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The influence of the thin ideal in fashion magazines on women at risk for anorexia
Anorexic women will be interested in reading the following paper on some cognitive processes behind the influence of beauty and fashion magazines on driving at-risk women toward anorexia.
Internalizing the Impossible: Anorexic Outpatients’ Experiences with Women’s Beauty and Fashion Magazines
STEVEN R. THOMSEN, J. KELLY MCCOY, and MARLEEN WILLIAMS
Eating Disorders, 9:49–64, 2001
Address correspondence to Steven R. Thomsen, PhD, Department of Communication, Brigham Young University, Provo, UT 84602. E-mail: steven_thomsen [at] byu.edu
A growing body of research has linked the readership of women’s beauty and fashion magazines with the development and perpetuation of anorexic behaviors in some young women. Although we know the link exists, little is known about the actual cognitive processes and the ways in which at risk women “use” these magazines to internalize the impossible thin ideal that appears to drive the illness. To understand this phenomenon and the process of internalization in greater depth, the authors conducted qualitative, semi-structured interviews with 28 outpatients at an eating disorder treatment facility in the western United States. Using a grounded theory approach, the authors’ analysis provides a detailed description drawn from the patients’ personal accounts of how the magazines have influenced their lives and eating-disordered behaviors.
Much of the research that explores the mass media’s influence on eating disorder symptomatology focuses on the effects of frequent exposure to messages and images that perpetuate a “thin-ideal” female stereotype (Harrison & Cantor, 1997; Levine, Smolak, & Hayden, 1994; Myers & Biocca, 1992; Silverstein, Perdue, Peterson, & Kelly, 1986; Stice, Schupack-Neuberg, Shaw, & Stein, 1994). By inundating young women with a steady barrage of messages—both visual and editorial—that suggest to be attractive, happy, and successful one must be ultra-slender, the media’s emphasis on appearance is believed to lead many young women to internalize unrealistic and unattainable physical standards of beauty and to develop high levels of dissatisfaction with their own bodies (Harrison & Cantor, 1997; Levine & Smolak, 1996; Myers & Biocca, 1992; Silverstein, et al., 1986; Stice, et al., 1994).
While almost all women indicate they are aware of the social pressures created by these media messages, anorexic women are much more likely than other women to report being influenced by those pressures (Murray, Touyz, & Beumont, 1996). What effect does their heightened state of vulnerability or suggestibility have on the way in which at-risk women use, interpret, and experience media images and messages? This question is at the very heart of the present study. Through the use of semi-structured, in-depth interviews with 28 anorexic outpatients, this study sought to develop a clearer picture of how a group of at-risk women “use” the mass media, and to understand how that use moderates the development and continuation of their eating-disordered thinking and behavior. Our focus is on their experiences with women’s beauty and fashion magazines, which may be among the most influential media formats in perpetuating and reinforcing the sociocultural preference for thinness and in creating a sense of dissatisfaction with one’s body (Harrison & Cantor, 1997).
Most estimates suggest that about 1 to 4% of all young women in the United States, and growing numbers around the world, are believed to be affected by anorexia nervosa, which leads some women to starve and restrict food intake to the point of extreme emaciation (American Psychiatric Association; Harrison & Cantor, 1997; “Out of Control,” 1999). Anorexia nervosa has the highest mortality rate of all mental illnesses—estimates suggest that as many as 10–20% of anorexic women will die as a result of the effects of their eating disorders (“Out of Control,” 1999). Even more important is the fact that the onset of anorexia most often occurs during adolescence, an important period of socialization and identity development in young women (Arnett, 1995; Larson & Richards, 1994).
