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.,.

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Last month, Alastair Macaulay, dance critic for The New York Times, was less than graceful in his review of the New York City Ballet's production of "George Balanchine's The Nutcracker" when he expressed his opinion that two of the dancers were less than "ideal" for body size. Macaulay reported that Jenifer Ringer, who portrayed the Sugar Plum Fairy, "looked as if she'd eaten one sugar plum too many" and that Jared Angle, who was the Cavalier, "seems to have been sampling half the sweet realm." His comment regarding Jenifer Ringer, who has been open about her past personal battle with both anorexia and compulsive eating, caused an outcry from some of Macaulay's readership, who perceived his comment to be disrespectful and insensitive in light of Ringer's history of eating disorders.

Macaulay defended his position in a subsequent article in which he pointed out that a ballet dancer's appearance is integral to the profession. He stated that "ballet demands sacrifice in its pursuit of widely accepted ideals of beauty .....[and, therefore,] if you want to make your appearance irrelevant to criticism, do not choose ballet as a career."

Fault lies in this mindset. It undermines the serious health risks that an eating disorder poses. Anorexia is not a lifestyle for which you choose to make "sacrifices." It is a disease to battle.

During an interview with the Today Show's Ann Curry, Ringer stated that she is now at a healthy weight. In my opinion, to suggest that she "has eaten one too many sugar plums" is irresponsible.  It implies that health should be jeopardized for the sake of appearance. At Ringer's current weight, if she were to eat less, she could, theoretically, drop to an unhealthy low weight.  As Ringer noted in the Today Show interview, when you are too thin, you are physically weak and, therefore, cannot perform well.

Macaulay shirks the blame of his stance onto the profession of ballet, stating that he may be severe, "but ballet, as dancers know, is more so." Perhaps this can serve as a wake-up call that "ideal" beauty should arise from a state of good health, not from unbearable sacrifices that compromise it.  Ringer summed it up well when she told Curry that "in the New York City Ballet, we have every body type you can imagine...They can all dance like crazy, they are all gorgeous. I think dance should be more of a celebration of that--seeing these beautiful women with these different bodies all dancing to this gorgeous music and that is what should be celebrated."