Here we are again discussing eating disorders, on the occasion of the Settimana Lilla (“Purple Week”) which this year begins on March 9th. In the first article on eating disorders, we focused on EDs as psychological and behavioral conditions distorted towards food, on the consequences for physical and mental health, and on alarming statistics.
Now, however, we have turned the page and are about to start the second installment on eating disorders. Specifically, we will talk about the causes that trigger EDs and the role played by social media, cyberbullying, and body shaming.
Table of Contents
The Silent History of Eating Disorders
What are the Causes Behind the Development of Eating Disorders?
How Food Control Intertwines with our Perception of Body Image and Eating Disorders
The Beauty Ideals that Shape Contemporary Society
The Role of Social Media in Body Shaming and the Subsequent Development of Eating Disorders
Quick Summary
The causes of eating disorders (EDs) are varied, including genetic factors, biological influences, external influences (such as the behavior of parents and classmates), psychological factors (such as stress and depression), personality, and cultural pressures, including beauty ideals promoted by the media and social media.
There is a strong link between obsessive food control and a distorted perception of our body image, responsible for the idealization of thinness as a means to achieve the prevailing beauty standards in society and the development of eating disorders.
Terrible, but recurrent words on social media are cyberbullying and body shaming: the sight of perfect images online leads us to aim for a fictitious, erroneous, and non-existent perfection through excessive use of filters and recourse to cosmetic surgery, to avoid falling victim to cyberbullying and body shaming. Among the risks are the development of EDs and suicidal thoughts. It is essential to underline the importance of self-acceptance, social support, and proper education to face these challenges.
The Silent History of Eating Disorders
Although eating disorders are a very current issue, one should not make the mistake of thinking that EDs have only appeared in recent years.
The first testimonies of people who would have shown symptoms associated with eating disorders date back to the Hellenistic period (323 BC - 31 BC), although the richest documentation dates back to the Middle Ages, when refusing food and denying physical needs were considered culturally and spiritually accepted practices. Specifically, there was talk of a true "holy anorexia," and stories are told of young women who died prematurely due to extreme self-induced fasting. The first cases of anorexia nervosa are said to have been diagnosed towards the end of the 1600s, although the medical term was only coined in 1873 by the English doctor William Gull.
While signs of anorexia nervosa have been found throughout history, bulimia nervosa seems to have a more modern development. There are reports of Roman emperors who often ate excessively during banquets and then vomited, but there was entirely lacking that cultural aspect of "celebration" of thinness, which, on the contrary, we have initial traces of in 1903 when Pierre Janet (a psychiatrist whom Sigmund Freud was inspired by for his own theories) dealt with the case of Nadia, a young woman who exhibited dietary restrictions, fear of fat, and episodes of binge eating. However, bulimia nervosa was first described as a variant of anorexia in 1979 by British psychiatrist Gerald Russell (Very Well Mind, 2020).
Other EDs were recognized much later: just to give an example, consider that Avoidant/Restrictive Food Intake Disorder (ARFID) was only included among eating disorders in 2013 (Seetharaman et al., 2021).
What are the Causes Behind the Development of Eating Disorders?
Let's start by acknowledging the fact that eating disorders can affect individuals of any gender, ethnicity, age, or socioeconomic class. In any case, there are various risk factors that could influence and determine the development of eating disorders or EDs (News Medical Life Sciences, 2022):
Genetic factors: Individuals with a first-degree relative who has a history of an eating disorder are more likely to develop an ED compared to individuals without such a relative. Furthermore, specific genes have been identified that influence hormones like leptin and ghrelin, which, in addition to regulating eating, can condition personality traits and behaviors associated with anorexia and bulimia.
Biological factors: A bodily system called the "hypothalamic-pituitary-adrenal axis" (HPA) can play a significant role in eating disorders. It releases appetite, stress, and mood regulators such as serotonin and dopamine, and it is believed that anomalies in these chemical messengers contribute to the development of EDs. More precisely, serotonin is needed for controlling anxiety and appetite, while dopamine is essential for reward-seeking behavior. An imbalance between serotonin and dopamine can, for example, help explain why people with anorexia do not derive a sense of pleasure from food and other common comforts.
