Influence of Media on Eating Disorders

Chapter one: Introduction

1.1Introduction

Eating disorder (ED) is a serious condition that cause disturbances on the person’s eating habit. ED can affect people obsessions with food, shape and body weight. There are different types of ED’s including binge-eating disorder, anorexia nervosa and bulimia nervosa (Nimh.nih.gov, 2016). The Joint Commissioning Panel for Mental Health (2011) state that over 1.6 million people in United Kingdom (UK) has been affected by ED. The illness affects the teenagers and young adulthood- as it affects their health and well-being.  The statistics shows that ED is a common condition that is affecting people in the UK. The NHS (2015) found that 1 in 250 women and 1 in 2,000 men experience anorexia nervosa, as this condition develops around the age of 16 or 17.  They also stated 90% of females suffers from Bulimia; it develops the age of 18 or 19. These shows that the ED starts from a younger age where most teenagers starts seeing the changes in their bodies.

Media defines in television shows, magazines, fashion, the internet, this is relating to Mass Media. Mass communication is achieved by an organisation working as a team in the industry to produce and circulate a wide range in entertainment to news to educational programmes (Turow, 2003). Mass media has been portraying the society when it comes body image and beauty. It also can set the standard of beauty and it can also cause insecurities for those who cannot fit in with those standards.

1.2 Justification of topic

In today’s society adolescents and children acknowledge the different types of mass media such as films, videos, television and social media (Morris and Katzman, 2003).

The NICE guidelines (2004) state that the outlook for ED can be improved by taking action in changing certain key areas; in referral strategies, service provision for young people and changes in the media industries.

There is link that ED and media can be part of a social factor. The Parliamentary Office of Science and Technology (2007) state that social pressure can play part in media and ED, where the media industries such as fashion and advertisement may be the factors that can influence ED. There are some media industries that can be responsible for the behaviour to ED.

There is not enough research in the UK about ED (Parliamentary Office of Science and Technology, 2007) as there are no policy and legislation relating to ED. This is a problem as it is a health problem. The government will need to apply a guideline or policy that shows the importance’s in ED, health and safety and the consequences of ED.  The Parliamentary Office of Science and Technology (2007) states that in April 2007 the health department given £2 million to fund research in treatment and early intervention strategies.

1.3 Research question

The research question for this dissertation is:  What level of influence does the media have on eating disorders?

1.4 Aims

The aims of this research will investigate at:

• How does the media portray on eating disorders?
• What impact does the media have on eating disorder for teenagers?

1.5 Background

The NHS Choice (2015) state the ED is associated with the social pressure as being thin, and young people feel the need to look a certain way.  Eating disorder can be associated with these factors such as biological, genetic or environmental, as it has an impact on the individuals. This risk factors can develop the likelihood in an individual having ED such as having certain experiences; sexual and emotional abuse or death.

The Charities

There are charities in the UK that associate with ED.  The Beat is one of the charity that helps individuals with ED.  The Beat aims is to end the pain and suffering that is caused by ED, and help to give advice and support for those that are suffering from ED.   The charity helps people that suffering from ED to get the best help that they need, getting the treatment that they will to be able feel restored. The charity also offers awareness training in workplaces and schools to help people to find the available treatment in their area.  The charity also helps healthcare professional to identify the thoughts and feelings that cause the mental illnesses, instead concentrating on physical indications, as it will deliver the support that the patients’ needs (B-eat.co.uk, 2017).

The Anorexia Bulimia Care (ABC) is a call centre that talks to people who suffer from ED. The charity spend time with the caller and able to help them through the phone. The ABC helps to support individuals to learn how to manage their conditions and start living a better life. They help the individual to regain control over their lives, talking about their low self-esteem and their emotion, and helping them to improve their confidence.  The ABC helps to address this by talking about their social isolation and allow them feel confidence about themselves as getting back to work (Anorexiabulimiacare.org.uk, 2015).

The concepts of media and Eating Disorders

In the past decade, researchers and clinicians has been investigating the media effect and mental health, as it has turned to their attention that thin-ideal media and ED are linked (Harrison, 2000). Other studies believe that the development of ED relates to family, peer influences and pressure family, and sociocultural pressure (Field et al., 2001). Morris and Katzman (2003) imply that there have been several studies that have proposed a link that how the media portray on thin female beauty ideal and muscular male body ideal- that involves in a range of psychological symptomatology associated with body dissatisfaction and ED. There has some other studies state that body dissatisfaction is high among adolescence, especially in girls than boys (Knauss, Paxton and Alsaker, 2007).

According to Ferguson et al., (2013), some believe that the media influences body dissatisfaction which may extend to in eating disorders conditions, and is likely to explain the increases of Bulimia Nervosa across the twentieth centuries in the western nation. Other researchers believe that the relationship between media and body dissatisfaction are not consistent and it may be explained by other variables such as personality traits or family environment (Holmstrom, 2014) and may not apply to all girls (Roberts and Good, 2010).

There has been evidence that ED is linked to different factors (Shepherd and Seale, 2010) such as in psychological factors, having low self- esteem or being stress. The social factors contain the way media advertise thin ideal body images. It also includes factors in family, environmental, genetic and biological.

Shepherd and Seale (2010) found that the public perceptions differ from the medical view in EDS, in countries such as UK and US, with mental health perceptions that is common, associated with a view that emphasises EDs as the consequence of moral failings. Crisafulli, von Holle, and Bulik, (2008) as cited by Shepherd and Seale (2010) state that these perceptions could allow the health care professional to blame the individual for their ED, as it play part in the socio-cultural causation instead the biological and genetics causation.

