From Thinspiration to Opposition

Permanent Link: http://ufdc.ufl.edu/UFE0022795/00001

Material Information

Title: From Thinspiration to Opposition How Do Women in Recovery from Anorexia Negotiate the Thin Ideal?
Physical Description: 1 online resource (560 p.)
Language: english
Creator: Demare, Deborah
Publisher: University of Florida
Place of Publication: Gainesville, Fla.
Publication Date: 2008


Subjects / Keywords: anorexia, eating, media, negotiate, opposition, recovery, thin, thinspiration, women
Journalism and Communications -- Dissertations, Academic -- UF
Genre: Mass Communication thesis, Ph.D.
bibliography   ( marcgt )
theses   ( marcgt )
government publication (state, provincial, terriorial, dependent)   ( marcgt )
born-digital   ( sobekcm )
Electronic Thesis or Dissertation


Abstract: This dissertation contributes to the vast body of literature on the relationship among the female body ideal, anorexia nervosa, and the media. There are several studies of the media's influence on the female body ideal, on self-esteem, and on the development of eating disorders. Literature in the psychology and health journals also has provided a growing body of knowledge of the recovery process from anorexia. However, this is the first study to explore how women who are in recovery (or recovered) from anorexia navigate the media landscape, one that is saturated with dominant ideologies that define cultural ideals of female beauty. Given the prevalence of media messages promoting the thin body ideal, how do women on the trail of recovery maintain their commitment to healing from anorexia? This qualitative dissertation explored the challenges women face in recovery from anorexia, with a specific focus on media influence. Participant media journals and in-depth interviews provided rich insight into the lives of 32 women who have experienced and survived the negative effects of a culturally influenced phenomenon, Anorexia Nervosa. The media collectively serve as a dominant institution, which portray and perpetuate a powerful cultural message that women should strive to attain the thin ideal. Previously, the women in this study had subscribed to that ideal, and in doing so, they sacrificed their physical, mental, and emotional health. Part of the participants' recovery process entailed learning how to negotiate or resist pervasive media messages promoting a body type that they now perceived to be unrealistic and unhealthy. The women in this study no longer passively accepted the mediated ideal, but they had varying degrees of resistance informed by their personal life experience. The insight gained from the women's media diaries and interviews provided a better understanding of how media are implicated in the recovery process from anorexia. This type of information could improve the design of treatment plans for women seeking long-term recovery from eating disorders. It is critical that physical and mental health care professionals develop a better understanding of the factors related to recovery from anorexia, including any relevant socio-cultural factors, such as the media.
General Note: In the series University of Florida Digital Collections.
General Note: Includes vita.
Bibliography: Includes bibliographical references.
Source of Description: Description based on online resource; title from PDF title page.
Source of Description: This bibliographic record is available under the Creative Commons CC0 public domain dedication. The University of Florida Libraries, as creator of this bibliographic record, has waived all rights to it worldwide under copyright law, including all related and neighboring rights, to the extent allowed by law.
Statement of Responsibility: by Deborah Demare.
Thesis: Thesis (Ph.D.)--University of Florida, 2008.
Local: Adviser: Duke, Lisa L.
Local: Co-adviser: Treise, Deborah M.

Record Information

Source Institution: UFRGP
Rights Management: Applicable rights reserved.
Classification: lcc - LD1780 2008
System ID: UFE0022795:00001

Permanent Link: http://ufdc.ufl.edu/UFE0022795/00001

Material Information

Title: From Thinspiration to Opposition How Do Women in Recovery from Anorexia Negotiate the Thin Ideal?
Physical Description: 1 online resource (560 p.)
Language: english
Creator: Demare, Deborah
Publisher: University of Florida
Place of Publication: Gainesville, Fla.
Publication Date: 2008


