A few weeks ago, my good friend and fellow skeptic Ben Radford wrote an article for Discovery News asserting that the movie Black Swan “cannot ‘encourage’ anorexia, any more than photographs of depressed patients can ‘encourage’ clinical depression.”

This was in response to Kate Torgovnick’s ABC News article (link here but beware of the streaming video that starts playing) that pointed out that pro-anorexia sites are using images from the film as “thinspiration.”

I suggest you read both (very brief) articles to decide for yourself, but I think Radford has misunderstood Torgovnick’s post. For instance, he writes “Even if seeing thin people could somehow encourage eating disorders in audiences, there’s little reason to blame this film.” However, Torgovnick doesn’t seem to blame the film at all. She says it’s great, and that the movie is actually showing a dystopia “of a subculture riddled with body issues.”

I agree. I saw the film last week and loved it for the way it horrifically portrayed a character who was repressed and obsessive. Like Torgovnick, I can appreciate a great film while also recognizing that some women could see these emaciated women as aspirational.

All that is beside the point I really want to address, though. Radford takes issue with the very idea that images in the media can contribute to eating disorders, even branding it a “myth” and linking to a post he made back in March that I’m sorry I missed the first time around.

In that article, Radford asserts that “The idea that a model, photo of a model, or Web site can “encourage” anorexia is not supported by science or research.” He cites several papers to support that assertion, and the average layperson might be easily convinced that the science is on his side.

When I read that article, though, I was immediately alarmed at this point:

For example, R.A. Botta, writing in his 1999 study, ‘Television Images and Adolescent Girls’ Body Image Disturbance’ in the Journal of Communication, noted that, ‘Concrete evidence is still necessary to show that this existence of thin images and ideals has an effect on viewers. At this point, the relationship between television exposure and body image disturbance remains in question.

First of all, I thought I recognized the surname “Botta” as a researcher who agreed with what appears to me (a layperson, FTR) to be the consensus opinion: media images are directly linked to body image. Second of all, I’m always suspicious when I see that many ellipses.

I brought up my concerns on Radford’s Facebook page where he had posted a link to his article. I didn’t have the full paper Radford got that quotation from, but I did know that many other papers cited Botta’s in support of the hypothesis that media images and body image are linked. When I asked Radford to explain how Botta’s paper supported his conclusions, he continued to quote the above truncated quotation. When I mentioned that I didn’t have the full paper, Radford said he couldn’t send it to me because it was in hard copy form, but he did add two more excerpts (caps and brackets are Radford’s):

The results replicated the study by Stice and his colleagues (1994), WHO DID NOT FIND A SIGNIFICANT RELATIONSHIP between overall media exposure and endorsement of the thin ideal.

and

There was NO SUPPORT for the notion that increased exposure [to thin images] leads to body image disturbance

Luckily, someone else was viewing that discussion and had access to the full paper. Jenna Marie Griffith sent it to me and I was able to verify exactly what Botta was writing. What I found surprised me.

In Television Images and Adolescent Girls’ Body Image Disturbance, Botta (who, by the way, is a woman despite Radford’s use of the masculine pronouns in the initial article), wrote in conclusion:

Overall, the results suggest that media do have an impact on body image disturbance, both directly through body image processing and indirectly by encouraging adolescent girls to endorse a thin ideal and by establishing what they see as realistic ideals.

All the quotes Radford gave were completely out of context, and I’m tempted to quote the entire paper because every word of it disagrees with Radford’s assertion that media images have no relationship to body image. Instead I’ll just give you longer excerpts with Radford’s chosen quotes unbolded and the rest of the quote in bold:

The results replicated the study by Stice and his colleagues (1994), who did not find a significant relationship between overall media exposure and the endorsement of the thin ideal.

However, by looking deeper into the relationship between media and thin ideal endorsement with more conceptually derived measures, this study revealed that the combined media variables accounted for 33% of the variance in endorsing a thin ideal. As predicted, this was because the measures went beyond mere exposure to include body image processing effects of media images. The impact on endorsing a thin ideal seems to be more about how adolescent girls process thin images than about how much they view those images.

Botta found that girls who saw the women on TV as having realistic bodies were much more likely to be bulimic than girls who saw those images as unrealistic. She also found that for girls who already saw thinness as a positive goal for women, viewing thin images increased their rates of bulimia. For girls who did not feel that women “should” be thin, viewing those images did not necessarily increase rates of bulimia. In other words, these images were incredibly damaging to girls who were processing them the wrong way. Make a mental note of this, because we’ll see it again later.

Here’s another of Radford’s quotes:

The one prediction not supported was H2 about exposure. There was no support for the notion that increased exposure leads to body image disturbance as a result of forced comparisons. This may be due to the media exposure measures in this study. Perhaps daily rather than weekly viewing measures might have been better able to detect this relationship.

H2 was only one of six hypotheses that were tested, and the only one that wasn’t supported by the results:

H1: Forced automatic comparisons will result in a direct impact of exposure on body image disturbance.

H2: Thin ideal endorsement will significantly interact with exposure as a predictor of body image disturbance, because those who are predisposed to thin ideals may be more vulnerable to automatic comparisons.

H3: Making goal-directed comparisons with media images for self and significant others will predict body image disturbance.

H4: Goal-directed processing will predict more variance in body image disturbance than mere exposure.

H5: Outside information and personal standards put to use through critical viewing will result in a significant interaction effect between endorsing a thin ideal and questioning thin media images on body image disturbance.

H6: There will also be a significant interaction effect between seeing media images as realistic and questioning thin media images on body image disturbance.

Botta goes on to suggest better ways to test H2 in the future, and makes it clear that she believes the hypothesis is still valid.

As for the first quotation Radford used in his article to suggest that Botta agreed with him, well, I’d like to show you the context around those ellipses but that would require excerpting three pages of the paper. Here’s the best I can do without potentially violating copyright. The brackets indicate where Radford’s ellipses were:

Concrete evidence is still necessary [however] to show that this existence of thin images and ideals has an effect on viewers. [1,188 words deleted] At this point, the relationship between television exposure and body image disturbance remains in question.

The “however” is required because Botta had just finished listing many studies that show how the thin ideal is getting thinner in the media. The 1,188 words that are deleted between these two sentences detail the many studies that suggest a link between the way adolescents process media images and the way they construct their own body image. Then she examines the experimental studies that have suggested a link. Botta covers a dozen studies that support her hypothesis, and that’s just within the second of Radford’s ellipses. When Botta says in her introduction that concrete evidence is still necessary, she’s making the case for why her study matters.

What of the other papers Radford cites in his Discovery News article? Well, I’m glad I asked. After his misleading sentence about Botta, he wrote:

This view is supported by other researchers including Heidi Posavac, who wrote in her 1998 Sex Roles journal study, ‘Exposure to Media Images of Female Attractiveness and Concern with Body Weight Among Young Women’ that ‘experimental investigations have not found a link between exposure to the media ideal and increased concern with weight.’

Luckily for us, that article is online in full. If you care to read it, you will experience the same realization I did: this paper comes to the exact opposite conclusion Radford claims. It is, in fact, an experimental investigation that did find a link between exposure to the media ideal and increased concern with weight:

Together, the results from the three experiments clearly demonstrate that exposure to media images of female attractiveness is capable of causing increased weight concern among most young women.

The quote that Radford once again takes out of context is in the introduction, which explains exactly what Botta found: that when you lump all women together into one experiment involving total media exposure, you don’t get significant results. When you pay attention to how these women are processing said images, you do. Posavac and her team evaluated their subjects’ body images prior to viewing images, and found that those with high levels of body dissatisfaction (the majority, btw) experienced the greatest negative impact after viewing thin images. Those women who were generally satisfied with their bodies weren’t as affected.

The only other research Radford cites is Cynthia Bulik’s 2007 study The Genetics of Anorexia, in which researchers find evidence that anorexia may have a genetic link. It is accurate that these researchers have compelling evidence to suggest that this one eating disorder is inherited (putting aside the usual concerns about twin studies), but that doesn’t have anything to do with whether or not media images impact body image. For starters, this possible genetic link is about anorexia, not bulimia or body dysmorphia. Additionally, it doesn’t suggest that sociocultural factors can’t trigger or worsen the anorexia. (Bulik does seem to believe that the genetic factors are more important than the sociocultural factors, though.)

And that’s all the research mentioned in Radford’s article. So is it a myth that images in the media are linked to body image as he claims? I’m not convinced, seeing as of his three citations, one is fairly irrelevant and two solidly rebut his claim. In fact, as much as I love Radford’s work and consider him a friend, I have to admit that I’m blown away by how out-of-context those quotes are. Some of those sentences are buried in page-long paragraphs, surrounded by the evidence that refutes what Radford is trying to assert.

In the Facebook thread, I genuinely wanted to see what evidence actually supported the idea that the link between media and body image is a myth, but I got nothing from Radford or anyone observing the thread. So, I’m forced to continue to side with what appears to be the consensus opinion: the media’s portrayal of the thin ideal most likely negatively impacts the body image of those who process those images poorly.

+++

EDIT: Commenter foutch took a look at the paper and offers some more number crunching for the statistic fans out there.

Rebecca Watson

Rebecca Watson

Rebecca leads a team of skeptical female activists at Skepchick.org and appears on the weekly Skeptics' Guide to the Universe podcast. She travels around the world delivering entertaining talks on science, atheism, feminism, and skepticism. There is currently an asteroid orbiting the sun with her name on it. You can follow her every fascinating move on Twitter or on Google+.

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69 Comments

  1. Profile photo of John
    December 28, 2010 at 11:26 am —

    Rebecca, it looks like you’ve read the article properly while Ben misread it. In that sense I think you’ve “won” this one. But we don’t actually have the information here to understand whether or not media imagery influences girls’ eating behavior – we have the variance, but not the effect size.

    We know that “the combined media variables accounted for 33% of the variance in endorsing a thin ideal,” but we don’t know the strength of that variance. Perhaps we’re talking about 33% of, say, a 0.1% difference in group outcomes for eating behavior. Does anyone (a)have access to the paper (the Google Scholar version is gated) and (b)know what the effect size was? That, to me, will actually settle this one.

  2. Profile photo of PragmaticallyWyrd
    December 28, 2010 at 11:40 am —

    That was very informative. Thanks for that. Dunno what Ben Radford’s deal is. One thing I do know though–there’s almost no one (maybe Randi, but certainly not me) that is properly and un-biasedly rational on all things.

    That is to say: most of us, no matter how rational we may think we are, have one or more topic areas where we just go crazy with bias for or against something. And then, in those cases, all the evidence in the world won’t make much difference.

    But you were able to refute well, so that’s good. Now maybe if a dozen more people refute Radford’s claim on this particular issue as well, he might “see the light”. But probably not. Because that’s how these things work.


    Furry cows moo and decompress.

  3. Profile photo of Rebecca Watson
    December 28, 2010 at 12:23 pm —

    @John: I have the paper . . . specifically concerning endorsement of the thin ideal, r=.28 for predicting body dissatisfaction, .42 for predicting drive for thinness, and .30 for predicting bulimic action tendencies.

    If someone else who actually is a scientist-sort-of-person has the paper and wants to elaborate or correct something I may be getting wrong here, please do! While I understand that anything around .3 is a medium effect and around .4 is a large effect, I’m a total layperson and my eyes tend to cross at the sight of charts with Greek letters. :)

  4. Profile photo of James
    December 28, 2010 at 12:36 pm —

    @Rebecca Watson:

    Hey, I don’t have it, but if you want to send it my way, I’ll be glad to look it over for you.

    Just to let you know, effect size is different depending on the measurement used. If it’s Cohen’s d, then 0.2 is small, 0.5 is medium, and 0.8 is large, but if the effect size is calculated using r^2, then the evaluation is completely different.

  5. Profile photo of James Fox
    December 28, 2010 at 12:38 pm —

    Nicely researched and presented Rebecca.
    One of my first jobs after graduating from college was working as a mental health specialist at a psychiatric hospital. This was a number of years ago so my knowledge of treatment protocols is likely dated. Anyway, one of the treatment rules was that the patients (12-17 adolescent girls) were not allowed to have media with pictures of thin models because they would frequently and obsessively look at the pictures. This behavior would reinforce their faulty perceptions of normalcy and also reinforce their feelings of inadequacy, guilt and all the other pathologies that can come with eating disorders. For many young women/girls what the media says about how you should look is what the world says you should look like. And one more thing about eating disorders everyone should remember; the end result of these kinds of disorders is not just a sad life, some depression or being frighteningly thin, it can be permanent disabilities, organ failure, and even death.