There are some people that feel afraid in what they eat and becoming overweight. It is challenging to blame the media in causing and maintaining individual’s ED (Spettigue and Henderson, 2004). Majority people living in the Western countries receive streams of impression in television commercial, which most of the commercial uses young, attractive and thin women to represent their products (Abraham and Llewellyn-Jones, 2001). These messages affect teenagers when going through emotional stress as they may seek to be more independence from their family, finding their identity and to compete with their friends.

Differences between both genders

The explanation regarding to the gender differences in body dissatisfaction is that there is greater sociocultural that emphasis on the importance on physical attractiveness in girls and women (McKinley, 1999). Wiseman, Gray, Mosimann, & Ahrens (1992) state the media portray girls being thin and perfect body as a beauty standard.

Sepúlveda and Calado (2012) describe that the sociocultural factors can negatively influence female, and the perceptions in male body image that can also be stereotypical ideal body representations that can be communicated though socialisation agents and especially in mass media. Sepúlveda and Calado (2012) explain how that mass media can involve in social learning theory in applying the positive and negative reinforcement of mechanism in behaviours and beliefs. Social learning theory acknowledge how the individual’s thought, affect and behaviour can be influenced by observation, as well real life experience. Social learning theory explain human behaviour by applying cognitive, behavioural and environmental determinants (Bandura, 2002).

Chapter 2: Methodology

This section will be focusing on the rationale, strategies and criteria that have been applied to help answer the research question of ‘What level of influence does the media have on eating disorders on teenagers?’ A literature-based approach will be taken.

2.1 Rationale

Literature- based approach will be suitable for this research because there are different journals that will be appropriate for the research question, which it has to be only primary data. The reason for choosing a literature-based dissertation to answer the research question is because using empirical approach, such as questionnaires and interviews, it would have been difficult to analyse the primary data and it is also time consuming. Literature-based approach does not require ethical approval. ED is a sensitive subject, so be using 2^nd data you are avoiding harm for participants. Literature- based dissertation will be successful for the research question based on the how does the media influence eating disorders as it will provide appropriate material towards the research question by examining journal articles and database at the DMU library.

The strength of using literature-based dissertation is that the findings can be appropriate with the right sources of information. A literature- based dissertation is useful because it does not need a data collection and ethical forms to accept the proposal to be approved, which is time consuming.  Due to the ED sensitive topic, it is not appropriate for empirical research by an inexperienced researcher to be carried out, but the literature-based approach allows these topics to be addressed as patterns in the data. The themes in the data will be a quick progression in the area of gaining an understanding of current state of researcher on similarities and differences. The weakness of using library-based dissertation is that the data may not produce enough pieces of evidence to explain the complex issues of the research and data; therefore, this could make the research difficult to analyse. The search is limited to free and open access journals, only in English so I may not have found all relevant articles.

2.2 Alternative approach

The empirical approach is based on primary data that uses questionnaires, focus groups and interviews. The empirical approach focuses on the consent and ethical approval for a research question. The research is based on teenagers, which I will need to inform a consent form, and under 18’s will need parental discussions.  The problem is that the requirement to sign the consent form may prompt rather than alleviate concerns on the part of perspective participants; therefore they may end up not taking part (Bryman, 2012). This may because the topic may be sensitive towards the participants or they may not have time to participant in the project such as in ED research.  It will be difficult to recruit, as often it is a secretive disorder because people will not want to admit it so they may not feel comfortable to take part. If an empirical approach were used, it would investigate qualitative data because it would have used a semi- structured interview to be able to collect information about the participants. This would allow the participants to answer the questions on how they feel about how the levels of influences the media has on eating disorders.

2.3 Search strategy

The search strategy was used at De Montfort University Library Catalogue for journal articles using the search terms (See Table 1) ‘body image’ and ‘body esteem’, ‘media’ and ‘eating disorder’ and ‘media effects’.  The reason why I used different key terms is because there was a lack of information in the database. These were the terms that provided in relevant journal articles to examine.

I created a literature search table. The majority of the databases that I used were linked to De Montfort University database and Google Scholar. Some articles were relevant to my research question but many articles did not focus on the topic and so were excluded. There were two articles that I used to examine were found in reference chaining. However, I did not use any books because of the collection of primary data only.  The table below shows the journal articles that will be used in the dissertation. The number of hits represents the search results prior to the exclusion and inclusion criteria being applied.

Source	Keywords	Number of hits	Relevant texts (following application of exclusion criteria)
Google Scholar	‘Body image’ and ‘body esteem’	1,370,000	9
EBESCO	‘Media ’And ‘Eating disorder’	1,053	8
EBESCO	‘Media effects’ and ‘Body image’ And ‘Adolescent’	70	3
Google Scholar	‘Body ideal’ and ‘media’	1,4200,000	6

Table 1: Literature Search Table

2.4 Inclusion and exclusion criteria

This section will be discussing the inclusion and exclusion criteria based on the research question. Media has been changing rapidly throughout the past years.  Only articles that used a sample from Western countries such as United Kingdom, United States of America and Australia were included. The exclusion criteria are that the media culture is very different from Eastern to Western countries.  Only articles published after 2000 will be included. The audience will be targeted at teenagers under the age of 18. The data will be in the 21^th century whereas it is mostly relevant in today’s society.

Only peer reviewed journal articles were used. it is important the journal articles are linked to the research question, and making sure of the high academic standards before it is related it to the research questions.

