This article aims to help social workers who are working with eating disordered clients in clinical settings, and school social workers who are frequently in contact with females of different ages, to raise their awareness of the prevalent body image oppression in society. How does body image oppression manifest in the eating disorders (ED) and affect women’s lives pervasively? This article will focus on female body image oppression, because based on 2004 statistics, women comprise 90% of the entire eating disordered population in the United States. Most ED clients also suffer from a distorted body image.
Being more conscious of how the message of body oppression is manifested in our society will better prepare us to empower our female clients to resist its influence and to teach them to advocate against this oppression.
First, let’s look at how this oppression is manifested in different facets in society. Then, we will give some suggestions for how we, as social workers, can act proactively to help our clients approach issues of body image.
Facts About Eating Disorders
The term “eating disorders” is an umbrella designation for the various forms of illnesses that exist when a person uses harmful eating behaviors as a means to control his or her weight and body shape. Such disorders can gradually aggravate one’s physical, emotional, and behavioral development, even leading to death (Bardick, Bernes, McCulloch, Witko, Spriddle, & Roest, 2004). More than five million Americans have eating disorders, 90% of whom are adolescent and young women (National Institute of Mental Health, 2005). The mortality rate among individuals with eating disorders is more than 12 times higher than any other causes of death in females ranging in age from 15 to 24 years (Cavanaugh & Lemberg, 1999). In the past few years, more studies indicate that eating disorders are not only affecting young, white females, but also other racial and ethnic minorities in the United States. According to the Minnesota Adolescent Health Study, dieting, weight dissatisfaction, and distorted body images are found in all ethnic groups (Story, French, Neumark-Sztainer, Downes, Resnick, & Blum, 1997). In the study of Kilpatrick, Ohannessian, & Bartholomew (1999), 6,504 adolescents, Asian, Black, Hispanic, and Caucasian youth have all reported attempting to lose weight at similar rates, with Native American adolescents rating the highest level of attempt.
The number of cases shows how prevalent and destructive eating disorders are, especially for females. In recent decades, the number of cases of eating disorders and the affected age range are higher and broader than in the past. One of the key risk factors is the socially constructed ideal body—the thin female as perfect or desirable.
Many studies demonstrate that females have a strong desire to be thin (Dolan, 1994; Ferron, 1997; Hesse-Biber, 1996; McFarland, 1990; Vincent and McCabe, 2000), whereas males are more likely to be content with their body image (Vincent & McCabe, 2000). Although both genders have their culturally defined standards of attractiveness, studies show females are more vulnerable to cultural influence because of higher stress as related to their gender role and weaker power in the patriarchal society (Eldredge & Agras, 1996; Martz, Handley, & Eisler, 1995). To reach this ideal of thinness, an unrealistic standard, many women diet, undertake excessive amounts of exercise, or take diet pills or laxatives. It is common to see excessive forms of dieting gradually become self-starving, while the guilt of food intake will trigger the development of purging behaviors. Both of these unhealthy coping mechanisms are common symptoms of eating disorders. Some feminists claim that women’s obsession with weight control and dieting results from the desire for power in a sexist society (Cogan, Bhalla, Sefadedeh, & Rothblum, 1996; Eldredge & Agras, 1996). Body oppression can be manifested in many different forms in our society. We must be very conscious of it to avoid being hypnotized by it.
Body Oppression Manifested in Different Forms in Society
In the United States, thinness is associated with attractiveness, fitness, and health, whereas obesity is equated with poor health, brainlessness, lack of self control, unattractiveness, clumsiness, and ineffectiveness (Marlowe, Schneider, & Nelson, 1996; Popkin & Udry, 1998). The social desirability research in psychology also documents our prejudices against the unattractive, particularly the obese (Pipher, 1996). The majority of society seems drowned in this concept, which can be found in the job market, the mass media, schools, and romantic relationships.
Job market and placement. The social value imposed on people based on their body size causes inequality for women in job placement, and there is bias based on physical appearance in the job market (Puhl & Brownell, 2001). For example, it is very unlikely to find employers in the modeling industry, cosmetic and fashion industries, and even health promotion providers who will hire women who are fatter than the cultural ideal standard (Becker & Hamburg, 1996). It might even prove impossible for women deemed to be fat to be hired by a company to do health promotion, or for the media to use fat women in advertising (Becker & Hamburg, 1996), regardless of the type of product being advertised. A successful female image is always portrayed as slim, tall, independent, and decisive, and most of these qualities are just the opposite of how people perceive the obese. In Puhl & Brownell’s study (2001), results showed that regardless of the settings, obese people are often perceived as lacking self-discipline, having low supervisory potential, and exhibiting poor personal hygiene and professional appearance.
