Social and Cultural factors in Eating Disorders; The Apprentice to Kim Kardashian.
Social and Cultural factors have long been blamed for the development of eating disorders in females and also more recently in males too. Do shows like The Apprentice in 2013 with pretty much only fit, slim attractive women and highly publicised women like Kim Kardashian cater to this perfect body ideal, or is there more to it than just media portrayal? In order to evaluate the socio-cultural model of eating disorders (EDs) it is first essential that a definition of an ED be provided and an explanation of the socio-cultural model given. Following this the model shall be broken down into its three component parts in order to indicate the importance of those areas within the concept and the validity of the model as a whole.
ED’s are characterised by a pronounced disturbance in eating behaviour and negative self-attribution that promote such a disturbance. Classified ED’s include: Anorexia Nervosa (AN; disorder with calorie restriction, binge eating or purging in order to remain at a below optimum weight), Bulimia Nervosa (BN; calorie purging and non-purging, with a lack of control over eating to maintain a below optimal weight) and Eating disorders not otherwise specified (EDNOS; where criteria in the previous descriptions are met with slight differences indicating the presence of a disorder) (DSM-IV, 2000). The criteria for ED’s are not rigid with regards to some disorders as indicated by the presence of EDNOS and there are also other disorders that can be seen as co-morbid with ED’s (Muscle Dysmorphia, OCD). The current work will focus on AN and BN as the bulk of data with regards to the socio-cultural model involves primarily women suffering from these illnesses although information shall be briefly related to males also.
Research implicating socio-cultural pressures on ED development argues that, the unrealistic standards for attractiveness set by society (particularly, western, white, adolescent women) mean that the vast majority of individuals do not match these standards. They then go onto develop body dissatisfaction and undertake compensatory eating behaviour for somatotype alteration (Thompson, 1999). The classic model comprises 3 general categories: the thin-ideal body for women, the centrality of appearance in the female gender-role, and the importance of appearance for societal success that individuals internalise (Stice, 1994). This is then influenced by family, peer and media influence which are regarded as the transmitters of socio-cultural pressures. Much past research focuses on BN in females (as ED’s are more prevalent in females) although the prevalence of socio-cultural effects is increasing in males (MD) and is almost comparable (Frederick, 2007). The current work will therefore treat both genders and related syndromes under the broader term of ED’s, however, efforts shall be made to briefly relate the data to the gender and disorder most implicated. The aim is to evaluate if the model has sufficient predictive power so as to identify direct and indirect factors in disordered eating. The first of the three components shall be evaluated next.
The thin ideal body for women is a contentious issue and is generally seen to be, the thinner the media model, peer, family member, the more attractive. Research does indicate that increased exposure to the ultra thin media models leads to image concerns amongst women (Groesz, 2002). Other research indicates an intrasexual competition, where ED’s are seen to enable the thin ideal which is important for mate attraction (thin from a female perspective) and influenced by socio-cultural factors such as the increased amount of media time devoted to female appearance (Abed, 1998). Although another study using playboy centrefolds and beauty pageant winners as representatives of the ideal, report many discrepancies in male preference for what is the ideal female body (Freese & Meland, 2002). This would indicate a mixed bag of competing perspectives between the genders and so male influence is potentially less important. A females own internalisation (making behaviours and attitudes part of one’s nature through learning) based on media influence of her fellows is more prominent and thus supportive of the model. Further research by Halliwell (2005) asked participants with ED’s to rate anxiety levels when shown ultra-thin, average and control images. Results showed no increased anxiety when viewing the ultra-thin but a relief effect when viewing the average size. This suggests that average size attractive models could be used in advertisement to relieve body image concerns. From a female perspective, the notion of internalising these thoughts of the thin ideal and the therapeutic effect of average sized women, seems to support the notion of thinness as an important component of the model despite evolutionary discrepancies. Images generated by other females in the media, are seen to have a greater effect on ED aetiology than that of opposite sex preference on the grounds of the thin ideal and gender role, which shall be discussed next.