2.5 Analysis

The critical appraisal tool that will be used to critical the journal articles is Critical Appraisal Skills Programme (CASP). CASP is used by anyone who wants to use it for research evidence in their professional practice, professional and personal decision-making and the policy and guidelines development (Critical appraisal skills Programme, n.d). I will be discussing the steps on how I found my themes in the articles.

The first stage is to make sure that the study was unbiased through assessing its methodological quality. This will assess the different criteria for the validity of articles that are being used for different types of questions such as prognosis, economic evaluation and treatment. Depending on whether the validity in the article is useful, it is important that it can classify the scale of levels of recommendation and evidence.

The next stage was that I decided that the study was valid and then starting looking at the results in the article. This helps to consider whether the study’s results are important, for example, if the methods that they used in the article were appropriate.

Then decided if the evidence in the article was valid and if it was appropriate to use for the research question. For example, ED affects more females than males, and so it may have different impacts on females than males because females are more likely to diagnose ED than males. The critical appraisal skills delivers a framework that helps to consider whether these issues are explicit.

Overall, the methodology section involves the reasoning behind choosing the literature- based approach rather than the empirical approach and why it is suitable for this research question.

Chapter 3: The three themes

3.1 Introducing the themes

This chapter will introduce the three main themes relating to the research question: What level of influence does the media have on eating disorders on teenagers?  The three themes that have been identified in this research question are:

• Theme one: Does media have an impact on male appearance?
• Theme two: The effects of the media on the ED of teenagers
• Theme three: The concern about media that it has on ED in adolescent girls

These themes were analysed of 12 primary research studies, as other information was gained by secondary sources such as books and website. The aims of these themes were to relate to the research question, and give a summary on the impact the levels of media have on ED on teenagers.

The themes were highlighted by the use of the data extraction (see appendix 1).

Chapter 4: Theme one: Does media have an impact on male appearance?

4.1 Introduction

There is substantial past research that views objectified media images that can affect women. Johnson, McCreary and Mills (2007) state that media exposure to these images influences women on how they view their bodies, and can also influence their eating behaviour and their self-esteem. There are not a lot of research on males’ views on the levels of influences media has on eating disorders. There is some views on masculinity and how males view their body perception differently than females. Most research focuses on female perspectives on their body image.  Pope, Phillips, and Olivardia (2000) imply that they have been an increase in media attention on both genders, and an increasing body of research on male’s body images shows men are also focusing on the size of their bodies.  This chapter will discuss the roles of media in males’ perspectives on their bodies.

4.2 Ideas of masculinity

Most males especially teenagers and young men believe that being muscular is attractive (McCreary and Sasse, 2000). McCreary and Sasse (2000) state that the drive thinness in boys and men is rare. Johnson, McCreary and Mills (2007) state that about 28% and 68% of normal weight boys and young men feel that they want to gain towards their muscle and weight. Most males want to be bigger, more muscular and bulkier.  McCreary and Sasse (2000) discover the two findings in male perceptions of ideal body shape that most men consider that women find it attractive and their ideal man if there are masculine and male will pick the muscular shape as their ideal man. However, these results may not apply to homosexual males if they are not motivated by female attraction. This shows that men especially young men take their body seriously by feeling fit and being able to healthy. This also shows that that male feel that their appearance is important towards them e.g. the way they look.

Most Western countries are affected by how media portray individual body images. The study of Pope et al., (2000) indicate that about three million men in North America are taking anabolic- androgenic steroids or some harmful drugs to develop their muscularity, while a large amount of men have developed ED and about millions more of men have developed body dysmorphic disorder.  Androgenic-anabolic steroids (AAS) are synthetic derivatives of the male hormone testosterone. They can exert strong effects on the human body that may be beneficial for athletic performance. This shows the reason why males feel the need to take steroids to feel better about themselves. Taking harmful drugs and steroids could affect their physical well-being and realising that taking steroids can be very dangerous.

Johnson, McCreary and Mills (2007) conducted research on ninety male undergraduate students aged between 17 and 28 on the influence of viewing gender-objectified images on men’s drive on muscularity and their psychological well-being.  Johnson, McCreary and Mills (2007) recruited the participants for a market research experiment, as the purpose was to evaluate the effectiveness of magazine ads.  The results that they found was that there were no effects of the images towards men’s body image.  The research had quite a few aims: firstly, the participants had to complete a self-esteem questionnaire. The questionnaire took place before the experimental manipulation even though the participants were randomly assigned to one experimental conditions, this did not change their self- esteem beforehand. Secondly, the participants were presented with seven laminated full page colour ads, which it was taken from different magazines that represent men and women.  Moradi and Huang (2008) define objectification theory as it outlines the understanding on women’s experiences of sexual objectification and socialization. It also involves mental health problems such as depression, ED and sexual dysfunction; these factors affect among women than men.  The participants were randomly allocated to one out three ads conditions which were 7 ads viewing 5 objectified male images and neutral ads (with selected pictures of automobiles and household products), 7 ads representing 5 objectified female images and 2 product ads and the last one was the neutral condition which viewed all 7 ads and showed the automobiles and household products. Thirdly, the participants were given a questionnaire called The Consumer Response Questionnaire which it was produced by Mills et. (2002) which they were given seven minutes to analyse all the ads.

The study had used the post-test only design, which they felt that it was suitable in the study, in order to assess the self-esteem of three experimental groups. The main results show that the men that were exposed to objectified female images experienced higher levels of anxiety and hostility compared to men in both male images and neutral images conditions. In addition, the outcome was that viewing the images of objectified images on both genders did not affect the participants on how they view their own bodies, for example being more muscular.

