AComparativeReviewofResearchonDisorderedEatingAmong CollegeWomenintheUnitedStatesandUnitedKingdom ConnieKalble SOCL36502W LoyolaUniversityChicago Dr.

Krogh 30April2012

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Background WomeninWesternizedsocietiesfeelconstantpressuretobeincreasinglythin.The ratesofbothbodyandeatingpathologyinwomenareatanalltimehigh,especiallyamong college women, a very vulnerable population. In the past fifteen years, researchers in the UnitedStatesandtheUnitedKingdom,twohighlyWesternizedcountries,haveextensively studied the risk and resilience predictive factors for eating pathology. The UK has implementedmanylawstoregulatethepresenceofunrealisticidealsinthemedia,yetthe ratesofdisorderedeatingremainverysimilarintheUSandUK. Purpose&Method This study looks at the most common predictive factors studied by researchers in the United States and United Kingdom over the past fifteen years. A content analysis of twelve randomly selected scholarly articles from the US and UK was conducted and each wascodedforthesignificanceoftheindependentvariablesinpredictingdisorderedeating behaviorincollegewomen. Results&Implications Results indicated that there was not one independent variable that was used significantlymorethanothersacrossallstudiesexamined.Crosstabulationrevealedthat the most significant differences between studies in the United States and the United Kingdom were in terms of the increased prevalence of selfobjectification in US studies comparedtoUKstudies.BodyshameandsurveillancehadanequalpresenceintheUSand UKstudies.WhiletheconsumptionofmediawasnearlyequallyrepresentedacrossUSand UK studies, it had a very small presence in the studies. Many times media consumption leadstofactorssuchasbodydissatisfaction,selfobjectification,lowlevelsofselfesteem, and body shame. This study reveals the need for an increase in media studies, especially the impact of media of womens body and eating pathology.

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TableofContents Section PageNumber 4 4 8

Introduction LiteratureReview Design Data Methods

8 9 10 11 13 14 14 17

TheRealImpactofMedia Results

ImprovementstoStudy Conclusion

Bibliography Appendices

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Introduction Many young women in Westernized societies struggle with issues such as body dissatisfaction and disordered eating behavior. Researchers have made great efforts to identify the lead risk and resilience factors for young women in the development of disordered eating behaviors and attitudes. The national literature regarding womens eating and body pathology in the US and UK is fairly extensive. The levels of body dissatisfaction and disordered eating in the US have been on the rise, with no one direct cause identified. On the other hand, disordered eating in the United Kingdom has been shown to be linked to external influences, not an issue of individual dissatisfaction. Consequently, the United Kingdom has implemented many programs to regulate the perpetuation of the thin ideal in the media, whereas the United States has no such programscurrentlyinplace,yetthelevelsofdisorderedeatinginthesecountriesarevery similar.AcrossculturalstudyofthesetwoWesternizedcountrieshasyettobeconducted. Thisstudywillhighlighttheeffects,orlackthereof,ofpoliciesimplementedinWesternized countries on young women living in these environments. This study bridges the gap currently present in the scholarly literature on body and eating pathology of college womenintheUnitedStatesandUnitedKingdom. LiteratureReview WomenintheUnitedStatesarestrugglingwitheatingpathologyinrecordnumbers. 6%ofyoungwomenareestimatedtohavesubclinicallevelsofdisorderedeating(Bishop, Bauer, & Baker, 1998). Whereas, 0.3% of young women are estimated to have a clinical diagnosisofAnorexiaNervosa,and1%ofthispopulationisestimatedforBulimiaNervosa

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(Berkman,Lohr,Bulik,2007).RatesofdisorderedeatingintheUnitedKingdomhavebeen shownintheliteraturetobeveryequivalenttothosepresentintheUnitedStates(Makino, Tsuboi,Dennerstein,2004). Womenhavebothindividualandcollectiveexperiencesthatshapetheirselvesand individual personas. Personality traits such as perfectionism are generally seen in the literature as common predictors of disordered eating behaviors. Family backgrounds, includingahistoryofsexualabuseandacontrollinghousehold,havealsobeencommonly showntopredicteatingdisorders.FamilialinfluenceinboththeUnitedStatesandUnited Kingdom has been shown to significantly affect womens standards of beauty, primarily thinness,fromaveryearlyage(Fairburn,Brownell,2002).Manywomenresorttohostility towardstheirfamilyandcompulsivebehaviorstocopewiththeseissues(Berkman,Lohr, Bulik,2007).However,environmentalfactorsandsocioculturalinfluenceshavegenerally been blamed for the development of body and eating pathology (Fredrickson & Roberts, 1997). This is thought to be because of the Westernized norms of beauty and the ideals aspiredbythesewomen. Women are constantly bombarded with images of the thin ideal in the media. The majority of women have many deeplying anxieties about not being thin enough. These media influences inform women of their right to starve, and the progression of technology allows women to share their thinspirational quotes and images, mostly of celebrities in the media (Saukko, 2006). This phenomenon is nothing new. Since the beginning of the 1920s, women in the United States have engaged in body surveillance, monitoringthewayothersseetheirbodyandtakinganoutsiderperspectivetoselfimage. However, this was initially an upper class issue. Beginning in the 1960s, this experience