External influences: Parents' behaviors can impact their children's eating habits (for example, mothers who diet or overly worry about their weight can induce their child to develop an abnormal attitude towards food, as well as a father or brother who, by practicing body shaming, mock even just a stranger for their weight or shape). Similarly, comments made by classmates, in the school environment, can influence one's body perception and, consequently, a child's attitude towards food. Likewise, high expectations from a parent or teacher regarding a child's academic performance can lay the groundwork for an eating disorder.
Psychological factors: Psychological conditions (among many, post-traumatic stress disorder, panic attacks, phobias, and depression) and stressful life events (for example, job loss, divorce, dealing with bullying and cyberbullying, or the diagnosis of learning difficulties like dyslexia) can be responsible for abnormal eating habits.
Personality: People with EDs tend to share similar personalities and behavioral traits such as low self-esteem, distorted perception of their own image, perfectionism, approval-seeking, dependency, and self-direction issues. Moreover, the risk of developing EDs may increase in individuals with specific personality disorders, such as:
Avoidant personality disorder: Individuals with this condition are typically perfectionists, emotionally and sexually inhibited, non-rebellious, and terrified of being criticized or humiliated.
Obsessive-compulsive personality disorder: Individuals affected by this disorder may be perfectionists, morally rigid, or excessively fixated on rules and order.
Borderline personality disorder: This disorder is associated with self-destructive and impulsive behaviors.
Narcissistic personality disorder: Features of this disorder include the inability to self-soothe or empathize with others, as well as a need for admiration and hypersensitivity to criticism or defeat.
Body image disorders: Body dysmorphic disorder, where an individual has an altered body perception, or muscle dysmorphia, which describes an obsession with muscle mass, are often associated with anorexia or bulimia.
Cultural pressures: The impact of social media can fuel the fear of becoming easy victims of body shaming and, consequently, the desire or obsession for thinness, often equated with success and popularity, which can encourage and nurture the idea of necessarily being thin, especially among younger girls. The pressure to lose weight can also be perceived by individuals who engage in competitive or athletic activities such as modeling, dancing, or running. As a result, people may develop unrealistic expectations regarding their body image and place excessive emphasis on the importance of being thin.
How Food Control Intertwines with our Perception of Body Image and Eating Disorders
Let's reiterate a fundamental concept: eating disorders are closely linked to the psychological realm, and very often, a sort of obsession with food and the "consequences" that would be caused by consuming food in excess, containing many calories or considered unhealthy is triggered. It's not just a simple matter of a balanced diet, but something more: such fixation, which stems from the desire to be well, can contribute to laying the groundwork for the development of potential EDs and the onset of severe psychophysical discomfort.
"Orthorexia nervosa" is the pathological impulse to obsessively control anything that passes through our mouth: indeed, patients suffering from orthorexia nervosa demand only a healthy diet based on healthy food to ensure good health (Pontillo et al., 2022).
Moreover, control over food is often seen as a means to manage physical appearance in relation to traditional beauty standards and the prevailing body image in society. This approach can be influenced by various factors, including social pressures, fear of cyberbullying and body shaming, cultural norms, media idealizations, and personal expectations.
In many societies, there is a strong connection between physical appearance and the concept of beauty. People may perceive control over their diet as a way to achieve or maintain a specific weight, shape, or appearance in such a way as to be considered socially desirable. This attitude can be fueled by aesthetic ideals spread through the media, which often promote certain physical standards.
Concern for physical appearance and that humiliating body shaming can lead to distorted eating behaviors, such as extreme diets, caloric restrictions, and excessive concerns about weight, which can be associated with EDs, such as anorexia nervosa or bulimia, where food control becomes a way to compensate for anxieties related to the perception of one's image or to achieve a beauty ideal, generally thin.
The Beauty Ideals that Shape Contemporary Society
It is said that "Beauty is in the eye of the beholder"... it's a pity that, in a society of appearances like ours, it is those who attract the gaze who are considered beautiful. Every day we see online, on TV, on social media, boys and girls so perfect they seem like deities descended from Olympus, not even appearing real. Although today, fortunately, efforts are being made to break down traditional beauty standards, unfortunately, aesthetic standards that affect both the male and female figure continue to exist.
