Editing Eating disorder (section)

===== Western perspective =====
There is a cultural emphasis on thinness which is especially pervasive in western society. A child's perception of external pressure to achieve the ideal body that is represented by the media predicts the child's body image dissatisfaction, body dysmorphic disorder and an eating disorder.<ref>{{cite journal |vauthors=Knauss C, Paxton SJ, Alsaker FD |title=Relationships amongst body dissatisfaction, internalisation of the media body ideal and perceived pressure from media in adolescent girls and boys |journal=Body Image |volume=4 |issue=4 |pages=353–60 |date=December 2007 |pmid=18089281 |doi=10.1016/j.bodyim.2007.06.007}}</ref> "The cultural pressure on men and women to be 'perfect' is an important predisposing factor for the development of eating disorders".<ref>{{cite journal |vauthors=Garner DM, Garfinkel PE |s2cid=15755468 |title=Socio-cultural factors in the development of anorexia nervosa |journal=Psychological Medicine |volume=10 |issue=4 |pages=647–56 |date=November 1980 |pmid=7208724 |doi=10.1017/S0033291700054945}}</ref><ref>{{cite journal |vauthors=Eisenberg ME, Neumark-Sztainer D, Story M, Perry C |title=The role of social norms and friends' influences on unhealthy weight-control behaviors among adolescent girls |journal=Social Science & Medicine |volume=60 |issue=6 |pages=1165–73 |date=March 2005 |pmid=15626514 |doi=10.1016/j.socscimed.2004.06.055}}</ref> Further, when women of all races base their evaluation of their self upon what is considered the culturally ideal body, the incidence of eating disorders increases.<ref>{{cite journal |doi=10.1177/1077727X03255900 |title=Body Image, Appearance Self-Schema, and Media Images |year=2003 |vauthors=Jung J, Lennon SJ |journal=Family and Consumer Sciences Research Journal |volume=32 |pages=27–51}}</ref>

Socioeconomic status (SES) has been viewed as a risk factor for eating disorders, presuming that possessing more resources allows for an individual to actively choose to diet and reduce body weight.<ref>{{cite journal |vauthors=Nevonen L, Norring C |title=Socio-economic variables and eating disorders: a comparison between patients and normal controls |journal=Eating and Weight Disorders |volume=9 |issue=4 |pages=279–84 |date=December 2004 |pmid=15844400 |doi=10.1007/BF03325082 |s2cid=13089418}}</ref> Some studies have also shown a relationship between increasing body dissatisfaction with increasing SES.<ref>{{cite journal |vauthors=Polivy J, Herman CP |s2cid=2913370 |title=Causes of eating disorders |journal=Annual Review of Psychology |volume=53 |pages=187–213 |year=2002 |pmid=11752484 |doi=10.1146/annurev.psych.53.100901.135103}}</ref> However, once high socioeconomic status has been achieved, this relationship weakens and, in some cases, no longer exists.<ref name="Sohl, N. L. 2006">{{cite journal |vauthors=Soh NL, Touyz SW, Surgenor LJ |s2cid=178892 |year=2006 |title=Eating and body image disturbances across cultures: A review |journal=European Eating Disorders Review |volume=14 |issue=1 |pages=54–65 |doi=10.1002/erv.678}}</ref>

The media plays a major role in the way in which people view themselves. Countless magazine ads and commercials depict thin celebrities. Society has taught people that being accepted by others is necessary at all costs.<ref>{{cite book |vauthors=Essick E |chapter=Eating Disorders and Sexuality |chapter-url=https://books.google.com/books?id=ZaM04DMwK3gC&pg=PA276 |pages=[https://archive.org/details/contemporaryyout0000unse/page/276 276–80] |year=2006 |veditors=Steinberg SR, Parmar P, Richard B |title=Contemporary Youth Culture: An International Encyclopedia |publisher=Greenwood |isbn=978-0-313-33729-1 |url=https://archive.org/details/contemporaryyout0000unse/page/276}}</ref> This has led to the belief that in order to fit in one must look a certain way. Televised beauty competitions such as the [[Miss America]] Competition contribute to the idea of what it means to be beautiful because competitors are evaluated on the basis of their opinion.<ref>{{cite web |vauthors=DeMonte A |title=Beauty Pageants |url=http://www.credoreference.com/entry/sharpecw/beauty_pageants |publisher=M.E. Sharpe |access-date=24 September 2013}}{{dead link |date=June 2016|bot=medic}}{{cbignore|bot=medic}}</ref>

