UNC LAUNCHES GLOBAL EFFORT TO IDENTIFY GENES THAT CONTRIBUTE TO ANOREXIA NERVOSA

Last week marked the launch of the UNC Center of Excellence for Eating Disorders Anorexia Nervosa Genetics Initiative (ANGI) study (http://www.unceatingdisorders.org/angi). ANGI is an international research effort, with research teams at UNC and in Denmark, Sweden, and Australia working together to unlocking the mystery of anorexia nervosa. From decades of research, we know that genes influence the risk for anorexia. Early family studies found that first degree relatives of individuals with anorexia were 11 times more likely to develop AN during their lifetime than relatives of individuals with no history of anorexia (Strober et al., 2000). Later work has suggested that the heritability of anorexia, or the proportion of observable differences in anorexia between individuals due to genetic factors, is between 28% and 74% (Trace et al., 2013). However, the specific genes be contributing to anorexia nervosa risk are still unknown.

The goal of ANGI is to finally identify these genes. ANGI will recruit over 8,000 individuals with current or past history of anorexia, as well as individuals with no history of an eating disorder. Participants are asked to provide clinical information and blood samples. From this information, we will be able to explore whether there are specific genes that may increase risk for the development of anorexia. One of the most exciting aspects of ANGI is that individuals have the ability to participate from anywhere in the US! If you cannot come in to UNC, we can mail a sample kit to you and help arrange to have your blood drawn at your local laboratory at no cost to you. To say thanks, we’ll send you a $25 Amazon.com gift card! Together, we can work towards finding the cause and the cure for anorexia nervosa.

If you are interested in participating in ANGI, please email angi@unc.edu or call 919-966-3065.

References:

Strober, M., Freeman, R., Lampert, C., Diamond, J., & Kaye, W. (2000). Controlled family study of anorexia nervosa and bulimia nervosa: evidence of shared liability and transmission of partial syndromes. American Journal of Psychiatry, 157, 393-401.

Trace, S.E., Baker, J.H., Peñas-Lledó E, Bulik, C.M. (2013). The genetics of eating disorders. Annual Review of Clinical Psychology, 9, 589-620.

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UNC Science Expo

On Saturday, April 13, 2013, the UNC science community gathered along Cameron Avenue in Chapel Hill, NC for the second annual UNC Science Expo hosted by the Morehead Planetarium. The UNC Center of Excellence for Eating Disorders featured a booth at the event, along with over 80 other exhibitors and 100 hands-on activities, demos, lab tours, stage presentations, and more. Lindsey and I spent the beautiful spring day showing the rubber hand illusion to the science enthusiasts. For a detailed account of the rubber hand illusion, please visit Katie Weinel’s blog post from January 2013 (click here).

Everyone from young students on field trips to adults seeking new knowledge flocked to our booth to learn about the rubber hand illusion. A fake hand sure attracts a lot of attention! After explaining the basic purpose of our study, the measures that were employed, the target population, and the general findings, we gave people the opportunity to participate. Everyone really loved it and thought it was an interesting project! In addition, some people were curious about the general topic of eating disorders. It was nice to educate and openly discuss our area of study while hopefully reducing the stigma and stereotypes associated with these disorders.

Attending the science expo was UNC’s new chancellor-elect, Carol Folt. As a former research instructor in biological sciences at Dartmouth College, Folt represents and supports women in science. Her personal research interests include metal toxicity and the effects that dietary mercury and arsenic have on aquatic and human life. We welcome UNC’s first female chancellor, and we are glad she celebrated with us for a day of science!

Overall, it was fun to be able to share the rubber hand illusion with my fellow Tar Heel community. The greatest thing I took away from the expo was the feeling of all-around excitement and passion for science on the UNC campus, especially from the youth. Carolina can look forward to a lot of bright, young scientists in its future!

By: Morgan Walker

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Reaching Adolescent Boys in the Treatment of Eating Disorders: What We Can Learn from the Help-Seeking Literature

Boys are beyond the range of anybody’s sure understanding, at least when they are between the ages of 18 months and 90 years – James Thurber

As a clinical psychologist working in the field of eating disorders, when people find out what I do, I am often asked, “Do you ever see teenage boys struggling with eating disorders?” I try to answer this question as directly and honestly as possible. “Yes, but far less often that I would expect”. People seem surprised by this answer, both that boys struggle with eating disorders and that I would expect to see more of them presenting for treatment. Let’s look at the facts.