  6. Profile photo of scribe999
    December 28, 2010 at 12:43 pm —

    This movie…is…great. Go…see…it

    Yeah, ellipsis points = concerning.

  7. Profile photo of James
    December 28, 2010 at 12:43 pm —

    @Rebecca Watson: also, you may want to contact the author, Renee Botta (rbotta [at] du.edu) to let her know her work is being misquoted.

    I did.

  8. Profile photo of Rebecca Watson
    December 28, 2010 at 1:01 pm —

    @foutch: Thanks! I assumed that because it was r that it was Pearson, and r^2 is also included in the results as a separate bit of data. I’ll send you the paper to have a look and verify.

    Also, I did email Botta back when the initial back and forth was happening on Facebook but never heard back from her. I don’t blame her, though, because really, how much time can one researcher spend making sure her work isn’t being misused? I’m glad you emailed her, though, since I would love to have her weigh in.

  9. Profile photo of Kimbo Jones
    December 28, 2010 at 1:20 pm —

    This sort of thing was discussed on SheThought a while back: http://shethought.com/2010/08/16/reactions-to-a-poll-on-girls-and-fashion-photos/ and http://shethought.com/2010/08/15/deconstructing-barbie-and-bridget-jones/ They concluded that the evidence did *not* support that girls are fooled by idealized media imagery like touched photos. But from what evidence I’ve seen, I disagree with the idea that it’s not influencing them, so I thought you might also be interested in reading their article if you hadn’t already.

    Edited for clarity.

  10. Profile photo of mrmisconception
    December 28, 2010 at 1:34 pm —

    Mr. Ben Radford seems to be very dismissive of the power of popular culture, for what reason I’m not sure.

    Having said that I would like to pick at Ms. Torgovnick’s original article a bit. I agree that there is a disturbing amount of emphasis on unhealthy body images in the media and I will say upfront that I have not seen Black Swan; yet judging by his previous works (and Ms. Torgovnick’s own comments) I doubt that there will be much “thinspiration” in this movie for anybody but those who are seeking it. Movies that show realistic, and terrible, consequences for abhorrent behavior are not likely to be held up as inspiration by any but those desperate for validation.

    Pointing to pro-anorexia websites’ use of the film as “thinspiration” misses the greater point that this is anything but a pro-anorexia movie. I seem to remember reading that neo-Nazis were touting the first part of American History X, that anarchists loved Fight Club, many drug users obsessed over Trainspotting, and wannabe thugs fallowed the ways of Reservoir Dogs. These movies could not, in their entirety, be considered pro-white power, pro-anarchy, pro-drug, or pro-gunplay respectively; quite the contrary, but never the less were used in that way.

    There is an emphasis on unhealthy body type in the media. Mr. Radford has, wrongly I believe, dismissed this as not the medias’ fault and has even gone the further step of dismissing its potential to be at fault but Ms. Torgovnick has also been mistaken by pointing out that a certain group has latched on to a movie that could not be considered inspirational as “thinspiration” for their dangerous obsession. We need more awareness of this problem in general so the extra exposure is a good thing; it will spark a, hopefully healthy, debate amongst some and will drive other to see the decidedly not pro-anorexia movie (going by reviews) preferably with someone to whom they can talk.

    I hope that all made sense coming from a middle-aged overweight male.

  11. Profile photo of Rebecca Watson
    December 28, 2010 at 1:49 pm —

    @Kimbo Jones: Yeah, note that the author of that piece is Ben Radford.

    I haven’t looked into that study, though obviously it’s a wee bit suspicious that a cosmetic surgeon is sponsoring a study that happens to find that girls don’t feel the images they see are realistic.

    However, let me just point out that in Botta’s study mentioned in my and Radford’s articles looked at whether or not girls thought the images they saw were realistic. Here’s a direct quote (bolding mine):

    Regardless of how much total television and thin dramas they reported watching, how realistic they saw the media images, and how much they questioned media images, the more the girls made comparisons with characters’ bodies, the more they reported endorsing a thin ideal.

    Seeing media images as realistic also remained a significant positive predictor of endorsing a thin ideal (β = .25, p < .001), predicting 5% of unique variance.

    The more realistic the girls reported media
    images to be, the stronger their endorsement of a thin ideal.

  12. Profile photo of Rebecca Watson
    December 28, 2010 at 1:53 pm —

    @mrmisconception: “I doubt that there will be much “thinspiration” in this movie for anybody but those who are seeking it.”

    That’s exactly what Torgovnick’s article is saying, and I agree with her. And she and I also have clearly written that we agree that this is not a “pro-anorexia” movie. Please re-read both our articles, particularly the parts where we mention the fact that the movie presents the world as a dystopia.

    The exact problem is that there are women out there who are primed to process these images in a way that is very different from the way someone with a healthy body image would process them.

  13. Profile photo of mrmisconception
    December 28, 2010 at 2:24 pm —

    @Rebecca Watson

    I absolutely agree and I realize that neither of you thought this was a pro-anorexia movie. I don’t think I made myself clear; basically what I am asking is how do you stop someone from using your art in a way that is counter to its intentions? This movie has a message that would seem to discourage unhealthy body image yet those who promote the exact opposite goal are using it to further their agenda. My only quibble with Ms. Torgovnick’s article was that I felt it was laying the blame for that misappropriation on the film and its director for including underweight actors in the film.

    Rereading the article I realize I has misread that point and that there may be some question as to whether Mr. Aronofsky encouraged this dangerous behavior on the part of his actors and whether he therefore deserved such blame. That was a valid point that was touched very lightly upon and which I missed. I would have personally gone after the fact that pro-anorexia sites exist (who knew?) and perhaps that is where I went wrong; I have a tendency to judge harshly those things that miss a point that I so clearly see.

    My failing, not hers or yours.

  14. Profile photo of James
    December 28, 2010 at 2:31 pm —

    So Dr. Botta’s study, which is a meta-analysis of multiple studies, uses several measurements to take all the disparate data and make it legible. Unfortunately, it only makes it legible to those who know what β, α, Δ, and other statistics-greek mean.

    She was using r² as a measurement of effect size, which in this case, since the r² of each test ranges from .28 to .43, the measurements are considered to have a large effect. In other words, the images had a large effect on the participants. However, this measurement does not explain length of time it takes for the effect to occur, nor does it measure correlation; that’s what r and her friend β is for.

    However, the r value is less important as the β values which show the type of correlation, its strength, and the amount of possible error. Most of the correlations were positive (as more images of thinness were shown, levels of dissatisfaction rose); of moderate strength, which means the people won’t immediately turn bulimic after seeing one image, but after multiple viewings and reinforcement (which Dr. Botta talks about later in the paper and Rebecca talks about in her post) the change in behavior is likely; and had a moderate-to-low chance of error.

    Long story short; Ben cherry-picked what he wanted to hear and unfortunately reported to a wide audience the exact opposite of what Dr. Botta actually said.

  15. Profile photo of Ben Mad Dog Radford
    December 28, 2010 at 2:37 pm —

    I’m pleased that there’s some discussion on this topic, though I’ve moved on to other subjects and can’t address the comments in full. These subjects are complex and nuanced, and cannot possibly be dealt with in a forum like this. Nonetheless, I’ll be happy to offer some replies.

    1) I’m confused by Rebby’s claims about Black Swan; on one hand she agrees that the film depicts a dystopia “of a subculture riddled with body issues,” but on the other hand she believes that it will serve as an inspiration for women who want to become anorexic. Typically media which are said to “inspire” people are positive, glamorous depictions of a lifestyle (gangster, fashion model, etc.), not horrific visions of psychological disturbance. I’d be curious to know why Rebecca thinks that a film such as Black Swan would make audience members identify with, and emulate the characteristics of, a self-mutilating woman enduring terrifying hallucinations. According Albert Bandura’s Modeling theory of psychology, an actress’s behaviors may be modeled, but physical appearance is not. I encourage Rebecca and anyone else interested in the claimed link between actresses or fashion models and young women to research Bandura’s theory, it’s fascinating.

    2) This is of course not the first time that Rebby has accused me of taking Botta’s words out of context. The first time she did it, she had not even read Botta’s article (she admitted she only read the abstract, and therefore could not have even known the context of the quotes!). For example, in a Dec. 14 Facebook post, Rebecca wrote, “You’re taking out of context Botta’s recommendation that the link she has found be explored further.” Actually, that’s not true, and Rebecca knows this. I invite readers to see the actual context of the quote, on page 23 of Botta’s (1994) article. The sentence just before the quote (“concrete evidence is still necessary, however, to show that this existence of thin images and ideals has an effect on viewers”) does not even mention Botta nor any “link she has found,” but instead the work of researchers Wiseman, Gray, Mosimann, and Athens (1992), which dealt with Miss America contestants. So Rebecca has a history of mistakenly suggesting that I have taken quotes out of context when in fact I have not. I’m sure it was a minor oversight!

    Rebecca consulted several of the references I provided in my short columns and states that, “If you care to read it, you will experience the same realization I did: this paper comes to the exact opposite conclusion Radford claims.” This misunderstanding seems to lie at the heart of the matter, and I figured out what the problem is so I will address it at length. Rebecca is assuming that the quotes were selected as representing the conclusions of those particular studies from which they were cited. I made no such claim.

    Rebecca is finding contradictions where none exist. We are both correct and accurate in our quotes, but we are talking about two different things. I was addressing the larger question of whether there’s good overall evidence that media images cause or bring about eating disorders. On this, Botta agrees with me that (as of 1999), the answer is no. The same is true for the Posavac article that she cites; the claim that (as of 1998) “experimental studies have not shown that exposure to media images increases women’s weight concerns” is completely accurate, not taken out of context, and (like the Botta piece) is quoted merely as an accurate and concise summary of the literature up until that point from dozens of studies—not specifically reflecting either Botta or Posavac’s work.

    Do some studies (including by Botta and others) suggest that there’s a link? Of course. That’s not the question. There are published studies that offer support for everything from cold fusion to memory water to psychic powers. Other studies have found the opposite result. Anyone can cherry-pick studies to make their case; the question is, what does the totality of the evidence show?

    Why did I use those quotes from Botta and Posavac? The reason is simple: For understanding a phenomenon, the body of research is much more important and relevant than discussing the results of one or two studies. To tell if something is true or not, you must look at the big picture, the totality of research, because any individual studies you may pick may be flawed in any number of ways (or even accurate but the result of statistical fluke). Thus the Botta and Posavac quotes I provided are actually more important and relevant to understanding the effects than the details of any given study, such as those Rebecca provided.

    What Rebecca sees as “pulling words out of context” is nothing of the sort. The researchers were correctly quoted. The purpose of the quotes I provided was to give readers a sense of the unproven nature of these claims across the body of research. The quotes I provided do not claim that the studies cited themselves came to any particular conclusion. Often one-fifth to one-third of journal articles include summaries and works from people other than the authors, surveys of prior research, and so on. There is nothing misleading about quoting that material; the quotes I provided were accurate, correct, and properly attributed.

    Rebecca sees some unspecified deviousness in the use of ellipses in writing. As a professional writer, I must often condense material and use ellipses in quoted material. When you’re writing a 1,000 word column on a subject, as I must often do, it is impossible and impractical to give every detail about studies. Writers must by necessity condense and summarize information to make it readable and understandable. No matter how Rebecca or anyone else tries to spin the context quotes, the fact is that the quotes are accurate and correct as applied to the larger questions. Renee Botta DID correctly write that “concrete evidence is still necessary… to show that this existence of thin images and ideals has an effect on viewers”; Heidi Posavac DID correctly note that “experimental studies have not shown that exposure to media images increases women’s weight concerns.”