Media images exposure can affect self-esteem ((Kim and Lennon, 2007). Kim and Lennon (2007) states that one of the main factors that develop self- esteem is the physical attractiveness that teenagers found it important. The researchers also imply that it is understandable the way mass media portray thin ideal images can also be connected with negative body attitude and having low self -esteem.

4.3 Is Muscle Dysmorphia linked to ED

Male self-esteem is affected by their perceptions of how they look and how the media portray male body image negatively. A study from Grieve and Helmick (2008) reports on a disorder called Muscle Dysmorphia. Muscle Dysmorphia is an obsession that focuses on the idea that one’s body can be insufficiently lean and muscular and it plays part in body image disorder among men (Wolke and Sapouna, 2008). The common behaviour that is linked to Muscle dysmorphia contains dieting, anabolic steroids and extensive weight lifting. Grieve and Helmick (2008) state that men with this disorder tend to feel that they are too small even though they may be muscular. The outcome of this is that they may feel ashamed of their body and feel fear of body exposure, which results in reduced social functioning.  But, some researchers cited by Grieve and Helmick (2008) have claimed that Muscle Dymorphia should be considered as an obsessive- compulsive spectrum disorder (Maida & Armstrong, 2005) or eating disorder (Goodale, Watkins, & Cardinal, 2001; Grieve, 2007). In that case, the impact of Muscle Dysmorphia should be classified as similar to that of the development of anorexia nervosa and bulimia nervosa.

The effect of the media portrayal of male body images has been argued to be negative. This could potentially lead to developing of muscle dysmorphia and also self-esteem. A study that support this view come from Grieve and Helmick (2008).

Grieve and Helmick (2008) recruited 74 participants. The researchers approached men on campus and asked them to be able to fill out a survey on body image. Some participants were recruited by sending an electronic inquiry (email) to male colleagues and other male’s students at their universities. Those that received an email were directed to the study’s webpage where all the data were collected. The participants had to be over the age of 18.

The main findings of this study were to investigate what influence the self-objectification on male body image. Self-objectification is how individuals value body than as third person perspectives, aiming on how they look, instead on focusing from a first person perspective. Grieve and Helmick (2008) reported that self-objectification can associate with men’s drive for muscularity. The researchers discovered that men high in self-objectification have a higher drive for muscularity, and have a higher chance to increase their levels of muscle dysmorphia symptoms than men with low self-objectification have. This shows that the self-objectification can increase the risk to men’s physical and psychological health. These findings are supported by previous researcher, for example Fredrickson et al., (1998), Morry & Staska, (2001), Strelan & Hargreaves, (2005) demonstrate that men self-objectify, and that Western culture can prompt the ideal of muscularity in men. This is because the western society has been criticizing in emphasise on stereotyping body images, as the mass media is to be blamed by promoting attitudes in body and self-enhances as it develops a risk towards ED.

Grieve and Helmick (2008) reported that self-objectification has a significant impact on how the media portray and emphasise body appearance. A researcher found that media can have an impact on body dysmorphia as they discovered that the media images can have an impact on men’s dieting attitude and causing ED. This shows that males could feel that being muscular is attractive and feel that they need to achieve their ‘ideal’ look.  A study from Ridgeway and Tylka (2005) stated in their study the male participants feeling pressured by the way the media portray on being built and muscular.

The reason for this is that the media has been exposing the images of the ideal male body, which lessens men’s body satisfaction.  The limitation of this study was that they had a small sample size. This limits the generalizability of the findings. The sample in the study was different from the general college population, as the number of athletes in the sample were overrepresented compared to the general college population.  This may show that athletes may have higher levels of self-objectification because they may associate themselves with dieting and participating in ED symptoms, as it could affect the results.

4.4 The effect of Eating disorders has in males

Women and young females develop ED than men and young males (McCabe and Ricciardelli, 2001).  According to Ricciardelli and McCabe (2004) state that 10% of males have ED and that males are diagnosed in Bulimia nervosa than Anorexia nervosa. It is implying that moist young teenagers experience bulimia but it is not that common. Ricciardelli and McCabe (2004) also focuses on the effect that the ED has in adolescent boys in biological, social cultural and psychological factor.  The researcher state that it has been shown that puberty status in males is important in the biological factors that it could affect their body image in adolescent boys. The researchers imply that depend on how the puberty can be around for, it can lead to some weight loss behaviour in adolescent boys.

Ricciardelli and McCabe (2004) main findings that they found was that disordered eating among males shown in both studies in cross sectional and longitudinal shows that they may be pressured from parent or friends to be able to lose weight. This shows that most teenagers especially girls are likely be peer pressure from their friends because they might like the way they look. For example, going gym or even not eating as much as before (dieting) and the way the media portray has an influences via modelling can also have an impact towards girls. However, for teenage boys is different because in the sociocultural aspect, they could be pressured by their teachers or even coaches and this could negatively have an impact on them to lose weight.  However, they are not many evidences or study to support this.

Ricciardelli and McCabe (2004) reported the relationship between ED and sports in teenage boys, which have been observed from numerous cross-sectional studies. However, this association can be more complex than other observed direct effects. In this case, for some boys, being involved in sports may be as protective factor in the athletic involvement which appears to be physical, mental, and social development (Ricciardelli and McCabe 2004). The positive outcome of this shows that adolescent boys who are likely to be fit to participate in athletic than involving themselves doing steroids or dieting. Especially, for those that like to play sports will help them to be mature and being popular with their friends. This could associate with a positive factor that will help teenage boys from developing ED and other emotional difficulties. According to Ricciardelli and McCabe (2004) state that boys who’s participant in sports, especially for those that prescribe weight restrictions or have a high emphasis on aesthetic ideals are more likely to diagnose with ED.