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became more prevalent, mirroring the advent of television and the wide range of media (Nasseretal.,2005). Selfobjectification is common among women in Westernized countries, perpetuated by the gendered norms that have been in place there for centuries. Women havebeentaughtbothbythemediaandfamilyhowtoproperlygroomandmanicuretheir bodies until they are perfect. Fat talk, or the discussion of the flaws women perceive themselvestohave,hasbecomeverycommonplaceinWesternizedsocieties,somuchsoit is considered a social norm, especially among friend groups. This norm is largely problematic because it leads women to compare themselves to one another, which is largelyassociatedwithbodydissatisfaction(Payneetal.,2011). TherateofobesityisatacurrenthighintheUnitedStates,whereasthemodelsare youngerandthinnerthantheyhaveeverbeen.Whilethemediaispartlytoblameforthe glamorizationofcelebritiesopenwiththeirexperienceswitheatingdisorders,themedical industry is also to blame. Medical science has allowed women to change their physical appearances in an infinite number of ways, from the use of weight loss formulas to the everyday nature of plastic surgery. Due to the progression of technology, Photoshop and plastic surgery have significantly influenced the way society sees the womans body (Nasseretal.,2005). Inordertocopewiththeunrealisticbodyfocusedstandardssetforthembysociety, women engage in practices such as body watching and food monitoring. Women spend hours in front of the mirror carefully examining physical changes from day to day, evaluatingtheresultsoftheirruthlessefforts.Thisillustrateshowwomenseethemselves from an outsiders perspective, viewing their bodies as objects. The standards for these

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womenarelargelydepictedbythemedia,consistingofmodels,ballerinas,andgymnasts. Womenthataregreatlyaffectedbythebodyperfectexampleperpetuatedbythemediause theirclothing,photographs,and,mostfrequently,ascaleinordertotracktheireffortsin achieving the thin ideal. Since many times women cannot achieve the high beauty standardssetbysociety,theyturntodisorderedeastingbehaviors,especiallyatsubclinical levels,toloseweight(HesseBiber,1996). Almost seventy percent of young women reported being influenced by fashion magazines to achieve the perfect body and almost fifty percent expressed desire to lose weightduetothosesameimages.Manysignificantrelationshipshavebeenshownbetween themediaandunhealthypracticesandlifestylechoicesamongwomen.Thereisapositive correlation between the amount of fashion magazines read by young women and dieting behaviors over time. The most shocking of these statistics is the positive relationship betweentheeffortwomenreportedputtingintolookinglikeimagesinthemediaandthe likelihoodshewouldbeginpurgingoverthenextyear(Field,2000). The media has also been criticized for the sexual objectification of women. Seeing theobjectificationofwomeninthemediahasbeenshowntohavesignificanteffectsonthe selfobjectificationofyoungwomen.Whenyoungwomenseehypersexualizedmedia,they areatahigherriskfordevelopinglowselfesteemandhigherlevelsofbodyshame.Dueto their diminished ability to cope properly with such images, women turn inwards and attempttoconformthemselvestothebodyperfectstandardssetforthbythemedia.The bodybecomesapawnofsortsfortheindividual,meaninglesstothemthantheyperceiveit to mean to others. The sexual objectification of women is also seen as a significant risk

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factor in the development of disordered eating attitudes and behaviors among women (Calogero&Thompson,2008). The literature examining body and eating pathology names college as the most vulnerabletimeforwomentodevelopthesedisorders(Keel&Klump,2003).Womenare exposedtomanynewexperiencesandchangesatthispointintheirlivesincludingmoving awayfromhome,theinfluenceofnewfriendgroups,anewlivingenvironment,andmedia consumption,manyofwhichforcewomentocopedifferently,andoftenmaladaptively. Design TobestreviewthecurrentstateofresearchoneatingdisordersbothintheUnited States as well as the United Kingdom, this study utilized a content analysis of scholarly journal articles. This approach was chosen to frame the risk and resilience factors for eatingpathologyincollegewomenintheUnitedStatesandUnitedKingdomoverthepast fifteen years. A surveybased study would have been preferred, but a sample of college womenfromtheUnitedKingdomcouldnotbeobtained.Thispaperwillexaminethemain contributorsresearchershavenamedasprimaryriskandprotectivefactorsfordisordered eatingincollegewomen.TheUnitedKingdomhasimplementedmanyprogramstoregulate the perpetuation of the thinideal in the media, whereas the United States has no such programscurrentlyinplace,yetthelevelsofdisorderedeatinginthesecountriesremain verysimilar. Data