    Rebecca seems to think that I cited those Botta and Posavac studies as claiming that the researchers had found no link between media images and eating disorders. I did not write that, and if I gave that impression then it was my mistake. Did Botta find evidence in the study I quoted of some link between eating disorders and the media? Yes, and in fact I stated that quite clearly in the Facebook discussion. The point of the quote was to demonstrate that, as Botta acknowledges, as of 1999—after nearly twenty years of research—“the impact of media images on adolescent’ body image…has remained inadequately tested.”

    Rebecca says she’s “forced to continue to side with what appears to be the consensus opinion: the media’s portrayal of the thin ideal most likely negatively impacts the body image of those who process those images poorly.” That’s an eminently testable (though heavily qualified) claim: what does “most likely” mean? What does “impact” mean? Any effect, or a causative effect? Is there a proven causative link or isn’t there? Is the claimed effect only limited to “those who process those images poorly”?

    The burden of proof lies with the claimant, and thus those who claim that media images are causing (or contributing to) eating disorders have the burden of proof. After thirty years of research, the burden of proof has yet to be met. My larger point, that the mass media’s role in eating disorders remains speculative and unproven, remains quite true, and in fact has recently gotten even more support. See, for example the recent article “Everyone Knows that Mass Media Are/Are Not [pick one] a Cause of Eating Disorders: A Critical Review of Evidence for a Causal Link Between Media, Negative Body Image, and Disordered Eating in Females” by Michael P. Levine and Sarah K. Murnen in the Journal of Social and Clinical Psychology (Vol. 28, No. 1), 2009, pp. 9-42. The article reviews the research about the link between mass media as a causal risk factor for negative body image and disordered eating in females. It concludes that “currently, engagement with mass media is probably best considered a variable risk factor that might well be later shown to be a causal risk factor.” That is, despite over 30 years of research, the link between mass media and eating disorders is not strong enough to be considered a causal risk. Apparently these researchers did not find the “consensus opinion” that Rebecca refers to.

    At best, it might possibly be one of many factors that might have an influence. It seems that good evidence of a connection remains elusive, and the research done to date has been inadequate: “Stronger methodology, in connection with clearly articulated theories and well-developed, practical interventions is critically important for clarifying whether mass media are in fact a causal risk for the spectrum of disordered eating.”

    Re-read that sentence (the last line in the article), and you’ll find they are saying the same thing that Botta and Posavac said in their summaries of the literature years ago: the link remains unproven. Maybe one day we’ll find good evidence, but that day has not come. Until then, skeptics such as myself are well advised to adopt the skeptical dictum: “Prove it!”

    Anyone interested in reading more about this can see my article “Media and Mental Health Myths: Deconstructing Barbie and Bridget Jones,” in The Scientific Review of Mental Health Practices, (Vol. 5, No. 1), 2007.

  16. Profile photo of Cint
    December 28, 2010 at 4:16 pm —

    I just wanted to say that I think you did an excellent job on the article, Rebecca. I used to suffer from anorexia, and can say first-hand that those pictures definitely result in and escalate the disorder.

    Even though I completed treatment last year, my automatic thought when I see photos like the one in your article is “Look, she’s skinny. That means if I’m as good/controlled as her, then I can be that skinny, too”. Along with that automatic thought comes an automatic sense of guilt/shame for not being like her. It’s after these automatic thoughts that the treatment kicks in and I’m able to challenge these automatic cognitions, but without treatment the automatic reactions to pictures like that go unchallenged.

    I’ve learnt extensively about eating disorders through my study (I’m doing a PhD in Psychology) and through my own experiences, and media images of thin woman undoubtedly have an impact on the development of eating disorders. It’s true that there is a genetic component, but most updated theories around any form of mental illness hold that the development of a disorder is a result of both genetics and the environment; genetics predispose you to a disorder, whilst the environment exposes you to stressors that trigger the emergence of the disorder. Images of thin women like in this movie can certainly be a trigger for eating disorders.

    As you have already mentioned, this is only going to affect the girls who already process images of women in an abnormal way. However, one has to ask why these girls started to process images abnormally to begin with. Perhaps it’s genetic, perhaps it has something to do with the messages that these girls take in from their family and the media when they were growing up, perhaps it’s both. Whatever the answer, I think that the media has a lot to be responsible for, and I think it’s time that they start taking on this responsibility. They could start by putting a little disclaimer at the bottom of every picture that includes an air-brushed model.

    So in a nutshell: awesome job, Rebecca!

  17. Profile photo of Ben Mad Dog Radford
    December 28, 2010 at 5:03 pm —

    Cint- “Images of thin women like in this movie can certainly be a trigger for eating disorders.” And yet decades of research has yet to prove this simple claim. Very odd. Let’s assume that’s true, and the 1% to 3% of American women who have anorexia already have a genetic predisposition for the disease; that hardly implicates the mass media in the etiology of eating disorders, does it? If 97% to 99% of people who are exposed to airbrushed models don’t develop an ED, that kind of discredits your claim.

  18. Profile photo of teambanzai
    December 28, 2010 at 6:14 pm —

    @Rebecca Watson: Okay I read “weigh in” and snickered, I’m such a child.

  19. Profile photo of Anthropologist Underground
    December 28, 2010 at 6:19 pm —

    What strikes me about this discussion is that we are bombarded with images that super-thin is some sort of ideal. Yet in the US we are a nation of overweight and obese people. 63% according to this source. Why aren’t more of us thinner?

    That’s not to say that I, classified as “normal” weight, don’t feel badly about my body when I see smaller women looking awesome in cute clothes. But that’s all anecdotal.

  20. Profile photo of Ben Mad Dog Radford
    December 28, 2010 at 6:28 pm —

    @SubterraneanAnthro: “Why aren’t more of us thinner?”

    Great question. While we’re at it, why are so few people dieting? And why do many polls and surveys find that young women generally feel good about themselves and have good self-esteem? Very curious.

  21. Profile photo of CarolT
    December 28, 2010 at 6:32 pm —

    I think Rebecca and Ben are talking about two entirely different things. Ben’s article is about whether media imagery can cause or encourage the specific disease of anorexia. Rebecca’s argument seems to have to do with whether media imagery can cause or encourage body dysmorphic disorders.

    I think the two of them can at least agree that anorexia and generalized body dysmorphic disorder are two separate pathologies.

  22. Profile photo of Cint
    December 28, 2010 at 6:43 pm —

    Ben –

    I’m not sure how you have come to the conclusion that there is no evidence to support the idea that the thin ideal can lead to the development of an eating disorder. There are more than just “some” studies that have identified a link between images of think women and body dissatisfaction. These include Meade (1995) and Levine et al. (1994), who found that greater frequency of fashion magazine use was associated with eating disordered habits and an increased desire to emulate the thin models – Levine et al. included a stepwise multiple regression analysis whereby the consideration of fashion magazines as an important source of information regarding fitness and beauty was the strongest predictor of eating disordered habits; Stice et al. (1994) showed using SEM that there is a direct association between amount of media exposure and eating disorder symptoms, as well as an indirect association mediated by the media’s gender role endorsement; Irving (1990), Stice and Shaw (1994) and Thompson (1995) found that women reported lower self-esteem and body satisfaction, and increased depression, guilt and shame after being exposed to thin models as compared to average and oversize models. In addition, all participants in Irving’s experiment reported feeling greater amounts of pressure from the media to be thin, rather than from their family or friends; Want et al. (2009) found that exposure to a clip of a television show (“Friends”) depicting thin and attractive women decreased the body satisfaction of women participants; Myers & Biocca (1992) found that watching just 30 min of TV distorts perception of body size in women, just that their body size is overestimated, leading to body dissatisfaction. I could go on, but I’m sure you get the point.

    In addition to studies finding a link between the media and increased body dissatisfaction, some studies have reported that exposure to average-sized models/actresses can actually reduce the risk of developing eating disordered habits (eg Fister & Smith, 2004). Even if you refuse to acknowledge that the promotion of the thin ideal is causing or maintaining eating disorders, surely you can see the benefit in replacing the emaciated actresses being cast now with average-sized actresses that have been shown to have a positive influence on the women who are at high risk of developing disordered behaviours.

    I disagree that a genetic component to the disorder rules out the possibility that anything other than genetics can therefore be considered the cause of the disorder. When someone is genetically predisposed to a particular disorder, the triggers must still be present in the environment in order for the disorder to develop. A genetic predisposition basically means a lower threshold at which a disorder will be triggered; everyone has a threshold, it’s just that some people can manage a higher level of stressors than others i.e. some people have better coping strategies for dealing with the constant barrage of the thin ideal. In this sense, both genetics AND the mass media have a role in the etiology of the disorder. I am not proposing that the mass media is the sole cause of eating disorders, nor even that it’s the most influential trigger. But the thin ideal promoted by the media is a trigger, and also serves to maintain the disorder once it has set in.

    I have already covered it in a small way with my discussion of the genetic predisposition, but the 97-99% of women who do not develop a disorder do not discredit the claim that the mass media can lead to EDs any more than the 96% of people that do not have food allergies discredit the claim that certain food can lead to allergic reactions. The women who develop the ED are those that are at a high risk to begin with, potentially due to a genetic predisposition, perhaps due to a dysfunction in the way that they process “messages” fr0m the media, or the way they view their body etc etc. Not all women think this way or are as affected by the images to a point where an eating disorder sets in, but that doesn’t mean that women aren’t affected, nor does it mean that the mass media doesn’t play a role in the development of EDs in those women who do go on to internalise the thin ideal.

  23. Profile photo of Ben Mad Dog Radford
    December 28, 2010 at 6:58 pm —

    @ Cint: “I’m not sure how you have come to the conclusion that there is no evidence to support the idea that the thin ideal can lead to the development of an eating disorder. ”

    I didn’t say there is “no evidence,” in fact I’m familiar with many of the studies you cite. I merely pointed out that your claim that “images of thin women like in this movie can certainly be a trigger for eating disorders” has not been proven. As I’m sure you agree, “evidence for” a link is not the same as “proven.” Overall I agree with your points and analysis, I’m just pointing out that the evidence is much weaker than often claimed.

  24. Profile photo of Cint
    December 28, 2010 at 7:00 pm —

    @ Anthropologist and Ben

    Why aren’t more people thinner? Short answer: because a majority of people are not successful at dieting. That doesn’t mean that they don’t attempt to be thinner.

    http://www.sciencedaily.com/releases/2008/04/080422202514.htm: This article from Science Daily reports that 75% of women report eating disordered habits, 67% of women (excluding those with EDs) are trying to lose weight, 53% of which are dieting regardless of already being at a healthy weight.

    http://news.med.cornell.edu/nyp_health/nyp_health_2006/most-college-women-diet-o.shtml: This article, reporting on a study in the Nutrition Journal, reports that 83% of college women are dieting, regardless of how much they weigh; consciously eating less was reported by 44% of women who were at a normal weight.

    So it’s just false to assert that only a “few” are dieting.

  25. Profile photo of Konradius
    December 28, 2010 at 7:05 pm —

    Wow, great posts by Rebecca and Ben alike! This really shows how difficult it can be to read scientific works and come to a conclusion with a degree of certainty.

    My personal, provisional stance now would be that there’s no causal link between images and getting anorexia, but that those images are a trigger for the disease.

    Note that I cut out all the weasel words (possibly, probably etc) because I already put in the provisional part. And my certainty about it would be low to medium; I’d have to hear from new scientific works to change it.

    So what was the starting quote again:
    …asserting that the movie Black Swan “cannot “encourage” anorexia…

    Well, actually, it cannot encourage anorexia as in: cause people to get the disease. However, it can encourage anorexia as in: trigger more of the behavior.
    But so can any poster at a busstop, and we don’t outlaw bars because alcoholics get triggered for their behavior.

    And for those who think that the movie is too depressing or whatever to trigger anything, remember that Richard Saunders recently debunked the powerbalance bracelet on live television. This was followed by a purchasing spike of the now debunked and terribly overpriced plastic.

  26. Profile photo of Ben Mad Dog Radford
    December 28, 2010 at 7:06 pm —

    @ Carol- Yes, you’re right. Rebby and I are talking about two different things. I can see how she might have misread the purpose of the quotes, but I used them as those researchers’ summaries of previous research, not as the conclusions of those specific studies. That is NOT the same thing as taking the quotes out of context; the quotes were accurate, and in context. And yes, we’d agree that anorexia and BDD are distinct disorders!