The watchword for both genders: symmetry and proportions!
According to the physical stereotypes of our society, the ideal female form must have a beautiful symmetrical face, eyes proportionate to the head and face, full lips, a small nose, long hair, smooth skin, free of imperfections with a complexion described with adjectives like alabaster, milky, and creamy. To all this, a "correct" bust-waist-hips ratio is added. The golden rule of body proportions is that the bust should be eight inches larger than the waist, and the hips are ten inches larger than the waist. Height plays less of a factor in overall attractiveness for women: shorter women, below average height, are sought after as much as their taller counterparts. Men prefer a woman to be shorter than him, but as with all things, there are exceptions to the rule.
The socially appreciated male form is distinguished by hard, angular, and more geometric shapes. A high forehead, pronounced eyebrows, and a solid jaw represent the perfect male face. A strong and well-defined structure, a balanced waist-shoulder ratio, broad shoulders, a muscular chest, and a narrower waist meet the criteria for body perfection. Unlike for women, for men, height plays an important role in what makes him attractive: the taller he is, the more virile he appears (EverydayHealth).
The Role of Social Media in Body Shaming and the Subsequent Development of Eating Disorders
We live in an era where social media plays a dominant role in our daily lives. Although they have opened new doors to knowledge, connection, and sharing, it is important to closely examine how they affect our self-perception, especially regarding our body image. The widespread use of filters and editing tools has turned online self-presentation into an art. However, this often unrealistic and fictitious aesthetic can distort our perception of normality, leading to body dissatisfaction and low self-esteem in both women and men.
Indeed, social media filters have led to a condition known as "Snapchat dysmorphia," where people become desperate to look like their filtered version of themselves. Plastic surgeons are increasingly encountering patients who request changes to their features to resemble a "filtered" Snapchat photo or, worse, to mimic the (poor) copy of the moment's hottest celebrities (Ramphul et al., 2018). According to the annual survey by the American Academy of Facial Plastic and Reconstructive Surgery, selfies continue to be one of the main reasons people in the United States wish to undergo plastic surgery (The Washington Post, 2018): about 77% of surgeons reported having seen patients who requested surgery to look better in selfies, up from 55% in 2017 and a 35% increase from 2016 (Facial Plastic Surgery, 2022). What starts as a "non-acceptance" of one's image, often related to body shaming and cyberbullying, can turn into a real obsession. What might seem to many as a childish whim can lead people down a dark path: about 80% of individuals with Snapchat dysmorphia, also known as body dysmorphic disorder, experience suicidal thoughts over their lifetime, and 24% to 28% actually attempt suicide (Phillips, 2007). These are alarmingly high figures considering that, in America alone, 1 in 50 people suffer from this condition (Newport Academy, 2020).
Comparing ourselves with perfect images can fuel insecurities about our physical appearance, both due to our perception and the criticisms from others (body shaming and cyberbullying). Indeed, on one hand, social media can act as a distorted mirror where we constantly compare ourselves to beauty standards that are often unattainable because they are not always truthful. Moreover, many people tend to post only their best photos, which might not represent their true selves. For both men and women, this can contribute to a negative body image, the emergence of feelings of inadequacy, and cause mental health issues, such as depression and anxiety.
On the other hand, social media is fertile ground for cyberbullying, a form of bullying carried out through communication means such as the internet and social networks. Nowadays, the concept of cyberbullying is inseparable from body shaming, which involves a series of derogatory and offensive comments that negatively judge a person's physical appearance or a feature, such as being "too fat" or "too thin" (Istituto per lo Studio delle Psicoterapie, 2020). A 2018 Pew Research Center survey found that 59% of U.S. teenagers had personally experienced cyberbullying.
In Italy, nearly 9 out of 10 teenagers have experienced body shaming at least once, and for about 3 out of 10, it is practically a daily occurrence to receive insults about their physical appearance, which has the power to develop shame or discomfort in the victim. The main perpetrators are, in 60% of cases, peers (as in 60% of cases), individuals slightly older (for 8% of respondents), or even adults (for 20%) (ANSA, 2021).