Mass media. The mass media, including magazines, television, and advertisements, are an influential source of images and messages about the ideal body for which women and girls are expected to strive (Botta, 1999; Field, Camargo, Taylor, Berkey, & Colditz, 1999). It is not uncommon to see how thin figures are promoted and praised in an advertisement or magazine. These thin images are often associated with wealth, prosperity, fashion, and elegance (Rathner, 2001).
Other mass media, especially those for dieting and weight-altering products, promote the idea that body shape and size are flexible, and that achieving the thin ideal is just like taking a magic pill—painless and requiring no special effort (Brownwell, 1991). No matter that the pictures are heavily edited and refined with computer software—consumers, mainly women, still believe the body type presented is realistic and reachable for everyone (Richins, 1991; Thompson & Heinberg, 1999). It pushes them to be on a ceaseless, life-long diet.
School setting or peer groups. From an early age, boys and girls are taught how to meet the societal ideals for their gender—not just how to act and talk, but what they are supposed to look like (Byrant & Creck, 2000; Bussy & Bandura, 1992; Egan & Perry, 2001; Ragg, 1998).
Research found that anorexia nervosa (AN) often begins in junior high, and bulimia nervosa (BN) tends to develop in a later stage of adolescence (Piper, 1994). High school students are already very sensitive to body shape and weight, often leading to the formation of peer pressure or mutually accepted ideal image. There is high stress among peers, who compare with each other and compete with each other, which, in turn, is a strong form of body oppression. This oppression further provokes the development of eating disorders among high school and college females (Thompson, Corwin, & Sargent, 1997). It is believed that peer/group influences usually have a tremendous role in shaping the thoughts and values of school-aged people (Irving, 2000; Hayden-Wade, Stein, Ghaderi, Saelens, Zabinski, & Wilfley, 2005). Researchers show that post-pubertal girls, especially those who are dating, may be more vulnerable to developing eating disorders because of internalizing the concept of thinness as the equivalent of beauty (Cauffiman & Steinbert, 1996).
Romantic relationships. Some studies have focused on people’s preference of romantic partners based on physical appearance, and the results showed both men and women least preferred the obese sexual partner and the partner in the wheelchair (Flegal, Carroll, & Ogden, 2002). Men also ranked the obese partner significantly lower than women did (National Center for Health Statistics, 2005). This trend reflects how social worship of thinness affects one’s thoughts and actions for both genders. This idea that thinness is preferable imposes a heavy pressure on females within their romantic relationships. It is common to find teenage females concerned about their figures because of the fear of not having a boyfriend. It is also common to see married women, regardless of the age range, on diets because of their fear of losing their husbands after aging and maternity change their body shapes (Markey & Markey, 2006).
The foundation of self-esteem. The influence of body oppression is more likely affecting people with low self-esteem or who value themselves based on social acceptance. It is important for people to recognize their intrinsic values, such as virtues or potential talents, and not to put their self-esteem solely under the social influence.
Education and prevention. In order to combat the negative influence of body oppression, social advocates, including educators, social workers, and health promoters, could bring this issue to the forefront and encourage the public to be proactive in fighting against this oppression. In addition, education to emphasize the possible severe consequences brought by this oppression, such as eating disorders, is essential. Eating disorders are very difficult to cure and there is no specific method guaranteed to be wholly effective. However, bringing up awareness of its risk factors so as to prevent it happening is essential.
Combat the social stigma of eating disorders. Eating disorders are often associated with social stigma. Individuals with eating disorders are readily misunderstood by society as the product of self-induced or self-deserved problems. In fact, research suggests that eating disorders, like all addictions, are a way to run from pain (Pipher, 1994). Studies also show that eating behaviors symbolize a desire for safety through creating a sense of control in life (Wilson, 2004). Young females may feel intense fear of moving toward womanhood because femininity in our culture is constructed as “a complex and difficult to define concept, laden with impossible cultural and personal expectation” (Wilson, 2004).
Thus, eating disorders should be addressed from a public health perspective in which primary prevention is implemented at the level of the community and educational institutions (Mensinger, 2005). Access to informaton about eating disorders helps the general public form a better understanding of the issue and will encourage those suffering to disclose the problem and seek help.
Body image oppression of females is not something new for our society. It has manifested through centuries and has negatively affected females’ self image and well being to a great extent. Even as we come to understand the underlying factors, we know that change will take time. It is, however, important to bring up this issue again to remind us, our clients, and the next generations about what oppression we are facing and how we may help ourselves and each other in this battlefield. Bringing awareness is the first step, and becoming proactive is the next. It is time for females to fight back and redeem their sense of worth, as well as their personal and collective empowerment, in this long-term battle toward understanding and acceptance.
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Ting-Ting Avis Lau, MA, MSW, is a May 2007 graduate of Washington University in St. Louis. She is originally from Hong Kong. She has been interested in the issues of eating disorders, depression, and trauma for years. Most of her studies were on topics related to eating disorders. She also has a master’s degree in linguistics.