Subjects / Keywords: anorexia, eating, media, negotiate, opposition, recovery, thin, thinspiration, women
Journalism and Communications -- Dissertations, Academic -- UF
Genre: Mass Communication thesis, Ph.D.
bibliography   ( marcgt )
theses   ( marcgt )
government publication (state, provincial, terriorial, dependent)   ( marcgt )
born-digital   ( sobekcm )
Electronic Thesis or Dissertation


Abstract: This dissertation contributes to the vast body of literature on the relationship among the female body ideal, anorexia nervosa, and the media. There are several studies of the media's influence on the female body ideal, on self-esteem, and on the development of eating disorders. Literature in the psychology and health journals also has provided a growing body of knowledge of the recovery process from anorexia. However, this is the first study to explore how women who are in recovery (or recovered) from anorexia navigate the media landscape, one that is saturated with dominant ideologies that define cultural ideals of female beauty. Given the prevalence of media messages promoting the thin body ideal, how do women on the trail of recovery maintain their commitment to healing from anorexia? This qualitative dissertation explored the challenges women face in recovery from anorexia, with a specific focus on media influence. Participant media journals and in-depth interviews provided rich insight into the lives of 32 women who have experienced and survived the negative effects of a culturally influenced phenomenon, Anorexia Nervosa. The media collectively serve as a dominant institution, which portray and perpetuate a powerful cultural message that women should strive to attain the thin ideal. Previously, the women in this study had subscribed to that ideal, and in doing so, they sacrificed their physical, mental, and emotional health. Part of the participants' recovery process entailed learning how to negotiate or resist pervasive media messages promoting a body type that they now perceived to be unrealistic and unhealthy. The women in this study no longer passively accepted the mediated ideal, but they had varying degrees of resistance informed by their personal life experience. The insight gained from the women's media diaries and interviews provided a better understanding of how media are implicated in the recovery process from anorexia. This type of information could improve the design of treatment plans for women seeking long-term recovery from eating disorders. It is critical that physical and mental health care professionals develop a better understanding of the factors related to recovery from anorexia, including any relevant socio-cultural factors, such as the media.
General Note: In the series University of Florida Digital Collections.
General Note: Includes vita.
Bibliography: Includes bibliographical references.
Source of Description: Description based on online resource; title from PDF title page.
Source of Description: This bibliographic record is available under the Creative Commons CC0 public domain dedication. The University of Florida Libraries, as creator of this bibliographic record, has waived all rights to it worldwide under copyright law, including all related and neighboring rights, to the extent allowed by law.
Statement of Responsibility: by Deborah Demare.
Thesis: Thesis (Ph.D.)--University of Florida, 2008.
Local: Adviser: Duke, Lisa L.
Local: Co-adviser: Treise, Deborah M.

Record Information

Source Institution: UFRGP
Rights Management: Applicable rights reserved.
Classification: lcc - LD1780 2008
System ID: UFE0022795:00001

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2 2008 Deborah M. Demre


3 To the individuals and family member s of women in recovery anorexia. There is hope.


4 ACKNOWLEDGMENTS I would like to thank m y chair, Dr. Duke Co rnell, for her guidance throughout the entire process of this challeng ing endeavor. I also would like to th ank my co-chair, Dr. Treise, for her continual support as I completed this dissertati on. Thanks also are in order for my committee members, Dr. Kim Walsh-Childers and Dr. Julia Gr aber for their insightf ul contributions. In addition, I would like to thank Dr. Helena Sarki for introducing me to reception studies, which served as the most appropriate theoretical fram ework from which to examine the participants readings. Beyond the individuals on my dissertation co mmittee, there are many other people that deserve recognition. First, I would like to express my gratitude to the 32 inspirational women who participated in this st udy. In sharing their personal e xperiences, they have provided invaluable insight in terms of how women can become more resist ant to the thin ideal message that is so pervasive in todays media. In a ddition, these women provided me with resolve to strengthen my own recovery. I also would like to acknowledge Barbara Harris, Dr. Seldman, Dr. Emerson, and Dr. Zeckhausen for referring participan ts to this study. I would like to give special thanks to Barbara and Dina, who allowed me to solidify my recovery process and instilled confidence in my ability to complete this dissertation. Thanks are in order for Sandy who provided a necessary zany outlet and for teaching me the importance of brevity and clarity. In addition, I would lik e to acknowledge how much I appreciate the time that Melissa and Donna spent in Dancing Goat s dedicated to Operation Debi Gets Done. I also am indebted to Melissa for her friendship and continual support as I completed the final stages of this dissertation.