Women’s beauty and fashion magazines make a significant contribution to the process, particularly in regard to gender-role learning, identity formation, and the development of values and beliefs (Arnett, 1995; Berchmans, 1998; Ferguson, 1983; Hermes, 1995; Klein, Brown, Childers, Oliveri, Porter, & Dykers, 1993; McCracken, 1993). Given the popularity of teen and women’s beauty and fashion magazines—at least three fourths of white females in the United States between the ages of 12 and 14 read at least one regularly (Klein et al., 1993)—it may not be surprising that these magazines potentially play such a major role in the socialization process (Arnett, 1995). Adolescents take ideals of what it means to be a man or women partly from the media, which present physical and behavioral . . . ideals . . . . Magazines are a medium where gender role identity formation is an especially common implicit theme, particularly in magazines for adolescent girls. Nearly half of the space of the most popular magazines for teenage girls is devoted to advertisements, mostly for fashion and beauty products and fashion/beauty is a prominent topic of the articles in these magazines (Arnett, 1995, p. 522).
What are the ideals being presented? Recent studies suggest that young women today see models and actors who are thinner and far less curvaceous than those seen by their mothers and grandmothers only a generation or two ago. Not surprisingly, research has shown, for example, that the body measurements of models, and even Miss America finalists, for the past several decades have gradually become less hourglass-like, more boxy, more boyish, and more androgynous (Czajka-Narins & Parham, 1990; Garner, Garfinkel, Schwartz, & Thompson, 1980; Gordon, 1988; Harrison & Cantor, 1997; Levine et al., 1994; Myers & Biocca, 1992; Silverstein et al., 1986; Wiseman, Gray, Mosimann, & Ahrens, 1990). Further, magazines targeted to adolescent girls and young women typically approach the topic of self-improvement by focusing on fashion dressing and physical beautification (Evans, Rutberg, Sather, & Turner, 1991). A goal of this focus, McCracken (1993) argues, is to contribute to a “consumption-based culture” in which the answer to all one’s problems can be found by changing one’s physical appearance by purchasing the products that appear in women’s magazines. By creating and then exacerbating insecurities about one’s body and one’s self in order to sell products, beauty and fashion magazines teach readers at an early age to look critically at their bodies and be ashamed of the parts that do not fit the established model (McCracken, 1993). In turn, they also teach readers to fantasize about the creation of an ideal or perfect self (Hermes, 1995). “Readers of women’s magazines,” Ferguson (1983) writes, “are presented with examples of superwomen, an endless procession of successful, beautiful, and inspirational role models to envy or emulate” (p. 9).
In order to explore the ways in which anorexic women use and experience women’s beauty and fashion magazines, and to understand how that use has influenced their eating-disordered thinking and behavior, in-depth, semi-structured interviews were conducted with 28 outpatients at an eating-disorder treatment facility in the western United States.
The patients interviewed for this study ranged in age from 18 to 43. Eighteen of the patients were between the ages of 18 and 25, and the average self-reported age for the onset of the patients’ eating disorders was 15. Eighteen of the women were single, eight were currently married and lived with their spouse, and two said they were separated from their husbands. All had been diagnosed by the therapists at the center as having anorexia nervosa according to the DSM III-R and IV (American Psychiatric Association, 1987, 1994). Although anorexia nervosa was the primary focus of their treatment, several patients indicated that they had also developed bulimic tendencies during their struggle with their eating disorders.
Interviews were conducted at the center, in campus conference rooms, or in the patients’ homes, based on their preferences. The interviews were conducted during a 17-month period by the three principal investigators and two student research assistants who had been trained in qualitative interviewing techniques. Each interview lasted approximately two hours. All interviews were tape recorded, and verbatim transcripts were produced for the data analysis phases.
The goal of the study was to produce a descriptive explanation of anorexic media use grounded in the reality and experiences of the anorexic patients. To do so, the interview transcripts were analyzed using the constant comparative analysis technique outlined by Glaser and Strauss (1967), Corbin (1986), and Strauss and Corbin (1990). One of the principal goals of this method of analysis, in which the investigator identifies and links explanatory categories, is to generate a grounded theory that is “faithful to the everyday reality of the substantive area and carefully induced from diverse data” (Strauss & Corbin, 1990, p. 23). A number of procedures recommended by Lincoln and Guba (1985) also were used to enhance the trustworthiness and credibility of our analysis. Throughout the period in which the interviews took place, research team members met for weekly debriefing sessions. In these sessions, interview transcripts were reviewed, theoretical implications discussed, and codification and analysis schemes revised for use in subsequent interviews. We also developed and shared brief summaries of the themes, concepts, and ideas that each of us saw emerging from our individual coding, as well as entries from our research diaries for each interview, both of which reflected insights from our respective disciplines—mass communications, family science, and clinical psychology. To further enhance the analysis, preliminary findings were shared with a counselor from the center, who made a number of recommendations, and with two of the patient/informants who had agreed to work as assistants on the project.