The appearance of females in their gender role and also males on a comparison to others basis including: family, media portrayals or peers (the transmitters), is seen to have a large effect on ED development. Ricciardelli & McCabe (2001) indicates body dissatisfaction among adolescent boys is predicted by perceived pressure to lose weight from their family, and for boys with low self-esteem, the media. Young women remain however more susceptible to internalising socio-cultural ideals, indeed this is the strongest relating factor to ED development. A key exploratory study and a demonstrative one for cross gender effects of this aspect of the model is by Halliwell & Harvey (2006). They Used Stice’s original model, including peer comparison due to the evidenced link and administered self-report materials for body dissatisfaction, eating behaviour, internalisation, perceived socio-cultural pressure and perceived weight. They found of 250 females and 257 males, aged 11-16 years that for both males and females (mostly white) social comparison was particularly important. Females, however, tended to be more influenced by the societal pressure of appearance; experiencing higher levels of body dissatisfaction than males by desiring to be thinner. A difference in age was indicated in male scores; decreasing scores as they got older and across the sample, internalisation and body dissatisfaction was associated with eating behaviours via social comparison. Evidence supports aspects of Stice’s (1994) socio-cultural model among adolescent girls. Additionally, findings indicate that the model can also explain ED behaviour in boys. Furthermore, findings support the inclusion of social comparisons (a transmitter) in the model, as appearance comparison partially mediated a link between perceived pressure and internalization among adolescents. The fact that this internalisation may also be increased by other factors such as appearance being important for social success is also seen to be important.
Catwalk in which I modelled highlighting ED’s in the industry
A physical attractiveness equals a good person stereotype has been abundantly demonstrated (Dion, Berschied and Walster 1972) and might also affect the way individuals internalise the need to be attractive (thin for women, muscular and lean for men as per the thin ideal and gender role stereotype) for success. More attractive people are seen as more sociable, dominant, intelligent, healthier in general and more successful and evidence suggests that they actually do possesses these traits (Feingold, 1992). Smith (2011) conducted a study on status aspiring college-aged women (not adolescence this time) to investigate status, body dissatisfaction and ED’s. The study asked 77 undergraduate women (majority white) to complete the Achievement Motivation Scale, Body Image State Scale and Eating Disorder Inventory. They completed questionnaires pre-manipulation then asked to rate random attractive, successful, unattractive, unsuccessful and combination images on likert scales of weight, success and attractiveness. Results indicated high aspiration women reported greater body dissatisfaction after being exposed to thin, successful women than did low aspiration participants although high aspiration women did not report greater bulimic symptoms. This indicates that women with high ambition do have greater body dissatisfaction after seeing thin successful images. This seems to support the entire link between thinness as the gender ideal and moreover an important factor for success in the way women feel about themselves. The fact that this doesn’t contribute to the manifestation of eating disorders in this instance is notable but in the majority of cases a drive for thinness does predicate ED development under the socio-cultural model (Bardone-Coe, 2006).
The original socio-cultural model was important and had high predictive validity. The thinness ideal is well supported by the increase in media portrayal and the hyperinternalisation of this by women is evident. Like any model though some discrepancies leave it open to refinement and that is exactly what has happened, with regards to gender roles and peer comparisons. Research regarding peer influence is scarce, although findings such as Halliwell’s are encouraging especially in that they include males. Improvements could include longitudinal studies starting with younger children (due to the non-uniform age and gender distribution) to explore body image concerns, to enable firmer conclusions to be made. Attractiveness is still seen to relate to societal success although the development of ED’s is less of a factor. It is likely that women with status aspirations will find themselves in situations where there will be other status aspiring females. Thus, there appears to be a paradoxical nature to success; although aspiring for status may help women become more successful and confident, it may also make them more vulnerable to the development of an eating disorder as indicated by much of the literature. The literature still remains heavily reliant on western white participants although this should not be a reflection on the fact that this is a western cultural condition. In conclusion, the socio-cultural model does seem to be well supported. With developments being made to enhance its use it is reasonable to assume that it will continue to remain so. It provides more than enough evidence for the contention that socio-cultural factors influence the development of ED’s.