April 1st, 2014

Extreme weight loss: media’s misplaced message

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PHOTO BY Tom Croke
Extreme dieting and exercise are two risk factors for developing eating disorders, says Christine Tortolani, Ph.D., staff psychologist at Rhode Island Hospital and an adjunct assistant professor at Brown University.

Thin is in. Or so various media sources would have the general public believe. Magazines, newspapers and now reality shows are promoting the message that excessive dieting and exercise regimens can help achieve unrealistic body images. While some individuals may experience weight loss, what is the ultimate price?

Stuart Koman, Ph.D., president and CEO of the Walden Center and Walden Behavioral Care, indicates that television networks have tapped into the major American preoccupation with food and weight. “When you think about what’s going on in our society, it’s a national obsession. You can’t go anywhere without being bombarded with the message about food and weight. [The Biggest Loser] portrays a fairly unrealistic message that you can lose [significant amounts of] weight. All you need to do is work hard. To make this kind of treatment program routine is impossible for most people,” he notes.

Furthermore, reality shows like this one might trigger unhealthy eating habits. “If you put people in this pressure cooker and offer them a quarter million dollars, they will develop an eating disorder,” says Koman. “We see people rotate through different expressions of different eating disorders. TV shows and social media tap into this.”

Rather than accept the unrealistic messages such shows are sending, Koman suggests viewers become more introspective. “Focus on how you feel about yourself on a day-to-day level. The overall psychology is to be more tuned into who you are as a person,” says Koman. “All [eating disorder] diagnoses share a common theme: a certain psychological immaturity and a lack of self-esteem. As treaters, we’re constantly helping people understand who they are and bring them to a greater and larger definition of self, instead of a number on a scale.”

Extreme dieting and exercise and a drive to become thin are two risk factors for developing eating disorders, according to Christine Tortolani, Ph.D., staff psychologist, Rhode Island Hospital, Division of Child and Adolescent Psychiatry, and adjunct assistant professor of Psychiatry and Human Behavior at the Warren Alpert Medical

School of Brown University. “Statistics show that of normal dieters thirty-five percent will progress to more pathological dieting and, of those, twenty to twenty-five percent will develop eating disorders,” she says, citing numbers from the National Eating Disorders Association (NEDA).

Tortolani works with adolescents and college age students who have eating disorders. “Dieting is a slippery slope. It starts out harmlessly, but quickly picks up speed and turns to disordered eating,” she says. “When you are dieting, you have distorted thinking. It’s hard to keep in check with reality. Your drive for thinness is paramount. This speaks to why the dieting industry is a billion dollar monster. We buy into the message that there’s a certain way to look. The Biggest Loser and other reality shows don’t use moderation.”

Dissatisfaction with your body leads some individuals to suffer from low self-esteem, Tortolani says. “You begin to think that if you change your outward appearance, you will be happier. The message is that physical beauty is the ultimate cure-all,” she says.

Tortolani adds that eating disorders are not gender-specific. A study published in “Contemporary Pediatrics” indicates that for every three females with an eating disorder, there is one male with a similar issue. Additionally, the study reports that 20 percent of obese males engage in disordered eating behavior. However, since more stigma is attached to boys with eating disorders, they often fail to seek treatment, Tortolani adds.

The tendency toward eating disorders comprises a number of factors, including genetics, personality traits, experiences, coping with difficult emotions and sociocultural roots. “I can see how seductive a show can be in its message. If you’re unhappy with yourself you might be looking for ways to be happy,” Tortolani points out. “The missing piece is educating the consumer. We need to become more media literate so we don’t just absorb the messages they are sending. We have to be more critical.”

Rather than relying on dieting for a fix, Tortolani suggests thinking about lifestyle changes. “You should consider being and feeling healthy emotionally, mentally and physically. There is no quick fix. It’s a lifelong process,” she says. “We need to emphasize self-love/care and fueling the body with a wide variety of food. Aim for moderation and establish healthy habits we can sustain over time. Five hours of exercise a day doesn’t fit into life. It’s excessive and carries a host of medical risks. We need to shift our attitudes around the goal of being perfect.”

Jennifer J. Thomas, Ph.D., co-director, Eating Disorders Clinical and Research Program, Massachusetts General Hospital and assistant professor of psychology, Department of Psychiatry, Harvard Medical School, points out that reality shows that focus on weight loss promote the dangerous idea that larger people are immune to eating disorders. “It’s helpful to remember that obese people can have eating disorders,” she says. Additionally, these shows imply that anyone can lose weight, but don’t consider related circumstances, underlying causes and other elements. “The show gives viewers the impression that obese people can lose weight if they just put their mind to it. It doesn’t take into account any other factors.”

Additionally, shows of this nature fuel bias toward overweight individuals, says Thomas. According to a study published in the journal Obesity in May 2012, participants in The Biggest Loser had significantly higher levels of dislike of overweight individuals and more strongly believe that weight is controllable after the exposure.

The results of this study indicate that anti-fat attitudes increase after brief exposure to weight-loss reality television. “Psychologists suggest that discrimination and weight bias is alive and well. Obese people face workplace and relationship discrimination,” Thomas points out. “The main thing to remember is that the show is ostensibly about health. But at the end of the day, it’s really entertainment. It doesn’t give health advice. It’s great to have role models on TV trying to get healthy. There are other shows that depict drugs, debt and other negative behaviors so it’s good to get the media to focus on health.”

By Phyllis Hanlon

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