The Body Problem

Originally posted on March 8, 2014 by Dr. Arigo

Around 2005, I decided to focus my work on disordered eating behavior and body image. Like many college women, I saw this broad topic everywhere. In addition to concerns among family and friends, body image, eating, and weight were plastered all over the media (and critiques of the media). During my gap year, I worked on an eating disorders unit at a psychiatric hospital, and I doubt that I could have been any more immersed in these issues.

Given the chasm between treatment and research in eating disorders, I was fortunate that the cultural interest in eating and weight included in the empirical literature. Professional journals do succumb to trends, and it seemed that body image research was fashionable at the time. Some of the classics include Crandall’s examination of social contagion of binge eating and Becker’s description of introducing disordered behavior to a population by giving them televisions. To me, some of the most interesting work was in mapping the temporal relationships between mood state, social and self-perceptions, and eating behavior, using electronic daily diaries. (I have yet to contribute to this area, though it is on the agenda for my first few years in my new position.)

Although there still is much to learn about these relationships, the fervor for body-related topics seems to have died down in the past few years. The first clue regarding this change came from my students in Abnormal Psychology, around 2010. Until then, I had been very much aware of the negative stereotype of young women with eating disorders (see Wasted and Skinny Bitch, for examples). When I asked my students to describe the stereotype, they surprised me: many of them seemed not to share this perception (including males), and expressed compassionate, considerate attitudes toward all people with these disorders. I suspect there were several reasons for this disconnect, including a high SES student population. But it seemed that times were a’changin, and I was behind in my own field.

Much has changed in the past ten years. Obesity is a bigger problem than ever, and the innovative work of Brian Wansink and Kelly Brownell has shifted attention to macro-level problems such as the food environment and public health policy. My own work has broadened to include the full spectrum of eating and weight disorders, with a heavier emphasis on obesity, diabetes, and weight loss than on body image and disordered eating. I’m also much more interested in the science of eating behavior – and how eating can be manipulated – than in collections of symptoms. But as I continue to write and publish in body image and disordered eating, I realize that I am farther from the pulse of these topics than ever. For example, I’m currently working with a student to revise her Master’s thesis for publication – a clever approach to help young women combat their immediate negative responses to thin media figures. Yet the Introduction to the “problem” of negative body image features a preponderance of references to literature from the 1980s and 90s, with virtually nothing newer than 2004.

Have we solved the body problem while I wasn’t looking? Or, have we come to accept it as such a part of our culture that we’re no longer doing interesting, novel research on it? Perhaps neither, or a little of both. In retrospect, part of the appeal of this research in the late 90s and early 2000s was its novelty; women were first starting to speak out about their experiences and disclose the severity of the consequences. We do have better treatments than ever (e.g., the Body Project, CBT for bulimia nervosa), though there is more to be done to optimize them. Members of our society are aware of the problem and talk more openly about it than they used to. And as obesity wreaks physical and psychological havoc, more of our resources go to understanding problems of excess weight and overeating (e.g., binge eating disorder).

I’m pleased to see the increasing unification of the eating disorders and obesity fields. From both research and clinical perspectives, what makes eating so interesting to me is that we cannot live without it (unlike heroin), but there are so many ways that it can go awry. And it’s entirely possible that each of the distinct problems I’ve noted stem from the same central disturbance. For example, a recent paper in Psychosomatic Medicine demonstrated that, in both healthy weight and overweight women, exposure to degrading treatment of overweight individuals in media clips led to increases in salivary cortisol (a stress hormone). Interpretations can and should vary, until further research is shared. It suggests to me that among women, there is something universally anxiety-provoking about the negative overweight stereotype. Some of us avoid the immediate distress of it by eating more, and some of us take drastic measures to prevent it from becoming reality. At present, too little is known about the development of truly healthy mindsets and habits. Let’s hope that’s the next trend.