Eating disorder education programs are really harmful

A new article in the International Journal of Eating Disorders suggests that teaching teenagers about eating disorders can make them more knowledgeable about the problem, but it may also make them more likely to engage in eating disorders behaviors.

Yale University researchers found that when they presented female high school students with videos on eating disorders, it met the intended goal of boosting their knowledge about anorexia and bulimia.

However, the team saw that the students didn't necessarily find the results of eating disorders unappealing. Teens who watched a video featuring a woman recovering from an eating disorder became more likely to view girls with eating disorders as "very pretty," and some thought it would be "nice to look like" the woman in the video.

The findings suggest that more research should go into the unintended effects of eating disorder education before such programs are widely used, the researchers conclude in their article in the International Journal of Eating Disorders.

Marlene B. Schwartz (the principal investigator) suggested that having an attractive, articulate woman talk about her eating disorder could inadvertently "glamorize" the condition.

• 376 female high school students viewed one of two videos on eating disorders.
• Both videos were the same, except for the "presenter." In one video, the presenter was a young woman identified as a doctor, who told the story of a typical eating disorder patient; in the other, the woman was a "recovered eating disorder patient" who described her personal experience.
• The students completed questionnaires before and after the video.
• Overall, the study found, both videos increased the girls' knowledge about anorexia and bulimia.
• Regardless of which video they saw, the girls were more likely to say afterward that "it's not that hard" to recover from an eating disorder. They were also more likely to believe girls with eating disorders have "strong" personalities.
• Girls who viewed the video featuring the eating disorder patient were particularly likely to see women with anorexia or bulimia in a positive light.
  

Some of the discussions of the article suggested that instead of targeting "anti-eating disorders" programs, schools should address eating disorders by promoting healthy eating, exercise and positive body image, and discouraging "weight bias" and teasing based on physical appearance.

In general, I think that this is a correct view to espouse. In essence, by developing eating disorders prevention videos, we are focusing on the elimination of behaviors (or future behaviors) without teaching new behaviors.

Media influence varies accoring to ethnicity

An article in theMarch issue of Archives of Pediatrics and Adolescent Medicine indicates that white teenagers are more likely than black adolescents to start smoking after high exposure to R-rated movies and minimal restrictions on television viewing.

I wonder how the effects of youtube and myspace also affect the issue as well.

Researchers suggest that since the majority of actors are white, the behavioral impact does not transport to black adolescents because they do not identify with the characters.

Past research has suggested that all U.S. adolescents, regardless of race, have a higher risk of initiating smoking as their exposure to smoking in the media increases. In 2002, smoking was portrayed in 90 percent of PG- and PG-13–rated movies, and in 100 percent of R-rated movies, according to background information provided by the authors.

The article goes on to say that about 20 percent of episodes of popular, non-educational prime-time television programs depict tobacco use, and pro-smoking portrayals outnumber anti-smoking portrayals by a ratio of 10 to 1.

Christine Jackson, Ph.D., from Pacific Institute for Research and Evaluation, Chapel Hill, N.C., and colleagues interviewed 735 12- to 14-year-old adolescents from 14 public middle schools in the southeastern United States.

About equal proportions of the students were black and white, male and female, and none smoked at the beginning of the study. In the fall of 2001, the students were asked which of 93 popular films shown in theaters from 2001 to 2002 they had seen, how often they watched television, and whether their parents had rules about the types of television shows they watched.

At a follow-up interview in 2004, they were asked about their smoking behavior.
White adolescents with high exposure to R-rated movies were nearly seven times more likely to start smoking compared with those who had low exposure. Even after adjusting for other risk factors such as having a friend who smokes, lack of parental involvement and poor academic performance, those who watched more R-rated movies were still three times more likely to start smoking. White adolescents who had access to unsupervised television viewing were also more likely to start smoking.

However, in black adolescents, there was no association between risky media-watching habits and smoking initiation; those with higher exposure to R-rated movies and a private television were just as likely to start smoking as those with lower exposure.

The reasons for an association between media exposure to smoking and smoking behavior present in white adolescents but not black adolescents are not known. The researchers suggest the “transportation theory” as one possible explanation.

This theory speculates that the impact of a media type on an audience depends on that audience’s involvement in that media type. It has been shown that black adolescents identify better with black rather than white characters in the media. The researchers note that it may be the case that television and movies, in which the majority of actors are white, are less influential on their smoking behavior compared to white adolescents.

Why do we persist in our bad habits?

Although this article mentions many interesting reasons why (http://www.sciencedaily.com/releases/2006/11/061106144757.htm), I think that the main reason has to do with the delivery, quanity and quality of reinforcement.

Take alcohol or drug use (or hey, even scouring sites like myspace and youtube excessively): These activities give people immediate reinforcement. Oftentimes it is very difficult to eliminate a behavior which delivers immediate reinforcement (e.g., overeating) with a behavior that delivers delayed reinforcement (excercise --> better physique).

This could be looked at as a societal response as well - it is easier for societies to pollute in order to receive immediate reinforcement (getting rid of waste and participating in the burning of fossil fuels) vs. having them participate in activities designed to recycle and reuse waste in order to reap benefits in the future (Al Gore - eat your heart out!)

These examples highlight how important the immediacy of reinforcement is.

Real play vs. artificial entertainment

This article was sent to me from Stephen Lange, a good friend who studied school neuropsychology with me. He co-wrote this article with Brent Thompson.

They talk about the TV Kart, a shopping cart designed to continuously entertain children while their adult companions shop. The principal entertainment offered is exactly what the cart's name implies.

I agree with the point of the article: that is to say, little by little, we are supplanting natural opportunities for children to interact with the world with electronic, passive, automated interactions, which is definitely a negative.

From a young age, babies are exposed to mindless videos via Baby Einstein (which has been shown to not work); as children grow older, they spend inordinate amounts of time on sites such as myspace and youtube - I think that this article is correct in its warning.