The number of hospital admissions for UK teenagers with eating disorders has risen by 89% in the past three years, it was reported today. While this is clearly of concern, so too is the quick jump some have made to link this rise with social media.
Although nothing new, the Royal College of Psychiatrists’ suggestion, quoted by the BBC, that “much of the increase is down to social pressure made worse by online images” is troubling. It risks undermining the lived realities of people with eating disorders by conflating two issues that are not so neatly linked.
Images of sculpted, sucked-in and slimmed-down female bodies across Instagram and Facebook, for example, as well as in the news media, are deeply problematic. They give women of all ages the message that to be of value in contemporary British society they should look a certain way. And, habitually, that way is thin.
This society-wide obsession with the thinness and supposed perfection of female bodies is dangerous. It has the potential to define the boundaries of girls’ ambitions, limiting their sense of self to bodies alone.
However, to cite such imagery as a root cause of eating disorders is too simple. It both undermines and genders the condition, making it simply about female bodies, and ignoring men who may be living with these illnesses.
Listening to sufferers
Recent qualitative studies, have suggested that to understand eating disorders, their causes and possible relationships with social media, it is imperative to listen to the stories of individuals themselves.
I first met Miriam in 2007 during the course of PhD research into eating disorders – specifically anorexia – and pro-anorexia websites. Miriam had a diagnosis of anorexia and, during the course of her interview, it became increasingly clear that she was angry. She felt that her illness was misunderstood due to the association widely made between eating disorders and the media.
There’s lots of people who think it’s just a vanity thing like, you know, anorexia is just the thinness and wanting to look thin but it’s not a vanity thing, it’s not at all. People go: ‘Oh, everyone’s trying to copy this size-zero trend.’ And it’s not, it’s not! You don’t open a picture … look at a picture, and say: ‘Oh, I must look like that girl, therefore I must lose weight, therefore I’m an anorexic!’ It’s absolutely nothing to do with that.
To understand Miriam and the illness she lived with, we first need to acknowledge that she was not obsessed with being thin and that she never had been. Rather, Miriam discussed how her anorexia caused mental and physical anguish, but also fulfilled a role for her. She had fallen into it as a way to cope with pressures in her life at a particular time, rather than through dieting.
In a 2013 interview from an ongoing research project at the University of Birmingham, another participant, Nita, said that her anorexia had: “been a safety net for so long, removing it is the scariest thing in the world … I think that’s what has stopped me getting better completely and being fully recovered, is that it’s a safety net that I don’t want to remove”.
She continued, “it becomes so much a part of you". Without it, she asked: “what would I be?”
There is no doubt that eating disorders are dangerous and also profoundly distressing to individuals, their families and friends. Yet narratives such as Miriam’s and Nita’s highlight the need to acknowledge that those affected may recognise the suffering that eating disorders cause while also viewing them as integral to how they cope with being in the world.
One participant, Leila, described her anorexia by saying: “It looks after you.”
That these illnesses can be an (extremely painful and not necessarily chosen) way of coping with life events – from exams to bereavement, work stress to sexual assault – has been recognised in studies that have looked into the causes of eating disorders.
This means we should reconsider the relationship between body image – and therefore social media imagery of bodies – and eating disorders. Individuals’ stories suggest that, although not necessarily a primary goal, thinness may become important to people when already in the grip of an eating disorder. It becomes a visual marker of the continuing presence of this illness that “looks after you”.
While this suggests the need for more research that listens to the voices of individuals themselves, it also highlights a different relationship between eating disorders and social media than the one-dimensional relationship cited by the Royal College of Psychiatrists.
If thinness is not necessarily a goal of people with eating disorders, then looking at online images of thin people is not an underlying cause of those conditions. Rather, as research has suggested, this may be a way of motivating oneself to continue to self-starve when already in the grip of the illness.
This does not take social media out of discussions about eating disorders but it does suggest that we need to be framing these differently. This would involve reflecting on how our societal obsession with thinness and so-called “perfection” may be harming individuals both with and without eating disorders. But not, perhaps, in the ways we might assume.
Names have been changed
Anna Lavis has received funding from the Economic and Social Research Council and the NIHR Collaboration for Leadership in Applied Health Research and Care for the studies mentioned in this article.
Authors: The Conversation