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Does the media play a role in eating disorders?

Posted Nov 16 2009 10:00pm
I got invited to join a Facebook group of this name late last night, and I spent part of the day contemplating my response. I hesitated in writing for several reasons, not the least of which were that I don't have time right now to be responding to a lot of potentially irritated people, and also because I wanted to frame my thoughts properly. After a while, I figured what the hell- I'll bite. I decided to blog my thoughts here and post a link to the group so I didn't have to check two places for comments.

I searched through my blog archives and was astonished to discover that I had never answered this question head-on, in its own post. So, here it is.

To me, the question of "Does media play a role in eating disorders?" is usually asked in a sense of "Does media play a role in causing eating disorders?" And that answer, I would have to say, is pretty minimal. Media provides lots of context, and more than enough triggers, but to say that people with eating disorders are "dying to be thin" minimizes the seriousness of the illness and does everyone a disservice.

I was flipping through a copy of The Handbook of Treatment for Eating Disorders and I stumbled across an article that looked at the Three Ps of eating disorder onset: P redisposing factors (ie, genetics and other neurobiological factors), P recipitating factors (ie, culture, dieting, "healthy eating," etc), and P erpetuating factors (ie, what keeps the illness going). The role of the media certainly fits in the category of "precipitating factors," but although these factors are important, they seem more incidental than causative. Predisposing factors are largely homogeneous; precipitating factors can vary widely.

Finding yourself afraid to eat is a rather bizarre phenomenon. Our brains need to explain it somehow--so we turn to the vocabulary we know. I did blog about this almost two years ago now, rather briefly, and I think I shall plagiarize myself a bit:

Could eating disorders be women and men trying to be perfect? To live up to society's expectations? To look like models? I doubt it. That's part of it. It's the cultural context of the illness. In the Middle Ages, women (most of the recorded cases were in females) who starved themselves were considered saints. They fasted to get closer to God. Some, like Catherine of Siena, got hooked. It felt good. Her explanation was of faith. Ask a sufferer today, and a lot of it seems to be 'healthy eating' and images of supermodels and the idea that you can Have It All. It's no more a reason than faith. But it is a context. It does explain the triggers, the psychological environment from which an eating disorder develops.

One of my OCD fears was that I was going to catch AIDS from someone, or that I already had AIDS and was going to give it to someone else. Regardless, it was OCD. But if I was about 15 years older (the OCD AIDS stuff started in about 1993-1994, when I was 13-14), AIDS wouldn't have been on the radar. It might have been another disease. It might have been something else entirely. A person with schizophrenia would not have feared the CIA listening in on phone calls 100 years ago. First off, they probably wouldn't have had a phone, nor would there have been wire taps, and lastly- there was no CIA. Diseases have a context. But that doesn't mean that AIDS fear mongering caused my OCD, nor that the CIA causes schizophrenia.

Or, for that matter, that the media caused my eating disorder.

Much of the debate about media and eating disorders boils down to this: do eating disorders exist along a continuum with more normalized eating (that is, are eating disorders an extreme version of a diet and common body image issues?), or are eating disorders a separate entity. The answers aren't all in, and I won't pretend to understand all the answers that we do have (but I'll pretend enough to do a more in-depth blog tomorrow- stay tuned!), but I believe that eating disorders are a distinct entity separate but similar to our obsession with dieting and thinness.

Let's compare eating disorders to depression. Saying eating disorders are just a really whacked out diet is like saying depression is just a really bad mood. Most people with depression are in a really bad mood--that's kind of the definition of depression, really. And many people with eating disorders appear to be dieting and have body image distortion. But depression isn't a really bad mood that won't go away. When the weather sucks or the store is out of eggs or the car won't start, people will often say, "Ugh- I'm so depressed!" Not really. You're pissed off, sad, annoyed, whatever, but that's not depression. Both eating disorders and depression frequently pass through stages of seeming like just another diet or a really bad mood that lasts for-freaking-ever, but they then take on a life of their own. They stop becoming a choice and become an illness.

I thought for a long time that the thinness ideal had a lot to do with eating disorders, and I've since changed my mind, especially in light of the emerging research that suggests that up to 82% of eating disorder risk is genetic. * Eating disorders existed long before supermodels and they'll probably exist long after. And I think we are missing so many opportunities for prevention and education by focusing on the media aspect and leaving so many other areas out in the cold.

*A, this wasn't the study that I was referring to in a previous post (the study is too new), but it does confirm the numbers in the talk that I scribbled down.
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