The Media & Eating Disorders

By Deanne Jade, National Centre For Eating Disorders. Acknowledgement: The British Medical Association, Eating Disorders Body Image and The Media

The media are held responsible for the supposed growth of eating disorders in the country. To what extent is this true? In this short article I would like to separate myth from fact, and to provide the reader with some articles that might help them decide which is cause and which is effect.

What Is The Media?The Media and Eating Disorders

The media is an important aspect of life in our culture. About 95% of people own a TV set and watch for an average of 3-4 hours per day. By the end of the last century over 60% of men and 50% of women read a newspaper each day and nearly half of all girls, from the age of 7 read a girls magazine each week. In addition, people interact with a wide variety of other media such as music delivered by cd’s or videos, and communications via personal computers.

Each form of medium has a different purpose and content. The media seek to inform us, persuade us, entertain us, and change us. The media also seeks to engage large groups of people so that advertisers can sell them products or services by making them desirable. Other institutions such as Governments also engage the public via the media to make ideas and values desirable. Institutions from politics to corporations can use the media to influence our behaviour. We can trace our involvement with the media back to the drum messages of the Indians, the shouts of the town crier. All that has changed are the multitudinous ways in which information passes to us and the increasing sophistication of the media providers.

The argument about whether the media shape society or merely reflect current or nascent trends is constantly under debate. Before the Second World War, it was believed that the media “injects” values and morals into society. However, social research in the 1960s showed that the audience is not a passive receiver of moral values. Society is constructed of many different subcultures, classified by factors such as race, social class, political outlook, adhesion to value systems such as ”vegetarianism” or lifestyles (such as “cocooners” (Popcorn 1999) . These differing social groups select and filter information and reject messages that are not consistent with the values of that group. On the other hand, irrespective of social clusters, research has shown that it is those with low confidence and self esteem within each group who are most influenced by media communications.

So there have been many debates about the influence of the media and social behaviour, for example sexual morality or violence. We recognise, as a result of these debates, that the interaction between message and response is complex and audience dependent. To quote the BMA report on eating disorders, body image and the media:

“In a media saturated culture, the argument that long term exposure can help shape the world views of particular sections of the audience is one that merits consideration, however, the EXTENT to which the media contribute to the personal identity remains unclear and is subject to continuing academic debate….the media do not, by their very definition, provide pure experience of the world but channel our experience of it in particular ways”.

In other words, all research into the media must take into account the different levels of attention, and interpretation of individuals with different motivations, personalities, immediate situations and socio-cultural contexts who bring different information processing strategies to the task.

The latest “POSTMODERN” thinking on the role of media is that it provides learning that is incidental rather than direct, and it is a significant part of the acculturation process.

Now the battle centres on a new morality of food and eating. We accuse the media, by glorifying the culture of thinness, of causing an epidemic of eating distress, especially among young women. The media denies culpability, or at least responsibility for doing anything about it. Kelly Brownell, a US expert in eating disorders, argues that the media contribute to a toxic environment in which eating disorders may be more likely to occur. This is because of the “Damaging Paradox” of modern society in which the media promotes, in a compelling manner, a low weight sculptured ideal body.

At the same time the environment provides an increasing array of foods high in fat and calories, with compelling pressures to consume these products. As a result we are getting heavier, and the gap between the ideal and normal body weight is giving rise to anxiety. We seek to reduce this anxiety by reducing our body weight, the preferred method being to go on a diet, since we believe that weight IS under our control and, in addition we believe that once weight is lost it should not be regained. But dieting causes rebound binge eating and attempts to deal with this, by going on further diets, will lead many people into a disturbed relationships with food.

There are other dangers arising from this cultural paradox. The models and actors who promote consumption of these calorie laden foods are usually slim and attractive, which would not be possible in a real world if they actually ate these foods. This will add to the cultural confusion, which is said to nurture the onset of eating distress. To what extent are these accusations true?

Is There An Increase In Eating Disorders?

There is no doubt that the ideal body size, as reflected in the style icons promoted in the media, is getting thinner. This ideal body size epitomised by “Gerri Halliwell” “Posh Spice” or “Ally Mcbeal” is unrealistically thin, their BMI is on the borders of what a clinician would regard as anorexic. Due to the proliferation of food in our culture, people are getting bigger, fatter, and maturing younger and younger as the years pass by. The gap between actual body sizes and the cultural ideal is getting wider, and giving rise to anxiety among almost all women, although it is the most vulnerable who are most affected by this.