Chapter 5: Theme two: The effects of the media on the ED of teenagers.

5.1 Introduction

According to Morris and Katzman (2003), there has been a concern that the media may play part in body dissatisfaction, and also may be partly of responsible in the increase in the prevalence of ED. This is most likely to affect the teenagers’ views on how they look, triggering changes in eating behaviour changing which may relate to ED. Grogan (2008) defines body dissatisfaction as the fact that the individuals view their body negatively. This refers to their judgement about their size, muscle tone, and it involves the difference between the individual’s body type and ideal body type. The types of media that are affecting teenagers most today’s society (especially in western countries) are television, magazines, fashion, and internet.

Morris and Katzman (2003) state that there have been numerous research studies over the past 20 years on thin female beauty ideal, and the muscular male body ideal. This research provides a psychological perspective on how the media has been portraying the body ideal in psychological perspectives; by discussing body dissatisfaction and eating disorders.  The impact of ED is highly affected in the Western countries where the media expose body images.  This chapter will be discussing the effects that media has on ED, and how it can influence teenagers to develop ED.

5.2 Does Body dissatisfaction relate to media?

The factors can influence teenagers body images are the way media delivers the messages, self-esteem, gender and peer pressure including the support from family (Lally, Ludden and Ata, 2006). Lally, Ludden and Ata (2006) study explains how the body image research identifies how self-esteem, gender and peer pressure and media pressure associate to ED behaviour and body images among teenagers.  The researcher indicates that there is a link between self-esteem and negative body image can be more extensive influences from family, friends and media. This implies that the media has been influencing teenagers on how they view bodies by seeing advertisement on television or other types of media. The problem of this is that it is making teenagers feel insecure about their body and feeling the need to change by taking part in dieting especially female teenagers, as it is linked to social comparison and self-concept.

Social Comparison Theory was presented by Festinger in 1954. The theory explain how individuals are determined by the desire involving self-evaluation. The theory explains that when individuals do not value themselves, they compare their own abilities and attributes with other individual. Social Comparsion Theory also clarify that individual compare themselves to others in certain characteristics can influences on how individual feel and think about themselves, which this could lead to them to participate in harmful and positive behaviours (Reel, 2013).  Reel (2013) explain the upward and downward of social comparison. The researcher describes how the upward comparison focus on the other person evaluate the other person positively.

For girls, they may involve themselves in dieting and more likely to experience oh having a negative feeling about their figures. However, for boys it is different because they are more likely to focus on being muscular and having positive view on their bodies (CDC, 2006; Harter, 1999; Ricciardelli and McCabe, 2003; Weltzin et al., 2005). Ata, Ludden, and Lally (2006) indicate that female adolescents are prompted to change more in improving their physical appearance by reading fashion magazines. Other media sources produce similar effects as well. According to the studies of Field et al., (1999), Levine, Smolak, & Hayden, (1994), Taylor et al., (1998) discovers that adolescent girls and women are likely to get influenced by magazines and television especially in relation towards weight concern. The negative impact that this has on female adolescents is that most of them feel the need to look at magazines and advertisements to define their body. These media provide them with an image of the ideal body or celebrity role models. It is likely that they will experience body dissatisfaction because of the difference between their real body size and the ideal described in the media. Ata, Ludden, and Lally (2006) found that watching television can increase the body dissatisfaction in young girls and thin desire to have a thin body when they are older, and this could cause the ED over time. However, for males it is different because they do not really experience the pressure from the media that associate with the thinness but are likely to aspire for muscularity.  As I mentioned in my previous chapter, male adolescents adopt in strategies in order to achieve more muscularity look; these includes exercising and use of food supplement (McCabe and Ricciardelli, 2003).

In today’s society media has make a huge impact especially among teenage girls. Media plays a part in revealing the sociocultural ideals and also plays an important role in the development of body dissatisfaction and ED. Tiggemann (2003) states that the sociocultural model has had a massive impact in contempory society’s especially resulting in high levels of body image disturbance, body dissatisfaction and the levels of rates in ED among women. There has been some empirical research that has attempt to investigate the measures between the weight concerns and media exposure that has been less clear (Tiggemann, 2003). There also has been a positive correlation that demonstrate the media exposure with body dissatisfaction. This is with portraying the media with positive images that will make young teenagers to be able help them to not become oversize.

Tiggemann (2003) used 104 female undergraduate students at Flinders University of South Australia the age of 20 years old. They had to present 17 women’s fashion magazines that was available in the local newsagents and also they had to follow the procedures of   Tangney and Feshbach (1988), which the participants were presented a coy that was previous weeks’ television guide and had to circle the programmes that they actually watched.  Tiggemann (2003) found that magazine and television exposure are related to body dissatisfaction which none of these factors are associated with ED.  However, television was associated with the most Body Mass Index (BMI) and lower self-esteem which magazine was not. Therefore, magazine exposure was related with the internalization.