- Adolescent males comprise approximately 5-15% of cases of anorexia nervosa and bulimia nervosa (Becker, Grinspoon, Klibanski, & Herzog, 1999).

- Approximately 40% of cases of binge eating disorder (BED) occur among adolescent males (Becker et al., 1999).

- Kjelsås and colleagues (2004) found that 6.5% of males met diagnostic criteria for an eating disorder, with most males meeting diagnostic criteria for Eating Disorder Not Otherwise Specified (EDNOS).

- A recent study by Dominé and colleagues (2009) found that approximately half of adolescent males in a community sample reported experiencing some concern about their eating, with approximately 20% describing having engaged in at least one type of disordered eating behavior (e.g., self-induced vomiting).

- The National Eating Disorders Association estimates approximately 10 million males in the United States struggle with an eating disorder.

So I am left wondering, why is it that we do not we see many males in treatment, and what are the barriers? Some have argued that current diagnostic classification systems (e.g., DSM-IV) could do better at capturing adolescent males’ experiences of eating disorders and that clinicians have a higher threshold for diagnosing eating disorders in males (Muise et al., 2003). Others, like Dr. James Lock, have commented that valid and reliable measures of boys’ symptomology are lacking. In general, what we know is that they are out there, and they are not getting help. A recent piece on ABC News entitled, Men with Eating Disorders Have Tougher Time Getting Help, highlights the struggle adult males and their families go through to access services and points to answers from the world’s leading professionals on why this may be the case (please see link to story below).

Help-Seeking Behavior as a Barrier for Reaching Males

We face a number of barriers when reaching males with eating disorders. At the individual level, one major challenge is help seeking behavior. There are two sources from which adolescents generally seek help: informal sources, such as family and friends, and more formal sources (e.g., guidance counselors, physicians, psychologists, etc.). Help seeking can be divided into three stages: (1) recognizing there is an issue; (2) deciding to seek assistance actively for the issue; and (3) selecting a source of help (Anderson, 1995). Unfortunately, only a small proportion of youth will seek out professional sources of help when faced with a serious problem. In fact, the National Survey of Mental Health and Wellbeing revealed that only 29% of youth with a mental health concern had actually sought professional help over a one year period (Sawyer et al., 2000). It is also known that boys, in general, are less likely to seek help than girls, and that even when they do seek assistance, they are more likely to turn first to informal sources like friends and family before they consult a professional (Boldero & Fallon, 1995; Schonert-Reichl & Muller, 1996). This becomes even more complicated within the field of eating disorders when we take into consideration that adolescents with eating disorders present a unique challenge; the illness is ego-syntonic (i.e., consistent with one’s self-image; not something a person wants to get rid of)  in that youth typically do not want to engage in recommended treatment in the first place. Not only does this place them at greater risk for not seeking help and being formally identified, but it also increases the chances of treatment dropout when they do actually access formal sources of support.

Reaching and Engaging Boys in Treatment

There are a number of ways we can facilitate adolescent males’ engagement in help seeking. First, knowledge is power and a catalyst for change. Providing adolescent males with psychoeducation on the nature of eating disorders and the role of biology and genetics has been suggested to help with reducing stigma surrounding seeking formal support. Although the data on how effective this is as a strategy in males is lacking. Helping them to understand that biology is at play, but that biology is not necessarily destiny may be essential. Second, seeking out boy’s informal support networks (e.g., friends, teachers, athletic trainers, and coaches) and educating them about eating disorders and how they manifest specifically in boys is important. We cannot expect the informal sources of support to be able to recognize the signs and symptoms unless they are aware of those signs themselves. Further, we need to begin to challenge some of the common misperceptions that get in the way of us seeking support for the males in our lives (our fathers, sons, friends etc.). Challenging thoughts like “he is just stretching out”, “don’t worry, he will fill out”, or “he is just going through an exercise phase or a healthy phase” will go a long way in facilitating formal help-seeking.