There is a lot of dieting going on as a result, because dieting is viewed as the solution to the problem of “excess weight”, even if the excess is just all in the mind, as a result of faulty messages from “out there”. There is evidence from dieting studies that twice as many people diet as need to; in other words’ of all people who diet, half are not even overweight. However, dieting doesn’t inevitably lead to anorexia. Anorexia is not a slimming disease.

To push the point home, there is no strong evidence of an increase in anorexia. There are more reported cases coming to the attention of services, but we believe that this is just because we now know so much more about the illness. Hence we are more likely to recognise it rather than hide it away. There are more services available so the anorexic person is identified rather than left to fight the illness on their own. It is hard therefore to justify an accusation that exposure to supermodels will cause our teenageers to develop anorexia.

Dieting behaviours are however a risk factor for the other eating disorders, compulsive eating and its variant, bulimia nervosa, an illness in which the sufferer, usually a young woman but many men suffer too – diets, experiences rebound binge eating due to food deprivation and then purges to rid herself of unwanted calories. Compulsive eating is a direct outcome of rebellion against food restraint, a behaviour that can rapidly turn into a remorseless habit. On the other hand, bulimia is an illness which may start out as a useful strategy to control weight gain but rapidly develops into an addictive illness, which engulfs the sufferer and becomes a way of coping with emotional difficulties.

Studies of prevalence show that bulimia nervosa is on the increase, although again these figures may just reflect a growing awareness of the disorder or an increased provision of services. People are more likely to apply for help Still, the link between the media and bulimia is tenuous. Women feel pressure from many sides to control their weight, from the media but also from their peers, from boyfriends, from parents and from the fashion shops that carry clothes in ranges and sizes that suit only the smallest among them.

What Power Does The Media Actually Have?

There is no doubt that the media provides significant CONTENT on body related issues to young women, over 50% of whom, (between the ages of 11 –15 years) read fashion and beauty related magazines. The exposure to ideal images coincides with a period in their lives where self regard and self efficacy is in decline, where body image is at its most fragile due to physical changes of puberty and where the tendency for social comparison is at its peak. Girls thus find themselves in a subculture of dieting, reflecting messages not only from the media but also from parents, peers, members of the opposite sex as well as the media.

Analysis of media content both provide a stream of articles on weight control, either through fitness or food control, and physical beauty, together with models whose curvaceousness has declined steady over the period from 1959-1978 (Guillen and Barr). In all cases, the emphasis on diet or fitness was designed to help someone become more physically attractive and thus acquire status.

In the late 1990s, there was a fair degree of comment from the media about Sindy dolls sold to girls under the age of puberty, with an impossible bust to waist ratio and impossibly long, lean legs. The accusation was that Sindy dolls would “encourage anorexia” by providing young girls with an adult body shape that they would aspire to but never achieve. Various experts appeared on radio and TV accusing the manufacturer of social irresponsibility.

It must be pointed out however, that while it is true that growing and adult women are exposed to thin images and many article on diet and fitness, this fact tells us little about how these messages are received by the audience or by parts of it.

How Messages Are Received

There have been a number of studies, which attempted to combine analysis of the content of messages with studies of attitudes or behaviour to assess the impact of images or messages.

However, we are warned to guard against the short term view of media influence on body image or eating behaviours, rather than assess the long term outcome of exposure to certain images and values, or even to assess the effect of exposure to any set of values independently of the “shifting sands” of social and technological change.

Some of these studies point to a measurable, short-term association between reduced self esteem, heightened anxiety or anger and depression, and exposure to culturally ideal body shapes, less among men and more among women. However there is no way to know how or if this anxiety persists over time or translates into future dieting or aberrant eating behaviours. One other study showed that there was no relationship between body dissatisfaction and the number of hours of TV watched per week, although there was a relationship between body anxiety and number of hours spent watching soap operas. Drive for thinness, a different construct, is related significantly to watching pop or music videos among adolescent girls. Women in a variety of studies consistently report that magazines influence their idea of what a good body shape is, and lead to determination to lose weight with subsequent dieting behaviours.