Relating this to both articles of Tiggemann (2003) and Ata, Ludden, and Lally (2006), both imply that the media has been affecting young adolescents in both genders especially in the Western countries.  In the Western countries such as United Kingdom, United States of America and Australia are exposed to the media that are affecting adolescent as showing inappropriate programs that leads to ED and also could affect their wellbeing such as taking part in dieting for the wrong reasons and also their self-esteem, how they feel about their boy shapes especially in female teenagers that are most likely to be concern about their bodies. These factors are related to how the media’s portray body image in a negative way. Different interventions that involves in media such as health communication campaigns, entertainment education, media advocacy and media literacy training will need to demonstrate how the media’s portrayal with a respect and also the unachievable images that affect young teenagers with the images of beauty that young teenagers are exposed that could lead to an imp act of ED and disordered eating behaviours. This will help if the media minimize the programs that relates to body images.

5.3 The relationship in media ideal, peer social association and body dissatisfaction in ED

As it has mentioned that, the body dissatisfaction is related with ED. There has been a relationship between media ideal, peer social association and body dissatisfaction in ED.  Rodgers, McLean and Paxton (2015) state that body dissatisfaction is becoming an issue in ED, which it has been, predicted that it might increase psychopathology and unhealthy behaviours. The negative perspectives of this show that individuals that are not comfortable in their body are more likely to have low self-esteem, depression, weight gain and disordered eating.  In the early stages of adolescent,

Rodgers, McLean and Paxton (2015) stated the difference in adolescent boys and girls in puberty in a relation to body image concern. Rodgers, McLean and Paxton (2015) mentioned that girls that goes through their puberty develop a relation in body image concerns, as their physical changes starts to change, as they may be influenced how the media promote body ideal. However, according to Rodgers, McLean and Paxton (2015) the difference in boys related to puberty is different because their physical changes tends to associate with muscularity, and tends to move closer to the social ideal. Therefore, for girls it different because they are influenced by the media compared to boys that involve more in social appearance, which these factors are a risk in body dissatisfaction. This also shows that body dissatisfaction can develop in early stages in adolescent especially in girls in the way how the media portray body image, and therefore it will develop adolescent girls to be able to participate in developing in body images concerns and ED.

Rodgers, McLean and Paxton (2015) took a sample of 277 Grade 7 which were recruited from three coeducational and girl school in Melbourne, Australia in order to be involved in in a body image intervention trial.  The participants had to complete a self- report questionnaire, which before they completed it they had to provide a parental consent in order to participate in the study. The overall aim of this study was to examine the longitudinal and the temporal relationships between body dissatisfaction, media internalization and social appearance comparison in adolescent girls.  The researchers suggest that media internalization leads to social appearance comparison which it could develop body dissatisfaction. Also, the researchers discover the relationship between media internalization and body dissatisfaction are common and it can influence each other.  As the researchers suggest that, the role of body dissatisfaction can develop an ED among older teenagers.

This study indicates the longitudinal relationship among media-internalization, social appearance comparison and body dissatisfaction the evidence suggesting that media internalization has a role in developing body dissatisfaction.  As the outcome of the results; the findings shows that relationships between media-internalization, social appearance comparison and body dissatisfaction highlights the significance in aiming the concepts in targeting to reduce body image concerns. Especially for early teenagers, the development of body image concerns is a critical stage, especially for younger teenager girls. The limitation of this study was that the measurement that was used to collect the results in media-internalization and social appearance comparison overlapped. Also, how the media internalization correlate with media targets, although the social appearance represents the associations with friends.

Chapter 6: Theme three: The concern about media that it has on ED in adolescent girls

6.1 Introduction

This chapter will discuss how the mass media influences on ED in adolescent girls. Previous studies indicate the media may have an impact on ED and it is still a debatable topic in today’s society. Ferguson et al., (2013) raise the concern about how the media influences women and girls body dissatisfactions.  Becker et al. (2002) specify that media influences on body dissatisfaction may lead to ED symptoms and explain the increase in ED, such as bulimia nervosa across the 20^th century in Western countries.

6.2 Social media

There are some media that most teenagers use in today’s society- that is social media. Social media has increased in recent years; this is because the majority of teenagers uses social media to interact (Feinstein et al., 2012).  According to Ferguson et al., (2013) social media may deliver an outlet for the promulgation of ideas that involves in thin-spiration images in advertisements and conversation with friends. Some studies have investigated the potential influences social media and body dissatisfaction have on ED symptoms in adolescent girls.

Ferguson et al., (2013) used 237 female participants aged 10-17. However, nearly all the participants were Hispanic. The participants were recruited by using the snowball sampling method from the local community and university. The main method that Ferguson et al., (2013) used to analyse was the hierarchical multiple regression to measure the outcomes of body dissatisfaction, life satisfactions and eating disorder symptoms.

Overall, the aims of this study, were to investigate the influence of media and peers on body dissatisfaction, life satisfaction and ED symptoms, because these issues need to be discussed in the academic community. There is still division in research on whether media associated with body dissatisfaction and ED symptoms and whether these issues affect only girls and women. The study also indicates that there is little research that considered the effects of peer pressure. Ferguson et al., (2013) found that social media could contribute to peer pressure by allowing individuals to communicate and sending ideal body images. This could have a negative outcome for teenage girls.

A study from Perloff (2014) examines the way the social media portray the perceptions of body and body image disturbance. The researcher stated that the communication and social psychological theories can help understand the effect of body images presented in social media towards young women. This includes exchanging ideal body image via social media. This concept shows that teenage girls may try to identify with the ideal image or peers could suggest strategies in order to achieve that look.