Lastly, in order to have someone be willing to seek help, they must perceive that it will in fact be helpful. Perceived helpfulness is an important variable that can positively impact the decision to seek professional care. Many of the traditional approaches to treatment are perceived as undesirable to boys (e.g., sitting in talk therapy), even though they may result in symptom reduction. Boys actually report finding action-oriented services that utilize multimedia activities, sports and recreation, and a hands on approach more helpful than traditional counseling (Smith 2004). Combining therapy methods that have been shown to be effective while integrating action oriented treatments (e.g., Cognitive Behavioral Therapy offered online, Cognitive Remediation Therapy) may help to get boys engaged and on the road to recovery.  We need more research on how best to adapt treatments for boys that incorporate these principles known to make a difference in how boys engage in and respond to treatment.

Selected References

ABC News (Feb., 2013). Men with eating disorders have a tougher time  getting help.   http://abcnews.go.com/Health/anorexic-men-harder-time-diagnosis-treatment/story? id=18591296#.UWxUb7Xqn44

Becker A. E., Grinspoon S. K., Klibanski A., & Herzog D. (1999). Eating     disorders. New England Journal of Medicine, 24, 1092–1098.

Boldero, J., & Fallon, B. (1996).  Adolescent help-seeking behavior: What do they get help for and from whom? Journal of Adolescence, 18, 193-209.

Dominé F., Berchtold A., Akré C., et al. (2009). Disordered eating behaviors: What about boys? Journal of Adolescent Health, 44, 111-17.

Muise, A.M., Stein, D., & Arbess, G. (2003). Eating disorders in adolescent boys: A review of the adolescent and young adult literature. Journal of Adolescent Health, 33, 427-35.

Schonert-Reichl, K., & Muller, J. (1995). Correlates of help-seeking behavior in adolescence. Journal of Youth and Adolescence, 25, 705-731.

Smith, J. M. (2004). Adolescent males’ views on the use of mental health counseling services. Adolescence, 39, 77-82.

By: Brad Mac Neil, PhD, Licensed Clinical Psychologist

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Me, My Son, and My Eating Disorder

I had the honor of appearing on a HuffPostLive segment with Jennifer Rhodes where we discussed various topics related to pregnancy, parenting, and eating disorders. You can view that segment here: http://live.huffingtonpost.com/r/segment/pregnant-anorexia-eating-disorders/514b469378c90a2ee800007c. I invited Jennifer to write a guest blog post for Exchanges, and she wrote this wonderful piece sharing her experiences of being the mother of a boy. Thanks to Jennifer for sharing her very honest story with our readers. You can read more by Jennifer on pregnancy and eating disorders at http://www.babble.com/pregnancy/my-pregnancy/anorexic-pregnancy-weight-gain/. -Cynthia Bulik, PhD

*Trigger caution: We care deeply about the well-being and comfort of the readers of this blog. If you are prone to being triggered by reading about others’ eating disorder-related thoughts or experiences, you may choose to exercise caution and/or seek support before reading this post. The take-home message is very important; however, the author is explicit about her struggles.

Me, My Son, and My Eating Disorder

I awoke in a draped-off recovery area, groggy from an unplanned C-section. Due to a dramatic plummet in my blood’s platelets during labor, the procedure had to be performed under general anesthesia. Next to me in a bassinet, my newborn baby slept soundly.

“Is my baby ok?” I called out, half-panicking, to anyone who was within earshot.

“He’s perfect,” answered a nurse, making her way through the curtains.

“He? It’s a boy?” I had resisted the urge to find out the sex of my baby, instead wanting to be surprised.

“It’s a boy!” she smiled.

It’s a boy. I can stop fighting my anorexia, I remember thinking. I don’t have to worry about passing my eating disorder on to a boy. Sure, boys aren’t immune to disordered eating but, I figured, he would not be nearly as prone as a girl to inheriting my preoccupation with thunder thighs, muffin-tops and a bloated belly. I’d continue the sound eating practices I’d established during pregnancy so as to stay physically healthy but even if the neuroses lingered, with a boy, nothing would be passed on. It’s safe to stop fighting, I decided.