These findings must be interpreted against the fact that women tend to overestimate their body size, a feature that extents back to early days of puberty. Waller and Hamilton have an interesting view of the effects of the media in this respect. They claim that the media may act as a “negative reinforcer of body size overestimation, which may lead to eating disorder”. In other words, the media doesn’t make women feel a need to be thinner per se, but the media may assist them in feeling bigger than they already feel themselves to be. The starting position for many females is thus a built-in vulnerability, which is reinforced by the culture of the media. This view must be considered alongside other, parallel studies on body image. These show that the development of body image over time, a more useful predictor of protection from eating distress, is dynamic and affected by many variables, including exposure to traumatic events, body issues in childhood and general self esteem derived from core personality traits.

Cross Cultural Studies

Many cultures have conferred status on a slim body size, for example in China – and some have had a preference for large builds for both sexes, such as in Polynesia. Anne Becker, an anthropologist of Harvard Medical School, who has worked extensively with the Fiji population, has shown that exposure to western ideals of beauty have led to a high percentage of adolescents dieting within the last decade. It is hard to prove that it is exposure to TV images which have caused this change, although it is reasonable to assume that this is the case.

Media Influences On Body-Image, Eating Behaviour And Self Esteem

It is hard to evaluate the relationship between the media and eating disorder without considering the multi faceted impact of media messages on body size, on food consumption, on the desirability of certain foods and their consequent consumption, and other matters relating to personal identity and status.

The media can have many influences in relation to food and eating including:

  • It confers hidden meanings on food – nostalgia, sexiness, being a good housewife and mother, rewarding oneself, having uninhibited fun etc, and creates unnatural drives for food.
  • The media can persuade us that wrong eating habits are right and natural. I cite the case of a MacDonald’s advertisement recently in which a young boy persuades both his parents to take him for a burger and chips rather than a healthy outing at the zoo.
  • The media can create anxieties about being deprived if we don’t have what “everyone else” is having.”
  • The media presents us with an idealised shape which is invested with attributes of being attractive, desirable, successful and loveable but which is unattainable without resorting to sinister or dangerous eating habits.
  • The media perpetuates the feeling in people who do not have the ideal shape that their life would be fine if they were slim.

What Is Body Image?

Body image is an important part of self-identity and self esteem. We all have a body image which is defined as the physical and cognitive representation of the body which includes values about how we should look along many dimensions (age, size, height, colour, attractiveness etc) and emotional feelings connected to acceptance or rejection. Body image is closely connected to self-esteem. It is possible to have low self worth and a good body image if other aspects of functioning are important. On the other hand it is hard to maintain good self worth if one’s body image is disturbed.

It is believed that women and men configure an internalised ideal body and compare their actual or perceived actual shape against the socially represented ideal (Myers and Biocca). This presents a body image which is elastic in that it will feel different at different times and in different contexts, such as being on a beach in a swimsuit.

We have already explained both that the ideal body has become smaller, thinner and differently shaped over the past 20 years. The ideal body is now sculptured, pared of fat (with a BMI that would place most models firmly in the anorexic category), with narrow hips, a small waist and rounded breasts, a stature which can only be achieved by most women with the help of surgery since under conditions of weight loss breast tissue tends to shrink.

This may explain two factors:

  • Why women consistently overestimate their weight, and
  • why dieting behaviours are so prevalent. Over half of all dieters are not overweight, which means that of all people currently dieting, 1 in every 2 doesn’t need to. Dieters, especially young ones, tend not to be responsible in their eating habits. We define this as “normative discontent”, referring to the fact that poor body image is normal among women in today’s society. But what is worrying is that, responding to this low level of body dissatisfaction; women may be harming themselves with their responses. On a study of 869 Australian diets in 1998, one third were using extreme methods such as fasting, crash dieting, smoking or drugs, in the belief that these methods would be harmless.

It would seem that the media doesn’t simply make the ideal body desirable, these dieting behaviours spring from an epidemic of low esteem, stress, guilt and depression about having a body that falls short of the cultural ideal. People who diet believe that they look bad, and that this will affect their ability to get a good job or attract members of the opposite sex unless they are thinner. This is true to a certain extent. Research shows clearly that OVERWEIGHT women suffer in a number of important respects. They are less likely to be accepted into higher education, they have lower salaries; they are less likely to date in adolescence and are less likely to be married in adult life. Conversely, graduate career women are more likely to feel guilty about eating than any other target group.