Internalizing the Impossible: Telling Their Stories
While none of our informants specifically blamed the media for their eating disorders, many had very strong feelings about the role it had played, and continued to play, in their illnesses. Most described heavy media use, often beginning in early adolescence; and several described their consumption as an addictive behavior, suggesting that the greatest use or dependency occurred after their eating disorders had begun to take control of their lives. Our findings suggest that magazine use for these patients often reflected specific affective needs influenced by both personality and familial factors.
As the interviews progressed it became apparent that the women shared a number of personality factors, including a high drive for achievement, perfectionism, high levels of intelligence, and an extreme empathy with and sensitivity to the problems of those around them, particularly close friends and family members. These characteristics led to high expectations not only for themselves, but also for all those around them. Unfortunately, however, the world rarely lived up to these expectations. Not surprisingly, they frequently described the world as being unfair and disappointing, and said they felt a strong need to shield others, and themselves, from the bad things—real and imagined—going on around them. This meant taking “control.”
The need to “take control” was, for many of the women, an adaptation to being a parentified child in the family (Jurkovic, 1997). Family interaction patterns required them to assume roles and responsibilities that are normally assigned to parents (Mika, Bergner, & Baum, 1987). As children, they were not developmentally prepared to assume these mature roles. Our informants often described parenting younger siblings, protecting their mothers from abusive spouses, shielding brothers and sisters from abuse or chaos, or simply feeling that no one else in the family was in control. Focusing on fulfilling these responsibilities forced the patient to postpone or foreclose her own identity development in favor of filling a caretaker/protector role in the family. Being forced to prematurely assume adult roles and responsibilities resulted in a pseudomaturity that was problematic because it was not built on mastery of developmentally appropriate skills (Arnow, Sanders, & Steiner, 1999; Newcomb, 1996).
Patient #16, for example, said she spent most of her adolescence protecting her mother from a physically abusive husband and was often forced to break up fights between them. She felt responsible to “make the waters smoother.” As the mother aged, she suffered from additional health problems that increased Patient #16’s sense of responsibility as caretaker. This patient functioned as the primary caretaker of her mother for 26 years. During this time, the patient postponed her own social life, caring for her mother until her death. A year later, at age 43, this patient entered into her first serious relationship and married for the first time.
Patient #20, who is now an 18-year-old college student, developed anorexia at about age 14. At about that same time, her mother began coming to her as a confidante, unloading her problems in tearful exchanges. Concerned about her mother and fearful of adding to her burdens, Patient #20 began to withhold and suppress her own feelings. “I didn’t want to hurt her,” she explained, adding that she “just worked harder” to fix her family’s problems.
For the caregiver or protector, control becomes synonymous with the ability to “make things go away.” This unrealistic sense of responsibility for events or circumstances around them leads these women to believe that they can make the problems go away by becoming better or more nearly perfect. In other words, they see themselves as both the cause and solution to all the problems within and around them. By changing themselves, they believe they can eliminate the problems. As one patient explained:
I didn’t want to be the cause of another problem. . . . Everything was so big and all together . . . it was easier for me to just worry about my body and exercise and food. I mean three simple things. Basically, if those things were taken care of, then I thought, “Oh, everything else will be OK.”
This belief that “if I could be more perfect, my problems would go away” leads these women to search for standards of perfection to emulate or for messages that resonate with this type of thinking. In this heightened state of susceptibility, beauty and fashion magazines, which play on a woman’s anxieties and fears, become an enticing and even overpowering force. They also became the how-to manual used by these women in their desperate attempt to obtain an elusive and impossible standard of physical thinness. In the following sections, we explicate these and the other primary uses of women’s beauty and fashion magazines as described to us by the anorexic patients.
