et al., 2002; Posovac et al., 2001; Steiner-Adair & Vorenberg, 1999).

There has been some limited success in using media literacy to improve the self-esteem and body image of young women (Irving, DuPen, & Berel, 1998; Levine et al., 1999; Levine et al., 1996; Posovac et al., 2001). College women with negative body image who were exposed to a seven-minute psychoeducation presentation involving media analysis were less likely to engage in social comparison and less likely to be negatively affected by images of slender models than students exposed to the same images without the media literacy component (Posovac et al., 2001). Others have found it effective to provide girls with a new framework for interpreting the media images and messages (Martin & Gentry, 1997). Three prevention programs for adolescent girls that incorporated media literacy demonstrated modest results (Irving et al., 1998; Levine et al., 1999; Levine et al., 1996). These programs were able to effect some improvement in knowledge, internalization of the thin-ideal, and body image, but they did not consistently meet all of their goals. It is possible that these programs may still provide unexpected protection with longer term follow-up.

Researchers have also focused on ways to combat the risk factors that make certain individuals more vulnerable to the media’s negative effects. It has been suggested that treatment programs for eating disorders will be most effective when they incorporate media literacy with strategies to help address the patient’s deficits in self-esteem and social skills (Groesz et al., 2002; Murray, Touyz, & Beumont, 1996; Thomsen et al., 2001).

CONCLUSION

In conclusion, the mass media surrounds us with images of the “thin ideal” for females, an ideal that has become increasingly thin since the 1950’s and thus increasingly unrealistic for most girls and women. The messages and images that focus on the value of appearances and thinness for females have a significant negative impact on body satisfaction, weight preoccupation, eating patterns, and the emotional well-being of women in western culture. Research has demonstrated that the media contributes to the development and maintenance of eating disorders. Prevention and treatment of eating disorders should therefore include media literacy, activism, and advocacy. Given the prevalence of body dissatisfaction and disordered eating in females in our society, and the associations which have been found between eating disorders and the media, it would be prudent for professionals and the public to advocate for more positive and self-esteem building messages to be conveyed to females by the media. Future research should focus on ways to counter-act the effects of the media, in order to improve body satisfaction and self-esteem for girls and women in western culture.