Purging: Peers and Media Influences

It might be like tilting at windmills, but if Dr. Alison E. Field and her colleagues had their way, television, movie, and magazine industries would immediately hire more models and actresses at healthy weights. Eventually, images of androgynous, underweight young women would disappear from print and screen.

The ‘Growing Up Today’ Study

The researchers assessed the relationship of peer and media influences on the risk of developing purging behaviors in a 1-year follow-up study of nearly 7,000 girls aged 9 to 14 (The Growing Up Today Study). Although questionnaires had initially been sent to boys, the analysis was restricted to girls because the incidence of purging was too low among the boys to conduct meaningful analyses.

None of the girls were purging when the study began (Arch Pediatr Adolesc Med 1999; 153:1184). The researchers used the McKnight Risk Factor Survey and the Youth Risk Behavior Surveillance System questionnaire from the Centers for Disease Control and Prevention. Seven McKnight Risk Factor Survey questions included overconcern with weight, importance of thinness to peers and adults, teasing and comments about weight by adults, social eating, and influence of the media.

One year later: 1% were purging

During the year of follow-up, 74 girls, or about 1%, started using vomiting or laxatives at least once a month to control their weight. Among the 74 girls, 54% purged less than weekly, 16% purged once a week, and 30% used vomiting or laxatives 2 or more times a week.

Personal, peer, and cultural factors were independently associated with the development of purging. Regardless of age, girls who were more mature physically were more likely than less developed peers to begin purging to control their weight. Both peers and popular culture, independent of each other, influenced the girls’ weight control beliefs and behaviors. The more effort a girl made to look like females on television, in movies, or in magazines, the higher her risk of beginning to use vomiting or laxatives to control her weight. Finally, the more girls changed their eating patterns around their peers, the more likely they were to begin purging within the next year.

Ironically, a dual message

The authors report that despite the fact that women’s magazines include articles on the dangerous and deleterious effects of severe dieting, bulimic behaviors, and maintaining a very low body weight, such issues also contain ads and features illustrated with pictures of excessively thin models. Thus, young readers get a dual message: excessive thinness can be dangerous but it is also be desirable.