Social comparison theory suggests that the mass media are commonly used for comparative or self-evaluative purposes, particularly by young women who are anxious to evaluate their own personal and physical traits, abilities, and opinions against the ideals of their culture (Festinger, 1954; Martin & Gentry, 1997). Martin and Gentry, for example, posit that these comparisons are driven by three basic motives: self-evaluation, self-improvement, and self-enhancement. Of particular interest to us were the first two.
Self-evaluation, the most common motive for young women, is driven by a desire to compare one’s physical attractiveness against those models or individuals who are considered to be superior in appearance. Self-improvement, on the other hand, focuses on comparisons made in an attempt to learn how to improve one’s self, or to be inspired to improve a particular attribute. This often allows the individual to fantasize about her ability to become the “ideal” self (Martin & Gentry, 1997).
Not surprisingly, comparison was the most frequently discussed use of beauty and fashion magazines by the anorexic patients and appears to be an extension of behavioral patterns already developed by these women prior to the onset of their magazine reading habits. The process of comparing their bodies to the bodies of other women usually began in elementary school and became more common and frequent when, as young girls, they participated in social or athletic activities that placed an even greater emphasis on body size or shape.
Patient #3, who is now in her early 20s, began attending aerobics classes with her mother at age 8 and dance classes at age 9. She was among the first of her friends to mature physically and was very sensitive about the curves she was developing. “I always considered myself on the heavy side and I was really curvy,” she explained. “I hated my body and thought I was fat ever since I was really young.” As the patients became older, the focus of the comparisons was driven more by a self-evaluation motive, with women’s beauty and fashion magazines becoming a primary source of images used in the evaluation process.
The anorexic women described the way in which they were drawn to specific ads and expressed a surprising familiarity with many of the models—not only knowing them by name but also being able to provide biographical information as well as height and weight. These comparisons often involved zeroing in on specific body parts that seemed to immediately capture the attention of the patients. The following exchange with Patient #13, who has suffered from her eating disorder for more than 11 years, illustrates this:
Interviewer: If you were to have picked up one of your Mademoiselle magazines and turned the page and saw a girl like this [interviewer shows a picture from a copy of Mademoiselle magazine], what would you look at on her?
Patient #13: Her, well, her legs are what I notice.
Interviewer: What about her legs?
Patient #13: They are so thin and long.
Interviewer: And is that like the ideal body to you?
Patient #13: Yeah. The tall-model type. Definitely.
What may set the anorexic patients apart from other readers is their propensity to somehow see themselves in competition with the models in the magazines. Patient #4, a 20-year-old college student who developed her eating disorder about four years ago, indicated that she was particularly interested in articles that revealed the weight of the models in the photographs. “If there was an article about gymnasts or models, I would always look and try to find out how much they weighed,” she said. The goal, as Patient #4 and many of the other patients explained, was always to weigh less, even if the article was about other anorexic women. “I wanted to be the best anorexic,” one patient explained. Another added, “If the article said she weighed 88 pounds, then I knew I could do 87.”
A common practice among these women was to cut out pictures of the thin models and keep them in neatly organized file folders, pin them on bedroom walls, attach them to the refrigerator, or place them in scrapbooks. One patient referred several times to her “obsession book,” a scrapbook of magazine photographs she had collected over the years. Patient #8, who is now a 22-year-old married college student, said she began cutting pictures out of the magazines when she was a sophomore in high school. The pictures, which came primarily from Seventeen, YM, and Elle, were either pinned to her wall or filed into what she described as a well-organized filing cabinet.
On my wall, I would cut out all the pictures of the models, you know, the stick thin models, the thinner the better, and put them on the wall. I’d cut them and pin them up on my wall just like a motivator. I’d think, “Those are the legs I want. Those are the arms I want.” And I just filled my room up with that and that was my goal.
These cut outs would also become an important part of regular, ongoing comparison rituals. Patient #10, an 18-year-old college student who has been anorexic since junior high, said she conducted comparison sessions on a weekly basis:
I would look at my body and then I would look at the bodies of people in the magazines, and they weren’t the same. And I would always try to make my body the way that I saw in the magazines. . . . I would just be standing naked in front of the mirror looking at my body and I would be able to compare.
