Eating Disorders | Introduction
Fiji, a small island in the South Pacific that has only had electrical power for fifteen years, was almost completely isolated from Western culture until 1998, when the country’s one television station began broadcasting Hollywoodproduced programs such as “Seinfeld,” “ER,” and “Melrose Place.” Soon afterward, teenage girls on the island—whose traditional culture values large figures over thin ones—began developing behaviors associated with disordered eating, such as induced vomiting and self-starvation. Anne Becker, an anthropologist at Harvard Medical School who has studied the island’s eating habits since 1988, reports that, after the advent of U.S. television programs, 74 percent of Fijian teenage girls said that they felt “too big or fat” and 15 percent had vomited to control weight.
In some cases, Fijian girls exhibited the symptoms of a full-blown eating disorder. According to the DSM-IV, a manual of mental disorders created by the American Psychological Association, a woman is suffering from anorexia nervosa when her weight is 15 percent below the normal range and she has not menstruated for three months; other physical symptoms include dry skin, brittle nails and hair, lanugo (fine downy hair on the face and body), constipation, anemia, and swollen joints. Bulimia nervosa is defined as two or more episodes of binge eating, followed by induced vomiting or the use of laxatives, every week for at least three months. Those suffering from binge eating disorder also engage in frequent eating binges, but do not use compensatory measures to prevent weight gain.
Eating disorders have confounded clinicians for more than a century, and the debate over what causes these disorders has yet to be resolved. Becker’s study demonstrating the link between television and eating disorders in Fiji lends influence to the theory that cultural values are a significant cause. According to many eating disorders specialists, the prevalence of Western media images equating extreme thinness with beauty causes women to feel dissatisfied with their bodies and consequently to engage in dangerous methods of weight loss. Kathryn Putnam Yarborough explains how society’s obsession with thinness, transmitted through media images, affects women:
It is hard not to be affected by the media bombarding us constantly with the message, “Thin is in!” On TV commercials we are told to “lose weight fast” or “exercise for thirty minutes” to have a beautiful body. Magazines displaying thin, attractive women try to convince us that we are not okay until we “slim our thighs.” The overriding message is that we need to change something about ourselves in order to be loved or successful. In particular, if we have thin, fit bodies, “our lives will be perfect.”
The results of a study conducted by psychologists Eric Stice, Diane Spangler, and W. Stewart Agras, however, suggest that the media may not be a highly influential factor in the development of eating disorders. The researchers provided a fifteen-month subscription to the fashion magazine Seventeen to a random sample of thirteen- to seventeenyear- old girls; a control group read no fashion magazines. The findings surprised many: Participants who spent time reading the fashion magazine did not report any increased body dissatisfaction, belief in cultural ideals of thinness, dieting, or negative emotions. Only adolescents who had already exhibited low self-esteem prior to the study felt depressed after exposure to the magazine.
Stice, Spangler, and Agras’s study affirms the theory that psychological problems are the underlying cause of eating disorders. According to the findings of an Australian research team, girls who suffer from anxiety and depression are seven times more likely than others to have an eating disorder. Other research demonstrates that women who are overly sensitive to rejection and prone to feelings of irrational guilt and obsessive worry may be at increased risk of developing eating disorders. Thus, as stated by the Harvard Mental Health Letter,
anorexia has been described as one way a girl with this kind of personality may respond to the prospect of sexuality and independence. . . . Fasting restores a sense of order to her life by allowing her to exert control over herself and others. She is proud of her ability to lose weight, and self-imposed rules about food are a substitute for gaining independence.
Although many experts believe that a psychological predisposition to eating disorders is caused by a person’s family environment, recent studies documenting the biological basis of many psychological problems has led researchers to investigate a link between genes and eating disorders. Based on her interview of two thousand twins, psychiatrist Cynthia Bulik estimates that bulimia is 83 percent genetically influenced and anorexia is 58 percent genetic. Matt Crenson, an Associated Press reporter, states that “researchers . . . are far from finding an ‘eating disorder gene.’ In fact, such a gene does not exist. But having some gene—or more likely, some collection of genes—greatly increases a teenage girl’s chance of developing an eating disorder.”
The theory that eating disorders are hereditary would explain, for example, why eating disorders are found on the Caribbean island of Curacao, where fatness is considered attractive. However, claim some specialists, the theory that eating disorders are a cultural, rather than a biological, phenomenon better explains why eating disorders are increasing among males as media images of men with perfectly sculpted bodies are becoming more widespread. In the following chapters—How Serious Is the Problem of Eating Disorders? Who Is at Risk of Eating Disorders? What Causes Eating Disorders? How Should Eating Disorders Be Prevented? and How Should Eating Disorders Be Treated?—the authors in Eating Disorders: Opposing Viewpoints pose contrasting arguments about the causes of eating disorders and offer solutions as to how society can respond to this problem.