  27. Profile photo of Cint
    December 28, 2010 at 7:15 pm —

    @Ben:

    I agree that the link has not been conclusively proven, and I don’t think that it ever could be, short of inducing eating disorders in the lab. But I think that the evidence is strong and shouldn’t be dismissed. I also agree that more influence is attributed to the media than is justified – it is one of many triggers of eating disordered habits – but I still believe that they should be more proactive in mitigating the effect that they have on a certain proportion of the population. Only a small proportion of the population will ever develop a full eating disorder, but anorexia is the most fatal of all disorders (including depression), and this should therefore be taken very seriously.

  28. Profile photo of Ben Mad Dog Radford
    December 28, 2010 at 7:37 pm —

    @ Cint: “This article reports that 83% of college women are dieting, regardless of how much they weigh…”

    Seems high, but note that “dieting” is defined very broadly in this study: “consciously eating less than you want, using artificial sweeteners, skipping breakfast, and smoking for weight control.” I had a diet Coke today, therefore I’m dieting? I wanted a third slice of pizza, but I decided not to, therefore I’m dieting? Not impressed.

  29. Profile photo of Buzz Parsec
    December 29, 2010 at 12:24 am —

    I haven’t read the comments yet, and don’t really know what causes eating disorders, or whether they are “nature” (as Radford implies) or “nurture”, but [rant] what I found really disturbing was the existence of pro-anorexia web sites. Are these people freaking morons?

    At least the people running pro-disease (i.e. anti-vax) sites think they are promoting good health, even if they are completely wrong. But how can someone possibly think starvation is healthy? It boggles the mind.

    Maybe I’ve just seen too many images of Darfur, Biafra, terminal AIDS and cancer patients, concentration camp survivors, and so on, even though according to Radford, as best I can understand his point, these images shouldn’t matter to me. Or maybe they just affect my conscience without affecting my eating habits.

    [/rant]

  30. Profile photo of Wanderfound
    December 29, 2010 at 5:57 am —

    @Buzz Parsec: “Are these people freaking morons?”

    Ah, no: they’re mentally ill. Pro-ana websites are generally run by people who would themselves be diagnosed as anorexic, AFAIK.

    (although, to be pedantic, “mentally ill” and “freaking moron” aren’t exclusive sets)

    I’m more gobsmacked that there are people out there who aren’t already aware of these sites. If you take a moment to dig on the web, you’ll find pro-ana sites, pro-cutting sites, “voluntary amputation” stuff and a host of “psychonaut” groups (which are arguably more defensible, but when you get up to the pages where people are describing how much fun it is to inject sodium pentobarbital, even the most ardent legalisation advocates tend to have some doubts…).

    It’s all just a variation of Rule 34. People are strange.

  31. Profile photo of exarch
    December 29, 2010 at 8:28 am —

    I think we’ve had something like this discussion before when the subject was boulemia.

    Unlike an alcoholic, who can consciously avoid bars and liquor stores, or someone with an allergy who can at least avoid consuming peanuts, a human being HAS to eat. In a sense, the thinness ideal is like an addiction, and one that gets worse by repeated exposure to thin models. But every time a person eats, they’re confronted again with their “problem”, and every time they turn on the TV, open the newspaper, or even stand and wait for the bus, they get exposed to more unrealistic beauty ideals that further distort their perception of reality.

    Being an alcoholic is just as unhealthy, and can destroy organs too (or more when combined with driving), but at least they don’t have to live in a bar. The temptation will be there even if it is a dirty bar with cheap drinks, and full of examples of why too much alcohol is bad for you.

  32. Profile photo of geek goddess
    December 29, 2010 at 8:54 am —

    @Kimbo Jones:

    This sort of thing was discussed on SheThought a while back: http://shethought.com/2010/08/16/reactions-to-a-poll-on-girls-and-fashion-photos/ and http://shethought.com/2010/08/15/deconstructing-barbie-and-bridget-jones/ They concluded that the evidence did *not* support that girls are fooled by idealized media imagery like touched photos. But from what evidence I’ve seen, I disagree with the idea that it’s not influencing them, so I thought you might also be interested in reading their article if you hadn’t already.

    You know there are 43 different contributors on shethought.com, right? From a extremely wide variety of backgrounds and viewpoints. There is no “they’, nor is it “their” article. It’s an outlet, not a hive mind.

    Another take on the issues :ICBS Everywhere › Know Not Only What You Know, But Why and How You Know It http://bit.ly/gSPCZE

  33. Profile photo of Rebecca Watson
    December 29, 2010 at 10:48 am —

    @Ben Mad Dog Radford:

    I’d be curious to know why Rebecca thinks that a film such as Black Swan would make audience members identify with, and emulate the characteristics of, a self-mutilating woman enduring terrifying hallucinations.

    Because they are. As the author points out, there are a few pro-ana sites using images from the film as “thinspiration.” Not sure what’s so controversial about pointing that out.

    So Rebecca has a history of mistakenly suggesting that I have taken quotes out of context when in fact I have not.

    But I wasn’t mistaken. This entire post is proof of that . . . I wrote it in order to explore what I was talking about in that Facebook thread. You can’t score cheap points by pretending as though I was mistaken just because I didn’t have the full paper to start with (which I admitted, both in the FB thread and here in this post). And it’s odd that you would “invite readers” to see the context around your quotes . . . in my post, I provided the context that you refused to provide, and it shows that Botta was not discussing the greater body of research.

    You claim that you were quoting these two authors in order to make a point not about the individual studies, but about the greater body of research. If that’s the case, then why did you fail to mention that those excerpts did not refer to the greater body of research? As I point out when giving readers the actual context, those quotes refer to very specific points within the research.

    And did you seriously think that the layperson would read your article and see you quote from prominent researchers and not assume that those quotes accurately represented those authors’ viewpoints and research?

    Because no matter how you try to slice it, those quotes are not representative of the greater body of research, nor are they representative of the authors’ work, as I’ve shown in my post. Why did you not quote from any researchers that actually agree with you, or that have done studies that help support your assertion?

  34. Profile photo of Rebecca Watson
    December 29, 2010 at 10:54 am —

    Also:

    Do some studies (including by Botta and others) suggest that there’s a link? Of course. That’s not the question. There are published studies that offer support for everything from cold fusion to memory water to psychic powers.

    Did you really just compare your own two sources to pseudoscience?

  35. Profile photo of SJBG
    December 29, 2010 at 11:23 am —

    @Ben Mad Dog Radford: “@SubterraneanAnthro: ‘Why aren’t more of us thinner?’

    Great question.”

    Because you don’t have to already be stick thin to be anorexic or bulimic. I knew many girls in high school who were one or the other and they were not stereotypically skin & bones. That’s *why* they weren’t eating (or were binging/purging). They’d get there eventually, for sure. But when people start out, they aren’t like that. You’d be surprised how many people have an eating disorder but don’t look the part (yet).

  36. Profile photo of Ben Mad Dog Radford
    December 29, 2010 at 12:33 pm —

    @ Rebecca: “You claim that you were quoting these two authors in order to make a point not about the individual studies, but about the greater body of research. If that’s the case, then why did you fail to mention that those excerpts did not refer to the greater body of research?”

    Rebby, what are you talking about? The quotes I provided DO clearly and specifically refer to the greater body of research!

    Both quotes (by Botta and Posavac) were written by Renee Botta and Heidi Posavac et al. as summaries of the larger body of research. When Botta writes, “At this point, the relationship between television exposure and body image disturbance remains in question,” that is by definition referring to the greater body of research, not specifically to Botta’s work. How could you possibly read this sentence and conclude that it refers to anything other than the greater body of research? Honestly, I’m baffled.

    “No matter how you try to slice it, those quotes are not representative of the greater body of research, nor are they representative of the authors’ work, as I’ve shown in my post.”

    You are correct that they are not representative of the authors’ works; I never said they were. The statements are, however, representative of the state of the evidence. You apparently think that Botta or Posavac are simply wrong when they state that the links remain unproven. If you think they are wrong, you need to take that up with them, not me!

  37. Profile photo of Ben Mad Dog Radford
    December 29, 2010 at 12:39 pm —

    By the way, Barb Drescher wrote an excellent analysis on this discussion at http://icbseverywhere.com/blog/2010/12/know-what-you-know/.

    Part of the intro: “In her post, Rebecca accuses Ben of cherry-picking and quoting out of context. In a response to Rebecca , Ben defends himself quite well regarding the accusations that he misrepresented the authors (there were two), but I think that there is a lot missing from the discussion that is important and, in fact, this is shaping up to be a great example of why organized skepticism is needed and why more working scientists should get involved.”

    For anyone who wants to understand the issues, this is a great, in-depth discussion.

  38. Profile photo of Rebecca Watson
    December 29, 2010 at 12:59 pm —

    @Ben Mad Dog Radford:

    Rebby, what are you talking about? The quotes I provided DO clearly and specifically refer to the greater body of research!

    No, they obviously do not. Go back and read the quotes in context. Your quotes from Botta and Posavac specifically address total amount of exposure to body image disturbance, and not, for instance, total exposure leading to thin ideal endorsement or any other vector.

    But the worst of it is that you’re simplifying their words to make it seem as though there’s no reason for anyone to think there’s a link between media and body image, when they are actually saying the opposite: that there is much evidence for that link, and that more experimental tests should be done to be positive. When I give the excerpts in context above, that is clear.

    Again, why did you not solicit an expert opinion on the greater body of research from a researcher who agrees with you? Why did you not give any examples of that research?

    And why are you now comparing your own sources to pseudoscience like cold fusion?

  39. Profile photo of Ben Mad Dog Radford
    December 29, 2010 at 1:40 pm —

    >Me: “The quotes I provided DO clearly and specifically refer to the greater body of research!”

    >Rebecca: “No, they obviously do not.”

    They don’t? So, for example, Botta is simply wrong when she states that “the relationship between television exposure and body image disturbance remains in question”?

    Okay, you believe that statement is incorrect (as applied to the general body of evidence as of the time of writing), that the relationship between TV exposure and body image disturbance DOES NOT remain in question.

    Do you have any evidence of this? And how do you explain Botta (and Posavac and others) getting it so wrong?

    I’m not sure what you mean by soliciting an expert opinion on the greater body of evidence from a researcher that agrees with me. I agree with Botta and Posavac that the claimed links remain unproven; that was the whole point in quoting them!

    By the way, as Drescher notes in her detailed analysis, Botta’s study actually doesn’t support your claims….

    And I did not compare either Botta or Posavac to cold fusion! I stated that in any scientific inquiry there are studies that show evidence both for and against–including topics such as cold fusion. The point is that even hypotheses that turn out to be false will have some evidence for them. Thus, even if the hypothesis that mass media cause eating disorders is false, we should expect to see a fair number of studies supporting that view.

  40. Profile photo of Ben Mad Dog Radford
    December 29, 2010 at 2:08 pm —

    Ah! I think I figured it out. Once again we are talking about two different things.

    If I’m understanding you correctly, you don’t deny that Botta and Posavac wrote the quotes, and that the quotes correctly and accurately reflect the state of the body of evidence at the time for those respective measures.

    What you’re saying is that those quotes do not accurately address the overall state of evidence for the link between media exposure and eating disorders. Is that right?

    If so, then please provide some recent research that indicates that the link between media exposure and eating disorders has been proven, or at least has strong evidence for it. I provided a 2009 journal reference above that concluded that the link remains speculative and unproven; what have you got?

    Also, please explain why, if there is good evidence for the link, Botta and Posavac concluded that the specific measures they discussed (again, in the general body of evidence) contradict that claim.

    If that’s not right, then please clarify your position, because it’s honestly not clear to me. Or maybe another reader can help explain?

  41. Profile photo of Rebecca Watson
    December 29, 2010 at 2:17 pm —

    @Ben Mad Dog Radford:

    >Me: “The quotes I provided DO clearly and specifically refer to the greater body of research!”

    >Rebecca: “No, they obviously do not.”

    They don’t? So, for example, Botta is simply wrong when she states that “the relationship between television exposure and body image disturbance remains in question”?