As many of the patients became frustrated with their inability to look like the women in the magazines, these comparison rituals sometimes led to episodes of physical self-abuse and mutilation. The case of Patient #5 illustrates this. Now a 20-year-old college student, Patient #5 began serious food restriction in the sixth grade. As a child she suffered from an undetected thyroid condition that caused her to be “chubby.” Her parents constantly warned her that she needed to watch her weight, and when she was 11 offered to buy her a mountain bike if she would lose 10 pounds. When she lost the weight she experienced a new sense of popularity at school and developed a desire to lose even more weight. As a teenager, she says she became even more determined to look like the models in her two favorite magazines—Seventeen and Glamour. The harder she tried, the angrier with herself she became. That anger eventually led to an episode of self-mutilation. She explains:
I had exercised a whole lot and went up [to my bedroom], and I was reading Seventeen actually. And I got in the shower because I was all sweaty and I don’t know if I had rolls, but to me I did. Right here [she grabs her sides and stomach]. And I remember being so mad at myself for not being as thin as those models. And I scratched myself. I was so mad at that. And frequently it would upset me.
Some researchers have suggested that anorexia represents a flight from assuming adult roles and responsibilities (Bruch, 1979; Byrne, 1987). A mechanism for enacting this is starving the body, which stops or reverses physiological maturation and returns the body to a prepubescent state. Ironically, many of the women in our study reported that reading the magazines made them feel more mature. For these women, media use appeared to be a mechanism for obtaining information about how to perform adult roles and responsibilities that was not available from their families. This reliance on the media, women’s magazines in particular, as a means of acquiring developmental skills appeared to be an attempt to moderate the fear of feeling unprepared for the adult roles and responsibilities demanded of a parentified child.
Twisting the Message
Another interesting paradox to emerge from the interviews was the fact that articles that may have been written to scare women away from eating disorders were actually used by some patients to support their eating-disordered cognitions and behavior. One patient, a 20-year-old college student, was critical of the media’s potential to create double messages:
I remember reading once like in a teen magazine, or something like that. . . . and it was about an anorexic girl and I didn’t even finish the article ‘cause I was so upset because maybe the intention was to say, “Girls, this is really a problem,” but it totally glamorized it in my eyes. To me it was saying to girls, “Look, here’s an option.”
Patient #8, who was in dance as a child and participated on the drill team and as a cheerleader in high school, grew up in an environment where there was tremendous pressure to be thin. ‘Teen magazine, she says, hooked her on magazines and body image. At one point in high school, she explains, anorexia became enough of a challenge that she decided it would be easier to become a bulimic, which would at least allow her to eat more. Unfortunately, she could not make herself throw up and, as a result, urgently turned to beauty, fashion, and fitness magazines for help in learning how to purge.
I would shove fingers down my throat. I would put spoons and spatulas down my throat and constantly I would listen for other people’s cues. I would, if a magazine said, “Bulimia ruined my life, a true story,” I would read it just to find ideas. . . . I wanted to get people’s secrets and I wanted to figure out what Karen Carpenter did because I needed to do the same thing.
It appears that the most heavy, and potentially influential, media use occurs after the eating disorder has been triggered. As patient #20 indicates, once she started into her eating disorder, “that’s when I noticed everything in the magazines.” This may, in effect, allow the media to play a cognitive dissonancereducing function. According to Festinger (1957, 1964), cognitive dissonance is created when a person voluntarily commits to a behavior that may have negative consequences in order to satisfy a more relevant, salient motive.
The individual recognizes that this voluntary commitment results in some negative consequences and this creates cognitive tension between the competing goals or desires. In order to reduce that tension, and stay committed to the most important goal, the individual is forced to distort both internal and external reality. The tension-causing concern that creates the most dissonance is the one most likely to be the focus of the individual’s dissonance reducing efforts (Zimbardo, 1969). Anorexic women, then, may use pictures of models and celebrities not only to motivate them to lose weight, but also to reduce cognitive dissonance created by having a life-threatening disorder. Seeing successful, famous women who are portrayed as extremely thin makes it easier to distort the painful reality of having a psychological disorder. As one patient, a 22-year-old college student, explained:
There is one thing that I think is interesting with the media; and I don’t know if this is just my perception, but anorexia I don’t think is portrayed as a disease. I would, or maybe this is just my own perception, but I see it as almost a reward, a prize kind of thing. . . . I mean on one page, you got the girl with the disease. On the other page, you’ve got the model. And they look exactly the same.