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Sixtyfive scholarly journal articles were collected, which have been published

withinthepastfifteenyearsandexaminetheriskandresiliencefactorsofeatingpathology. Since the literature on eating pathology is so large, the focus of this study is on college womenandthefactorsthatmostaffectthispopulation.Articlescamefrombothnational and international journals, including Body Image, Eating Disorder Review, Sex Roles, Psychology of Women Quarterly, Journal of Womens Health, British Journal of Health Psychology, International Journal of Eating Disorders, British Journal of Psychiatry, and EuropeanEatingDisordersReview.Articlesthathavebeendeemedproperforinclusionin this study have been published between 1995 and the present that evaluates risk and resiliencefactorsfordisorderedeatinginyoungadultwomen.Thesearticleswereentered into a database and randomly assigned a number. Using a random number generator, a sample of these articles was chosen, six articles evaluating a US population and six evaluating a UK population. The twelve randomly selected articles are considered representative of the population of articles published on eating pathology in the United StatesandUnitedKingdomoverthepastfifteenyears. Methods All twelve articles randomly selected for inclusion in this study were coded according to significance in predicting disordered eating behavior on a code sheet listing independent variables collected from the scholarly articles (see Appendix 1). The code sheets were then entered into SPSS data analysis software. From those code sheets, the variables that most often predicted disordered eating behavior as well as variables that were most often included in studies but did not predict disordered eating behavior were

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analyzed.CrosstabswererunonthedataenteredintoSPSStoseerelationshipsbetween predictorsofeatingpathologyandtheoriginofparticipantsinpublishedstudies. TheRealImpactofMedia Bodydissatisfactionstemsfromthefeelingsparticipantshavetowardsthephysical

componentsoftheirbodies.Measuresusedtogaugebodydissatisfactionaskparticipants toratetheirlevelofagreementtostatementslikeIthinkmythighsaretoolargeorIlike the shape of my buttocks. While it may be that participants are dissatisfied with their physical appearance in and of itself, it is more likely that participants are engaging in a form of social comparison. This may be a comparison among peers and family members, but it may also be a comparison of ones self to the medias representations of women, whichisgenerallyhypersexualizedandincreasinglythin. Similartobodydissatisfaction,bodyshameisexperiencedwhenrespondentshave

feelings of shame and humiliation in not conforming to a norm or ideal. This shame commonlyarisesinwomenwhenthereisagapbetweentheperceptionsoftheselfdiffer fromtheculturallyacceptedandinternalizednormsofbeauty.This, too, is a reflection of thepervasivemessagesandnormsthemediasetsforthforwomenasanideal.Participants whoreportedengaginginbodysurveillanceactivelyviewedtheirbodyfromanoutsiders perspective. Body surveillance is a highly dangerous activity for women to engage in becausetheynotonlyfeelobjectifiedbysociety,buttheyviewthemselvesasanobjectto beseenbyothers,takinganexternalperspectivetomonitoringselfimage.Culturalideals andstandardsforbeautygreatlyimpactstheshameandsurveillanceexperienceswomen haveduetothepressurestoconformthatareeverpresentindailylife.

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Selfobjectification, similar to body surveillance, occurs when individuals view themselves from a third, rather than first, person perspective. By doing this, individuals focusprimarilyonphysicalaspectsofthemselves,asopposedtothinkingofthemselvesas wellrounded person. While some women may have a natural tendency to selfobjectify, many women are influenced by fashion and fitness magazines to constantly police their looks,thusinducingathirdpersonstandpointtoafirstpersonideaoftheself. Results Afterrunningdescriptivestatisticsonindependentvariables,therewasnotasingle

variable that stood out as a significant predicator of disordered eating behavior in the literature. Several independent variables that significantly predicted disordered eating among college women included body dissatisfaction, body shame and surveillance, and selfobjectification.Oneindependentvariablehypothesizedtobeapredominantpredictor of disordered eating was media consumption; however, this variable did not significantly predict disordered eating behavior in any article randomly chosen for selection in this study. Crosstabulation of the data revealed several significant relationships between

independentvariablesandthecultureofparticipantsrecruitedforthestudy.Whilebody shameandsurveillancehadnoassociation(=0.000)andbodydissatisfactionhadavery weakassociation(=0.333),manyothervariablesincludedinthestudyexhibitedstrong associations. Body shame and surveillance had mirror image reportings in the United StatesandtheUnitedKingdom,anequalamountofstudiesfindingthevariablesignificant aswellasnotsignificant.Likewise,theuseoftheindependentvariablebodydissatisfaction