    I can only assume you’re being willfully thick at this point. She is not wrong (AFAIK). You represented that statement (and are continuing to represent it) as an indictment on all research that has explored the link between media and body image. It is not. As I stated in the post AND in comments here:

    Your quotes from Botta and Posavac specifically address total amount of exposure to body image disturbance, and not, for instance, total exposure leading to thin ideal endorsement or any other vector.

    Ben, I find your behavior really disturbing. You’re a science communicator, and laypeople trust you to honestly represent your sources. My last hope was that when it was pointed out to you, you would admit a mistake and correct it. Instead, you’ve continually tried to twist the facts to make yourself look better.

    The fact remains that you made an assertion and supported it by taking quotes out of context from two papers that explicitly oppose your assertion. If you can’t understand that after having it carefully and politely laid out for you, I’m not sure what else I can say here.

  42. Profile photo of Ben Mad Dog Radford
    December 29, 2010 at 2:47 pm —

    Rebecca- See above. I figured out what the misunderstanding is about.

    >>”The fact remains that you made an assertion and supported it by taking quotes out of context from two papers that explicitly oppose your assertion.”

    That’s simply not correct. Here is my assertion, taken from the original article: “Most research studies have failed to find a cause-and-effect link between media images of thin people and eating disorders.”

    That claim is correct. If you think that most research studies HAVE found a cause-and-effect link between media images and eating disorders, please provide references.

    I then (accurately) quoted Botta and Posavac’s summaries of the body of research in their respective fields, stating that the links between TV exposure and body image disturbance (Botta); and exposure to thin ideals and increased concerns with weight (Posavac) remain in question and unproven. Which is true, and supports my point.

    I’m not sure what “mistake” you believe I made, unless you are claiming that studies about body image disturbance, weight concerns, and TV exposure are somehow completely unrelated to the question of whether media images have an effect on eating disorders.

    As I noted, Botta and Posavac were quoted because they provided an accurate, concise, valid summary of the body of evidence.

    The irony is that Botta, Posavac, and many other researchers agree with me that the link between mass media and eating disorders remains unproven! So no one’s words are being taken out of context or twisted.

  43. Profile photo of Rebecca Watson
    December 29, 2010 at 3:07 pm —

    @Ben Mad Dog Radford: You are continuing to claim that these researchers agree with you despite the fact that their research and their words clearly say otherwise. If after all this you can still look at your article and say that it was honest and correct to pull those excerpts out in support of your assertion, then we have nothing more to discuss on the topic.

    You still think it was right and I still think it was dishonest.

  44. Profile photo of Josh2085
    December 29, 2010 at 3:11 pm —

    @Rebecca

    What did you think of Barbara Drescher’s analysis?

  45. Profile photo of Rebecca Watson
    December 29, 2010 at 3:38 pm —

    @Josh2085: Just took a look and I see she’s mostly focused on Botta’s findings. Her breakdown does remind me that I probably should have been more critical of Ben confusing anorexia and body image, etc. . . . I granted that he was throwing it all into the mix despite the fact that he spends most of his article focusing on anorexia. If we focus on that, then Botta’s study is at best completely irrelevant to his point (instead of being diametrically opposed to it).

    Regardless, both those studies were ridiculous to mention and quote out of context in support of his article.

  46. Profile photo of Ben Mad Dog Radford
    December 29, 2010 at 3:45 pm —

    @ Rebecca: >”You are continuing to claim that these researchers agree with you despite the fact that their research and their words clearly say otherwise.”

    Their words do not say otherwise, as noted below. If you believe that Renee Botta, Heidi Posavac, or any other researcher disagrees with my claim that the link between mass media exposure and eating disorders remains unproven (across the general body of research), where’s your evidence?

    >”The fact remains that you made an assertion and supported it by taking quotes out of context from two papers that explicitly oppose your assertion.”

    Nope. Again, we are talking about two different things. Let’s be clear: My assertion is that the link between mass media and eating disorder remains in question and unproven in the general literature. Neither of the two papers “explicitly oppose” this conclusion.

    What about Posavac’s and Botta’s “research and words” you chose that supposedly undermine my claim? The quotes you provided from Botta and Posavac were themselves cherry-picked. Both papers cited research both for and against the claimed link, as any valid survey of the literature would do. We could both cherry-pick what we want from them to support whatever claim.

    The quotes I selected discussed the general body of research suggesting that the links are unproven; the quotes you selected discussed a few specific studies suggesting that there is some evidence for a link. Both are valid.

    But what’s a more accurate, honest, and fair quote to cite about the status of a given research subject? A quote that summarizes research from dozens or hundreds of studies over a decade or more (“link remains unproven”) or a quote that cites a few studies that found an effect (“these studies suggest there is a link”)?

    If you believe that Botta or Posavac have concluded (contrary to my assertion) that the general body of evidence (actually, I think you used the word “consensus”) has found a cause-and-effect link between media images and eating disorders (my original assertion), then please provide evidence. Otherwise, this is a tempest in a teapot.

  47. Profile photo of mrmisconception
    December 29, 2010 at 4:27 pm —

    I hate it when mom and dad fight.

  48. Profile photo of daedalus2u
    December 29, 2010 at 4:34 pm —

    @Ben Mad Dog Radford: I call BS and agree with Rebecca.

    The statement “Concrete evidence is still necessary…to show that this existence of thin images and ideals has an effect on viewers.” is false. Thin images do have an effect on viewers, they increase body dissatisfaction in people who are not emaciated. There is abundant and robust research that shows that thin media images do have an effect on body image in young women.

    The statement “At this point, the relationship between television exposure and body image disturbance remains in question.” might be true, but so what? The movie “Black Swan” is not a TV show. TV images are not the only type of images that people are exposed to. The images that are usually objected to are not TV images, they are photo shopped images that make models thinner than is possible for an actual women to be while retaining good health.

    This statement :

    “Nearly every woman in America regularly sees thin women in everyday life and the media, yet according to the National Institute of Mental Health, only about one percent of them develop the disease. If there a strong link existed between media exposure and anorexia, we would expect to see an incidence many orders of magnitude higher than is found.”

    Is to me, clearly disingenuous BS. If anorexia is rare (1%), and you intuitively expect to see the incidence “many orders of magnitude higher”, do you mean unless the incidence goes up by 2 orders of magnitude (a relatively small value of many to be sure ;) ) there isn’t a strong link? In other words, unless the incidence goes from 1% to 100%, there isn’t a strong link? Is that what you mean?

    If you look up the Botta study on Google Scholar, it has 208 citations. If you look at the first of those citations, it is a meta-analysis, titled “The effect of experimental presentation of thin media images on body satisfaction: A meta-analytic review” from 2002.

    You can download a pdf of it. When you do, you see that it is a meta-analysis of 25 studies

    Their conclusion (page 11)

    “The overall d value was -0.31, z = -7.37, p< .0001; 95% confidence interval (CI): -.40 to -.23. Consistent with Hypothesis 1, body satisfaction for women is significantly lower after viewing thin media images than after viewing media images of average size models, of cars or houses,or of overweight models.”

    The paper also mentions that (page 7) “Due to statics placing the eating disorder prevalence rate for females ages 15-19 at 125.1 per 100,000 per year and for females ages 20-24 at 82.7 per 100,000 per year (van Hoeken, Lucas, & Hoek, 1998), we expected females younger than 19 to be significantly more susceptible to thin images than females older than 19.”

    That study has 434 citations.

    The incidence of eating disorders isn't very big. What kind of a study would be necessary to show a causal relationship between media exposure to thin images and eating disorders in what populations?

    If it is ~100/100,000 per year, then if you want to see if there is a difference between an exposed and not exposed group, supposing that the non-exposed group has an incidence of 1/1000 (0.001) and the exposed group has an incidence twice as high 2/1000 (0.002), what sample size do you need?

    Plugging those values into an online statistics calculator for populations needed to test the equality of two proportions,

    http://www.stat.uiowa.edu/~rlenth/Power/

    I get that you need two groups of 25,570 in order to see the effect with an alpha of 0.05 and a power of 0.80.

    Are we going to see a study with two groups of 25,570 each? Followed for a year? Where one group isn't allowed to look at thin media images? I don't think so. Even then, the study would only have an 80% chance of detecting the effect at a p of 0.05.

    Lets suppose the effect was 10x higher, 0.001 for non-exposed and 0.01 for exposed. Finding that effect with a p of 0.05 with a study of .95 power only takes 1969 in each group. We are not going to see studies with 3938 people in them either.

    What this analysis says is that there well never be “proof” that thin media images “cause” eating disorders.

    The 2009 article by Levine & Murnen says:

    “In sum, of the 7 criteria, there is strong evidence for Criteria 1, 2, 5, and 7, and solid evidence for Criterion 3. However, the evidence for two of the most important criteria—4 (factor precedes and predicts) and 6 (reducing the risk factor prevents the disorder)—is encouraging but complicated, preliminary, and inconclusive. Consequently, engagement with mass media is probably best considered a variable risk factor that might well be later shown to be a causal risk factor (Kraemer et al., 1997; Stice, 2002).”

    So, out of 7 criteria to demonstrate not merely association but causation, 4 have strong evidence, 1 has solid evidence and 2 merely have encouraging evidence. This is not for media images having no effect, this is for media images causing eating disorders. Media images do have an adverse effect. They cause dysmorphic body image.

    So your default is that because it is not “proven”, we should do nothing? We should default to believing that there is no causative association at all? That sounds like the argument of a denialist. Until it is “proven” that AGW is actually happening, we should do nothing?

    Does that mean we should never do anything about thin media images? No, it does not. Eating disorders are really bad. They are a mental health issue with one of the highest death rates.

    http://bjp.rcpsych.org/cgi/content/full/194/1/10

    The death rate from essentially every other cause is increased with anorexia.

    Very often when studies can’t be done to the desired end point (in this case anorexia), a surrogate endpoint is used instead. That is why researchers have looked at body image instead of full-blown eating disorders.

    The skeptic keeps an open mind, but not so open that their brain falls out. It is not “proven” that media images cause anorexia, it is also “not proven” that media images do not cause anorexia. The skeptic weighs the evidence pro and con, and considers the risks and benefits pro and con and considers action when it becomes very likely that the costs of action produce benefits that very likely exceed the costs of those actions.

    Just as global warming denialists want to delay all action until AGW is “proven” and it is “proven” to be bad, media induced dysmorphic body image deniers want to delay all action until thin media images are “proven” to cause anorexia. To me, it seems that the costs of reducing thin media images are not very big compared to the deaths of women from anorexia. I think just reducing dysmorphic body image all by itself would be enough to justify it, and that we do know.

  49. Profile photo of Ben Mad Dog Radford
    December 29, 2010 at 4:53 pm —

    @ daedalus2u: >”I call BS and agree with Rebecca. The statement “Concrete evidence is still necessary…to show that this existence of thin images and ideals has an effect on viewers.” is false.”

    Nope, sorry. Your first and second sentences are mutually exclusive. Rebecca admitted that Botta’s statement was accurate (as far as I can tell). Therefore you cannot logically both agree with Rebecca AND claim that Botta’s statement is wrong. Unless you mean that you agree with Rebecca about everything except that!

    Also, as I noted, if you disagree with Botta’s summary, then your issue is with the researcher, not me. Perhaps you know more about it than she does?

    >”Is to me, clearly disingenuous BS.”

    Odd that Levine & Murnen did not consider it to be B.S. and they discuss this in depth on pages 12 and 13. Perhaps you know more about it than they do?

    >”It is not “proven” that media images cause anorexia, it is also “not proven” that media images do not cause anorexia.”

    I’m fascinated by your logic. It reminds me of people who say, “You can’t prove that psychic powers DON’T exist!” The burden of proof is on the claimant. Those who make the claim that there’s a causative link between media images and eating disorders have the burden of proving that claim.

    >”So your default is that because it is not “proven”, we should do nothing?”

    Nope. I have no idea where you got that idea, I never said any such thing. But I’m glad you agree with me, that the link is unproven. That’s my whole point. They have been researching this for over 30 years, and have yet to prove a link. The money and resources spent on this apparent dead end could be much more effectively spent on avenues of research that have actually been fruitful (such as genetic testing).

