Are eating disorders really linked to the perfect appearance?

22.01.2020 - Articles, Eating disorders

These days, when everyone is preoccupied with the cult of the slim body, many adults and even children suffer from bulimia and other eating disorders. These conditions are a serious health problem that affects an increasing number of young people. The percentage of bulimia cases in the last 40 years has increased tenfold. Today about 3% of the adolescent population exhibits these problems. Why is that the case? What has the biggest influence on young people and why are more and more of them succumbing to these illnesses?


Early studies investigating the role of the media in the context of eating disorders focused on the decreasing weight of women who are held up as ideals of beauty, including actresses and models.

Studies have confirmed that women in Playboy centrefolds, Miss America Contestants and fashion models between the 1950s and the 1990s were getting thinner and thinner[1]. A significant increase in weight in American and Canadian women was observed during the same period.

It showed the difference between the image of a woman as shown in the media and in reality[2].

Press, television and advertisements have created a social context that may contribute to body dissatisfaction and disordered eating in girls and women.

Studies found a significant increase in advertisements for diet foods and diet products for the years 1973–1991[3]. Anderson and DiDomenico compared pressures on women and men. Studies showed that women’s magazines contained 10.5 times as much content promoting dietary topics as men’s magazines[4].


The media have changed but the problem has not

You may not even realise what impact social media have on our society. The numbers provided by the Pew Research Center[5] demonstrate that social media are more influential than most of us would imagine. For example, 69% of US adults use Facebook, 73% of US adults use YouTube, 75% of 18-24 year-olds use Instagram and 73% of 18-24 year-olds use Snapchat. While we can see that the majority of Americans use social media, what is even more surprising is the regularity. 74% of US adults use Facebook daily, with 51% visiting it several times a day. Roughly 77% of Snapchat and Instagram users aged 18-24 use the apps several times a day.

Although social media by themselves do not constitute the sole cause leading to eating disorders, they have predisposed individuals to engage in disordered patterns of eating. According to research[6], media are “a causal risk factor for the development of eating disorders” and have a strong influence on a person’s body dissatisfaction, eating patterns and poor self-concept. Individuals begin to constantly compare themselves to thin models, their peers and famous social media users, and begin to feel inadequate about their own self-image.

According to the National Eating Disorder Association[7], a recent study of women between the ages of 18 and 25 showed a link between Instagram use and increased self-objectification and body image concerns, especially among those who frequently viewed fitspiration images.

Americans that spend around two hours a day on social media are potentially exposed to unrealistic standards of beauty, diet talk, body shaming, thinspiration, posts about weight loss and more. Another study[8] of social media users showed that higher Instagram use was associated with a greater prevalence of orthorexia nervosa symptoms, highlighting the influence social media have on psychological well-being.

Thin beautiful lady black and white


The change of the standard of beauty

Social media channels are used to share everything today, and they have become a significant tool for influencing others and promoting the perfect body and appearance in several key ways. Media create a reality where one should strive to be slim. They also emphasise the great importance of appearance in general. Our culture glorifies an unattainable standard of beauty. The beauty industry invests billions of dollars to encourage women to buy products that are advertised as appearance enhancers.


Body dissatisfaction and unsafe weight control methods 

The drive for thinness, body dissatisfaction and unsafe weight control methods have become an epidemic. The size of the problem has led theorists to posit the existence of mechanisms that are capable of reaching women on a massive scale. They proposed the media as such a mechanism, as they have an ever-increasing influence and reach, encompassing women in the entire world.

This dissatisfaction with weight has become common. Therefore psychologists have coined the term “normative discontent”. It is meant to denote the idea that it is normal for females to be unhappy with their own weight.


Numbers for England in 2018/19

The number of children and young people admitted to hospital for eating disorders has risen by 8% in the last year, according to NHS Digital data for England.

The figures for 2018/19 – described by experts as “worrying” – show an increase of 37% in hospital admissions in the last two years, with 4,471 people aged 18 and under seen by medics – compared with 4,158 the year before.

