Addressing Stigma about Eating Disorders

Attention turns to needed changes in media coverage.

Australian eating disorders specialists recently have a new incentive to address stigma and shame among persons with eating disorders. In a program begun in November 2019, the government plans to invest $110 million to subsidize eating disorders treatment services (J Eat Disord. 2020; 8:11). The 4-year plan is aimed at improving recovery of the 16% of Australians estimated to have a DSM-5 eating disorder, according to Rachel Baffsky of the University of New South Wales, Sydney, Australia. In a recent commentary, Dr. Baffsky proposes media regulations that could, in time, diminish stigma and enhance treatment-seeking.

The role of the media

Dr. Baffsky has singled out the popular media as creating stigma for people with eating disorders by reinforcing stereotypes that people with eating disorders are young and female, discounting the experiences of men and older adults. She noted that current articles in the popular press often focus on the social causes of eating disorders and ignore the biological causes. This reinforces the harmful stereotype that eating disorders are easy to recover from because they are a choice, which again creates stigma. Another element suggests that  people with eating disorders feel undervalued by the public and as a result may conceal their eating disorder for fear of being stigmatized (J Ment Health. 2016;25:47).

A number of suggestions have been made to help improve media coverage of eating disorders, according to the author. One is that media could use more precise medical language to describe eating disorders, to reduce blame-based stigma. A number of studies showed that nursing students and undergraduate psychology students, for example, showed blame-based stigma when they were presented with social causes for eating disorders.

A mandatory code with 4 sections

The author recommends that Australia develop a mandatory Industry Code of Conduct that specifically helps guide media toward a more “medicalized” approach to reporting stories about individuals with eating disorders. The Code of Conduct would include 4 sections. The first code would mandate a more demographically diverse representation of real individuals with eating disorders (Patient Educ Couns. 2007; 68:43). A second code would stress eating disorders articles that address biological etiologies for eating disorders. A third code would prohibit journalists from using derogatory language to label the symptoms of eating disorders.  Finally, a fourth code would mandate realistic reporting of times for recovery for individual eating disorders.

The author does acknowledge some limitations of the Code of Conduct approach.  One such limitation is that the Code has been criticized as being paternalistic, which is potentially problematic since persons with AN, for example, often perceive a need for control.  Also, media emphasis on a biological etiology for eating disorders might encourage the general public to perceive that a person with an eating disorder is helpless to combat an eating disorder because of the disorder’s biological and genetic origins. To counter this, a fourth code was strategically introduced to make certain that journalists accurately report that individuals with eating disorders “can and do recover if they seek help.” (The Butterfly Foundation, 2019; https://butterfly.org.au).

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