In observance of Eating Disorder Awareness Month, Gozamos is examining eating disorders (EDs) in a pair of posts this February. What is the nature and prevalence of eating disorders? Who gets them and why? And, what is the role of television and the mass media in all of this?  In this post, we focus on anorexia, bulimia, and how the mass media influences disordered eating.

The Nature of Eating Disorders

Anorexia Nervosa (AN) and Bulimia Nervosa (BN) have historically been the most diagnosed eating disorders in the United States–although rates of the newly-recognized Binge Eating Disorder (BED) are on the rise. All EDs are characterized by extreme disturbances in eating behavior. For people suffering from anorexia and bulimia, those disturbances include an irrational fear of gaining weight; excessive body dissatisfaction; and, an overemphasis on the evaluation of body shape and weight in relation to the self concept. Individuals with AN refuse to maintain a normal body weight as designated by height and age standards. They drastically decrease their caloric intake through starvation and/or excessive amounts of physical activity. People with BN engage in recurrent binge eating episodes followed by inappropriate compensatory behaviors to prevent weight gain. These compensatory behaviors may include vomiting; misuse of laxatives, diuretics, enemas; fasting; and, excessive exercise.

About nine in ten individuals with AN or BN are female. But rates of EDs among males are increasing. Behaviors characterizing AN or BN may look different in males (e.g., abusing steroids or supplements; too much weight lifting) but the underlying disturbances are largely the same: internalization of unrealistic body ideals and a preoccupation with body shape and size. At one time, EDs were considered unique to Western women, but there is evidence that the incidence of EDs is increasing in the United States and globally among populations previously considered culturally resistant to EDs.

The Development of EDs and the Role of the Mass Media

The influence of mass mediums like television, cinema and the print magazine industry has been strongly implicated in the increase of ED rates. Mass media are defined as methods of communication that generate profit-oriented messages targeting large scale audiences. Because of their ubiquity, mass media (in particular, television, movies, music videos and print) are considered the most powerful channels in existence used for the communication of sociocultural norms, like those associated with beauty, success and power. On a global level, children, underrepresented ethnic and social groups, and men have been increasingly targeted as consumers through mass media. Adult females portrayed in mass media advertisements today are substantially thinner and smaller than was common in decades past. Even action figure toys and cartoon heroes marketed toward young boys are more muscular than in the past and more muscular than is humanly possible. Improvements in broadcast technologies, digital infrastructures, transportation and related scientific advances have brought unattainable standards of beauty–and other questionable messages–to more corners of the world than ever before. It’s no wonder that disturbances in eating behavior and body satisfaction are no longer unique to Western women and are increasingly common everywhere.

Earlier perspectives on the development of EDs focused on peer and family relationships, histories of sexual abuse, self-esteem issues and other individual characteristics. In recent decades, theorists examining the development of EDs have turned their attention to larger sociological factors, like exposure to mass media. The relationship between excessive consumption of mass media and disordered eating is well-documented today. Overall, it is widely accepted that the tendency to internalize beauty ideals expressed in mass media mediates the relationship between media consumption and disordered body concept and eating. That is, for most people, simply watching television and spending time leafing through fashion magazines will not lead to an eating disorder. However, for individuals who internalize mass media’s beauty ideal messaging, and hold those standards to be true (e.g., “I should look like this person on television”), greater exposure to mass media leads to greater body dissatisfaction which, in turn, is strongly predictive of the development of EDs.  To be fair, individuals who express high levels of dissatisfaction with their bodies may be drawn to spending excessive amounts of time seeking body-image related media messages for consumption in the first place. As with all correlational research, we cannot definitively say that mass media is a cause of EDs. But, clearly, there is a relationship.  According to research done in the Ukraine, the introduction of market-based mass media resulted in increases of thin body idealization and greater body dissatisfaction among young girls. Similarly, following the arrival of television in Fiji, levels of disordered eating and vomiting for weight control were significantly higher than what was the norm before TV was introduced. For practical purposes, it is safe to say mass media messaging that extols unrealistic thinness contributes to the development of disordered eating.

Why are messages on the importance of thinness from mass media so much more powerful than other messages from peers or family? One reason is the sheer volume of media today. Between television, movies, advertisements in print and online, mass media have been fully integrated into our daily lives. On average, children and adolescents spend around six to seven hours per day consuming multiple forms of media. Adults are believed to spend around eight hours a day in front of various glowing rectangles. Some researchers argue that television and motion picture formats (e.g., films, music videos) leave us especially susceptible to passive acceptance of all sorts of messages. They argue that television, with its colorful lights, exciting sounds and rapid movement of would-be static images, hijacks our human orienting reflex–a system that is responsible for directing our attention to novel stimuli. Repeatedly attending to this stimuli may become rewarding on a basic physiological level, and thus, we are conditioned to want to watch more television.  We become relaxed when we watch TV and want to watch TV when we feel stressed. Some researchers have claimed that modern print advertisements also owe their power to their form: photographs are generally digitally manipulated and edited so extensively that the lines between reality and fiction become indistinguishable to the perceiver. Hence, the fantasy and fiction of unattainable body ideals come through to us as being realistic and thoroughly attainable. Unlike most verbal messages, arguments presented via images are hidden. Rarely do we question why society places such an emphasis on physical appearance, who gains from creating and then exploiting our psychological insecurities, and/or what it means to be valued solely on what your body looks like. It is all too easy for us to just turn the page, flip the channel and move on to the next show. Before we can think about an image, another one appears before our eyes.

Undoing What the Media has Done: Media Literacy to the Rescue!

Suggestions for interventions geared toward prevention of EDs and reducing the negative influence of mass media have included helping consumers become more discriminant in their media consumption and teaching individuals how to reduce the tendency to compare themselves to fictional others. What are the motives of this message’s producer? How many real people look like the representations of people that we see in movies and videos? Will buying the product advertised make me look like the person in the ad? If it did, would that make me happy?  Why is it important for my physical appearance to match up to standard ideals of beauty? These are examples of questions that have been identified as important starting points in the evaluation of media messages and critical consumption.  That is, in an ideal world, these questions are just starting points. But in an increasingly mass marketed world governed by corporate interests, critical thought and media literacy may actually be our only line of defense.

In addition to promoting unrealistic beauty standards and body ideals, it is said that the media influences the development of EDs by not accurately portraying the negative consequences of disordered eating behaviors. Behaviors like those found in EDs are presented out of context and away from their negative long term effects. The media presents to us images of a bulimic celebrity on the red carpet in a designer gown, but would never show us that celebrity hunched over a toilet bowl, spewing bile and blood through her loosening teeth. Not surprisingly, a promising avenue for providing stimulating, viscerally powerful education and information regarding non-romanticized aspects of EDs is through mass media campaigns. Increasing diversity of people’s sizes and bodies represented in the mass media may also go a long way in reducing body dissatisfaction. But, reducing the centrality of body satisfaction and physical appearance to one’s overall sense of worth as a human being may go an even longer way when it comes to reducing the development of harmful health behaviors like those associated with EDs.

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