More than half of the recent admissions (2,403) were for anorexia, up 12% from 2,147 the previous year, with 10 cases involving boys – and six among girls aged nine and under.

Eating disorder in numbers horizontal
Eating disorder in numbers horizontal

Direct relationship between media exposure and eating pathology

Numerous studies have examined the correlation between the use of mass media and body satisfaction, eating disorder symptomatology and negative affect. The majority of the research has demonstrated a direct relationship between these factors.

The strength of the correlations varies within and between studies and depending on the type of media exposure[9].

A number of controlled experimental studies have been conducted in order to understand the direct or indirect relationship between media exposure, body dissatisfaction and disordered eating. Researchers have conducted experiments concerning the role of the media as a mechanism that provokes eating disorders by showing images of slender models in fashion magazines to young women, and measuring the body satisfaction, self-esteem, mood, drive for thinness and eating pathology of the subjects before and immediately after the exposure. The results of these studies were mixed, with some of them demonstrating that females exposed to such media images experienced an increase in body dissatisfaction and emotional distress, while others found no immediate effects.

These mixed results led Groesz and colleagues to run a meta-analysis of 25 controlled experiments that evaluated the immediate effects of presenting images of models that represented the “standard of thinness” to women. The study demonstrated that body satisfaction in women was significantly lower after being exposed to images of this kind than after viewing control images. These results support the sociocultural theory that the modern mass-media create and promote a standard of beauty that drives many adolescent and adult females to experience significant body dissatisfaction.

Research shows that body dissatisfaction, negative affect or eating pathology are all results of trends that promote slimness. Some recent studies even point to an indirect influence exerted by the media on women’s views of their own bodies through the act of shaping men’s expectations on how a woman should look.

role of food in media

Which girls and women are more vulnerable to bulimia?

It has become evident that exposure to mass-media images of slim models and the perceived pressure from the media to stay thin negatively affect women’s emotional well-being and body image. This in turn has led researchers to evaluate the factors that can make certain girls and women more vulnerable to the images and the general narrative presented in the media.

Recent evidence suggests that individuals who are already at risk of, or vulnerable to eating disorders, are more susceptible to the negative effects of mass-media. The review written by Groesz and colleagues indicated that women who had already exhibited high levels of body dissatisfaction and/or who had already internalised thinness as the standard of beauty were the most vulnerable. A meta-analytic review by Stice indicated that adolescent girls with initial deficits in social support and increased perceived pressure to be thin were also more vulnerable to the effects of messages conveyed by the media. Recent research has also demonstrated that social comparison mediates the relationship between media exposure, body dissatisfaction and eating pathology. Thus the impact of the media is influenced by the individual characteristics of the girls and women who are exposed to them.

Young women who exhibit preoccupation with their weight and figure, body dissatisfaction, internalisation of the slim ideal and tendency for social comparison are the most influenced by the media, and they are also more likely to browse said media.

Women with anorexia nervosa who use media in an unrestrained manner describe their consumption of fashion magazines as an “addiction”. Many of them say that the periods of their greatest dependency on media started after their eating disorders had begun to take control of their lives.

Beauty magazines become manuals meant to help women who suffer from eating disorders in their attempts to obtain an elusive and impossible standard of physical thinness. Fashion magazines further reinforce the anorexic desire for restriction. They also serve as a counterbalance to the dissonance arising from comments made by family and friends by promoting and endorsing messages that encourage thinness and dieting.


Excessive preoccupation with one’s own body, as enforced by the mass media, can take on the following forms: 

  •  dismissing the reality of aging, which may be related to a fear of the future and the passage of time or the changes that one must constantly adapt to,
  •  striving after an excellent physical condition, which may lead to overexerting the body and struggling to achieve unrealistic standards,
  •  denying the existence of natural physiological processes,
  •  introducing more and more requirements related to appearance, which are often increasingly difficult to accomplish,
  •  becoming addicted to care and beauty treatment as well as utilising invasive measures related to plastic surgery.


