Gender and the Prevention of Eating Disorders

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Gender and the Prevention of Eating Disorders

• Linda Smolak, PhD
• Kenyon College
• smolak_at_kenyon.edu

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The Case for Prevention

• Prevention is not just a good or interesting
  idea, it is essential.
• Targeted prevention does work but . . .
• Universal-selective prevention does work.
• Ecological approaches are the state-of-the-art
  program design.

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. . . prevention strategies should enhance
self-esteem and facilitate healthier social and
relational contexts within the family and school
communities Alberta
Provincial Eating Disorder Service
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Ecological Model

• Individual child
• Microsystemsimmediate environment
• Mesosystemsinteractions of systems within
  microsystems
• Exosystemssystems that affect child but child is
  not routinely part of
• Macrosystemculture, law, and society
• Chronosystem--- time dimension

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So distal factors (cultural gender norms) are
translated into proximal effects (e.g., sexual
harassment) and become part of a persons lived
experience
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Gender, Body Image, Disordered Eating

• Girls women are substantially more likely than
  boys and men to develop AN and BN. There may
  also be a gender difference in BED, albeit a
  smaller one.
• Girls are substantially more likely than boys to
  be invested in thinness. They are also more
  likely to restrict calories to lose weight.

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More Gender Differences

• Boys are more concerned about muscularity than
  girls are
• Boys are more likely to engage in exercise
  (rather than dieting) to modify their bodies
  (though girls tend to exercise more than boys)
• Boys are more likely than girls to use steroids
  or food supplements.

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Right now, the principal way that we address
gender is to direct treatment and prevention
programs towards girls. We also often see
studies that include only girls (or sometimes
only boys, when we are examining muscularity).
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Because gender is, for the most part, an
immutable characteristic, this factor is
categorized as a fixed maker according to the
taxonomy of Kraemer et al. (1997). Because of
the large effect size (101) female status is a
highly potent fixed marker for eating disorders .
. . - Jacobi, Hayward, DeZwaan, Kraemer,
Agras, 2004, p. 32 But But feminist theorists
have long argued that gender is socially
constructed and, hence, variable and changeable.
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Proponents of The Ecological Model argue
that Sociocultural variables are causal factors
in the development of eating problems and eating
disorders. For example OBJECTIFICATION
Theory Womens bodies or body parts are
treated as objects to be looked at and enjoyed by
men. There is a generalized, sexualized gaze that
constantly evaluates the attractiveness and
desirability of girls and women.
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Objectification TheoryFredrickson Roberts
McKinley Hyde

• Ubiquitous sexualized objectification of women
  exists in the culture
• Objectification leads to self-objectification
  where women start to view their bodies as outside
  observers continually monitor their own bodies
  (not necessarily a conscious process).
• Consequences
• Shame when body does not meet societal
  standards
• Anxiety - appearance anxiety and safety anxiety
• Lack of peak motivational states women not as
  likely to experience flow when their thoughts
  are disrupted by objectification
• Lack of awareness of internal bodily states
• Predicted consequences of these emotional states
• Depression
• Sexual Dysfunction
• Eating Disorders

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Self-Objectification Theory
Cultural Emphasis on Appearance
Self-Objectification (view self as object)
Appearance Monitoring
Body Shame
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Disempowerment

• Women are their bodies
• Womens bodies exist for mens sexual pleasure
• Women should do whatever possible to mold their
  bodies to the cultural ideal which includes
  extreme thinness
• Women should have no other ambitions than
  maintaining their bodies to obtain the attention
  of men

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Objectification Evidence

• Women show more trait self-objectification
• than men
• White and Hispanic women may be more self-
• objectifying than Black women, especially if
  
• thin bodies are the stimuli
• Self-objectification is related to body shame
• and body dissatisfaction
• When manipulated into self-objectification
• (Hebl et al., 2004), men behave similarly to
  women

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Specifically in adolescents

• Self-surveillance is more common in girls by
  early adolescence (d -.49 in Lindberg et al.,
  2006).
• Girls pubertal development, but not boys, is
  correlated with self-surveillance body shame
• For girls, body shame correlated with current
  dieting dieting in the past year. (Boys
  correlations were smaller current dieting, ns)
• Objectification is also related to depression
  among adolescent girls (both longitudinally
  cross-sectionally)

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Media Our Favorite Target

• Meta-analysis of 77 experimental and correlation
  studies of media and body image (Grabe Hyde,
  2008)
• Small to moderate effect sizes with body
  dissatisfaction, d -.28 with internalization
  of thin idea, d -.39 with eating behaviors
  beliefs, d -.30.
• The BD effect is homogeneous
• The internalization effect is larger in
  experimental than correlational studies for
  studies published since 2000.
• The eating disorder effects is larger for
  experiments, adults, and generalized media (as
  opposed to TV or magazines)

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While media certainly convey information about
gender and body . . .
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There are other daily experiences that are
crucial contributors

• Sexual Harassment
• Fat Talk

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Sexual Harassment

• Gendered meaning
• Related to body esteem in
• Elementary school girls
• Middle school girls
• High school girls

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More on harassment

• In elementary school, fearful or non-committal
  reactions to harassment are associated with
  poorer body esteem
• Puberty is associated with greater sexual
  harassment in 5th grade girls (but not boys).
  Peer sexual harassment is associated with
  self-surveillance body shame (Lindberg et al.,
  2007).

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Fat Talk

• Self-disparaging talk about weight and shape
• A questionnaire (vignettes) measure of frequency
  of engaging in fat talk (MacDonald, Murnen,
  Smolak)
• Among college women, frequency of fat talk is
  correlated with passive engagement (r .30),
  empowerment (r -.49), SATAQ Internalization (r
  .61), EAT (r .68), Surveillance (r .60),
  Body Shame (r .63)

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FEMINIST IDENTITY A PROTECTIVE FACTOR?

• Feminist identity critique of traditional roles
  for and portrayal of women empowerment support
• Research is marred by mixed and uncertain
  definitions of feminist identity
• Nonetheless, a sense of identity as a feminist is
  associated with higher levels of body
  satisfaction, lower DT, lower EAT, lower
  internalization of thin ideal (Murnen Smolak)

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Meta-analysis Results

• Synthesis with body attitudes r .12 (d .25)
• Synthesis with EAT, r .08 (d .16)
• Synthesis with SATAQ internalization, r .15 (d
  .30)

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Importantly

• Rates and effects of sexual harassment are
  amenable to intervention
• Some media literacy programs have been successful
• At least one program has successfully impacted
  feminist orientation

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Suggestions

• Empowerment/embodiment
• Ending gender and racially based teasing and
  harassment
• Changing media images and messages
• Awareness of cultural features in program design
• Involving the community Providing a safe and
  sane environment

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Feminist Empowerment

• Feminist identity and body dissatisfaction,
  internalization of thin ideal
• Importance of feminist empowerment
• Teaching girls assertiveness, self-valuation,
  resistance skills (e.g., Steiner-Adair, Piran,
  Scime et al.)
• Political activism