Saturday, January 14, 2012

Eating Disorders: The Internalization of the Thin Body Ideal

Research over the last two decades has indicated that the incidence of eating disorders appears to be increasing. Health care professionals have reported what some consider to be epidemic rates of these disorders in recent years, particularly among adolescents. One extreme (but possibly inflated) estimate is that 20% of the total female population between the ages of 12 and 30 suffer from a major eating disorder; this may represent a 10% increase from three decades ago.

Although most researchers concur that the number of new cases of eating disorders is increasing, there is less agreement about the factors that may be promoting this increase. Sociocultural factors are thought to play a central etiological role, and have received the most research attention in the last decade. Specifically, many theorists strongly believe that our culture's ultraslender ideal-body image (or thin-ideal) portrayed in the media has been a critical contributor. The thin-ideal woman is actually a caricature; she is well below the average weight of typical women in our culture, and is portrayed as optimally successful, desirable, and happy. Sociocultural theorists and researchers also argue that the thin-ideal depicted in the media has become significantly thinner over the last several decades and, therefore, the discrepancy between the thin-ideal (i.e., 5'10", 110lbs) and the average woman (i.e., 5'4", 142lbs) has increased. This, combined with the intense focus on dieting in our culture, has reportedly helped promote the current epidemic rates of eating disorders.


According to the sociocultural model of eating disorders, young girls in our society quickly learn that thinness elicits many forms of social reinforcement, achievement, and rewards, whereas obesity is associated with various social punishments such as social isolation. Therefore, repeated exposure to the successful thin-ideal portrayed by the media leads some girls and women to overinternalize the stereotype. That is, women's perception of the typically dramatic discrepancy between their body shape and size, relative to the cultural ideal, is thought to produce heightened body dissatisfaction and depressed moods, and prompts them to set unrealistic body-dimension goals for themselves. It is argued that as young girls are repeatedly exposed to thin-ideal images they will begin to internalize this thin-ideal. Theorists argue that with the thin-ideal becoming even thinner in recent years, many young women are finding it increasingly impossible to achieve an ultraslim body form. They begin to take more drastic measures to control their body weight (i.e., restricting, purging, excessive exercise) and develop negative feelings about themselves and their body. A vicious cycle is started, because growing body dissatisfaction is thought to lead to increased dieting and use of extreme measures to lose weight in some women.

Sociocultural researchers have compiled a plenitude of indirect evidence linking the decreasing size of the thin-ideal in the media and intense focus on dieting in our culture to increased rates of eating disorders. However, only a few research investigations have attempted to directly examine whether a relationship exists between the thin-ideal image portrayed in the media, and women's satisfaction with their own bodies. Given the prevalence of eating disorders, more empirical evidence is needed to determine whether there is a relationship between the thin-ideal image depicted in the media, and women's dissatisfaction with their bodies. To help further this area of research, I recently completed a study that experimentally examined the effects of exposure to the thin-ideal on women's affect, self-esteem, body satisfaction, and level of internalization of the thin body image. My research also assessed how the thin-ideal image differentially impacted women with a diagnosed eating disorder. College women (N= 145) were randomly exposed to photographs from three popular women's magazines (Cosmopolitan, Vogue, and Glamour) containing either thin-ideal images or neutral images (non-models). The subjects in each group viewed 40 images and were asked to answer a corresponding question on the Media Response Questionnaire. This questionnaire was developed specifically for this research to help maximize experimental conditions versus control effects and ensure that subjects adequately attended to all important features of the media materials for a set period of time. Subjects then completed several measures which included: subscales of the Eating Disorder Inventory, Second Edition (EDI-2), Profile of Mood States (POMS), Rosenberg Self-Esteem Scale (RSE), and the Sociocultural Attitudes Toward Appearance Questionnaire (SATAQ).

The results of this study indicated that brief exposure (30 minutes) to thin images produced heightened levels of body dissatisfaction among women. The findings also indicated that after being exposed to the thin-ideal images, women in the experimental group reported increased negative mood states (i.e. depression, anger, anxiety, fatigue and confusion) compared to women who viewed neutral images. The findings suggest that women had lower scores on the self-esteem measure after exposure to thin images. It was also found that women in the clinical group exhibited lower self-esteem scores than women with eating disorders in the control condition. It was expected that exposure to the thin body image would result in higher levels of internalization of the thin-ideal; however, the results indicated that women exposed to these images had significantly lower levels of internalization compared to women in the neutral condition. One explanation for this finding is that women in the experimental group were reluctant to endorse that they admired this thin-ideal body image given the majority felt dissatisfied with their bodies, exhibited negative mood states, and felt less self-worth after exposure to the images. Hence, women may be reluctant to willingly acknowledge wanting to aspire to look like a thin-ideal when it creates personal distress. One finding of particular interest was that women with eating disorders exhibited significantly more body dissatisfaction and depression after exposure to the thin-ideal relative to all other subgroups of women. This finding suggests that women with eating disorders experience pronounced changes in affect and self-approval compared with other women when viewing images of the thin-ideal.

It should not be surprising that media images have an influence upon their audience. However, the findings of this research suggest that the photographic representation of women in mass circulation fashion magazines can have a powerful influence on women's self-appraisals. The broader social implications of this research become apparent when one considers the current debate over the appropriateness of ultrathin fashion models (e.g., Kate Moss). It is clear that these images send a dangerous message. Exposure to the media-portrayed thin-ideal was shown to be related to body dissatisfaction, negative affect, and low self-esteem and suggests that women may directly model disordered eating behavior presented in the media (e.g., fasting or purging). Additionally, the focus on dieting in the media may promote dietary restraint, which appears to increase the risks for binge eating.

Media presentation of "idealized" women cannot be the only factor responsible for women's negative self-appraisals. However, this effect is substantial enough to suggest that media presentation of idealized women's bodies may have practical relevance. In terms of a clinical application, it might be critical to advise female anorexics and bulimics to avoid publications or television programs that portray women as thin-ideal images. Second, women's responsiveness to such images might be addressed through cognitive-behavioral therapy. Third, school-based prevention efforts could be aimed at reducing the internalization of the thin-ideal stereotype, as well as promoting body satisfaction. These programs should also emphasize the incongruence between biology and the thin-ideal body image. Negative psychological and physiological risks associated with the pursuit of this body type need to be underscored.

Today's women can be helped by using media to their advantage, encouraging media representatives to adopt role models reflecting a broader spectrum of beauty than that which has traditionally been portrayed. Several campaigns (Special K, Just My Size) suggest that some media representatives are trying to portray more realistic images.