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The Media and the Development of Eating Disorders
December 8, 2010
For the average American, itís hard to imagine even a day without media, let alone an entire lifestyle.† The average adolescent spends between six and seven hours a day engrossed in media, five of which are spent watching television (Morris and Katzman, 2003). Media is ever present in today's world, and it is nearly impossible to escape its influence. According to Dictionary.com, the fact that media influences people is part of its very definition: "the means of communication, as radio and television, newspapers, and magazines, that reach or influence people widely" (2010). From fashion to travel, religion to politics, the media impacts peopleís perceptions and choices in both large and small ways.
According to the DSM-IV-TR, there are two primary eating disorders. The first is anorexia nervosa, which involves a refusal to keep a minimal healthy body weight; an extreme dread of gaining weight; a distorted view of one's body, the importance of appearance, and/or the seriousness of one's condition; and amenorrhea. There are two subtypes: binge/purge and restricting. The second eating disorder is bulimia nervosa. One trait of bulimia is habitual binge eating, which is defined as eating within a certain period of time a quantity of food that is considerably larger than the average meal for the time frame and circumstances and feeling like one has no control over his or her eating. It also consists of fixation on body shape and repetitive unhealthy actions to prevent weight gain from binges, such as vomiting. Furthermore, the binging and purging must be frequent and chronic for a person to be considered bulimic. Like anorexia, bulimia nervosa has two subtypes, and they are purging and nonpurging (As cited in Schlundt, 2010).
Eating disorders have many negative consequences, most of which come from the starvation and malnutrition characteristic of the disorders. Visible physical complications include brittle hair and nails, discolored and irritated skin, growth of lanugo, cracking of the corners of the mouth, erosion of teeth, gingivitis, swollen salivary glands, and muscle hypertrophy in the cheeks. They also have countless adverse effects on the digestive system, liver, pancreas, circulatory system, kidneys, muscles, bones, immune system, and nervous system (Schlundt, 2010). Social complications include the avoidance of social activities and the destruction of personal relationships because of lack of energy, complete absorption by the eating disorder, having to hide behaviors (like purging), and irritability and change in personality resulting from hormone imbalances. Emotional repercussions such as depletion of self esteem, depression, loneliness, and lack of healthy coping mechanisms can also arise from eating disorders. Furthermore, bulimia is associated with impulsive behaviors like stealing, drug abuse, and promiscuity (Class discussion, Schlundt, PSY 115F, 2010)
Eating disorders are a serious problem in modern times. Anorexia nervosa has increased over the past fifty years, with a current prevalence rate in fifteen to nineteen year old girls of 0.48%. Bulimia nervosa is estimated to be diagnosable in one to five percent of adolescent females (Morris and Katzman, 2003). The cause of eating disorders is still unknown, but possibilities can be grouped into four genres. These are biological, psychological, familial, and sociocultural. Media, a sociocultural aspect, is theorized to be a risk factor for the development of eating disorders (Harrison and Cantor, 1997).
Influence of Media on the Development of Eating Disorders
The promotion of thinness as the ideal body type and the significance given to appearance are two cultural sources of eating disorder development in women (Stice, Shupak-Neuberg, Shaw, and Stein, 1994). It is theorized that because the mass media is a major communicator of cultural values and viewpoints, one of the social norms it transmits is the thin ideal (Harrison and Cantor, 1997). Because media is such an active promoter of the thinness ideal, media consumption can lead to the development of eating disorders in women.
The continual increase in eating disorders has occurred simultaneously with the media's depicting of decreasing ideal body weights and its increasing promotion of diets (Stice, Shupak-Neuberg, Shaw, and Stein, 1994). In the past fifty years, women portrayed by media have continually dropped in weight. Studies of Playboy centerfolds show that the women are steadily becoming thinner Ė seventy percent are underweight (Morris and Katzman, 2003). Over half are thin enough to be diagnosed as anorexic (Harrison, 2000). Furthermore, television characters, especially females, are hardly ever shown eating, and when they do it is typically very small portions (Harrison and Cantor, 1997).
Methods of Influence
Exposure to media is thought to result in women internalizing the portrayed weight standards, resulting in body dissatisfaction. Body dissatisfaction is proven to be strongly associated with eating disorders (Stice, Shupak-Neuberg, Shaw, and Stein, 1994). Media promotes the thinness ideal both directly and indirectly. Indirectly, it almost always portrays the most successful, well-liked, and beautiful women as being slender (Harrison and Cantor, 1997). Moreover, overweight characters are usually portrayed in a negative light (Harrison, 2000). Media consumption is also associated with the increasing of gender-role stereotypes, which in turn leads to the internalizing of the thin ideal and its aforementioned domino effect (Stice, Shupak-Neuberg, Shaw, and Stein, 1994). Furthermore, media makes men more concerned with the body shape of women, and it indirectly causes more eating disorders in women, who seek approval from men (Harrison and Cantor, 1997). Lastly, the mediaís fixation on dieting can lead to dietary restriction, resulting in an increased risk for binge eating (Stice, Shupak-Neuberg, Shaw, and Stein, 1994).