Many of this study’s informants said they found themselves in situations where they were at battle with family and friends over food issues. As the patients’ eating disorder behaviors worsened, family and friends were likely to tell them they were becoming too thin and often begged them to eat more. Women’s beauty and fashion magazines, on the other hand, counteracted those dissonance-creating comments by sending comforting messages that encouraged thinness and offered dieting tips to support the anorexic desire to restrict.
Feeding the Addiction
In many ways, Patient #7’s story typifies the way in which these women experience an addiction to particular women’s magazines. This patient, who has suffered from anorexia for more than 18 years, said she began reading ‘Teen magazine when she was about 13, about the time she says she began to obsess about her body. “I never missed an issue of it,” she explains, noting that her reading increased after her eating disorder began. “It became a total obsession afterwards. A total obsession.” During her interview she described the efforts she must now make to avoid certain magazines. In the room where her interview took place, the interviewer had left two health and fitness magazines on a nearby table. Patient #7 immediately reacted to their presence, explaining why she could no longer buy or look at them:
It’s just in one way, it’s like I can’t stand them because they are skinner than I am and I used to have that and I don’t have it now and, you know, it just really makes me mad. . . . I mean it becomes an obsession so quickly. So quickly.
Another patient, a 22-year-old college student, explained how selective she had become after four years of outpatient therapy:
So now I’m really selective, because I still have to be careful. It really affects me a lot. . . . As far as like I get a magazine and see those pictures or read those articles . . . it gets me more in the mode of “I need to exercise more,” “I need to do better,” “I need to do this.” And so I have to be careful, because I still have a hard time with it. But it’s a lot better than it was. I still struggle with it and I probably always will, but I can deal with it now. That’s what makes the difference.
Avoiding certain magazines is not always an easy thing for these women to do. Patient #7 indicated that some magazines now make her almost uncontrollably angry. Other patients used strong language to describe their hatred for particular magazines. While it may be a product of therapy (most of the patients had been in outpatient therapy for some time), it appears that they must develop this dislike, and even hatred, in order to break the influence of the publications on them. They must also, however, expend quite a bit of energy to avoid being drawn back in. In many ways, these women sounded like recovered, or recovering, alcoholics who have learned to avoid those situations that would create temptations too great to overcome. Patient #27 captures the essence of this challenge:
It’s harder than talking to some people, and it’s like, if you’re a drug addict or you’re addicted to alcohol and you want to recover, you make a point not to go into bars. You don’t have alcohol around your house; you associate with people who will support you in that decision. If you’re addicted to food either by not eating it or by eating it, you don’t have that escape. You have to eat food to survive. You go outside and the world inundates you with bodies and with food. You don’t have that escape from your addiction, which in some ways, it really is.
As the number of reported cases of women, teenagers, and preteen girls who suffer from anorexia nervosa continues to grow, it becomes increasingly important to understand the factors that contribute to the etiology of eating-disordered thinking and behaviors. This study has sought to illuminate the potential impact of one important sociocultural influence—women’s beauty and fashion magazines. While much has been written about the general relationship between the frequency of media use and eating-disordered cognitions, far less has been written about the process by which anorexic women actually internalize the thin ideal and how they perceive the ways in which the media influences their behaviors. Unlike other studies, this project has explored the lived experiences of an actual group of anorexic outpatients. In so doing, these findings expand the literature on the subject of this theorized relationship by describing specific uses of women’s magazines and the impact and consequences of those uses on the construction of the anorexic self.
