Media, body image, and eating disorders
Anorexia nervosa and bulimia nervosa are eating disorders characterized by thin-ideal internalization (embracing the thin body ideal as one’s own), a strong drive for thinness, and an intense fear of fatness (American Psychiatric Association, 2000). Lifetime prevalence estimates in the United States for anorexia nervosa and bulimia nervosa are 0.9 percent and 1.5 percent among women, and 0.3 percent and 0.5 percent among men (Hudson et al., 2007), with an additional 4.4 percent overall for “eating disorders not otherwise speciﬁed” (EDNOS) (Lewinsohn, 2001). Far more young people-17 percent, according to the U.S. Centers for Disease Control and Prevention (2007)—are obese, so why should we be concerned about cultural inﬂuences on child body image and disordered eating? The reason is that the costs of poor body image and disordered eating are exceptionally high, and disordered eating may have permanent developmental consequences. In one study, the death rate of anorexia was 15.6 percent over 21 years (Zipfel et al., 2000). Other complications include depression, anxiety disorders, attempted suicide, chronic pain, infectious diseases, insomnia, cardiovascular and neurological problems (Johnson et al., 2002), strained interpersonal relationships (Holt and Espelage, 2002), and depleted bone density and delayed menarche (Nicholls, 2004). Disordered eating can also lead to obesity; in longitudinal research, normal-weight children who used unhealthful weight-loss tactics increased their risk of both disordered eating and obesity in adolescence (Neumark-Sztainer et al., 2006).
Research on the media as a sociocultural inﬂuence on body image and disordered eating has been ongoing for more than 20 years. A full review of the corpus of relevant research is beyond the scope of this chapter, so articles described here comprise relatively recent studies that succinctly represent new or well-replicated research ﬁndings. The most comprehensive recent meta-analysis of media-body research (Grabe et al., 2008) summarized 141 studies involving 15,047 female participants. Media exposure was related to moderate decreases in satisfaction with the body and increased eating pathology. Eﬀects for thin-ideal internalization were stronger for adolescents than for adults, whereas eﬀects for eating behaviors and beliefs about eating were stronger for adults but still signiﬁcant for adolescents. There is no comparable meta-analysis for males, but
studies with boys have reported small-to-moderate eﬀects (Harrison, 2000a;Harrison andBond, 2007) indicating increased body image disturbance and eating pathology with greater media exposure. Most research on media, body image, and disordered eating has employed adult and adolescent
samples (Levine and Harrison, 2003). Only recently have researchers begun systematically studying pre-adolescent girls (Gilbert, 1998; Harrison, 2000a; Harrison and Hefner, 2006; Sands and Wardle, 2003) and boys (Harrison and Bond, 2007). Eating disturbances can begin in preschool (Stice et al., 1999), and anorexia and bulimia can appear prior to adolescence, especially among girls (American Psychiatric Association, 2000). Given the ubiquity of commercial media in children’s lives, it is important to understand how media portrayals inﬂuence body image and disordered eating in childhood. This understanding begins with an assessment of body ideals in the media children use.