In particular, in the attempt to conform to the unrealistic ideals promoted by social media, some individuals tend to develop a problematic relationship with food and body, such as anorexia nervosa or bulimia (Psych Central, 2023).
It is, therefore, essential to cultivate a critical awareness of the impact of social media on our body image. Recognizing that online perfection is often a fiction can help us maintain a more realistic and positive perspective on our lives and our bodies.
Include, Support, Educate: The Key to Overcoming Difficulties Related to Body Shaming, Cyberbullying, and Eating Disorders
To address the challenges related to body image and eating disorders, it is essential to start with self-acceptance: focusing on our abilities and passions, as well as those peculiarities that make us unique, helps to build positive self-esteem. Limiting exposure to unrealistic beauty standards on social media, preferring positive content, helps to mitigate negative impacts. Receiving social support, both from friends and family and from mental health professionals, is crucial for effectively tackling these challenges. Participating in online support groups can connect with people who share similar experiences and offer solidarity regarding body shaming and cyberbullying.
Educating and informing about the true factors that contribute to good health, embracing a balanced view of nutrition and consistent, but not excessive, physical exercise, is crucial. Consulting professionals focused on health and well-being, rather than aesthetic ideals, promotes a healthy lifestyle. Critical media awareness and education on retouched images help to reduce negative impacts. Finally, promoting a culture that celebrates body diversity and challenges stereotypes is crucial for creating more inclusive and supportive environments and attempting to reduce the spread of eating disorders (don't miss our article to say stop to beauty standards).
FAQs
Are eating disorders more common now than in the past?
Yes, eating disorders appear to be more common now, influenced by modern societal pressures, social media, and changing beauty standards.
What is the main underlying cause of eating disorders?
Eating disorders are complex conditions with no single cause; they stem from a mix of genetic, biological, psychological, cultural factors, external influences, personality traits and body image disorders.
What personality trait is associated with eating disorders?
Traits like perfectionism, low self-esteem, and a distorted self-image are commonly associated with eating disorders.
How does body image relate to disordered eating?
A negative body image, influenced by societal beauty ideals, can lead to disordered eating as individuals strive to meet unrealistic standards.
What is the link between body dysmorphic disorder and eating disorders?
Body dysmorphic disorder, involving an altered perception of one's body, can contribute to the development of eating disorders as individuals become fixated on correcting perceived flaws.
Which cultural ideas are often associated with eating disorders?
The idealization of thinness and specific body shapes, often propagated by media, social media and popular culture, is closely associated with eating disorders.
How does social media affect eating habits?
Social media can promote unrealistic beauty standards and diet culture, influencing users to adopt unhealthy eating habits to achieve a certain body image.
How has social media impacted diet culture?
Social media has amplified diet culture by showcasing idealized bodies and promoting fad diets, leading to increased body dissatisfaction and disordered eating behaviors.
What is orthorexia nervosa?
Orthorexia nervosa is an obsession with eating "pure" or "healthy" foods, to the extent that it becomes detrimental to one's well-being.
How do unrealistic beauty standards cause eating disorders?
Unrealistic beauty standards can cause eating disorders by creating a pressure to conform to an idealized body type, leading to unhealthy eating behaviors and body dissatisfaction.
Is Snapchat dysmorphia a real issue?
Yes, Snapchat dysmorphia is a real issue where individuals desire to look like their filtered selves in real life, sometimes leading to body dissatisfaction and the pursuit of cosmetic procedures.
What are the negative effects of social media on cyberbullying?
Social media can exacerbate cyberbullying by providing a platform for body shaming and negative comments, which can contribute to the development of eating disorders and mental health issues.
How social media causes body shaming?
Social media causes body shaming by facilitating the spread of idealized body images and enabling anonymous or public negative comments about individuals' appearances.
Is body shaming a form of cyberbullying?
Yes, body shaming is a form of cyberbullying that involves making harmful comments about someone's physical appearance online.
What is the impact of online shaming and cyberbullying?
Online shaming and cyberbullying can have severe psychological impacts, including low self-esteem, anxiety, depression, and can contribute to the development of eating disorders.