The Skinny on Regulating Media Images to Prevent Eating Disorders

The current study examines the effectiveness of a large-scale policy mandating disclaimers on media images that promote the thin ideal of beauty in reducing body image concerns and disordered eating behaviors among college-aged women. Participants were 97 female college students from a diverse range of ethnic backgrounds(67% white/Caucasian). Participants were randomly assigned to either the disclaimer or the control condition. In the disclaimer condition, participants viewed a set of magazine images of the thin ideal with disclaimers with the statement: “Caution: This image has been digitally altered to change the subject’s appearance. This is not an accurate representation of the subject’s shape and/or weight. ” In the control condition, participants viewed an identical set of magazine images without the disclaimers. Levels of thin ideal internalization, social comparison, body dissatisfaction, drive for thinness, and self-esteem were measured before and after the experimental manipulation. Between-samples t-tests revealed no significant differences in levels of the dependent variables between the conditions at baseline and post-manipulation. Pairedsamples t-test that measured changes within conditions from baseline to post-manipulation revealed significant decreases in self-esteem in both conditions and significant increases in thin ideal internalization in the disclaimer condition. Participants who scored higher than the norm for college students on a standard measure of disordered eating behavior and body image concerns demonstrated significant increases in thin ideal internalization and significant decreases in selfesteem from baseline to post-manipulation. The main implications of the study are that viewing media images of the thin ideal differentially affects women at high risk for eating disorders, and disclaimers are likely not an effective means to prevent body image concerns and disordered eating behaviors associated with viewing images of the thin ideal. REGULATING MEDIA IMAGES 3 The Skinny on Regulating Media Images to Prevent Eating Disorders Disordered eating pathology is common among female college students in the United States, with 4% 9% being diagnosed with a clinical eating disorder and 34% 67% endorsing symptoms of eating disorders, particularly pathological body image concerns (Fitzsimmons-Craft et al., 2011). Eating disorders encompass a range of pathological behaviors and attitudes related to weight, shape, and food. Pathological body image concerns are elevated weight and shape concerns that predict the onset of eating disorders (Stice, 2002). These behaviors and attitudes merit attention because eating and body image concerns result in high levels of impairment in physical, mental, and social health (Vannucci et al., 2012). The current study examines the potential efficacy of an emerging policy aimed at reducing these concerns, namely the inclusion of disclaimers on retouched media images that promote the thin ideal of beauty. Recent studies suggest that this broad level approach may be an effective large scale prevention strategy for pathological body image concerns and disordered eating among women (Slater, Tiggemann, Firth, & Hawkins, 2012). According to sociocultural theories of eating disorders, women develop body image concerns and disordered eating behaviors in response to overwhelming societal pressure to be thin. This standard for female attractiveness is often referred to as the “thin ideal” of beauty. Women are constantly bombarded with images and messages that support the thin ideal, as it is pervasive in magazines, television shows, movies, advertisements, books, and the internet, and is a frequent topic of conversation. This constant exposure leads many women to internalize the thin ideal and aspire to embody it, even though the weight and shape of the thin ideal would be nearly impossible for most women to achieve (Fitzsimmons-Craft et al., 2011). Research has REGULATING MEDIA IMAGES 4 found that women weigh considerably more than the body weight that they perceive to be ideal, the body weight women believe men consider the most attractive, and the body weight that they believe other women consider ideal (Barnett, Keel, & Conoscenti, 2001). The mass media has been scrutinized for its role in promoting the thin ideal and contributing to body image concerns and disordered eating among women. Content analyses of television shows, movies, and magazines indicate that many females depicted in the media weigh considerably less than the average American woman, and that the average weight of women in the media has been decreasing over time (Fouts & Burggraf, 1999; Silverstein, Purdue, Peterson, & Kelly, 1986). Meta-analyses conclude that exposure to images of the thin ideal in the media is associated with body dissatisfaction and disordered eating behaviors among women (Grabe, Ward, & Hyde, 2008; Groesz, Levine, & Murnen, 2001). There is also