This finding reflects the conflicting pressures on women of today which are reflected in media. Women are supposed to be thin, attractive and successful in the workplace and in academia, while maintaining feminine characteristics of nurturing, maternal, warm, socially engaging and givers. It is thought that women who cannot reconcile these roles and who feel out of control of their lives may turn to the control of weight to regain a sense of coping. However this is just a hypothesis.

The Media As Risk Factors For Eating Disorders

It is hard to separate the influence of the media in the development of eating disorders. Various studies point to the correlation between low self-esteem in young girls and high scores on eating distress measures as they grow.

Self-esteem is a dynamic construct, like body image, which is influenced by a whole variety of factors such as parenting, childhood experiences, core personality and body image especially in girls. It follows thus by logical reduction that influences on body image will affect self esteem and promote the risk of developing an eating disorder as a person turns to the control of their body in order to feel acceptable. In this respect the media may contribute to low self-esteem by promoting slenderness as the pathway to gaining love, acceptance and respect while at the same time reflecting a trend in society to demonise fat.

When women are asked what they fear most in life, most will cite the possibility of gaining weight. When women are asked what they least like about themselves most will describe a part of their body (usually stomach, thighs, legs) rather than no physical attributes like laziness or low confidence. Men conversely are more likely to mention non-physical attributes. When women are asked what men find attractive in them, most mention physical appearance. Women thus feel judged by their looks rather than their other resources.

Esteem isn’t the only risk factor for an eating disorder. Traumatic childhood experiences, timing of puberty, family functioning, emotional resilience, exposure to unhealthy eating patterns in other people, family concerns about weight, fear of growing up, sexuality problems, bullying, loss, history of dieting, all may have an influence on a persons relationship with food. So we can conclude that the media may both steer and reflect our cultural obsession with how we look and what we put into our mouths.

Advertising Policies And The Counter Argument

Some institutions in Government, Psychology and the media industry itself are becoming concerned about the use of thin models to promote goods and service. There was a Government “thin summit” in 2000 to which moguls of the magazine industry were invited. In a similar vein, the Independent Television Commission has issued guidelines stating that it is desirable to ensure that advertising does not stimulate unhealthy attitudes to eating and that is must not imply that being underweight is desirable.

Good in theory, but this is a policy which has not had significant impact on the sizes of models in magazines, nor of the size of girls in music bands. Celebrities continue to attract attention for their weight loss rather than their accomplishments, and the greater the furore about their size the more attention they receive. The new “celebrity anorexia” may be creating more ripples in society than any former use of models in fashion shoots.

As a direct repose to “do-gooders” in some sections of the media, a wristwatch manufacturer used an excessively thin model to advertise his watch. Many publishers, while paying lip service to a policy of self acceptance at any weight, continue to print pictures of slim models, run articles about dieting and fitness, and promote all sorts of esoteric eating plans. It is felt that the new wave of articles on healthy eating is just dieting in another guise, the objective being to manage health through control of weight thereby undermining such defences as may exist against dieting per se. These new wave articles are so compelling, that, viewed against a background of increasing confusion about what is good or bad to eat, they are creating a new eating disorder known as “orthorexia”. This is condition where the sufferer become wedded to stringent eating plans (such as food combining or anti allergy plans) which imply weight loss and which mask a profound unhealthy relationship with food.

Some style setters in the media frankly refuse to adjust their policies, they say, not unreasonably, that women like to look at perfect bodies, they won’t buy magazines with pictures of ordinary people, and that they are not quite as silly to believe that these fantasy figures, photographically enhanced in many cases, are bodies that they should aspire to. This is to a certain extent confirmed by my own discussions with teenage girls in schools who are fully aware that diet and exercise would not be enough to get you looking like a model in a magazine.