5 I would be remiss if I neglected to thank my dissertation support ne twork. I feel fortunate to have such wonderful friends and colleague s who offered their continual emotional and professional support as I completed the va rious stages of this dissertation. In addition, I would like to ex tend special thanks to Jody He dge. She is one of the most valuable resources in the College, providing a wea lth of critical informa tion over the years as I completed my degree. I also would like to expre ss my gratitude to her for always offering words of encouragement and for her continuous support and compassion. I am thankful to my family, who never really understood what all this dissertation stuff was about, but loved and supported me anyway. Th ere are also a few specific family members that I would like to recogni ze. I would like to thank my husbands family for having enough confidence in me to preemptively refer to me as D r. Debi. I also would like to extend gratitude to my Grandma in Florida for believing that I was intelligent enough to complete this dissertation and for supplying me with the resour ces to do so. You are missed. I also would like to offer a special thank you to my Grandma in New York for always loving me unconditionally. I dedicated my mast ers thesis to her for her 90th birthday, so I had to wait until she was 100 to finish my dissertation! Completing this dissertation required a tr emendous amount of commitment, and I faced several obstacles. Throughout th e entire journey, Nitanee serv ed as a much-needed calming presence, and no words can express how much I love and appreciate her. Finally, the completion of this dissertati on would not have been possible without the immeasurable love and support of my husband. He has taught me that nothing will scare him away, not even a dissertation! He is truly the most wonderful husband and best friend that anyone could ever ask for. I will always love him.


6 TABLE OF CONTENTS page ACKNOWLEDGMENTS...............................................................................................................4 LIST OF TABLES................................................................................................................. ........16 LIST OF FIGURES.......................................................................................................................17 ABSTRACT...................................................................................................................................18 CHAP TER 1 PREFACE AND PURPOSE OF THE STUDY..................................................................... 20 Prevalence of Eating Diso rders and Thin Ideal ...................................................................... 20 Placing the Researcher in th e Context of the Research .......................................................... 23 Background on Eating Disorders and Recovery..................................................................... 26 Eating Disorders on a Continuum...................................................................................28 Recovery Defined............................................................................................................29 Seriousness of Anorexia.................................................................................................. 30 Challenges with Recovery...................................................................................................... 31 Why Women?.........................................................................................................................32 Cultural Ideal..........................................................................................................................34 The Socialization Process.......................................................................................................35 Positive Associations with Thinness............................................................................... 36 Negative Associations with Fat....................................................................................... 37 Ideal Not Attainable........................................................................................................ 40 Media Set the Norm......................................................................................................... 43 Changes in American Weight Standards................................................................................ 45 Historical Standards for the Female Body Ideal..................................................................... 46 Where Do We Learn What Ideal Is?....................................................................................... 54 Media Do Not Reflect Diversity............................................................................................. 55 What is Body Image?............................................................................................................ ..56 Body Dissatisfaction...............................................................................................................57 2 REVIEW OF THE LITERATURE........................................................................................ 59 Overview....................................................................................................................... ..........59 Structure of the Chapter..........................................................................................................60 Socio-Cultural Influences.......................................................................................................62 Effects Theories Applied in the Literature.............................................................................63 Socio-Cultural Theory.......................................................................................................... ..64 Thin Ideal Endorsed in Media................................................................................................ 64 How Television Contributes............................................................................................65 How Magazines Contribute.............................................................................................67