I decided wrong. While the likelihood of a boy developing an eating disorder is statistically lower than that of a girl, I hadn’t factored in one very important fact: regardless of whether or not my son developed an eating disorder himself (which, admittedly, he still could), the way I sized myself up was going to have a lasting impact on the way my son sized up other women.

After my son was born I was able to drop the pregnancy weight rather quickly; when I was discharged from the hospital I had only 5 pounds left to lose. However, even after those extra pounds were gone, my weight had redistributed and my body was irreversibly changed. I suddenly had love handles, which I’d never had and did not love. My stretched-out stomach bloated to second trimester-proportions after eating. My still-swollen c-section scar formed a sausage-like ridge, visible under my jeans.

I spent many days weeping over the loss of my anorexic figure, which I knew I’d never regain, not just because of the pregnancy but because it wasn’t in the best interest of my son (or myself) to starve down to a “comfortable” size.  In those early days I’d spend naptimes scrutinizing my new body in great detail, pinching, poking and prodding the unwelcome lumps that were now a permanent part of me. “I’m a fat cow,” I’d announce to my husband several times a day. “My body is ruined.” And while I would never take back the birth of my son in exchange for my pre-baby body, I was still grappling with how to accept what I now looked like.

“You’ve got to stop talking like that in front of him,” my husband would say. And I knew I had to, but I couldn’t. And besides, I rationalized, what’s the worst that could happen? He grows up acknowledging that his mom has an imperfect body? It’s the truth, after all. What’s so wrong with that?

It took nearly a year for me to realize what’s so wrong with that. Just as my attitudes about other things are going to influence my son’s thoughts and opinions, my attitudes about weight and what a woman should look like are going to color the way he sees the world. In essence, what I had been inadvertently preaching is that a woman’s value is inversely proportional to her size. And while I was holding myself to unhealthy and unrealistic standards, I would never want to teach my son to be as hard on other women (and, for that matter, himself and other men) as I am on myself.

This realization has ushered in an entirely new feeling of responsibility. My eating disorder is not exclusively “mine” anymore. As a parent, the boundaries of disordered eating blur; the risk of dysfunction spilling over into one’s children of either sex— in even in the most abstract and obscure ways—is always there.

So, while I still struggle with my appearance, I am taking a more proactive role in conquering the negative self-talk and the looming thoughts that are detrimental to my recovery. I would do anything for my child, and this is my chance to prove it. That starts with acknowledging that just because ‘it’s a boy’, it doesn’t mean my fight with anorexia is over; really, it means it’s just beginning.

By: Jennifer Rhodes

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Regional obesity rates and the challenges of self-report in research

In research, it’s common to use self-report (having study participants report on their own characteristics, like weight). Self-report is definitely less expensive and more convenient than having researchers measure the characteristic in question.  But is self-report accurate?

When it comes to weight, self-reported weight is generally highly correlated with researcher-measured weight. That said, there is some evidence that individuals at higher weights tend to under-report their weight (i.e., report a number that is lower than the one obtained when their weight is measured by a researcher). Conversely, individuals at lower weights, such as individuals with anorexia nervosa, may over-report their weight (i.e., report a number that is higher than the one obtained when their weight is measured by a researcher).

A recent study from the University of Alabama at Birmingham suggests that self-report of weight and height leads to incorrect conclusions about regional obesity rates. For example, for the South Atlantic region, a collection of states including North Carolina, obesity rates based on researcher-measured height and weight were over 5% higher than obesity rates based on self-reported height and weight.

Does this mean researchers should stop using self-report?  In my experience, self-report is more problematic when you’re interested in using the characteristic in question (e.g., weight) to categorize participants into one group or another (e.g., not obese or obese). However, when you’re interested in relating that characteristic to something else (e.g., looking at how weight relates to being breast-fed as a child), the use of self-report can be less problematic.