In addition to socioeconomic status being considered a cultural risk factor so is the world of sports. Athletes and eating disorders tend to go hand in hand, especially the sports where weight is a competitive factor. Gymnastics, horse back riding, wrestling, body building, and dancing are just a few that fall into this category of weight dependent sports. Eating disorders among individuals that participate in competitive activities, especially women, often lead to having physical and biological changes related to their weight that often mimic prepubescent stages. Oftentimes as women's bodies change they lose their competitive edge which leads them to taking extreme measures to maintain their younger body shape. Men often struggle with binge eating followed by excessive exercise while focusing on building muscle rather than losing fat, but this goal of gaining muscle is just as much an eating disorder as obsessing over thinness. The following statistics taken from Susan Nolen-Hoeksema's book, (''ab)normal psychology'', show the estimated percentage of athletes that struggle with eating disorders based on the category of sport.
* Aesthetic sports (dance, figure skating, gymnastics) – 35%
* Weight dependent sports (judo, wrestling) – 29%
* Endurance sports (cycling, swimming, running) – 20%
* Technical sports (golf, high jumping) – 14%
* Ball game sports (volleyball, soccer) – 12%

Although most of these athletes develop eating disorders to keep their competitive edge, others use exercise as a way to maintain their weight and figure. This is just as serious as regulating food intake for competition. Even though there is mixed evidence showing at what point athletes are challenged with eating disorders, studies show that regardless of competition level all athletes are at higher risk for developing eating disorders that non-athletes, especially those that participate in sports where thinness is a factor.<ref>{{cite book |vauthors=Nolen-Hoeksema S |title=Abnormal Psychology |year=2014 |location=New York |publisher=McGraw-Hill Education |isbn=978-0-07-803538-8 |pages=353–354 |edition=6th}}</ref>

Pressure from society is also seen within the homosexual community. [[Gay men]] are at greater risk of eating disorder symptoms than heterosexual men.<ref name="Boisvert, J. A. 2009">{{cite journal |doi=10.3149/jms.1703.210 |title=Homosexuality as a Risk Factor for Eating Disorder Symptomatology in Men |year=2009 |vauthors=Boisvert JA, Harrell WA |journal=The Journal of Men's Studies |volume=17 |issue=3 |pages=210–25 |s2cid=144871695}}</ref> Within the gay culture, muscularity gives the advantages of both social and sexual desirability and also power.<ref name="Siconolfi, D. 2009">{{cite journal |title=Body Dissatisfaction and Eating Disorders in a Sample of Gay and Bisexual Men |year=2009 |vauthors=Siconolfi D, Halkitis PN, Allomong TW, Burton CL |journal=International Journal of Men's Health |volume=8 |issue=3 |pages=254–264 |doi=10.3149/jmh.0803.254|doi-broken-date=1 November 2024}}</ref> These pressures and ideas that another homosexual male may desire a mate who is thinner or muscular can possibly lead to eating disorders. The higher eating disorder symptom score reported, the more concern about how others perceive them and the more frequent and excessive exercise sessions occur.<ref name="Siconolfi, D. 2009"/> High levels of body dissatisfaction are also linked to external motivation to working out and old age; however, having a thin and muscular body occurs within younger homosexual males than older.<ref name="Boisvert, J. A. 2009"/><ref name="Siconolfi, D. 2009"/>

Most of the cross-cultural studies use definitions from the DSM-IV-TR, which has been criticized as reflecting a Western cultural bias. Thus, assessments and questionnaires may not be constructed to detect some of the cultural differences associated with different disorders. Also, when looking at individuals in areas potentially influenced by Western culture, few studies have attempted to measure how much an individual has adopted the mainstream culture or retained the traditional cultural values of the area. Lastly, the majority of the cross-cultural studies on eating disorders and [[body image disturbance]]s occurred in Western nations and not in the countries or regions being examined.<ref name=":14">{{cite book |vauthors=Mash EJ, Wolfe DA |year=2010 |chapter=Eating Disorders and Related Conditions |chapter-url=https://books.google.com/books?id=hhvjIBUVDeYC&pg=PT415 |title=Abnormal Child Psychology |pages=415–26 |location=Belmont, CA: Wadsworth |publisher=Cengage Learning |isbn=978-0-495-50627-0}}</ref>

