The advice seems easy enough to execute -- if you do not want your child exposed to media content you deem unacceptable then simply "change the channel or turn off the television." Unfortunately, pulling the plug on the TV in your own home may not be enough to curtail the beginnings of an eating disorder in your son or daughter. Data from recent research conducted by investigators from Harvard Medical School's Department of Global Health and Social Medicine indicates that the nature of the television shows viewed by your child's friend is a greater predictor of whether or not your child will develop an eating disorder than is the type of shows she watches directly.

The study, which was published in The British Journal of Psychiatry, investigated the impact of direct and indirect television viewing on adolescent girls in Fiji. Why Fiji? Broadcast television only became available in Fiji in the mid-1990's and home ownership of television sets still varies among the Fiji communities.  These circumstances create an ideal situation in which to test the impact of television on eating behaviors.

Traditionally, a more "robust body shape" has been favored in Fiji.  Broadcast television challenged this perception by introducing the concept of a thinner body frame. Prior research conducted by the investigators of the current study found that symptoms of disordered eating increased in Fijian adolescent girls when broadcast television became accessible. The current study was designed to determine the impact of direct and indirect mass media exposure on eating behaviors.

Investigators studied 523 adolescent girls, ages 15 to 20 years. Every participant's body weight and height was recorded. Each subject's eating behavior was assessed using the Eating Disorder Examination Questionnaire. The influence of mass media on each individual was determined via the Sociocultural Attitudes Towards Appearance Questionnaire. Furthermore, the type of media exposure was evaluated using four measures: frequency of personal TV viewing; accessibility of household electronic media; frequency of parental TV viewing; and, social network media exposure (e.g. how many of the subject's friends and schoolmates watched TV).

The results of the investigation revealed that both direct and indirect exposure to mass media increased the risk for disordered eating; however, indirect exposure to mass media was associated with a greater prevalence of eating pathology after adjusting for factors such as age, community location, and cultural orientation. The researchers concluded that as the perceptions of friends and schoolmates within one's social network change to favor a thinner body shape as a result of television viewing, the individual's likelihood of developing an eating disorder is increased.

Symptoms of Eating Disorders

• Restricted eating (e.g., limiting calories, eliminating food groups from the diet, etc.,)
• Purging (e.g., excessive exercise, vomiting after meals, use of laxatives, etc.,)
• Binging (e.g., compulsive eating, over eating, etc.,)
• Eating rituals (e.g., eating foods in a specified order or only eating at specific times of the day)
• Excessive weighing
• Preoccupation with appearance
• Intense fear of gaining weight
• Low self-esteem
• Distorted body image
• Excessive weight loss
• Disturbances in menstrual  cycle

If you suspect that a loved one has an eating disorder, seek the advice of your health care professional.

Reference
The  British Journal of Psychiatry (2011), 198, 43-50 "Social Network Media Exposure and Adolescent Eating Pathology in Fiji"; Anne E. Becker et al.,.

ACSM's Resource Manual for Guidelines for Exercise Testing and Prescription, Sixth Edition