In 1994, Stice, Shupak-Neuberg, Shaw, and Stein evaluated 238 female college students. The women reported the amount of various genres of magazines and televisions shows that they watched. Questionnaires were used to assess gender-role endorsement, internalization of body standards, body dissatisfaction, and eating disorder presence. Results showed that media consumption is directly correlated with eating disorder symptoms and with the acceptance of gender stereotypes. Acceptance of gender roles was shown to be associated with eating disorders, via the internalization of body ideals and the subsequent body dissatisfaction.
The study by Stice et al had both its strengths and weakness. One of its strong points was that all the questionnaires used by the researchers to evaluate subjected were proven to be reliable and valid. Also, all of the researcherís conclusions were backed up not only by the results of their study, but also by those of others. A fairly large subject pool was used, but the age range was small. A drawback is that it was a cross-sectional study, so it is difficult to assure that the relationship was casual and not just a correlation. Additionally, because the participants self-reported the data, it is possible that the assessments are not accurate. However, overall this study is considered a reliable source of information.
Harrison studied 366 adolescents, split fairly evenly among three age groups: sixth, ninth, and twelfth grades.† 49.7% of the students were female. Television exposure was determined through questionnaires, which assessed both the weekly total time spent watching television and how often the students watched certain television programs. Magazine exposure was also evaluated through questionnaires, which surveyed the quantity and genres. The centrality of the thin ideal in these television shows and magazine genres was determined by having college students rate each one. Systematically combining the data gathered from these surveys resulted in a thin-ideal exposure rating for each participant, and a similar process was used to determine exposure to "fat-character" television. Selective exposure was also assessed via survey. The presence of anorexia was evaluated by using the Children's Eating Attitudes Test and sections of the Eating Disorders Inventory (2000).
Harrison found that media directly promoting thinness or with especially thin women in leading roles and media with overweight main characters are both more strongly correlated with body dissatisfaction and eating disorders than average media exposure. Television viewing as a whole was associated with bulimia in women. When this was dissected among genres, it was discovered that "fat-character" television alone was correlated with female bulimia. Interest thin-ideal television was associated with anorexia in both sexes, however simply being exposed to these programs was not. Consumption of magazines that promoted the thin-ideal was connected to anorexia and bulimia in women. Even when researchers took in to account that some women are more concerned with the thin body ideal and therefore expose themselves intentionally to magazines† regarding fitness and weight loss and controlled for such, the relationship still remained. For men, the association only existed for those who expressed interested in these magazines and only increased the likelihood of anorexia (2000).
In Harrisonís 2000 research, all the participants attended school in the same city and the majority were middle-class, so one must be cautious in generalizing even though a sizable number of students were evaluated. For the most part, the rating by the college students of the presence of thin and overweight people in each television show and magazine fell within a small range, proving the systems validity. For those few over which there was much deviation, the combining of the scores resulted in it simply being considered average, preventing these shows from interfering with the results. All of this reportís conclusion were supported by the data obtained from the surveys and from other research. Like the aforementioned study, this one was also cross-sectional and so once again it is impossible to declare that the associations are causations. Once again, though, this article was deemed to be a legitimate resource.
In 2003, Morris and Katzman performed a literature review on the influence of media in the incitement of eating disorders. They discovered that when adolescent girls were shown pictures of models, those who looked at thin models had a considerably more negative body image than those who looked at average or larger than average models. Girls who reported trying to look like the women they saw in media were more likely to purge at least once a month. A study of girls in Fiji showed that when the girls, who previously had no exposure to television, were introduced to it, the cases of disordered eating among them rose considerably and many even reported that they were trying to look like the women they saw. When young women are aware of the media's promotion of the thinness ideal, they are less affected by it and less likely to develop eating disorders.
Morris and Katzmanís literature review analyzed relatively few studies. However, it did a good job of critiquing and synthesizing the information presented by these studies. The authors appeared to well understand the topic and all its intricacies. Thus, it too was evaluated as being worthy of inclusion in this paper.