We feel our findings offer an in-depth understanding of how anorexic women experience and use women’s beauty and fashion magazines. We also believe that our findings demonstrate how these magazines are used to fulfill “needs” that occur as a result of the nexus of personality, familial, and emotional factors and issues that arise in these young women’s lives. Our theory of anorexic media use suggests that anorexic women use beauty and fashion magazines to create desired effects and to gratify recognizable needs that are most typically connected with supporting and reinforcing the distorted cognitions and behaviors associated with their illnesses. These magazines are used for specific, goal-directed purposes that include comparison to other women, motivation for dieting and food restriction, information acquisition, dissonance reduction, and to create the illusion of social maturity. These uses are consistent with, and in response to, our patients’ needs to have greater control over themselves, their lives, and surrounding circumstances by adhering to a standard of perfection that offers the false promise of peace, happiness, and fulfillment—the very things they believe, accurately or not, they have been deprived of. The permanence and portability of the messages and images facilitates this type of use. In addition, these magazines counter the messages anorexic women receive from family and friends who have begun to recognize the emotional and physical changes occurring in the patients’ lives. In so doing, the magazines provide support, role models, and, in a rather convoluted sense, reassurance in the patients’ minds that their ultra-thin ideal or fantasy self may be attainable. The media’s images and messages become what they see as a soothing voice in a storm of conflict, confrontation, and confusion.
At first glance it might be argued that anorexic women use the magazines in much the same way as non-anorexic women. As Hermes (1995) and Ferguson (1983) have suggested, for example, women’s beauty and fashion magazines allow their readers to gain practical knowledge, connect their experiences to the experiences of others, and fantasize about becoming their ideal selves. A closer examination of our patients’ experiences, however, suggests that the difference between anorexic and non-anorexic women may lie in the extremity of use and the degree to which a dependent relationship with the medium is developed. This greater dependency appears to occur as familial, social, and environmental support systems, as well as affective and cognitive capacities, lose their ability to provide the support necessary to counterbalance the messages and images. When this occurs, the influence of the magazines becomes, as many of these anorexic women told us, addictive.
We contend, then, that while the media contribute to the perpetuation of sociocultural preferences for thinness, their greatest, and potentially most harmful, influence appears to occur after eating-disordered symptoms have begun to manifest themselves in the at-risk young woman. In this heightened state of susceptibility, these women turn to the media, women’s beauty and fashion magazines in particular, for support and reinforcement, which, they explain, can easily be found in stories, ads, and pictures. By turning to these magazines, they may feel that they are part of a supportive community in which the cult of extreme thinness is accepted and prevails. Frequently, the media attempt to offset the effects of their own thinness-promoting messages by developing articles or producing movies and programs that attempt to educate and inform readers and viewers about the dangers of eating disorders. One of the things we learned from the interviews is that these attempts to engineer socially desirable results often backfire, particularly when the messages are directed toward at-risk young women.
It is generally assumed that media messages are highly malleable and that the interpretation of them occurs rather selectively, based on an individual’s needs (Baran & Davis, 1995; McQuail, 1987). It was not surprising, then, to learn that many of these patients would twist these warning messages to suit their needs and purposes, often learning from them the very opposite of what would have been intended by writers and producers. The findings from this study have implications for mental health professionals who treat individuals with eating disorders. Merely blaming the media as a direct causal factor for eating disorders draws attention away from the underlying conflicts and concerns of anorexic women. This also further disempowers women because they may feel helpless in changing the larger, more powerful media culture. Working to identify and remediate the underlying concerns that create a dependence on the media can provide a powerful tool for combating the addictive need to use magazines to obtain social, emotional, and psychological gratifications.
Finally, future research should continue to explore the process by which women move from normal to more extreme or maladaptive uses of women’s beauty and fashion magazines. This research should examine how, and under what circumstances, this process occurs and whether readers, particularly at-risk women, recognize that this is actually occurring. In addition, future research should explore the uses and impact of other media in relation to eating-disordered behaviors. For example, do at-risk women use television or movies, for example, in the same ways as fashion and beauty magazines or do they experience them differently? How do personality, family lifestyles, and interpersonal skills and needs influence the way these other media are experienced and their potential role in the etiology of anorexia nervosa? The more we learn about the underlying role of the media in the pathogenesis of eating disorders, the more we may be able to improve current approaches to treatment and therapy.
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