It’s important that researchers relying on self-report make efforts to increase its accuracy. When doing so, researchers should consider two different sources of inaccuracy: misinformation (when participants don’t have accurate information) and misrepresentation (when participants intentionally report inaccurate information). Researchers can employ a variety of strategies to reduce both sources of inaccuracy, such as using rewards to incentivize accurate reports. Further, technology holds the potential to help researchers move away from reliance on self-report, as seen with wearable cameras that can be used to track diet, as well as other lifestyle factors (http://www.healthline.com/health-news/wearable-cameras-for-lifestyle-tracking-020513).

By: Dr. Kristin Javaras

Le, A., Judd, S.E., Allison, D.B., Oza-Frank, R., Affuso, O., Safford, M. M., Howard, V. J., & Howard, G. (in press). The geographic distribution of obesity in the US and the potential regional differences in misreporting of obesity. Obesity. DOI: 10.1002/oby.20451

Stone, A. A., Bachrach, C. A., Jobe, J. B., Kurtzman, H. S., & Cain, V. S. (2000). The science of self-report: Implications for research and practice. Mahwah, NJ: Lawrence Erlbaum Associates.

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UNC Eating Disorders Program Monthly Multi-Family Meal Program: One Year Later

In January of last year, The UNC Center of Excellence for Eating Disorders launched a monthly program to bring together parents, siblings, spouses and patients in our inpatient and partial hospitalization programs. Each month above the hospital Starbucks, families attend an hour-long group session led by our treatment team.  After the session, patients are served a buffet-style dinner together with their family while receiving meal support from the clinical team including therapists, social workers and dieticians. During this real-world buffet meal, we help families work together as a team and expand caregivers’ skills to foster recovery in their loved one.

A year later, we are happy to report that the program has been a great success! Around 45 to 65 participants attend the Multi-Family Meal Program each month—a fabulous turnout that has absolutely surpassed our expectations. Families say that they really appreciate the opportunity to connect with other families who are also struggling with these bewildering disorders. It’s a relief to know that they’re not alone and there are other families who understand. They also appreciate having new skills in their toolbox to provide increased support and encouragement so that they feel prepared for tough mealtimes.  Our team also is grateful to have the opportunity to provide additional psycho-education and support to families and the opportunity to practice supporting their loved one during a challenging meal.

The UNC Center of Excellence for Eating Disorders is so thankful for the generous support from the UNC Health Care Volunteer Association. With their funding, we are able to provide these monthly meals at no-cost to patients and their families. We know that attending hospital-based eating disorder treatment can result in stress or financial burdens for families, and are so happy we can cover the cost of this critical meal support program.

If you’d like to learn more about the Multi-Family Meal Program, we invite you to contact Kate Cardoza, MSW, LCSW or Rachel Finholt, MSW, LCSW at kcardoza@unch.unc.edu or rfinholt@unch.unc.edu .

By: Kate Cardoza and Rachel Finholt

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Walking for Life, Hope, and Each Other

This past Saturday, I attended the third annual Raleigh National Eating Disorders Association (NEDA) walk. The day brought the community together to raise eating disorders awareness and funds for research. Altogether, Katie Ringley (the event director) and her team doubled their fundraising goal, raising over $12,000 for eating disorders research. People from all over North Carolina came to be a part of the incredible event and share their stories of hope and recovery. As you can see, there was a lot to celebrate, and celebrate people did.

In total, 122 registrants attended the event, all with the common goal of celebrating life. Some celebrated the lives of loved ones they lost from eating disorders. Others celebrated their own path to recovery, whether they had just begun their journey or were months or years into a life free of eating disorders. Additionally, family members and friends cheered on their loved ones, walking in support of their son, daughter, sister, father, or friend who once struggled or continues to struggle with an eating disorder. These awe-inspiring men and women shared their stories, embraced each other, and celebrated. Together, under the beautiful blue sky, they walked for life, hope, and each other.

This was my first NEDA walk and it will certainly not be my last. I was truly moved by these brave individuals and the people in their corner. The sense of camaraderie, love, and hope was palpable. Each person had their own unique story, but the message was clear: Life without an eating disorder is possible. I am thankful to Katie and her team for allowing me to represent our center at the event. They did a wonderful job making the day so successful.

To those of you I met, thank you for sharing your stories with me, and best of luck to you all.