7 Ideal is Thinner over Time..................................................................................................... 70 Link to Eating Disorders.................................................................................................73 Increase in Diet Articl es and Advertisem ents................................................................. 73 Feel Fat?..........................................................................................................................75 Social Comparison Theory..................................................................................................... 77 Target Characteristics...................................................................................................... 78 Upward and Downward Comparisons............................................................................. 80 Body Satisfaction Measurement...................................................................................... 82 Mediating Factors for Social Comparison Theory.......................................................... 84 Discrepancy between real and ideal......................................................................... 84 Internalization of soci o-cultural pressures to be beautiful and thin ......................... 86 Endorsement of thin ideal........................................................................................87 Importance of target comparison.............................................................................. 88 Body weight.............................................................................................................89 Level of body-esteem and satisfaction..................................................................... 90 Self-esteem and marketing appeals.......................................................................... 92 Critical viewing........................................................................................................93 Age...........................................................................................................................94 Ethnicity, socioeconomics, and culture.................................................................... 94 Social Learning Theory..........................................................................................................97 Vicarious Reinforcement................................................................................................. 99 Vicarious Punishment.................................................................................................... 100 Prevalence and Incentives.............................................................................................100 Identification with Media Characters............................................................................ 102 Rewards for Losing Weight...........................................................................................103 Self-Schema Theory............................................................................................................. 104 Cognitive Dissonance Theory............................................................................................... 106 Body Objectification Theory................................................................................................107 Third-Person Effect..............................................................................................................110 Active Audience Theory....................................................................................................... 111 Uses and Gratifications Theory............................................................................................ 113 Women with Eating Disorders: Interactions with the Media................................................ 116 Social Comparison......................................................................................................... 116 Cognitive Dissonance.................................................................................................... 119 Self-Discrepancy...........................................................................................................120 Uses and Gratifications.................................................................................................. 120 Family and Peer Influences.................................................................................................. 121 Mothers Influence........................................................................................................ 121 Fathers Influence..........................................................................................................122 Peers Influence............................................................................................................. 123 Psychological Influences......................................................................................................129 Perfectionism.................................................................................................................129 People Pleasing..............................................................................................................132 Desire for Identity/Control............................................................................................133 Competitiveness............................................................................................................ 134


8 Genetic and Biological Influences........................................................................................ 134 The Voices of Women in Recovery...................................................................................... 135 The Challenge of Recovery.................................................................................................. 142 The Recovery Process........................................................................................................... 143 Limitations of Previous Research......................................................................................... 146 Contributions of This Study..................................................................................................147 3 METHODOLOGY............................................................................................................... 148 Research Question and Benefits of this Study...................................................................... 148 Justification for Using Qualitative Methodology.................................................................149 Grounded Theory..................................................................................................................150 Participant Requirements...................................................................................................... 151 Discussion of Recovery and Relapse.................................................................................... 152 Definitions of Recovery........................................................................................................ 154 Recruiting the Participants.................................................................................................... 158 About the Participants......................................................................................................... ..160 Pseudonyms...................................................................................................................160 Age................................................................................................................................160 Purposeful Sampling.............................................................................................................160 Typical Case..................................................................................................................161 Snowball or Chain......................................................................................................... 163 Theory-Based or Operational Construct........................................................................165 Stratified Purposeful......................................................................................................166 Confirming and Disconfirming Cases...........................................................................167 Opportunistic.................................................................................................................167 Methods................................................................................................................................169 Media Diaries................................................................................................................169 Interviews......................................................................................................................173 Establishing Trustworthiness and Credibility....................................................................... 177 Analyzing the Data............................................................................................................. ..179 Memos...........................................................................................................................181 Generalizability and Theoretical Validity..................................................................... 182 Presenting Grounded Theory................................................................................................ 183 4 FINDINGS....................................................................................................................... .....185 Perspectives of the Study......................................................................................................185 Socio-Cultural Theory................................................................................................... 187 Feminism As a Filtering Lens....................................................................................... 189 Feminism Not a Shield.................................................................................................. 191 Attractiveness Equate d with Thinness ...........................................................................192 What is the Ideal? The Participants Perspectives ................................................................ 193 Media Journal Contributed to Increased Awareness............................................................ 194 Participant Readings of the Mediated Ideal.......................................................................... 196 Premise for Five Types of Readings..................................................................................... 197