While there are many influences to how an individual processes their body image, the media does play a major role. Along with the media, parental influence, peer influence, and [[self-efficacy]] beliefs also play a large role in an individual's view of themselves. The way the media presents images can have a lasting effect on an individual's perception of their body image. Eating disorders are a worldwide issue and while women are more likely to be affected by an eating disorder it still affects both genders (Schwitzer 2012). The media influences eating disorders whether shown in a positive or negative light, it then has a responsibility to use caution when promoting images that projects an ideal that many turn to eating disorders to attain.<ref>{{cite journal |vauthors=Schwitzer AM |doi=10.1002/j.1556-6676.2012.00036.x |title=Diagnosing, Conceptualizing, and Treating Eating Disorders Not Otherwise Specified: A Comprehensive Practice Model |year=2012 |journal=Journal of Counseling & Development |volume=90 |issue=3 |pages=281–9}}</ref>

To try to address unhealthy body image in the fashion world, in 2015, [[France]] passed a law requiring models to be declared healthy by a doctor to participate in fashion shows. It also requires re-touched images to be marked as such in magazines.<ref>Kim Willsher, [https://www.theguardian.com/world/2015/dec/18/models-doctors-note-prove-not-too-thin-france Models in France must provide doctor's note to work] {{webarchive |url=https://web.archive.org/web/20161226221553/https://www.theguardian.com/world/2015/dec/18/models-doctors-note-prove-not-too-thin-france |date=2016-12-26}}, The Guardian, 18 December.</ref>

There is a relationship between "thin ideal" social media content and body dissatisfaction and eating disorders among young adult women, especially in the Western hemisphere.<ref name="auto">{{cite journal |vauthors=Ghaznavi J, Taylor LD |title=Bones, body parts, and sex appeal: An analysis of #thinspiration images on popular social media |journal=Body Image |volume=14 |pages=54–61 |date=June 2015 |pmid=25880783 |doi=10.1016/j.bodyim.2015.03.006}}</ref> New research points to an "internalization" of distorted images online, as well as negative comparisons among young adult women.<ref name="auto1">{{Cite journal |vauthors=Perloff RM |date=2014-05-29 |title=Social Media Effects on Young Women's Body Image Concerns: Theoretical Perspectives and an Agenda for Research |journal=Sex Roles |volume=71 |issue=11–12 |pages=363–377 |doi=10.1007/s11199-014-0384-6 |s2cid=28345078 |issn=0360-0025}}</ref> Most studies have been based in the U.S., the U.K, and Australia, these are places where the thin ideal is strong among women, as well as the strive for the "perfect" body.<ref name="auto1" />

In addition to mere media exposure, there is an online "pro-eating disorder" community. Through personal blogs and Twitter, this community promotes eating disorders as a "lifestyle", and continuously posts pictures of emaciated bodies, and tips on how to stay thin. The hashtag "#proana" (pro-anorexia), is a product of this community,<ref>{{cite journal |vauthors=Arseniev-Koehler A, Lee H, McCormick T, Moreno MA |title=#Proana: Pro-Eating Disorder Socialization on Twitter |journal=The Journal of Adolescent Health |volume=58 |issue=6 |pages=659–64 |date=June 2016 |pmid=27080731 |doi=10.1016/j.jadohealth.2016.02.012 |doi-access=free}}</ref> as well as images promoting weight loss, tagged with the term "thinspiration". According to social comparison theory, young women have a tendency to compare their appearance to others, which can result in a negative view of their own bodies and altering of eating behaviors, that in turn can develop disordered eating behaviors.<ref>{{Cite journal |vauthors=Yu UJ |title=Deconstructing College Students' Perceptions of Thin-Idealized Versus Nonidealized Media Images on Body Dissatisfaction and Advertising Effectiveness |journal=Clothing and Textiles Research Journal |volume=32 |issue=3 |pages=153–169 |doi=10.1177/0887302x14525850 |year=2014 |s2cid=145447562}}</ref>

When body parts are isolated and displayed in the media as objects to be looked at, it is called objectification, and women are affected most by this phenomenon. Objectification increases self-objectification, where women judge their own body parts as a mean of praise and pleasure for others. There is a significant link between self-objectification, body dissatisfaction, and disordered eating, as the beauty ideal is altered through social media.<ref name="auto" />

Although eating disorders are typically under diagnosed in people of color, they still experience eating disorders in great numbers. It is thought that the stress that those of color face in the United States from being multiply marginalized may contribute to their rates of eating disorders. Eating disorders, for these women, may be a response to environmental stressors such as racism, abuse and poverty.<ref>{{cite web |title=People of Color and Eating Disorders |url=https://www.nationaleatingdisorders.org/people-color-and-eating-disorders |website=National Eating Disorders Association |date=18 February 2018}}</ref>