By: Kate Nowlan

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Order of the Chocolate Fish

It is always my honor to bestow the Order of the Chocolate Fish upon members of the UNC Center of Excellence for Eating Disorders team for going beyond the call of duty in service of our mission. On this occasion, I am so pleased to induct two of our highly dedicated clinicians, Kate Cardoza, MSW, LCSW and Rachel Finholt, MSW, LCSW into the Order of the Chocolate Fish.

Kate and Rachel are both Clinical Social Workers with the UNC Center of Excellence for Eating Disorders. They work tirelessly spanning both inpatient and partial hospitalization levels of care to provide family based therapy for patients and family members throughout their time in treatment. In 2011, Kate and Rachel identified a need for additional family programming to provide even more support for family members and to offer a new opportunity for meal support. Out of this idea was born the Multi-Family Meal Program. This monthly program provides a place for family members to come together, learn more about eating disorders and treatment, and support their loved ones through a community meal.

Kate and Rachel have been instrumental at every step in the process of coordinating this program, including securing the funding needed to make these meals possible, coordinating with hospital catering to ensure we have enough food for our families each month, working with both the inpatient and partial hospitalization treatment teams to arrange for the necessary staff support at each dinner, organizing a schedule of speakers throughout the year to speak with patients and families, and overseeing every step of the meal from set-up to clean-up! A little over one year after the start of these meals, our families have benefited immensely from the efforts put forth by Rachel and Kate.

The UNC Center of Excellence for Eating Disorders is grateful for Rachel and Kate’s dedication to our patients and their families, and we are very excited to see the Multi-Family Meal Program continue to grow!

It is my honor and pleasure to bestow the Order of the Chocolate Fish onto Kate and Rachel. Congratulations and thank you!

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Eating Disorders on Popular TV Shows

Glee fans have spent this season getting to know a new character named Marley. Marley is a sophomore who falls prey to the cruel torment of a fellow Glee club member, Kitty. Kitty convinces Marley that, in order to succeed in auditions, she needs to lose weight. Succumbing to Kitty’s pressure, Marley begins purging and abusing laxatives—both symptoms of bulimia nervosa. Catherine Weingarten recently wrote an article, “Glee’s Harmful Portrayal of Eating Disorders,” in response to this new plotline. She discusses how Glee downplays the seriousness of eating disorders and fails to provide any type of statement to highlight the associated dangers at the end of the episodes. The show represents bulimia nervosa as a choice that Marley makes for a short time, instead of being a very dangerous, all-encompassing psychological disorder.

Although I am not the biggest Gleek, I am guilty of catching up on Gossip Girl episodes during my breaks from school. Reading Weingarten’s article made me remember that Gossip Girl also addressed the topic of eating disorders. Blair (a New York socialite, played by Leighton Meester) suffered from bulimia nervosa during several of the show’s seasons, and viewers are told that she was treated. Blair’s eating habits (including overeating during stressful time periods) and weight concerns are mentioned in various episodes of the program. Characters with disordered eating, eating disorders, and body-image issues have definitely been the topic of other popular television programs as well. This trend makes me worried for the impression that these characters will have on younger girls and the likely lack of awareness they may have regarding the severity of such disorders. I agree with one of Weingarten’s other points: without being particularly sensitive to how these topics are addressed, television shows may misrepresent these disorders.

The topic of eating disorders likely strikes a chord with many viewers who may be struggling personally or know someone who is struggling with an eating disorder. Knowing that such a vast audience watches Glee, I am disappointed that the production staff did not carefully consider how they addressed the topic prior to airing the episodes. I would assume teachable moments on television programs intended for entertainment purposes are probably few and far between. Choosing to include the topic of eating disorders could have been an excellent opportunity for the show to teach its viewers about the seriousness of the eating disorders and to encourage viewers to help any affected friends or family members to seek help. When TV producers want to include sensitive subject material in their scripts, I would hope that they would want to embrace their power to reach (and possibly teach!) such a wide audience. My gut feeling is that the production team is misinformed or unaware of the nature of eating disorders. I hope that Glee and other television programs will learn from responses to the show’s depiction of eating disorders and will exercise mindfulness during their portrayal of sensitive topics in later shows. If you would like to call attention to this or other harmful (or beneficial) messages in the media concerning body image and beauty, please report to the NEDA media watchdog program. Go to this link!

http://www.nationaleatingdisorders.org/get-involved/media-watchdog

If you would like to contact Fox about this issue, we suggest that you leave a message on Fox Broadcasting’s viewer comment line. The number is 310-369-3066. You can also write a letter to: Fox Broadcasting Co., P.O. Box 900, Beverly Hills, Calif., 90212.