Ghaznavi and Taylor, (2015) study implies that thin-ideal imagery is referred to as ‘thin-spiration’ across the social media Twitter, Tumblr and Pinterest that has received more attention in recent years. Thin-spiration is a thin- ideal media content on images that purposely encourages weight loss, often encourages dangerous behaviours characteristics of ED (Lewis & Arbuthnott, 2012; National Eating Disorders Association, 2013). Ghaznavi and Taylor, (2015) describe thin-spiration as being found in pro-eating disorder website which encourage disordered eating to achieve weight-loss and images. This is widely affecting the social media especially in the Western society (Columbia Broadcasting System New York, 2012). This also shows that teenage girls are likely to experiences thin-spiration.

Ghaznavi and Taylor, (2015) collected a sample through systematic random sampling of posted images on social media via Pinterest and Twitter. Ghaznavi and Taylor, (2015) state that these social media are popular among U.S. women.  The researcher aim is systematically analyse the thinispiration images via Pinterest and Twitter. They found out that the images tend to be sexually suggestive and represent the ultra-thin, bony, scantily clad women.

Kleemans et al., (2016) conducted an online experiment to investigate the effect of manipulated Instagram photo based on body images of girls. Kleemans et al., (2016) recruited 144 adolescent girls to partake in the experiment. The sample of this online experiment was small, this may affect the results.  The researcher also used snowball sampling to recruit participants.

Kleemans et al., (2016) found that social media such as Instagram among young girls’ exposure pictures. These shows that it may imply recommending including an exposure   when opening their Instagram account that would remind them that the images on Instagram are retouched and influenced.

6.3 Fashion Magazines

Extensive research literature focuses on TV and magazines since these types of media are the most popular among adolescent females (Hibschite and Greenberg 2001; Tiggemann and Pickering 1996).  Botta (2003) implies that magazine reading has been a main factor in influencing body image and eating disturbances for females. The researcher also states that previous studies found that college students spend substantial amount of time reading magazines and also found that the increased exposure to thin ideal bodies in magazines is related to ED symptoms in adolescent girls. Botta (2003) also found that reading magazines can also be a sources of information about fitness, beauty, and ideal weight, relating to increased body dissatisfaction and eating patterns symptomatic of ED.

Hogan and Strasburger (2008) imply that magazines are aimed at adolescent girls, who are aged 15-18 years old.  Hogan and Strasburg (2008) state that girls that read fashion magazines compare themselves to models in articles and advertisement, and are most likely to experience more negative feelings about their appearances. Also, young females with diagnosed ED are were influenced by magazines and newspapers.

Botta (2003) conducted a survey of 196 high school and colleges boys and 201 high school and college girls from the urban area in Midwest in America. The results show that boys had higher scores in sports magazines, body satisfaction and muscularity. However, the girls had higher scores involving in fashion magazines, health and fitness magazines and a range of ED symptoms. The results show that girls are more likely to experience body dissatisfaction after reading a fashion magazine.

Hogan and Strasburger (2008) found that a recent longitudinal study of 2500 girls from middle to high school exposed that those who are heavy readers of magazines, that publish dieting and weight-loss articles are more likely to engage in unhealthy behaviours. This is because those that do not ready fashion magazines has fewer symptoms of ED.

Relating this back to the research question, Botta (2003) and Hogan and Strasburger (2008) explain the levels of media influences on ED among teenagers. They conclude that fashion magazines are likely to affect more girls than boys.

6.4 Television

Teenager girls are more exposed to weight- loss advertisements that may cultivate beliefs involving dieting, which can affect the health and lifestyle decisions throughout their lifetimes (Hobbs, 2006).  Health communication theory examines ways to communicate media messages by entertainment and advertisements. These messages play a part in cultivating beliefs and attitudes that shape behaviour (Finnegan et al., 2002).

Hobbs (2006) study included 42 adolescent females aged 9-17 years from different state in United States.  Hobbs (2006) shows an examples of print and TV ads that relates to weight-loss products. The results of this study shows that the participants acknowledge the wide ranges of perceptions and experiences in the topic of weight-loss. The girls in this study understood how to demonstrate some media literacy skills. There also recognised some deceptive techniques that is being used in weight- loss advertising.

Herbozo et al., (2004) indicates that television has the greatest impact on body images in female teenagers by providing images that they will compare themselves to. The researcher suggested this is overwhelming because the female’s tendency to compare their bodies to another person can affect their levels of body satisfaction.

A study of Dohnt and Tiggemann (2006) found that girls who watched television shows that emphasizes appearance were less pleased with their own appearance.  The researcher also explained that soap operas and music television clips represent women as thin and attractive and sometimes dressed erotically. It has been also stated that such as soap operas and music video are linked with body dissatisfaction and ED in adolescents.

In conclusion, the three themes explained the level of influence the media have on teenagers eating disorders. Media determines the audience such as teenagers to value their outward appearance suggesting that being thinner and muscular is a positive outcome and lead to being accepted in society. Social media and peer pressure can affect teenagers’ mental perception on how they look. This could lead to risky behaviour such as eating disorder or participating in dieting.  The next chapter will conclude the project, and it will also be discussing the recommendations in this dissertation and the reflection. It will also include a reflection on doing the research.

Chapter 7: Conclusion, recommendation and reflection

7.1 Conclusion

The aim of this dissertation was to investigate the research question: of ‘What level of influence does the media have on eating disorders on teenagers?’

When producing the literature review for this dissertation, the themes were: Does media have an impact on male appearance, the effects of the media on the ED in teenagers and

The first theme discussed how media have an impact towards male appearance. It discovered the ideas of masculinity and how males being muscular is attractive. It also explained if muscle Dysmorphia is linked to ED and the effect of ED that it has on males.