  50. Profile photo of Cint
    December 29, 2010 at 5:03 pm —

    @ Ben: ““dieting” is defined very broadly in this study: “consciously eating less than you want, using artificial sweeteners, skipping breakfast, and smoking for weight control.” I had a diet Coke today, therefore I’m dieting? I wanted a third slice of pizza, but I decided not to, therefore I’m dieting? Not impressed.”

    Again, this is a problem of not reading the entire paper, or taking the information out of context. If you read the methods section of the actual article published, you will see that dieting was assessed more fully than merely ‘Do you use artificial sweeteners?’ or ‘Do you sometimes eat less than you want?’. This is a passage from the article itself (Malinauskas et al., 2004):

    “The dieting practices questionnaire was developed by a Registered Dietitian and reviewed for content validity by two Registered Dietitians who practice in eating disorder treatment and nutrition counseling of college students.”

    The two questions you refer to in your post explicitly refer to using sweeteners or eating less /in an effort to lose or control weight/. If you are deciding not to reach for that third bit of pizza because you are worried about it heading straight for your thighs, then yes, that is dieting.

    “My assertion is that the link between mass media and eating disorder remains in question and unproven in the general literature.”

    Although daedalus2u covered this far better than I ever could, in need of further research is not the same thing as “in question”. You can be fairly certain that a particular phenomenon is occurring, while still being cautious and recommending future research. Secondly, this link could never really be “proven” unless we exposed girls to images in the lab and it resulted in an eating disorder. That would be your “cause-and-effect” relationship. Obviously, that’s not going to happen, so all we have to go on are the studies that show a correlation between these things. And as we all know, correlation doesn’t equal causation; but it makes it pretty darn probable.

  51. Profile photo of Ben Mad Dog Radford
    December 29, 2010 at 6:41 pm —

    @ Cint: >” If you are deciding not to reach for that third bit of pizza because you are worried about it heading straight for your thighs, then yes, that is dieting.”

    If you believe that the definition of “dieting” used in this study was appropriate, that’s fine. I disagree that “sometimes eating less than you want” is a valid measure of whether or not someone is dieting.

    >”in need of further research’ is not the same thing as “in question.”

    They seem pretty similar to me: “in question” suggests that an answer or conclusion has not been reached, and that more research is needed to answer the question. In any event, researcher Renee Botta, who Rebecca claims to agree with, stated that the link was “in question,” not me. If believe this is inaccurate and have evidence to the contrary, Dr. Botta is the person you should talk to!

    >”this link could never really be “proven” unless we exposed girls to images in the lab and it resulted in an eating disorder.”

    Are you actually saying that the claim that media images cause eating disorders is unfalsifiable, and cannot be proven? If that’s the case, then why have so many researchers spent decades trying to prove there’s a link? If that’s the case, you are also contradicting Rebecca’s statement that there’s a “consensus” about the link–unless the consensus is that the link has not been proven! :-)

  52. Profile photo of Ben Mad Dog Radford
    December 29, 2010 at 6:48 pm —

    By the way, I’m curious about this claim made by daedalus2u:

    “Just as global warming denialists want to delay all action until AGW is “proven” and it is “proven” to be bad, media induced dysmorphic body image deniers want to delay all action until thin media images are “proven” to cause anorexia.”

    Who on earth are you talking about?

    Can you name a single “media induced body dysmorphic denier” who “wants to delay all action” until media images are proven to cause anorexia?

    Are there any, or did you just make that up?

    Evidence, please?

  53. Profile photo of daedalus2u
    December 29, 2010 at 6:56 pm —

    No Ben, you are being disingenuous.

    The statement “Concrete evidence is still necessary…to show that this existence of thin images and ideals has an effect on viewers.” is false. It doesn’t matter who says it, or how you spin it, it is still false. There is abundant data showing that media images of thin women has an effect on women’s body image. An effect on women’s body image is “an effect on viewers”. It has been proven in the meta analysis I posted about with a p of 0.0001. Images of thin women have an adverse effect on women’s body image.

    You don’t get out of repeating false statements by putting them in quotes.

    If you want to get disingenuously hyper-logical and hyper-skeptical, then where is your “proof” that the idea that thin media images cause anorexia is a myth?

    As you have said, the data doesn’t prove media images cause anorexia. So where is the data proving that media images do not cause anorexia. You saying it is a “myth” is an unsupported statement unless you can provide proof that the idea that media images cause anorexia is false.

    Since that is the statement you have made, where is your supporting evidence? Where is the evidence showing that the general belief that media images of thin women cause anorexia is disproven?

    You have gone beyond the data, which says that the idea that media images cause anorexia is not proven to making the statement that the idea that media images cause anorexia is a myth.

  54. Profile photo of Kimbo Jones
    December 29, 2010 at 7:08 pm —

    @geek goddess: Well, excuse me. I didn’t realize that the non-gendered use of the word “they” (because I couldn’t be arsed after work to look up the author of the discussed article) and “their” (because I was being grammatically ambiguous) was a capitol offense at SheThought. In NO WAY did I AT ALL insinuate that SheThought is a “hive mind”. Nor did I realize that linking to an article I thought interesting and might contribute to the discussion was going to net me a lecture.

  55. Profile photo of Ben Mad Dog Radford
    December 29, 2010 at 7:12 pm —

    Daedalus-

    Just so I understand: Dr. Botta (and decades of research) is wrong, because you have provided “concrete evidence” in the form of one meta-analysis? If you really are so certain of the power of your findings, I encourage you to write them up and submit them to a peer-reviewed journal. Seriously.

    I actually never claimed that the idea that media images cause anorexia is false. (You’re well-stocked on straw man fallacies tonight, aren’t you?)

    I stated that it is unproven- a statement you agree with.

  56. Profile photo of geek goddess
    December 29, 2010 at 7:49 pm —

    @ Kimbo Jones

    Well, excuse me. I didn’t realize that the non-gendered use of the word “they” (because I couldn’t be arsed after work to look up the author of the discussed article) and “their” (because I was being grammatically ambiguous) was a capitol offense at SheThought. In NO WAY did I AT ALL insinuate that SheThought is a “hive mind”. Nor did I realize that linking to an article I thought interesting and might contribute to the discussion was going to net me a lecture.

    First, I have no idea if there are any offenses at “shethought” since there don’t seem to be any rules. I wouldn’t say “What Science-Based Medicine” thought about an issue, since there are a number of contributors there, as well. It wasn’t a lecture (unless you are super-sensitive), it was an observation. Most people don’t like to be grouped, whether as contributors to a multi-contributor blog, like Skepchick, SheThought, etc. The authors are generally right under the title.

    Perhaps you meant ‘capital’ offense?

  57. Profile photo of geek goddess
    December 29, 2010 at 8:05 pm —

    Hah. Apparently I couldn’t be arsed to proofread.

    My bad.

  58. Profile photo of Kimbo Jones
    December 29, 2010 at 8:21 pm —

    @geek goddess: And as I explained, I didn’t group them.

  59. Profile photo of Cint
    December 29, 2010 at 8:43 pm —

    @Ben:

    >”I disagree that “sometimes eating less than you want” is a valid measure of whether or not someone is dieting.”
    And I agree with you there. My point was that this is not what was considered dieting in the study. Eating less than you would like /for the express purpose of losing/maintaining weight/ was considered dieting. I don’t see any problem with that definition at all.

    >”“in question” suggests that an answer or conclusion has not been reached, and that more research is needed to answer the question.”
    That’s true, and I think that it is false to suggest that no answer has been reached in terms of the link between the media and EDs. You seem to rely heavily on this one paper published by Dr. Botta and completely disregard the numerous other studies that have been published that show the link between the two variables. Is more research needed? Absolutely – when you’re looking at correlational research, then you always have need for more research. When you say it is “in question” you are implying that the link is dubious or somehow not supported by evidence. This is false.

    >”Are you actually saying that the claim that media images cause eating disorders is unfalsifiable, and cannot be proven? If that’s the case, then why have so many researchers spent decades trying to prove there’s a link?”
    No, I’m not saying it’s unfalsifiable. There are clearly ways in which they theory can be falsified (i.e. the inability for the use of media images to evoke or maintain an ED in the lab), however this would practically never be allowed. You spoke of “proven” in previous posts as a reference to proof of a cause-and-effect relationship. Without ethics allowing a true experiment to be done, this is impossible. What we can do is conduct quasi-experimental or correlational research in order to build up support for the causal relationship. One of the closest and most reliable correlational supports of a causal relationship is a SEM or multiple regression analysis. This was done in two seperate papers that I cited above, and both found a significant link between media images and ED symptoms. You chose to look over these findings.

    When you’re building a case on correlation research, then yes, it is going to take decades. I don’t see the issue with this. I think it is highly unrepresentative to suggest that decades of research has produced nothing in the way of proof for the link.

    What exactly would you take as “proof” of the link, remembering that we have ethics committees to consider?

  60. Profile photo of Ben Mad Dog Radford
    December 29, 2010 at 8:43 pm —

    Okay, kids. It’s been fun, but I got other fires to put out (as much fun as it is exposing daedalus2u’s obvious straw man fallacies!). Just for the record:

    1) My claim is / was that the link (especially the cause-and-effect link) between media images, poor body image, and eating disorders remains in question and unproven in the general literature (despite 30 years of research)– NOT that there is no link.

    2) This claim is based upon extensive research, including the infamous Botta and Posavac articles, and 2009 Levine & Murnen study mentioned earlier.

    3) Botta and Posavac, in their different studies, each summarized the overall state of evidence for their respective links (body image/eating disorder/etc.). I accurately quoted both researchers in a short piece I wrote for Discovery News. (A quote that summarizes research from dozens or hundreds of studies over a decade or more is more accurate, honest, and useful to use than one from a single study, or handful of studies.) The quotes I used clearly referred to overall research findings, and not to any specific studies by Botta, Posavac, or anyone else.

    4) Rebecca researched the articles I cited, and ignored the purpose and context of the quotes I used (which accurately reflected overall findings showing there was no proven link), instead selecting references to individual studies that did find some evidence for a link. She concluded that the information she found contradicted my (and Botta’s and Posavac’s) claims, but it did not. Their statements, which I quoted, were accurate and correct.

    No one’s words were taken out of context or twisted. We are simply talking about two different things: I was discussing overall trends, Rebecca was citing specific studies. It’s like me quoting a report from the restaurant industry that says fast food profits were up 10% across the country last year, and Rebecca quoting the same report pointing out that some restaurants in Texas and Montana lost money or went bankrupt. Both may be true, and one does not refute or contradict the other. The studies that Rebecca picked from Botta and Posavac do not reflect the general consensus regarding the overall strength of the evidence for a link; the quotes I selected from Botta and Posavac do. If anyone can point me to evidence of a consensus among researchers that the link has been proven, please let me know.

    Rebecca seems to admit that the quotes I used from both studies are accurate, but she claims that they are specific to just the measures cited (fair enough), and not relevant to whether or not a link has been proven between mass media and eating disorders generally. Readers can decide for themselves whether these quotes are relevant to the topic of media exposure, thin images, and body disturbance: “the relationship between television exposure and body image disturbance remains in question,” and “concrete evidence is still necessary…to show that this existence of thin images and ideals has an effect on viewers.”

    Rebecca is correct that “body image disturbance” is not exactly the same measure as “eating disorders,” though the two are closely related, and the distinction would be lost on 99% of Discovery News readers, the audience I was writing for. Furthermore, the quotes speak for themselves; they were not changed or taken out of context, the exact measures were clearly stated for all to see. There’s nothing misleading or dishonest about it. If anyone was misled by my piece, or misunderstood what I was claiming, then I apologize. The column was read by thousands of people, and Rebecca is apparently the only person who felt it was confusing or misleading. But that misunderstanding is clearly not the same as dishonestly taking quotes out of context; there’s no evidence of that at all.

  61. Profile photo of daedalus2u
    December 29, 2010 at 10:07 pm —

    @Ben Mad Dog Radford: The Botta quote which you used was from 1999, and said “Concrete evidence is still necessary…to show that this existence of thin images and ideals has an effect on viewers.” What that statement is saying is that more research is necessary.

    It is now almost 2011. There has been a lot of research done in the past 12 years. What you are doing is called “cherry picking”.

