Watching popular television shows full of skinny actresses can contribute to the development of eating disorders in girls. But turning off the TV isn't enough to protect them.
Girls who have lots of TV-watching friends, a new study found, are at the highest risk of succumbing to anorexia, bulimia and other body image problems -- whether or not they watch TV themselves.
The research took place in Fiji, where scientists have documented a massive cultural shift since broadcast TV arrived there in 1995. But secondhand TV watching is likely to have the same influence elsewhere, too, said psychologist Anne Becker, vice chair of the Department of Global Health and Social Medicine at Harvard Medical School in Boston.
"As a mom or dad trying to do right by your child, you may have a false sense of reassurance if you are limiting TV time in your home that you are protecting your child from these exposures," Becker said. "Our study suggests you may not be."
Becker's research first took her to Fiji in the late 1980s. At the time, Fijians held a round and plump body ideal and women there were remarkably comfortable in their skin.
It seemed to Becker an ideal place for exploring questions about how cultural contexts affect eating behaviors and disorders. For her dissertation research, she spent a couple years living in a Fijian village that had no electricity and no paved roads.
Eventually, the slow march of modernization swept through Fiji, bringing tourism and electronic devices to many of the island nation's remote villages. In 1995, the Fijian government finally approved the use of broadcast television, ushering in a flood of TV shows from the Western world.
"That seemed to be a watershed point, at least for teenage girls," Becker said. "Until then, eating disorder symptoms were rare. Using all the data available, eating pathology was not present in Fiji prior to TV."
After the arrival of broadcast TV, everything changed.
In 1995, Becker said, none of the girls said they had thrown up to lose weight. By 1998, more than 11 percent had tried purging.
A major reason for the shift, according to the girls themselves, was that they had become attached to actresses whose looks and lives were so strikingly different from their own. The Fijian girls also interpreted the shows not as fictional stories, but as real news outlets.
"Girls told us they thought these actresses were role models," Becker said. "They were really struck by how thin these girls were on TV and how successful they were. They began to emulate them. They wanted to look like them, act like them, speak like them, and dress like them to enhance their own social opportunities."
As clear as it was that TV had influenced girls in Fiji, Becker continued to wonder whether it was, in fact, specific images on a screen that actually caused a shift in eating behaviors. Or, as she speculated, maybe so much sitting around and talking about shows was having an impact, too.
To test the idea, Becker and colleagues collected data on more than 500 Fijian girls with a diversity of backgrounds. All of the girls spoke the same language, but some lived on developed coastlines, while others lived in remote mountainous areas. Access to TV varied among the group from one extreme to the other.
After performing a battery of psychosocial tests on the girls and conducting hundreds of interviews with them, the researchers found that the only factor that was consistently connected to eating disorder symptoms was how much TV a girl's peer group watched. It made no difference, they reported in the British Journal of Psychiatry, whether a she watches TV herself.
In the field of eating disorder research, this is the first study to distinguish between the direct use of media and more indirect exposures through friendship networks, said Michael Levine, an eating disorder researcher and professor of psychology at Kenyon College in Gambier, Ohio.
The findings, he said, offer powerful evidence that both kinds of exposure combine to make girls internalize a slender body ideal and start down a path of disordered eating. Acknowledging the power of media may be one of the first steps toward using media as a tool for promoting a healthier body image.
"If one source of cultural influence moves you toward a negative body image and eating behaviors, then what about multiple sources embedded in each other like Russian dolls?" Levine asked. "While mass media is extraordinarily important in any advanced civilization, like many powerful things, it can have negative effects."
From an advocacy perspective, Becker recommends targeting the producers of mass media and urging them to consider the kinds of images they presenting to kids about eating and body shape in the same way they avoid sending positive images of tobacco to young people.
Getting kids involved in the conversation is also important.
"If it's not enough to unplug or limit the TV," Becker said, "then we need to do a better job of advising parents on how to speak to their kids, not only about what they're watching but how to proceed in their social networks, to examine them so they understand the impact of their peer-group choices."