Harrison and Cantorís research evaluated 422 college students, of which 55 % female. The hours of television watched and frequency of watching six designated shows viewed were recorded, as were the quantity of each of five genres of magazines read. The body type of the primary characters in the television shows and the stress on body weight and shape by the magazines were noted. Eating disorder symptomology was assessed by two reliable scales, the Eating Attitudes Test (EAT) and the Eating Disorders Inventory (EDI). Interest in media regarding weight loss, a possible confounding variable, was also calculated. For the men, their endorsement of thin ideal for women was also surveyed (1997).
The results were that magazine exposure did indeed predicting eating disorders in women, but exposure to television did not. Even when just looking the participants viewing of televisions shows classified as "thin", there was still not substantial association. Among magazines, fitness magazines were the strongest risk factors for the development of eating disorders, fashion magazines were second, and news and gossip magazines were a close third and fourth and only barely significant. Even when selective exposure was accounted for, the high correlation between fitness magazines and eating disorders remained. Bulimia and anorexia were found to be equally influenced by media exposure. Media consumption as a whole was not found to influence men's views on thinness in women, but when researchers looked at just fitness and men's entertainment magazines, reading did predict the men's stress on thinness in women (Harrison and Cantor, 1997).
Harrison and Cantor explain the mediaís impact on eating disorders using Bandura's social learning theory, which states that individuals learn through modeling. Bandura also says the modeling increases with the prevalence of the behavior and the incentives to engage in the behavior. The prevalence of thinness and dieting in media is unquestionable, and it is almost always associated with various rewards, such as success, acceptance (both by oneself and others), and romance. They also say that magazines have a larger effect on the development of eating disorders than television because they have more direct instructions on dieting and fitness, whereas television shows usually only subliminally promote thinness. Also, there are a substantial number of televisions commercials for fattening foods, which may somewhat reverse the effect of the thin-ideal programs.
A considerable number of participants were involved in Harrison and Cantorís research, but only college students were evaluated, and the vast majority were Caucasian and of average to high socioeconomic status. Another weakness of this study is that the researchers only assessed the frequency of watching five televisions shows, which may not have been very accurate. For example, a participant might only watch the two shows ranked as having main characters of average weight, but may also watch several other televisions shows, the majority of which had thin leading characters. Like the others, this study was also cross-sectional and depended on self-assessment surveys. Nevertheless, it was judged to be a valid data source.
In summary, although it is impossible and impractical to say that the media alone can cause a woman to develop an eating disorder, its influence is indisputable. Garner and Garfinkel effectively summarize the issue when they said, ďAlthough it may appear superficial to ascribe to cultural ideals a role in the development of anorexia nervosa, the potential impact of the media in establishing identificatory role models cannot be overemphasizedĒ (as quoted by Harrison and Cantor,† 1997, pg.41). The relationship between media exposure and eating disorder development, rather than being strictly causal, can perhaps be best explained by a cyclical model. Media that promotes the thinness ideal may contribute to a woman developing and eating disorder, and the eating disorder may cause her to read more magazines or watch more television shows that depict or actively promote the importance of being slender and how to lose weight, fueling and empowering the eating disorder (Harrison and Cantor, 1997).
This author has three recommendations for future research on this topic. The first is that longitudinal studies need to be performed on media exposure and eating disorders to investigate whether or not the relationship is in fact causal. What factors intersect with media exposure to determine whether or not a person actually develops an eating disorder also should be determined. Lastly, methods for effectively altering media to diminish its current effects of body dissatisfaction and eating disorder development need to be created and instituted. Morris and Katzman state the necessity of this kind of intervention and recommend curricula such as health communication programs, media advocacy, and media literacy. Media literacy specifically has been proven to mitigate the effects of the media's presentation of violence and alcohol, and it is hypothesized that it will work similarity for the thinness ideal (2003).
Harrison, K. &. (1997). The Relationship between Media Consumption and Eating Disorders. Journal of Communication , 40-67.
Harrison, K. (2000). The Body Electric: Thin-Ideal Media and Eating Disorders in Adolescents. Journal of Communication , 119-143.
Morris, A. &. (2003). The impact of the media on eating disorders in children and adolescents. Paediatrics & Child Health , 8 (5), 287-289.
Schlundt, D. (2010). Complications of Eating Disorders [Class handout]. Department of Psychology, Vanderbilt University, Nashville, Tennessee.
Schlundt, D. (2010). What are the Eating Disorders? [Class handout]. Department of Psychology, Vanderbilt University, Nashville, Tennessee.
Stice, E. S.-N. (1994). Relation of Media Exposure to Eating Disorder Symptomatology: An Examination of Mediating Mechanisms. Journal of Abnormal Psychology , 103 (4), 836-840.
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