Eating Disorders In Media: What's Accurate?
Eating disorders are a form of mental illness often causing body dissatisfaction and a preoccupation with weight loss or changing one's body shape. Eating disorders can majorly negatively impact a person's physical and mental health, leading to death in some cases. Preventing, identifying, and treating eating disorders are important strategies to reduce the adverse effects these mental health disorders can have on a person, their family, and society at large. However, media can often play into stigma and fear surrounding these conditions, so understanding the media’s role in eating disorder recovery can help you make positive changes, whether in your life or for those you care about.
Media as a risk of eating disorders
Various factors may increase a person's risk of developing an eating disorder. Experts agree that media is one such factor, noting that exposure to media that promotes a thin body as an ideal can "play a major role in increasing eating disorders' prevalence worldwide." Exploring the accuracy of the portrayal of eating disorders in media and other ways in which mass media, social media, and other media images may contribute to disordered eating can be a helpful first step to reducing media’s impacts.
Media's portrayal of eating disorders
Movies and TV shows often portray eating disorders inaccurately. Researchers examined 66 US TV and movie characters with eating disorders from 1981 to 2022 and found that the characters were primarily heterosexual white women under age 30, which doesn't accurately represent reality. This phenomenon is sometimes called the "SWAG" stereotype, in which the media portrays people with eating disorders as "skinny, white, affluent girls" instead of showing a more accurate, diverse, and well-rounded portrayal.
News media's coverage of eating disorders
TV shows, movies, and magazines aren't the only forms of media that can promote stereotypes and stigma surrounding eating disorders. The National Eating Disorders Association (NEDA) recognizes that the way news media covers stories related to eating disorders can also have adverse effects. NEDA provides these suggestions, among others, as ways to cover eating disorders safely and sensitively:
- Don't share graphic images or descriptions of the bodies of people who have eating disorders
- Don't portray larger bodies as unkept or unflattering
- Don't share weight or weight loss numbers or calorie counts
- Don't glamorize eating disorders or present them as involving willpower
- Don't assume everyone with anorexia nervosa is underweight or that everyone with binge eating disorder is overweight
Media and weight loss pressure
Eating disorders like anorexia nervosa and bulimia nervosa center on a desire to lose weight and a fear of becoming overweight. While the media may not directly cause a person to develop an eating disorder, messages in the media are thought to contribute to eating disorder development by creating weight loss pressure. Researchers say the media provides "a social context for eating disorders" by emphasizing thinness in models, actresses, and pageant contestants, as well as through dieting advertisements. TV shows, movies, magazines, and mass media may make the development of eating disorders more likely among people who already have low body satisfaction or a desire to lose weight.
Media normalizes weight loss desire
The desire to lose weight extends beyond people with eating disorders, and experts believe the media is at least in part to blame. A desire to lose weight has become common among women of all ages, from adolescence to older adulthood, especially in North America. Because the desire to lose weight is so pervasive, researchers call it a "normative discontent," which means it has become a norm for women and girls to be discontent with their bodies. Experts state that media literacy and activism to change the media's portrayals of bodies are needed to change this discontent.
Media and body image issues
When a person has a negative body image, they have negative thoughts and feelings about their body's shape, size, or appearance. Often, body image issues stem from comparing one's body to an ideal and feeling like it doesn't measure up. A negative body image often negatively impacts a person's self-esteem.
Researchers have found that a negative body image plays a role in the development of an eating disorder and disordered eating behaviors. They've also found that body image dissatisfaction increases in response to media exposure. Experts have called the media "channels of transmission of the current body aesthetic model." When that current body ideal is thin, people may turn to disordered eating to try and achieve the “ideal” in their own bodies.
Social media platforms and eating disorders
Traditional media isn't the only form of media that affects the development of eating disorders. A scoping review of 50 studies spanning 17 countries found that social media use increases body image concerns, disordered eating, eating disorders, and the thin ideal. The authors of the study suggest that social media's role in the development of eating disorders among adolescents and young adults "is worthy of attention as an emerging global public health issue."