    It is disingenuous to quote a 12 year old statement about the state of the art of research that is ongoing and pretend that because it “represents” decades of research that is 12, 22, 32, and more years old, that it is still representative of current research. If an old quote is wrong, it is fraud to continue to use it after you know (or should have known) that it is wrong. You could even say it represents centuries of research, even millennia of research. When old research is superseded, we don’t cite it any more, unless we are trying to be deceptive.

    Just by reading what you have said, I think you are a denialist. If you write like a denialist, you shouldn’t be upset when people call you on being a denialist.

    “Anorexia is a tragic disease; some young women (and men) do diet to excess and have body image issues. But the scientific research shows that they are the exception, not the rule. The first step in solving a problem is correctly understanding it, and TV shows like “The Price of Beauty” may actually end up doing more harm than good.”

    “Since research suggests that the causes of anorexia have more to do with genetics than thin fashion models, efforts to educate young girls about the artificiality of airbrushed media images won’t do anything to treat or cure anorexia. Girls and young women deserve facts and truth instead of myths and misinformation.

    So where is that “research” on the genetics of anorexia that shows that educating women “won’t do anything”?

    You cited the Bulik CM review of 2007. What she said is “Family studies have consistently demonstrated that anorexia nervosa runs in families.” In terms of genetics work, that is an old review, there wasn’t much genetic data to actually consider at that time. What there was was twin data, which is not cleanly genetic because twins share an in utero environment for 99.999999%+ of their growth and development (their time in utero where they grow from a single cell and differentiate to ~10^11 cells). Running in families is not the same as “genetic”. Speaking English runs in families too, to an even higher degree than does anorexia, but we know speaking English isn’t genetic.

    I have not read this review, I am too cheap to pay for it and won’t get to the library for a while. Many (probably most) genetics researchers have vastly over estimated the power of twin studies to show genetic effects. The newer studies where they actually look at genes are showing that the genetics is either much much more complicated or these so-called “complex genetic disorders” (so-called because they can’t find the genes) are not due to genetics at all. The latter is my hypothesis, the gene researchers haven’t opened their minds to even considering that hypothesis, they just call for larger and larger whole genome studies. The one cited below had over 1,000 subjects and found nothing significant.

    Look at what Bulik CM has written since (open access from PubMed only). In this:

    http://www.ncbi.nlm.nih.gov/pubmed/19014858

    she says (page 8 ) (a warning seemingly presciently directed at you, but which you have ignored)

    “Media—One potential pitfall of genetic research on eating disorders is the misinterpretation that environmental factors such as the media do not matter. Western media’s idealization of an ultra-thin female body type has long been viewed as an important sociocultural risk factor for eating disorders [72,73]. However, given the ubiquity of this influence in Western cultures, other factors must influence vulnerability to the thin cultural ideal. As Bulik [1] suggests, genetically vulnerable individuals might seek out experiences, such as exposure to thin-ideal media images, which reinforce their negative body image. This hypothesis is supported by a longitudinal study which found that adolescent girls whose eating disorder symptomatology increased over a 16 month period also reported significantly greater fashion magazine reading at Time 2, compared with Time 1 [74].”

    In this one

    http://www.ncbi.nlm.nih.gov/pubmed/20191112

    they say (in the abstract)

    “Molecular genetic research, including genome wide linkage and case control association studies, have not been successful in identifying DNA variants that are unequivocally involved in the etiology of AN.”

    In this one

    http://www.ncbi.nlm.nih.gov/pubmed/20468064

    they say (in the abstract):

    “We performed association studies with 5,151 SNPs that were judged as likely candidate genetic variations conferring susceptibility to anorexia nervosa (AN) based on location under reported linkage peaks, previous results in the literature (182 candidate genes), brain expression, biological plausibility, and estrogen responsivity. We employed a case–control design that tested each SNP individually as well as haplotypes derived from these SNPs in 1,085 case individuals with AN diagnoses and 677 control individuals. We also performed separate association analyses using three increasingly restrictive case definitions for AN: all individuals with any subtype of AN (All AN: n = 1,085); individuals with AN with no binge eating behavior (AN with No Binge Eating: n = 687); and individuals with the restricting subtype of AN (Restricting AN: n = 421). After accounting for multiple comparisons, there were no statistically significant associations for any individual SNP or haplotype block with any definition of illness.”

    So, since the review you cited, the author of that review has published multiple things saying that eating disorders are not solely due to genetics and that the hypothesis that genetics is what causes eating disorders remains unproven.

    The 2009 article by Levine & Murnen talks about 7 criteria. So what are those 7 criteria and how does the “genetics causes anorexia” hypothesis stand up?

    “Thus, this review uses seven criteria to evaluate the status of mass media as a causal risk for negative body image and disordered eating. Content and exposure are foundational, so we will consider
    them criteria 1 and 2. The Kraemer-Stice standards are criteria 3 through 6, and the existence and impact of subjective experiences of media pressures and influence constitute criterion 7.”

    1 and 2, content and exposure: Have any genes been identified as being associated with anorexia and that individuals with those genes have a higher incidence of anorexia? No, and no.

    3. “The presence of a positive correlation between level of exposure to mass media, or to certain types of mass media, and the spectrum of disordered eating is a necessary but not sufficient condition for determination of causal agency. However, absence of a positive correlation negates the argument for causality.”

    Any evidence for a positive correlation between any genes, or any combination of genes to anorexia? No.

    4. “A causal risk factor precedes and predicts development of a problem. Consequently, longitudinal studies are critically important for identifying causal risk factors.”

    Any longitudinal studies showing presence or absence of certain genes leads to later development of anorexia? No.

    5. “Laboratory experiments cannot settle the question of correlation and causal agency in a developmental sense. However, experimentation can help determine whether, as predicted by a causal risk factor model, concentrated media exposure actually makes girls and women feel immediately worse or better about their bodies and their selves.”

    Any experimental studies showing presence of certain genes or genetic factors cause anorexia? No.

    6. “If media effects are a causal risk factor, then reduction or elimination of negative media influences should reduce or prevent negative body image and other processes that eventually result in eating disorders. One way to test this proposition is to evaluate the impact of interventions designed to promote “media literacy.”

    Any studies showing the absence of certain genes prevents or reduces anorexia? No.

    7. Subjective influence: Motives, pressures and Ideals: One sensible way to add to our understanding of media effects is to ask people about their experiences with media “pressures” and “influences.”

    This might not be applicable to genetics. So the idea that anorexia is primarily a genetic disorder doesn’t meet any of these 7 criteria, no genes have been identified. But for the “thin images in media cause anorexia” there is this:

    “In sum, of the 7 criteria, there is strong evidence for Criteria 1, 2, 5, and 7, and solid evidence for Criterion 3. However, the evidence for two of the most important criteria—4 (factor precedes and predicts) and 6 (reducing the risk factor prevents the disorder)—is encouraging but complicated, preliminary, and inconclusive.”

    So based on this, you conclude that the idea that media has influences on anorexia is “a myth”, and that the influence of genetics is so strong that education won’t do anything? I agree with you that “Girls and young women deserve facts and truth instead of myths and misinformation.” Unfortunately that is not what they get from reading your article.

  62. Profile photo of ShanePB
    December 30, 2010 at 12:20 pm —

    I’m once again disappointed by the skeptical community and it’s use of ad hominem attacks on people when the look at data differently.

    Calling Ben “thick”, a “denialist” or dishonest, all because he looked at data and came to a different conclusion. Second time in a month that skeptics have failed.

  63. Profile photo of daedalus2u
    December 30, 2010 at 3:33 pm —

    @ShanePB: Ben didn’t look at the data and come to a different conclusion. He had a conclusion, then looked for data to support it and ignored data that didn’t fit the point he was trying to make, a point which happened to be wrong. The idea that media images have no effect body image or anorexia is wrong, and has been shown to be wrong to a high degree of proof. Multiple studies have shown it, meta-analysis of multiple studies has shown it. He is still refusing to look at the data that shows his position is wrong. That makes him a denialist.

    What I found especially disingenuous was when @Cint: pointed out that if your “standard of proof” was to expose girls in a lab to thin media images and give them an eating disorder. His reply @Ben Mad Dog Radford: was to say that makes the question “unfalsifiable”. To which I say, what a POS. The reason the experiment can’t be done is because of ethics. The same reason a vaccinated-unvaccinated study to look at autism causation can’t be done. It is unethical to not vaccinate children and so risk them being injured and dying from vaccine preventable diseases, it is unethical to try and cause eating disorders in young women. What a disingenuous POS. Maybe he was just trolling.

    When you are a skeptic, you don’t get to make up your own facts. If you claim to be a skeptic, and want to be in the company of other skeptics, when you do make up your own facts (as Ben has done), other skeptics owe it to you to call you on your BS. That is the common courtesy that skeptics show each other. Skeptics don’t let other skeptics make up their own facts.

    It really is distressing when someone pretends to be a skeptic but doesn’t actually do skeptical thinking and it is especially upsetting when that person holds themselves out as some expert, and even more distressing when they gratuitously lie about the issue under discussion. I appreciate that calling someone on a gratuitous lie is distressing, but that is what Ben has done. Sorry if it is so harsh.

    In his comment #60 above, Ben says

    “Rebecca is correct that “body image disturbance” is not exactly the same measure as “eating disorders,” though the two are closely related, and the distinction would be lost on 99% of Discovery News readers, the audience I was writing for. Furthermore, the quotes speak for themselves; they were not changed or taken out of context, the exact measures were clearly stated for all to see. There’s nothing misleading or dishonest about it. If anyone was misled by my piece, or misunderstood what I was claiming, then I apologize. The column was read by thousands of people, and Rebecca is apparently the only person who felt it was confusing or misleading. But that misunderstanding is clearly not the same as dishonestly taking quotes out of context; there’s no evidence of that at all.”

    The idea that Rebecca is the only person who had issues with his take on anorexia and the media was Rebecca, that none of his thousands of readers had an issue with it. If you look at the comments that followed his blog in March 2010, you can see that statement is false.

    http://news.discovery.com/human/new-tv-show-perpetuates-anorexia-myths.html

    I see 30 comments, 11 of those are from Ben. Of those remaining I count about 6-7 commenters who disagreed with the article, some of them in multiple comments. About half the comments raised objections. Of course Ben simply dismisses their disagreement with his own projection. People call him on his ignorance, he turns around and calls them ignorant.

    “1) It’s interesting how many people assume that if someone disagrees with them, it’s because the other person is ignorant, or hasn’t done enough research, or doesn’t have their facts right. It doesn’t seem to occur to them that perhaps they haven’t read the same studies, or that maybe sincere, informed people can have honest disagreements about the interpretation of studies.”

    “2) None of the posters here addressed the topic of the piece: that there is little or no scientific evidence for a connection between the mental illness anorexia and thin models. Everyone is welcome to their opinions, but no one has yet come up with any studies or research that contradicts the conclusions of experts that were quoted in peer-reviewed medical journals.”

    Of course when Ben is unwilling (unable?) to read and understand scientific literature, and is unable to appreciate his lack of expertise, he exhibits the Dunning-Kruger effect.

    http://en.wikipedia.org/wiki/Dunning%E2%80%93Kruger_effect

    When he says that 99% of his readers would not be able to tell the difference, what he is really saying is that the difference doesn’t matter, so he won’t bother to make it.

    He makes mistakes and is unable to appreciate that they are mistakes even when they are pointed out to him in explicit detail. I guess what he means when he says none of his thousands of readers had an issue with it is that none of them were able to articulate their objections in ways that he could understand and could then appreciate his mistakes. I point them out in a fair amount of detail in my long comment above. Some of the mistakes he makes are pretty common, for example:

    “runs in families” does not mean “is caused by genes”. Language runs in families too.

    “genes are important in disease causation” does not mean “nothing else is important”

    “only a small fraction of exposed are affected” does not mean “exposure is not causal” Only a small fraction of people who are exposed to flu, measles, chickenpox, mumps, etc. die from their exposure. Does that prove that those diseases don’t cause death?

    Bora wrote about why many science journalists write stuff that is so bad. They simply don’t have the time to become sufficiently expert in the fields they are writing about to understand how ignorant they are.

    http://scienceblogs.com/clock/2010/03/new_science_journalism_ecosyst.php

    It is unfortunate when people who are trying to be science journalists can’t acknowledge and learn from their mistakes, but instead use disingenuous rhetoric to spin.