The Media And The Obesity Epidemic

There is one aspect of media policy which has largely been ignored, because of over concern with thin images. This is the use of media to promote unhealthy eating attitudes which may be contributing to a national epidemic of obesity, which in itself will provoke damaging eating strategies as our ever expanding nation seeks to control its weight. An individual watching television for 2 hours per day will see over 20,000 food advertisements in one year, most promoting foods high in sugar and fat, mainly urging us to eat for reasons that have little to do with survival. The problem is ever worse for our children. During child-friendly broadcasting hours, they are exposed to a continual stream of advertisements for sweets, chocolate, and sugar laden cereals. This aspect of media functioning supports the food industry in contributing to a significant effect on future problems with eating and with weight.

Positive Media Influences

The media does not influence eating patterns or self-esteem in an exclusively negative fashion. Broadcast and written media can be a source of valuable information on health and well-being. In addition, awareness of eating disorders, through magazines, articles and television programmes may educate people about the danger of abusing food, and may help to make sufferers aware that they have a problem and they are not alone.

In this respect the media may have two useful roles: the first in health promotion for the public at large, the second, in the arena of primary prevention. Health promotion seeks to promote healthful behaviours or attitudes to the public at large. Primary prevention is defined as an activity designed to eliminate or render ineffective, factors involved in the causation of a disorder and an activity designed to strengthen the host against noxious influences.

From this definition it can be seen that the media both opposes and contributes to health promotion and primary prevention.

It has been suggested that the media might respond to its critics in the following ways

  • Present a greater variety of body shapes and sizes in photos, in the music industry, as television presenters etc.
  • Should discourage dieting
  • Should assist people with an influence on young people (such as parents, teachers) from making weight an issue
  • Provide positive fat role models
  • Should not glamorise celebrities who lose weight
  • It is expected that such changes, if they were put in place, would take a while to filter down through society before any significant shift in attitudes could be achieved.

Can The Media Change Attitudes Against Current Trends?

Would all this work anyway? My personal view is that it would not. There is a larger dynamic behind cultural trends, which drive behaviours, cultural values and attitudes. Such changes would be swimming against the tide. I do believe therefore that the media is sensitive to these emerging trends and brings them to the surface. In this respect they are seen to be trend creators, yet they are just mirrors of patterns which already exist.

In addition we are not isolated, but are part of a global culture. The trends cross the entire developed world are consistent in their glamorisation of slenderness and youth as a feminine, and increasingly a masculine ideal.
The media would find it hard to convince the national psyche, therefore, that thinness is not a desirable ideal. By promoting sensible messages, however, they may impact on those individuals in society who are vulnerable and who may otherwise filter unhealthy messages, which will lead them into a path towards developing eating disorders.

Carl Jung in his book The Undiscovered Self; Routledge Press offers the view that it is hard to create change by pushing messages at the culture as a whole. The route to changing a culture is by changing individuals who will have a subtle influence within their immediate circle of acquaintances. This influence will ripple outwards and it will take time to filter through into public consciousness. In conclusion to this essay, I quote directly his opinion.

“…The psychologist seems to be the only person who knows from experience how precarious the psychic preparedness of modern man is, for he is the only one who sees himself compelled to seek out in mans nature those helpful forces and ideas which over and over have enabled the individual to find the right way through darkness and danger.

For this exacting work the psychologist requires all his patience, he may not rely on traditional “oughts” or “musts” leaving the other person to make all the effort and contenting himself with the easy role of adviser and admonisher. Everyone knows the futility of preaching about things that are desirable, yet the general helplessness in this situation is so great, and the need so dire, that one prefers to repeat the old mistake instead of racking ones brains over a subjective problem.

…The effect on ALL individuals, which one would like to see realized, may not set in for hundreds of years, for the spiritual transformation of mankind follows the slow tread… and cannot be hurried or held up by any rational process of reflection, let alone brought to fruition in one generation.

What does lie within our reach, however, is the influence of others of like mind in their circle of acquaintance. I do not mean by persuading or preaching – I am thinking, rather, of the well known fact that anyone who has insight into his own actions and has thus found access to the unconscious, involuntarily exercises an influence on his environment. The deepening and broadening of his consciousness produce the kind of effect which the primitives call “mana”. It is an unintentional influence on the unconscious of others…”

A full list of references on issues pertaining to the media may be found in
Eating Disorders Body Image and the Media. BMA 2000 ISBN 07279 13339