The National Centre for Eating Disorders (2017) discover that women are likely to compare themselves and talk about their anxiety by expressing how they feel about their weight and shape than men. Women also discuss about their dieting and food, and are possible to seek weight loss by participating in dieting. However, for men this is different because they are likely to hide their feeling about their eating problems by going to the gym and doing excessive exercise. This shows that men do not like to seek help by a health professionalism.

The second theme discussed the effects in media on ED that impacts towards teenagers.  This theme links to the research question; as the sub themes were; does body dissatisfaction relate to media and the relationship between media ideal, peer social association and body dissatisfaction that links to ED.  The main findings body dissatisfaction is linked to ED and also media relating to body concern that how the media portray on body image. This dissertation also discover that young teenagers are most likely to be affected by ED because as it has been mentioned that young female teenagers to participate in dieting in a negative way.

The third theme discussed the types of media that influences among girls. Fashion magazine is used more in girls than boys. Gallivan (2017) found that girls who read magazines associate with dieting or weight loss were 6 times more, and likely to engage with unhealthy weight control behaviour. Most studies found that teenager girls engage more via social media, as it promotes thin ideal images. Gallivan (2017) found that Socialworkers.org (2001) explained the social influences could relate to social media and other types of media that promote images of standard beauty and attractiveness that teenager’s girl can achieve a specific body type or image. Most studies found that girl’s experiences body dissatisfaction than boys, as they may experience poor health habits and have low self-esteem. It also shows that teenage girls feel being attractive is important and also to look a certain way in order to have their ideal body image.

The limitation of this dissertation is that some of the research was carried out in the secondary sources, this was due to the lack of information that the primary source. Even though the primary source had some information on ED relating to Media, the secondary source had many information which it had to be a primary source. The dissertation examined the levels of media that influence ED, however it did not really acknowledge the different factors that ED can be caused and explaining the complication that could have been found. Also, the dissertation did not examine if ED could be affected in the future generation because the word limit would have not been enough to write in the dissertation.

Most of the studies has small sample size especially in Australia and the United Kingdom (UK) and also the participants that was involved were females than males. This shows that the young teenager female are likely to get affected then young teenager males.

7.2 Recommendation

A recommendation in this dissertation highlights that females diagnose with ED than males. There are not much studies are that there that explains the issues of males being diagnosed with ED. This could be because males do not suffer from ED than females. As for this, there should more research on males’ perspective in ED.  However, because females are most likely to diagnose with ED, it would be best of the media cut down with advertisement that participate with body image. These factors can influence females especially young teenager girls.

The Parliamentary Office of Science and Technology (2007) state that the fashion and advertising industry is more targeted towards teenage girls that are more influences in ED. As its been mentioned in this dissertation that the western media are more affected in disordered eating and behaviours, however this issue factor can influence a small minority of individuals. The Parliamentary Office of Science and Technology (2007) outlines that the NICE guidelines apply information for patient groups and clinicians.  Though, the attitude towards for ED patients can be improved by focusing on the action in certain key factors. The improvement includes having referral strategies and service provision for young teenagers and adults. Also, this could fund further research on males’ perspectives and other causes of ED and changing how the media portray fashion and advertising industries towards teenager girls.

According to Parliamentary Office of Science and Technology (2007) state the specialist treatment is not often available, for example in Wales they do not have no specialist services and in south east England where they have services but there are some areas that are poor provision, as well as some parts of London.  A survey done by Royal College of Psychiatrists (RCP) in 2000 found that the are only 50% of health authorities in United Kingdom had a specialist service surrounded by their area. In this case, having more specialist services around the UK will be benefits for individuals that suffers from ED to get the treatments. However, the costs of the treatments will cost more, also the NHS will need to funded to be able to get the treatment available in the UK which the costs will be expensive.

7.3 Reflection

According to Moon (2008), he defines reflection as putting together your knowledge and thinking in order to understand the bigger picture of the purpose of doing this which it may exceed the preceding bounds of personal knowledge and thought.  Reflecting on my research was helping me to acknowledge important skills that I may tend to use for any of my research that I may partake in the future.

Before starting my dissertation, I did a dissertation proposal knowing that I was doing a literature based dissertation. My original proposal was a qualitative data through questionnaire on ‘What level of influence does the media have on eating disorders on teenagers?’ and speaking to my supervisor realised that empirical research was not suitable for my research question because my aim was towards teenagers under 18 years old. This made me realise that it would have been hard to collect data. The ethical consent form would have been a problem as well because most teenagers that are under 18 will need to their parents to sign the consent form because there are underage. This would have been time consuming. However, if it was empirical research this would have been interesting knowing the percentage of teenagers getting affected by ED relating to media. It will be difficult to recruit as often it is a secretive disorder because people will not want to admit it so they may not feel comfortable to take part. Though, some teenagers may feel not bothered or uncomfortable filling in the questionnaire. Also, conducting a semi- structure interview would be useful because it would have gathered information on my research questionnaire. I also believe that the participant will feel uncomfortable talking about it because it is a sensitive topic to touch on.

I also think the empirical research would have been so interesting because on other participant’s view on ED and how it has affected them. Even though, I have mentioned it is a sensitive topic to be discussed, as others may not feel they want to talk about it by getting emotional or frustrated.

This dissertation made me realise that most teenagers do effect on ED because the way the media portray by using fashion magazines and other media sources to attract their attentions.  I believe that this dissertation made me realise that they most of young teenagers are being affected by the ED and some are caused how the media portray and others psychological aspects in health. It also made me realise that it is mostly affected in the Western countries and see a bigger picture of how teenagers are being influenced by ED.