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lookedverysimilarinUSandUKstudies,withonlyminordiscrepanciesbetweenthetwo cultures.

IndependentVariable BodyDissatisfaction SelfEsteem Positive/NegativeAffect MediaConsumption BodyShame/Surveillance FamilyInfluence Perfectionism DriveforThinness InteroceptiveAwareness SelfObjectification Anxiety/Depression/OCD PeerInfluence

UKArticles 2 0 1 0 2 1 1 2 0 1 2 1

USArticles 1 1 1 1 2 2 0 2 2 3 1 2

AllArticles 3 1 2 1 4 3 1 4 3 4 3 3

Table1.FrequenciesofIndependentVariablesinpredictingEDbehavior(Code1&2) Thestrongestassociationsbetweenindependentvariablestudiedandcultureoccur

for selfesteem ( = 1.000) and media consumption ( = 1.000). In terms of both self esteem and media consumption, the association is very strong because the two countries had very similar numbers of these variables present in their studies. Selfesteem, as a whole, was not widely represented in the literature as a predictor of eating disordered

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behavior among college women in both the United States and United Kingdom. Similarly, mediaconsumptiondidnothaveapresenceintheliteratureintheUSorUK. IndependentVariable BodyDissatisfaction SelfEsteem MediaConsumption BodyShame/Surveillance SelfObjectification Gamma .333 1.000 1.000 .000 .700 PValue .580 .273 .273 1.000 .119

Table2.Gammaandpvaluesfordeterminedindependentvariables. One independent variable with a moderately strong association was self objectification(=0.700).ThisvariablehadapresenceintheliteratureinboththeUnited StatesandtheUnitedKingdom.Interestingly,selfobjectificationwasavariableinmoreUS studiesthanonesconductedintheUK.Further,selfobjectificationamongcollegewomen intheUSsignificantlypredictedeatingdisorderedbehaviorinreportedstudies. Manyofthearticleschosenforinclusioninthisstudyillustratedpathway,notonly direct, effects of varied independent variables on disordered eating behaviors in young women. Due to the nature and design of this study, only direct effects of independent variables on womens disordered eating attitudes and behaviors were counted as significantpredictors(code2). ImprovementstoStudy Inthebeginningstagesofcollectingarticlesthateventuallyformedthedatabase,it

became apparent there was a very wide range of topics researchers studied to predict

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disorderedeatingbehavior.Itwasalsoapparentthatmanymorestudiesoncollegewomen were conducted in the United States and the United Kingdom. Ideally, this study would havebeenasurveybasedstudycomprisedofmeasuresofdisorderedeatingbehaviorand other main influences selfesteem, selfobjectification, familial influence, community support,etc.amongcollegewomeninboththeUSandtheUK.However,giventhetime constraintsandtheaccessibilityofarepresentativesamplefrombothcountries,acontent analysisofothersworksconductedwasbestsuited. Conclusion Whiletheconsumptionofmedia,bothtelevisionandmagazines,wasnotavariable

researcherscommonlyincludedasanindependentvariableintheirstudies,doesnotmean theconsumptionofmediainparticipantsdailylivesdidnoteffectthevariablesaccounted for in the literature. The rates of disordered eating in the United States and the United Kingdomremainverysimilar,asdotheprimaryfocusofresearchersintheseWesternized countries.Attentionneedstobedrawntotheveryseriousinfluenceofmediaconsumption on the vulnerable state and impressionability of young women. Only then, can women critically view media and changes be made in fashion and fitness advertisements and medias. Bibliography Berkman, N. D., Lohr, K. N., & Bulik, C. M. (2007). Outcomes of eating disorders: A systematic review of the literature. International Journal of Eating Disorders, 40, 293309.