Why is bulimia addictive?

Much of the literature concerning the role of mass-media in the treatment and prevention of eating disorders has focused on media literacy, activism and advocacy. Media literacy involves teaching people to think more critically about the different aspects of media, increasing awareness of media use, and analysing the content and intentions of the media producers. Thanks to media literacy, adolescent girls know how to decipher and discuss the images and general narratives presented in the media. They learn that media images are constructed, that what they see in them is not reality, and that all media creations only represent a certain point of view. Media literacy usually emphasises that all forms of media are created through very deliberate and well-researched processes that are primarily profit-driven.

The use of media literacy has some limited success in improving the self-esteem and body image of girls. College women with negative body image who were shown a seven-minute psychoeducational presentation involving media analysis were less likely to engage in social comparison and also less likely to be negatively affected by images of slim models compared to students exposed to the same images without the element of media literacy.

Others have found it effective to provide girls with a new framework for interpreting the media images and messages[10].

Modest results were demonstrated by three prevention programs for adolescent girls that incorporated media literacy. These programs were able to provide some improvement in terms of knowledge, and the internalisation of the standard of thinness and body image. Unfortunately they did not consistently accomplish all of their goals, but it is possible that such programs can still provide unexpected benefits in the long-term perspective.

Researchers have also focused on ways to fight the risk factors that make certain individuals more vulnerable to the negative effects of the media.

Treatment programs for eating disorders will be the most effective once they incorporate media literacy with special strategies to help address the patients’ deficits in self-esteem and social skills.


Media give us images of the “thin ideal” for women

So far, mass-media have shown us images of the “thin ideal” for women. An ideal that has been becoming increasingly thin since the 1950s and thus increasingly unrealistic for most girls and women to achieve. The messages and images that focus on the value of appearance and thinness for females have a significant negative impact on body satisfaction, weight preoccupation, eating patterns and the emotional well-being of women in western culture. Researchers proved that media contribute to the development and perpetuation of eating disorders. Media literacy, activism and advocacy should be the weapon of choice for the prevention and treatment of eating disorders. Given the prevalence of body dissatisfaction and disordered eating in females in our society, and the associations which have been observed between eating disorders and the media, it would be prudent for professionals and the public alike to advocate for more positive and self-esteem-building messages to be conveyed to women by the media.



[1] Garner DM, Garfinkel P, Schwartz D, Thompson M. Cultural expectations of thinness in women. Psychological Reports. 1980;47:484–491: Link to source.

[2] Wendy Spettigue, M.D., F.R.C.P.C. and Katherine A. Henderson, Ph.D., C. “Can Child Adolesc Psychiatr Rev.” 2004 Feb; 13(1): 16–19: Link to source.

[3] Wiseman CV, Gray JJ, Mosimann JE, Ahrens AH. Cultural expectations of thinness in women: An update. International Journal of Eating Disorders. 1992;11:85–89: Link to source.

[4] Anderson AE, DiDomenico L. Diet versus shape content of popular male and female magazines: A dose-response relationship to the incidence of eating disorders? International Journal of Eating Disorders. 1992;11:283–287: Link to source.

[5] Pew Research Center: Link to source.

[6] Wendy Spettigue M.D., F.R.C.P.C. & Katherine A. Henderson Ph.D., C., Eating Disorders and the Role of the Media: Link to source.

[7] National Eating Disorder Association: Link to source.

[8] Turner PG, Lefevre CE. Instagram use is linked to increased symptoms of orthorexia nervosa: Link to source.

[9] Vaughan K, Fouts G. Changes in television and magazine exposure and eating disorder symptomatology. Sex Roles. 2003;49(7–8):313–320: Link to source.

[10] Martin MC, Gentry JW. Stuck in the model trap: The effects of beautiful models in ads on female pre-adolescents and adolescents. The Journal of Advertising. 1997;26:19–33: Link to source.


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