Use your voice to create change!

By: Annie Altschul

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When It Comes to Public Health, Not All Publicity Is Created Equal

The amount of media coverage related to obesity is staggering. Today, one can hardly watch the morning news without hearing stories about the latest predictor of excessive weight-gain or seeing shocking b-roll of the “average” overweight American.  While this increased attention has made weight-related disease a major societal concern, evidence suggests it has simultaneously augmented the prejudices toward obese individuals.

The Yale Rudd Center for Food Policy and Obesity recently completed a content analysis of videos that accompany online news to observe how overweight individuals are currently portrayed by the media. Out of 371 videos from five major news stations, 65% were found to stigmatize overweight/obese adults. Specifically, videos tended to show obese persons gorging on junk food or being inactive, and the camera usually focused in on only their lower bodies. In addition, obese individuals were less likely to be shown in business attire (or even fully-clothed, for that matter) in comparison to non-overweight adults. Peterson, Depierre and Luedicke (2013) argued that these unflattering angles and the videos’ narrow depiction of stereotypical behaviors both dehumanize overweight individuals and fuel connotations associated with obesity.

Considering peoples’ tendency to equate seeing with believing, Peterson et al. make a valid point. These visuals presented by reputable news sources are thought to be accurate and unbiased. Of course, as Peterson et al. divulge (2013), this is often not the case. Unfortunately, people might view the media content as a reliable representation of all obese individuals without recognizing possible framing effects that overgeneralize and dramatize the disease. In such a way, some news stories become a vehicle for spreading obesity stereotypes—ingraining assumptions like individuals are overweight because they are lazy and lack self-control (Puhl, Schwartz, & Brownell, 2005) and in extreme cases, inciting discrimination. In order to eradicate this increasing stigmatization, the Rudd Center has compiled a database of images and videos that show overweight individuals in a variety of settings (e.g., in the workplace, out with friends, gardening, or taking a walk through a park). Databases like these may not only redefine how others perceive obese individuals, but also encourage more supportive behavior during every day social interaction and treatment.

After reading this content analysis, I find myself further questioning the benefits of media attention for public health crises. There is a part of me that feels that the public health impact of the obesity epidemic, in particular, demands approaches that grab attention when provoking a nation to take action. So perhaps using these shocking images is just a way for the networks to make the signal stand out from the noise of the other news headlines? In the end, it appears that the shock publicity backfires. If there is a potential for viewers to take a victim-blaming approach in response to dehumanizing and stereotypical visuals, there needs to be just as much concern for maintaining a fair representation of story subjects as there is for trying to gain an audience’s attention.

On a personal note, as a former radio reporter, I always saw news as a tremendous community outlet and an especially valuable tool for communicating recent science to the general public. Our radio station often highlighted compelling research on the perils of snacking or the prevalence of Type II diabetes within the local school system. While these pieces were intended primarily to inform, I never considered how startling leads or accompanying photos may have intentionally casted a negative stigma over a group of individuals especially in need of community encouragement. I believe in the powerful impact other people have on our decisions and self-perception. Thus, due to the media’s ability to dictate cultural opinion, journalists covering societal weight issues should make a conscious effort both to invoke empathy and concern within the population while assuring a more humanistic portrayal of the individuals affected by this disease.

Puhl, R. M. Peterson, J. L, Depierre, J A. Luedicke, J. (2013). Headless, hungry and unhealthy: A video content analysis of obese persons portrayed in online news. Journal of Health Communication, 0:1-17.

Brownell, K.D., Schwartz, M.B., Puhl, R.M. & Rudd, L. (Eds.), Weight bias: Nature, consequences, and remedies (pp. 165-174). New York: Guilford Press.

By: Elise Hartley

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