Social media platforms and body image issues
Experts argue that social media platforms may lead to body image issues in three ways: through social comparison, internalization of the thin ideal, and self-objectification. In social comparison, people see images of other people and compare themselves to them. Internationalization of the thin ideal involves repeatedly seeing images of thin or fit people and adopting the belief that bodies that look like those are best. Self-objectification involves an increased awareness of one's own appearance and may lead to self-criticism, looking at photos of oneself to find flaws, and intentionally posting photos in which the body looks a certain way.
Instagram, food, and health
Research shows that using the social media platform Instagram, in particular, is associated with symptoms of orthorexia nervosa. Orthorexia nervosa is an eating disorder many experts recognize that is not present in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5). In orthorexia nervosa, a person has an unhealthy fixation on eating healthy foods. They may become obsessively focused on the perceived purity of their food and avoid foods or ingredients they deem unhealthy.
Unlike other eating disorders, orthorexia nervosa doesn't involve a preoccupation with weight or size. That said, a person with orthorexia nervosa may lose weight or become underweight if they engage in severe food restrictions. People with orthorexia nervosa may obsessively check ingredient lists and nutrition labels, adhere to a restrictive diet for health reasons, spend an unusual amount of time planning and preparing healthy meals, or be especially interested in or critical of other people's diets.
Instagram and food
Research shows that food is among the top eight categories of photos posted on Instagram, and "#food" is among the top 25 hashtags used on the platform. Photos labeled “healthy food photos” are more popular than those deemed unhealthy food photos by viewers. While seeing these photos could benefit some, others may experience adverse effects if these exposures promote obsessive behavior.
Some Instagram celebrities encourage their followers to cut out entire food groups for health reasons, even if research doesn't support that advice. Many health influencers on Instagram give nutrition advice they aren't qualified to offer, which could be harmful. While more Instagram use has been linked to more orthorexic symptoms, more research is needed to better understand how Instagram can influence people's food choices.
Instagram and health
In addition to being a home for many food photos, Instagram also houses fitness content. Photos with the hashtag "#fitspiration" have been found to display thin and toned women often presented in an objectified way. While other media types may pressure people to become thinner, these photos may pressure people to become healthier and more fit by the poster’s standards. Some viewers could experience adverse effects on body image and be more likely to develop an eating disorder as a result.
Eating disorder treatment options
Often, eating disorders are treated using multiple methods. A person with an eating disorder may receive treatment from a therapist, psychiatrist, dietitian, personal trainer, primary care physician, peers, or other mental health professionals at different times or in combination. However, two types of eating disorder treatment options appear to be most widely studied: medication and therapy.
Medication for eating disorders
Current research suggests that children and adolescents with eating disorders can benefit from psychological treatments, like therapy, more than medications. Medications haven't been approved for this age group, though some doctors may try certain medications in specific circumstances. In adults, both psychological treatments and medications may be considered, depending on the type of eating disorder present. While medications haven't had much success with anorexia nervosa, some are approved for bulimia nervosa and binge eating disorder.
The BetterHelp platform is not intended to provide any information regarding which drugs, medication, or medical treatment may be appropriate for you. The content provides generalized information that is not specific to one individual. You should not take any action without consulting a qualified medical professional.
Therapy for eating disorder treatment
Many people with eating disorders opt to receive therapy as part of their treatment. A therapist can provide a safe space in which a person can discuss their disordered eating habits, as well as related thoughts and feelings, which are often difficult to discuss with friends and family.
Remote therapy may offer a greater sense of safety than in-person therapy since a person can attend sessions from their chosen location as long as they have an internet connection. Through a remote therapy platform like BetterHelp, clients can be matched with a therapist with experience in eating disorders after signing up, often within 48 hours.
A 2023 systematic meta-review of meta-analyses identified the most evidence-based treatments for eating disorders. The authors named cognitive-behavioral therapy the top treatment for adults with anorexia nervosa or bulimia nervosa. Evidence supported medications as the most supported treatment for binge eating disorder but confirmed that cognitive-behavioral therapy was also effective. Online eating disorder therapy has also been proven highly effective, especially for binge eating disorder and bulimia.
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