    Anorexia and eating disorders is not my field. I just don’t want young women put at risk because of misguided ignorance like this.

  64. Profile photo of Ben Mad Dog Radford
    December 31, 2010 at 12:59 pm —

    Two final things:

    1) daedalus2u: Sorry, dude, your credibility went down the toilet about eight posts ago, when you compared me to global warming denier, stated that your off-the-cuff analysis overturns decades of published psychological research, and made up a story about fictional “body dysmorphic deniers.”

    2) There’s one more point that’s worth noting, and that has been missed amid all this discussion: Rebecca claims that I took quotes from two researchers, Renee Botta and Heidi Posavac (et al.), out of context. Recall that the quotes were used in a short piece about whether the link between media images and eating disorders has been proven or not.

    Ultimately, this is not a “He said / She said” issue. Only the authors, Botta and Posavac, are fully qualified to judge whether the quotes I used from their work were misleading or “taken out of context” or not.

    Rebecca’s personal opinion about the matter means nothing; she can cite all the quotes she wants from whatever studies she likes, but no one is better qualified to decide the matter than the authors.

    The burden of proof, of course, lies with the claimant. Rebecca made the claim that the quotes I selected were misleadingly used, and it is up to her to prove that. Barbara Drescher and I have addressed her concerns at length, and Rebby has failed to offer the one piece of evidence that would decide the matter one way or the other: a statement from either Botta or Posavac stating that my quotes were in fact inaccurate or taken out of context, as she claims.

    I believe they clearly were not: the researchers were correctly and accurately quoted summarizing the overall state of evidence about the respective links. The subject of the piece I wrote was NOT whether Botta, Posavac, or any other individual researcher had found some evidence in support of a link; the subject of the piece was whether or not the link (or even elements of that link) had been proven in the general literature, and both researchers wrote that it had not. I merely quoted them.

    The short article containing the quotes that Rebecca cites was posted March 8. There has been most of a year for the researchers (or anyone else) to contact me pointing out that the quotes were taken out of context. No one did, until Rebecca’s post a few days ago. Rebecca said she was going to contact one of the authors several weeks ago to help settle the matter…

    If Rebecca can provide a quote or statement from either researcher stating that she believes my quoting of their material was misleading, or dishonest, or taken out of context (given that my piece was a short, popular article and not a lengthy scholarly one), I will contact the researcher to verify the statement and happily admit I was wrong and acknowledge my mistake.

    It’s a shame that Rebecca did not obtain this definitive evidence from either researcher before publicly accusing me of intentionally taking words out of context. If the situation was reversed, I would have shown more respect and generosity toward her. I would have given her the benefit of the doubt (and offered much better evidence of error or malicious intent) before accusing a colleague of “dishonesty.”

  65. Profile photo of daedalus2u
    December 31, 2010 at 4:24 pm —

    @Ben Mad Dog Radford: I appreciate you don’t understand the scientific issues.

    I appreciate you don’t appreciate that you don’t understand.

    I appreciate that that is why you are arguing using fallacious reasoning (i.e. rhetoric) rather than arguing about facts and logic.

    Not appreciating that you don’t understand, and dismissing the facts, logic and arguments put forth by people who do understand makes you a denialist. Sorry if that label hurts, learn the field and you will see that the label is appropriate.

    http://en.wikipedia.org/wiki/Denialist

    Denial can be a gigantic part of body dysmorphic disorder. Denial by people who have it, that they do have it is one of the things that makes it so difficult to treat. Denial by friends and family of those who have it also makes it more difficult to treat. Denial by the larger community that there is such a thing, what causes it and how to prevent and treat it also makes it more difficult to treat, and much more difficult for people to appreciate they need treatment and to find it acceptable to seek treatment. Eating disorders have the highest fatality rate of all neuropsychiactric disorders. Women with eating disorders have a ~25 year reduction in life span. As in all things, prevention is better than treatment and cure.

    Whether I call you a denialist or a poopy head doesn’t change my credibility or your credibility, or the facts and logic of your or my arguments. I appreciate that people who don’t know what the facts are, instead rely on non-facts to try and figure things out.

    Rebecca had multiple claims. Her first claim, in the opening paragraph of her piece was that you were “asserting that the movie Black Swan “cannot “encourage” anorexia, any more than photographs of depressed patients can “encourage” clinical depression.”

    Rebecca writes “In that article, Radford asserts that “The idea that a model, photo of a model, or Web site can “encourage” anorexia is not supported by science or research.” He cites several papers to support that assertion, and the average layperson might be easily convinced that the science is on his side.”

    When I said I agreed with Rebecca, I was meaning I agreed with her claim that you had taken the quotes out of context (which you did), and that those quotes and statements did not represent the actual scientific understanding of the role of media and genetics in body dysmorphic disorder (which they do not).

    That you were able to use rhetoric to trick Rebecca into thinking that the quotes were not out of context does not change my considered assessment that they are and remain out of context. That you were able to trick Rebecca into thinking that genetics is so important in body dysmorphic syndrome that media images are unimportant also does not change my considered assessment that the statement is false.

    Usually the way that skeptics and scientists resolve disputes is via more and better data, and more logic applied to that data. Your approach is to become hyper-technical and precisely dissect quotes, while ignoring the meaning and the data behind those quotes, and glossing over the conclusions you reached which didn’t follow from the quotes anyway.

    My concern is not with the precision of your quotes, but with the false conclusions and false messages you are spreading, the idea that media images are unimportant in eating disorders. The idea that media images are important in eating disorders is a myth.

    The issue I am concerned about is not whether you precisely quoted some 12 year old study. Obviously a 12 year old study can’t be up to date. No matter how precise, the quote of a 12 year old study can’t be up to date. I appreciate the reason you are holding on to that 12 year old quote is because more recent research refutes it. The 12 year old quote was essentially saying that there wasn’t enough research yet. Guess what, there has been more research in the intervening 12 years, research that you don’t want to consider. When people want to actually understand something, they look to recent data, not old data. They do so especially when earlier the earlier conclusions said there wasn’t enough data. Why do you not want to look at recent data? It seems pretty clearly because you don’t like what the recent data says. From the Wiki article on characteristics of denialism:

    “2.Cherry picking — Selecting an anomalous critical paper supporting their idea, or using outdated, flawed, and discredited papers in order to make their opponents look like they base their ideas on weak research.” Cherry picking out dated paper? Check.

    Now you say “Recall that the quotes were used in a short piece about whether the link between media images and eating disorders has been proven or not”, which is not correct. In your article you said:

    “The idea that a model, photo of a model, or Web site can “encourage” anorexia is not supported by science or research.”

    which is false. There is supporting research, there is not “proof”. Raising the bar of “proof” is classic denialist behavior:

    “4.Moving the goalpost — Dismissing evidence presented in response to a specific claim by continually demanding some other (often greater) piece of evidence. In other words, after an attempt has been made to score a goal, the goalposts are moved to exclude the attempt. Thus denialists use the absence of complete and absolute knowledge to prevent the implementation of sound policies, or the acceptance of an idea or theory.”

    Now you say that only the authors of the quotes are competent to judge whether they were taken out of context. Again, moving the goalposts.

    Now you want a statement from the authors that their 12 and 13 year statements were taken out of context? Again, moving the goalposts. If Rebecca supplied it, would you then want the statements taken under oath and notarized?

    In your statement above you say “the subject of the piece was whether or not the link (or even elements of that link) had been proven in the general literature, and both researchers wrote that it had not.” is not what your piece said. You said:

    “The idea that a model, photo of a model, or Web site can “encourage” anorexia is not supported by science or research.”

    Your article didn’t conclude there was evidence but no proof, it said the idea was not supported by science or research. It called the idea that media images can influence body image and anorexia a “myth”.

    Sorry to be so harsh, and to call you on being a denialist, but that is what you are doing. You say one thing in your article, are called on it and rather than appreciate that you said something that was factually wrong and inconsistent with the research, you dig in and morph what you think you said into something different, move the goalposts and come up with all kinds of rhetorical and fallacious devices to “win” the argument, being hypertechnical about quote precision and missing the meaning behind the quotes, exhibiting faux outrage that someone would question the precision of your quotes. The problem I have isn’t with the precision of your quotes, but with the wrong conclusion you (mis)derive from them.

    In case you haven’t heard, Isabelle Caro has died.

    http://en.wikipedia.org/wiki/Isabelle_Caro

    http://www.foodconsumer.org/newsite/2/other_diseases/isabelle_caro_1231100242.html

  66. Profile photo of Xiira
    January 1, 2011 at 12:57 am —

    I haven’t read all of the comments so I don’t know if it’s been addressed or not, but what a lot of people don’t get is that eating disorders are not all about body image. They’re an abnormal way to handle stress or some other problem(s). I’m recovering from anorexia and have had a disordered relationship with food since I was a kid – I have memories of not eating very much at all when I was as young as eight. I wasn’t idealizing images of thin women and I wasn’t obsessing over my weight until 18 years old; didn’t even know it was a problem. Obsessing over weight and food is always a cover-up for some deeper issue. I will tell you that the obsession over dieting and the “obesity epidemic” is definitely making it very hard to recover however, and I have no doubt in my mind that it does trigger eating disorders in people predisposed to it.

    As to why that there are a lot of heavy people in a nation of dieting – dieting doesn’t work in the long term. Any weight lost will eventually be gained back plus 10%. That and people naturally come in all shapes and sizes and there’s not a damn thing you can do about it.

  67. Profile photo of Mimmoth
    January 1, 2011 at 11:23 am —

    Ben used a four dot ellipsis to jam together two sentences 1,800 (roughly) words apart.

    Standard practice in those circumstances is to end the quote and start a new one; unlike an ellipsis, that doesn’t imply that the two sentences are within a paragraph or two of each other.

    Plus, a skeptic who comes to a different conclusion than the paper’s author(s) did, but thinks the background section is better than anything he or she could produce would say something like “Though I disagree with {author} her (pardon me; this would have been”his”) analysis of the background is so excellent I will quote it here” and then does. Instead of giving the impression that the author supports the “skeptic’s” position.

    Nor is it reassuring that the most excellent analysis of the background Ben can find–so excellent he quotes it instead of coming up with his own–is, as daedalus2u points out, more than a decade old. Is this a field in which nothing is happening?

    Sure, the quotes are “correct” in the sense that every word in the quote is present in the article, in the order quoted, with deletions marked by ellipses. Any quote miner can say the same thing. The standard needs to be set a little higher than that.

  68. Profile photo of Luthien
    January 2, 2011 at 7:43 pm —

    Huh. Don’t know who Ben Radford is, but seems like Rebecca was right to call BS, especially since his response in this comments section has been really disingenuous in a lot of ways. Sounds like he has good skeptic cred in other ways, but his arguments here do not make sense.
    @daedalus2u: Thanks for linking the meta-study, that’s what I was wondering.

  69. Profile photo of daedalus2u
    January 2, 2011 at 8:49 pm —

    There was a really good statement by titmouse about what science is over at ERV

    http://scienceblogs.com/erv/2010/12/xmrv_erv.php#comment-3033939

    “A conclusion based upon available evidence isn’t the same thing as “bias.” New evidence will lead to revisions of previous conclusions. No big whoop.”

    “In science you don’t get gold stars for being “right all along” like in the movies. You only get points for weighing the *available* evidence appropriately.

    “If you bet against the available evidence and it turns out you’re right, that’s just dumb luck. It’s not impressive.

    In many fields, especially those that are on the edge of understanding, that understanding changes over time. To be and remain expert in a field, you have to understand how it is changing and adapt your understanding to it. Many scientist can’t do that. That is the source of the Max Plank quote:

    “A new scientific truth does not triumph by convincing its opponents and making them see the light, but rather because its opponents eventually die, and a new generation grow up that is familiar with it.” –Max Planck

    The conservatism of many senior scientists is a significant impediment to progress. It slows things down, but does weed out a lot of bad ideas. It also weeds out good ideas that the current crop of senior scientists can’t understand. This was the problem that Barbara McClintock had. She discovered transposition in the 1940’s, and no one else understood it until the 1960’s and 1970’s.

    http://en.wikipedia.org/wiki/Barbara_McClintock

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