Beliefs in links between "thin ideal" media and body dissatisfaction among women, perhaps even full-blown eating disorders, has been one of the "truisms" or sacred cows of media psychology for at least a generation or two. But just as the media violence/video game debate has spiraled into confusion and chaos, debates about the extent to which media actively cause body dissatisfaction and eating disorders can often leave readers confused and sometimes mislead. It's not at all uncommon to hear it expressed that there are no doubts media ideals cause body dissatisfaction, but we used to hear this with video game violence too. Just as with most areas of media effects, looking at the data reveals that the truth is complex.
First, let's dispense with the obvious. There's little question that the beautiful, airbrushed, sometimes even absurdly computerized folks we see on TV or in magazines are unrealistic standards of beauty. Second, there's equally no doubt that many people find this state of affairs to be morally offensive (although what people say about media publicly and how they talk with their wallets are often two different things). Indeed, I've written on this second issue myself . Third, it's clear that some women and men, when presented with media images of attractive folks, may, at least in that moment, be reminded about body dissatisfaction issues they may already have. But are media portrayals of beauty a root cause of body dissatisfaction or eating disorders?
Despite some claims to the contrary, it turns out the research evidence on this is less than clear. For a meta-analysis I conducted in 2013, I read through over 200 papers that existed at that time. These papers could be divided into three roughly equal groups: studies that found some evidence for a media effect, studies that found no evidence for a media effect, and studies that were inconsistent in outcomes (although they often claimed victory for the media effect position, despite their own evidence being murky). Fairly obvious flaws were common to many studies. For some studies the purpose of the research was pretty obvious to participants who might have altered their true responses to give the researchers what they wanted. Other studies also used poor media contrasts. For example, an experiment might compare images of thin, pretty actresses to images of household objects like soap or deodorant. Now, I'm willing to grant people compare themselves to other people, but an experiment like this has not isolated "thinness" as the key component. If an experiment compares pretty, thin actresses to pretty, average size actress (which, unfortunately, few do), then a decent argument can be made for thinness being a key variable. But if the comparison consists of pretty, thin actresses to, say brooms, all we know is that people compare their looks to other people more than they do brooms. Which we knew already. Some studies now suggest that comparing thin, attractive women, to average sized attractive women results in no differences or even inverse effects in body dissatisfaction.
At least one meta-study may have unintentionally compounded these problems. In examining this 2008 meta-analysis, it becomes clear that the authors included comparisons between thin models and inanimate objects, but excluded comparisons between thin models and average size models (the outcomes for such comparisons between actual people were less likely to be significant or very large.) The results for comparisons between groups of models were generally less impressive than comparisons between models and inanimate objects. For other studies, non-significant results appeared to have been dropped from analysis. It's important to note that I am not suggesting any wrongdoing on the authors' part. I suspect that such decisions about what to include and what not are problematic for many (perhaps most) meta-analyses. The authors of this meta-analysis concluded that small but significant effects existed for media on women's body image, but I am less confident about these conclusions given the choices the authors made in extracting their data. And other meta-analyses have sometimes disagreed with their assessment (although others do agree). This is also an example of a poor use of meta-analysis to try to smooth over differences between studies ("The average effect size wins!") particularly when those studies differ in quality.
I am also concerned because better controlled studies seem less likely to find these media effects. Other research, such as that by Alan Roberts at Indiana University have suggested that, far from being consistent and obvious, media effects are often subtle and complex, with negative effects on body image seen mainly among women who were already dissatisfied with their bodies. That is to say, media images didn't cause women to be body dissatisfied, but once they were, media images could remind them of this. This was essentially the conclusion I came to with my own meta-analysis: Media effects tend to be very small, idiosyncratic, limited to women with preexisting body concerns, and more a reminder than a cause.
As for eating disorders, it's important to point out there's really no evidence that media is a root cause of eating disorders. Part of this is due to the rarity of eating disorders themselves. The American Psychiatric Association in their Diagnostic and Statistical Manual estimate the prevalence of Anorexia Nervosa at about 0.4 percent, with prevalence of Bulimia Nervosa between 1-1.5 percent. Because these disorders are rare, it's difficult to get together large enough samples of such individuals to study them. Instead most media studies are on non-disordered college students, examining non-clinical body dissatisfaction or disordered eating symptoms (which include everything from feeling guilty after eating, dieting, worrying about weight through vomiting after eating).
So what's "the answer" to the question of how media influences body dissatisfaction? It seems to be "it's complicated." Much of the research remains of poor quality, and hasn't really provided a consistent result. Examples of poor quality designs are those that ask some women participants to view thin models, while other participants view non-human products like shoes, alcohol, toiletries, cars or jewelry. Too often the researchers then immediately ask participants how they feel about their bodies. Such designs all but pressure participants to respond the way the experimenters want them to, and haven't really isolated "thinness" as a variable. And the results even of these studies merely look at tiny differences between groups, not body dissatisfaction as a meaningful experience. People did not leave these sessions exclaiming, "I've seen your accursed pictures, and my day is ruined!" The differences amounted to something like a 2-3 percent variance difference in self-report responses. Pretty thin gruel.
Further, there's little evidence to link media to the onset of full-blown eating disorders. And media seems mainly to serve to remind women of body dissatisfaction than to cause it. I have no doubt that thin ideal media is obnoxious and often morally repugnant. Nor that many women (and men) feel anxious or angry when presented with such media. But media psychology has often had difficulty separating morality from good data. This appears to be yet another area where rhetoric on media effects has outpaced the science.
If you're struggling with an eating disorder, call the National Eating Disorder Association hotline at 1-800-931-2237.