Eating Disorders in Popular Media vs. Scholarly Research

Introduction: Two Approaches to Eating Disorders

A wafer-thin model smiles wanly at the reader. The blonde model is eating a large, greasy slice of pizza. The headline proclaims: "Looking Beyond the Runway for Answers on Underweight Models." Although the New York Times is a respectable media publication, in many ways this sensationalist and simplistic framing perfectly captures the popular media's attitude toward eating disorders. The media focuses on the glamorous, the strange, and the visible side of these conditions. A slice of pizza and greater vigilance from designers are presented as capable of "curing" a psychological illness.

The popular media focuses on the physical image of dangerous or beautiful thinness, or sometimes on a personal story that is supposed to highlight all of the facets of a complex disorder. In contrast, although less story-oriented, scholarly publications tend to examine issues of treatment from a clinician's rather than a sufferer's perspective. The popular media is driven by the visual, by personal narrative, and by explaining the causes of eating disorders and treating them as social phenomena. Scholarly publications focus on the specific treatment needs, psychology, and physiology of patients from a clinical standpoint, and do not focus on individuals or even on causation at all.

How Popular Media Frames Anorexia

A local media publication, the Greeley Tribune, tells of "The Struggle Against Anorexia: Former University Swimmer Battles the Disease." In this article, anorexia is portrayed as a mysterious, unstoppable force. The young woman was a talented swimmer, apparently happy according to her parents and the article, but after her swim coach encouraged her to lose some of her "baby fat," she engaged in a deadly diet that eventually required hospitalization. She has since been hospitalized multiple times to be "re-fed," but has failed to maintain her discharge weight and has been expelled from school. According to the article, no one understands — not even the young woman herself — why she cannot maintain her weight and seeks to cope with her problems through starvation. Anorexia has cost her school, friends, and even the swimming talent that apparently drove her to starve in the first place.

In the New York Times article, the physical complications of anorexia, other than death, receive little attention. Rather, the focus is on the media's ability to influence girls' self-esteem and the responsibility of the fashion industry to change its image as a promoter of eating disorders — driven by the demand for thinner and thinner models, even as the average American grows heavier. Both popular articles attribute tremendous power to media and social forces to reshape minds and bodies.

How Scholarly Publications Address Anorexia Treatment

Scholarly publications focus not on the face of the disease, nor on particular subsections of it such as the modeling industry, nor on social policy such as limiting models' Body Mass Index (BMI) below a certain threshold. Instead, they pose practical, clinical questions. The Nutrition Research Newsletter, directed at clinicians, describes one challenge of anorexia treatment as returning the malnourished body to homeostasis — specifically, the difficulty of determining the correct caloric intake for institutionalized patients. There are often large discrepancies between predicted and measured values of resting energy expenditure (REE) in anorexic versus healthy patients.

One study set out to identify the factors associated with increases in REE during refeeding, comparing eighty-seven malnourished anorexic patients and forty-eight healthy, non-anorexic controls. The anorexics' rates of caloric expenditure were measured alongside their energy intake (EI), physical activity, body composition, smoking behavior, complaints of abdominal pain, anxiety, depressive mood, serum thyrotropin and thyroid hormone levels, and urinary catecholamines. Caloric expenditure increased significantly more in the anorexic group — from 3.84 to 4.36 MJ/day — and the 13.4% increase was greater than that expected on the basis of the increase in lean muscle tissue alone. This increase was related to four factors: energy intake, anxiety, abdominal pain, and depressive mood.

Conclusion: Integrating Popular and Scholarly Perspectives

In these scholarly articles, the personal implications of treatment, or the feelings of anorexics in treatment, are seldom discussed, nor is the cause of the behavior or the tendency to relapse. These articles may be of value for clinicians, but they do little to humanize the person behind the disorder or even to provide guidance for families and sufferers dealing with a still thin-obsessed world after treatment. One of the strengths of the popular media, for all of its weaknesses, may be its ability to put a face and a societal context to this disorder.

Perhaps the best approach is to view popular and scholarly perspectives together. For example, the finding that certain anorexic patients may have a harder time maintaining weight even at higher caloric intake levels — because of anxiety and other features related to malnutrition — may help explain why some anorexics have difficulty adhering to a meal plan after treatment. If it is metabolically "easier" for an anorexic to lose weight once a state of malnutrition is established, even when the patient is eating more than she or he is accustomed to, that clinical insight gives important context to the personal struggles depicted in popular media accounts. Neither approach alone is sufficient; together, they offer a more complete picture of one of the most complex and dangerous psychological disorders affecting young people today.

Works Cited

"Energy Expenditure in Anorexia Nervosa." Nutrition Research Newsletter, Jan. 2005.

Murphy, Megan. "The Struggle Against Anorexia: Former University Swimmer Battles the Disease." Greeley Tribune, 4 Feb. 2007.

Paccagnella, Agostino, Alessandra Mauri, Carla Baruffi, Rita Berto, et al. "Application Criteria of Enteral Nutrition in Patients With Anorexia Nervosa: Correlation Between Clinical and Psychological Data in a 'Lifesaving' Treatment." JPEN: Journal of Parenteral and Enteral Nutrition, May/Jun. 2006.

Trebay, G. "Looking Beyond the Runway for Answers on Underweight Models." The New York Times, 6 Feb. 2007.