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Bishop,J.B.,Bauer,K.W.,&Baker,E.T.(1998).Asurveyofcounselingneedsofmaleand female college students: Perfectionism and adult autonomy or intimacy struggles, along with moderate distress and impairment in social relationships. Journal of CollegeStudentDevelopment,39,205210. Calogero, R. M., Thompson, K. (2008). Sexual selfesteem in American and British college women:Relationswithselfobjectificationandeatingproblems.SexRoles,60,160 173. Fairburn, C. G., & Brownell, K. D. (2002). Eating disorders and obesity: A comprehensive handbook.NewYork,NY:GuilfordPress. Field, A. E. (2000). Media influence on selfimage: The real fashion emergency. Healthy WeightJournal,8895. Fredrickson, B. L., & Roberts, T. (1997). Objectification theory: Toward understanding womens life experiences and mental health risks. Psychology of Women Quarterly, 21,173206. HesseBiber,S.(1996).AmIthinenoughyet?:Thecultofthinnessandthecommercialization ofidentity.NewYork,NY:Oxford. Keel,P.K.,&Klump,K.L.(2003).Aredisorderscultureboundsyndromes?Implicationsfor conceptualizingtheiretiology.PsychologicalBulletin,129,747769. Makino, M., Tsuboi, K., & Dennerstein, L. (2004). Prevalence of eating disorders: A comparison of Western and nonWestern countries. Medscape General Medicine, 6, 49. Nasser, M., Katzman, M., Gordon, R. A. (2005). Eating disorders and cultures in transition. NewYork,NY:Taylor&Francis.

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Payne, L. O., Martz, D. M., Tompkins, K. B. Petroff, A. B., & Farrow, C. V. (2011) Gender comparisonsoffattalkintheUnitedKingdomandtheUnitesStates.SexRoles,65: 557565. Saukko,P.(2006).Rereadingmediaandeatingdisorders:KarenCarpenter,PrincessDiana, andthehealthyfemaleself.CriticalStudiesinMediaCommunication,23,152,169.

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Appendices 0=VariableNotIncludedinStudy 1=VariableIncludedinStudy,NotStatisticallySignificantinPredictingDisordered EatingBehavior 2 = Variable Included in Study, Statistically Significant in Predicting Disordered EatingBehavior

Variable
Journal DateofPublication USorUKpopulation ParticipantSelectionMethod SampleSize BodyDissatisfaction SelfEsteem POS/NEGAffect MediaConsumption BodyShame/Surveillance FamilyInfluence Perfectionism DriveforThinness PerceptionofHunger/InteroceptiveAwareness SelfObjectification Anxiety/Depression/OCD PeerInfluence

Code

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ListofArticlesRandomlyChosenForInclusioninStudy Calogero,R.M.&PinaA.(2011).Bodyguilt:Preliminaryevidenceforafurthersubjective experienceofselfobjectification.PsychologyofWomenQuarterly,35,428440. Cordero,E.D.&Israel,T.(2009).Parentsasprotectivefactorsineatingproblemsofcollege women.EatingDisorders,17,146161. Gilbert,N.&Meyer,C.(2004).Similarityofyoungwomenseatingattitudes:Selfselected versusartificiallyconstructedgroups.InternationalJournalofDisorderedEating,36, 213219. Goodman,J.R.(2005).Mappingtheseaofeatingdisorders:Astructuralequationmodelof how peers, family and media influence body image and eating disorders. Visual CommunicationQuarterly,12,194213. Ioannou, K. & Fox, J. R. (2009). Perceptions of threat from emotions and its role in poor emotional expression within eating pathology. Clinical Psychology and Psychotherapy,16,336347. Limbert,C.(2010).Perceptionsofsocialsupportandeatingdisordercharacteristics.Health CareforWomenInternational,31,170178. Meyers, T. A. & Crowther, J. H. (2008). Selfobjectification related to interoceptive awareness? An examination of potential mediating pathways to disordered eating attitudes.PsychologyofWomenQuarterly,32,172180. Muehlenkamp,J.J.&SarisBaglama,R.N.(2002).Selfobjectificationanditspsychological outcomesforcollegewomen.PsychologyofWomenQuarterly,26,371379. Naylor, H., Mountford, V., & Brown, G. (2011). Beliefs about excessive exercise in eating disorders: The role of obsessions and compulsions. European Eating Disorders Review,19,226236. Noll, S. M. & Fredrickson, B. L. (1998). A meditational model linking selfobjectification, bodyshame,anddisorderedeating.PsychologyofWomenQuarterly,22,623636. Taranis, L. & Meyer, C. (2011). Associations between specific components of compulsive exercise and eatingdisordered cognitions and behaviors among young women. InternationalJournalofEatingDisorders,44,452458. Tylka, T. L. & Hill, M. S. (2004). Objectification theory as it relates to disordered eating amongcollegewomen.SexRoles,51,719730.