substantial evidence that media exposure to the thin ideal evokes increased drive for thinness, negative mood and affect, and decreased self-esteem (Dalley, Buunk, & Umit, 2009; Grabe, Ward, & Hyde, 2008; Groesz, Levine, & Murnen, 2001; Hausenblaus et al., 2013; Stice, Schupat-Neuberg, Shaw, & Stein, 1994; Stice & Shaw, 1994; van den Berg et al., 2007). Researchers have also found that women with elevated levels of pathological body image concerns and disordered eating behaviors are differentially affected by viewing images of the thin ideal. Yamamiya, Cash, Melnyk, Posavac, and Posavac (2005) found that women with elevated levels of thin ideal internalization demonstrated lower body dissatisfaction following exposure to magazine images of ultra-thin models compared to women with low levels of thin ideal internalization. Ferguson (2013) conducted a meta-analysis of media effects on body image concerns and eating disorder symptomology in males and females, and found that women with pre-existing body dissatisfaction were more susceptible to the effects of viewing images of the thin ideal; they REGULATING MEDIA IMAGES 5 demonstrated greater increases in body dissatisfaction following exposure than women without pre-existing body image concerns. Together, this research suggests that the media is a strong proponent of an unrealistically thin standard of beauty and exposure to this thin ideal contributes to body image concerns and disordered eating among women, particularly those with preexisting pathological body image concerns and eating disorder symptoms. Sociocultural theories also provide a compelling explanation of the process by which women develop body image concerns and disordered eating in response to societal pressure to be thin. Social comparison theory purports that people are driven to assess various aspects of themselves and often accomplish this by comparing themselves to others. Furthermore, individuals choose objects of social comparison based on how similar they are to themselves in relevant ways (Festinger, 1954). For example, a child who would like to judge her running ability would likely compare her speed to the speed of other children her age, not to the speed of a seasoned Olympic athlete. When applied to explain the effects of viewing media images of the thin ideal on female body image concerns and disordered eating, social comparison theory suggests that when viewing images of the thin ideal, women engage in a social comparison process in order to judge their own appearance (Tiggemann & McGill, 2004; Tiggemann & Polivy, 2010; Tiggemann, Polivy, & Hargreaves, 2009; van den Berg, et al., 2007). Women who engage in such comparisons often perceive discrepancies between their bodies and the thin ideal, and these perceived discrepancies result in body image concerns (Dalley et al., 2009; van den Berg, et al., 2007). Disordered eating often emerges as women with body image concerns attempt to alter their weight or shape through dieting or other unhealthy weight loss strategies, and may develop into an eating disorder (Stice, 2002). REGULATING MEDIA IMAGES 6 Social comparison theory also offers an explanation for why women’s magazines in particular evoke body image concerns, disordered eating, and other aforementioned psychological disturbances among females. Photo-editing techniques used to make images of women in fashion magazines and advertisements appear more visually appealing and congruent with the thin ideal of beauty exacerbate discrepancies between actual women’s bodies and the standard of beauty promoted in Western society. Photo-editing techniques are used to create the illusion that women appearing in advertisements and magazines have thin and toned bodies with ideally proportioned body parts (Kee & Farid, 2011; Metzmacher, 2008). Such photo editing techniques are widely used, and media consumers do not necessarily recognize when images have been retouched (Kee & Farid, 2011). This inability to distinguish digital fabrication from reality may partially account for the links between viewing images of the thin ideal in magazines and body image concerns, negative affect, and disordered eating behaviors. With this in mind, there have been recent efforts to regulate the use of photo editing techniques on media images through legislation and policy changes (e.g., limits on airbrushing, placing disclaimers on digitally altered images) in the United Kingdom, France, Australia, Israel, and the United States. The American Medical Association has endorsed the view that guidelines should be established for the use of digitally altered images in advertising in order to avoid promoting unrealistic standards of beauty to children and adolescents (American Medical Association, 2011). One policy under consideration in several countries and already adopted in Israel stipulates that fashion magazines must disclose when images in magazines and advertisements have been altered to make models appear thinner than they actually are (Lis &