Recently, the author of the Fox Medical Blog, Dr. Keith Ablow, published a piece debunking the supposed connection between the fashion industry’s obsession with rail-thin models and the “epidemic” of anorexia and bulimia among young girls that is supposedly the result of that obsession.  In keeping with Fashion Week, Manhattan’s Super Bowl of haute couture, we thought it appropriate to weigh in on this from a woman’s—and a beauty—perspective.

To cut to the chase, this comment by Dr. Ablow seems to minimize the complexity of the issue: “If size zero fashion models cause anorexia, why have decades of exposure to them resulted in an epidemic of obesity among young people?”  That seems fatuous or naive at best.  Dr. Ablow’s take on the topic is that the whole idea of marketing and media making healthy people more susceptible to things like eating disorders, smoking and violence is nonsense.  In the simplest way, he’s probably right: exposure to a flood of magazine images telling her that only being a size four or smaller is beautiful will probably not make an otherwise emotionally healthy young woman say to herself, “You know, I think I’m going to start binging and purging.”

But treating that as the end of the issue oversimplifies it.  First of all, we know that childhood exposure to extreme stimuli can produce extreme behaviors.  For example, as psychologist Craig A. Anderson wrote back n 2003, solid studies show conclusively that “violent video games are significantly associated with increased aggressive behavior, thoughts, and affect.”  But are five-year-old girls watching modeling reality shows and reading Vogue and later becoming anorexic?  Insufficient data.

However, what we do know is that unrealistic body images do exert subtle but real negative effects on women who are exposed to them. In their article “Media and Body Image,” published in the 2003 journal Media Effects, Jennings Bryant and Mary Beth Oliver showed that in a majority of studies, women who were exposed to images of ultra-slender models showed a substantial drop in satisfaction with their own bodies.

The point is not that such effects don’t directly drive women to develop bulimia and anorexia. It is that the saturation of images that convey an unattainable (and often unhealthy) ideal produce damage self-esteem in ways that can manifest as a range of behaviors.  Those can manifest as depression, social anxiety, yo-yo dieting (surely a contributor to the obesity epidemic) and yes, anorexia and bulimia.  It’s the subtle message that starvation-thin bodies are normal, and you’re not quite acceptable unless you have one, that’s partially responsible for our culture’s dysfunctional relationship with food.

Finally, about the supposed non-increase in anorexia and bulimia, says who?  This material courtesy of the Harvard Mental Health Letter, released September 25, 2009, puts the lie to that:

The Agency for Healthcare Research and Quality (AHRQ) reported that hospitalizations for eating disorders have increased in the new millennium. The most common diagnosis was anorexia nervosa, accounting for 37% of hospitalizations in 2005 to 2006, an increase of 17% over those reported for 1999 to 2000. The next most common diagnosis was bulimia nervosa, characterized by binge eating followed by purging, which accounted for 24% of hospitalizations in the year ending 2006.

Add to that the extremely disturbing increase in websites dedicated to anorexia and bulimia as a lifestyle.  It’s hard to imagine anything more unhealthy for a young girl than online communities that promote these deadly disorders as paths to healthy weight maintenance.  Ignoring these facts in favor of a “So why do we still have all these fat people” view overlooks the most important issue: balancing our unhealthy “body culture” with images and education that teach women of every age that there are many ways to be beautiful, and that nothing is more beautiful—regardless of your BMI—than total vitality and total self-confidence.

Stay beautiful,

Debi & Eva