9 Dominant.......................................................................................................................197 Negotiated......................................................................................................................198 Opposition Informed by Concern for Others................................................................. 200 Self-Protective Opposition............................................................................................202 Oppositional..................................................................................................................205 Summary........................................................................................................................205 Influential Factors on Participant Readings.......................................................................... 208 Thin Ideal Internalization.....................................................................................................208 What are Triggers?............................................................................................................. ..210 Explanation of Transcript Excerpts...................................................................................... 211 Organization of Findings and Discussion.............................................................................211 Appearance No Longer Defines Self-Worth/Identity........................................................... 215 I Honor and Accept My Body....................................................................................... 219 Body satisfaction affects readings..........................................................................219 Factors promoting a positive body image.............................................................. 221 God Created My Body, and I Will Respect It............................................................... 227 My Health is More Important than the Thin Ideal........................................................ 229 No longer equate the thin ideal with health............................................................ 230 Magazine usage focused on healt hy eating rather than dieting .............................. 231 Health as a negotiating tool.................................................................................... 232 Opposition: Making health the most salient factor................................................ 232 Age and children make health a priority................................................................233 Respect Celebrities for Qualitie s Not Focused on Appearance .....................................234 Opposition to celebrities who rely prim arily on their appearance......................... 234 Admire commitment to substance, not fluff........................................................... 235 Respect intelligent, talented television and movie actresses.................................. 236 Admire confident, empowering role models.......................................................... 238 Admire celebrities who dont fear food ................................................................. 241 Strategies for Self-Protective Opposition......................................................................243 Prevalence contributes to need for strategies ......................................................... 243 Restricting media exposure.................................................................................... 244 Remembering the misery....................................................................................... 244 Remembering the lowest point of their life............................................................ 245 Weighing options, Its not worth it........................................................................ 246 Invested in their recovery....................................................................................... 247 Redirecting their focus from the th in ideal to the value of health .......................... 249 Engaging in cognitive restructuring....................................................................... 251 Obstacles to Un -Internalizing the Thin Ideal ........................................................................ 253 Danger of Engaging in Comparisons............................................................................ 257 Social comparison theory and comparisons........................................................... 258 Women in the initial stages of recovery still compare........................................... 260 Learning the necessity of avoidance...................................................................... 260 Magazines were instruction manuals for life......................................................... 262 Challenging to avoid comparisons................................................................................ 265 Danger of Comparisons for Wome n with Body Dissatisfaction ................................... 268


10 Fear of Fat......................................................................................................................270 Still Value the Thin Ideal.............................................................................................. 277 Thinness is rewarded.............................................................................................. 278 Missing the identity of thinness............................................................................. 280 Sense of competition and jealousy......................................................................... 280 Body dissatisfaction...............................................................................................282 Prevalence of thin ideal.......................................................................................... 283 Socialization process..............................................................................................285 Thin indicates femininity.......................................................................................286 Hard to Avoid Diet Messages........................................................................................287 Media messages seep into everyday lives.............................................................. 290 Diets target women more than men........................................................................ 291 Weighing their Self-Worth............................................................................................ 292 Blind weights..........................................................................................................293 Not focusing on the scale.......................................................................................294 Media-Influenced Meaning of Clothing Sizes..............................................................295 Indicator of thin ideal............................................................................................. 296 Sizes of models....................................................................................................... 296 Sizes of celebrities.................................................................................................. 297 Getting rid of skinny clothes.................................................................................. 298 Clothing size and self-control................................................................................300 Media define unacceptable sizes............................................................................ 302 Self-protective oppos ition strategies ......................................................................302 Dominant interpretation......................................................................................... 303 Focus on health permits resistant reading.............................................................. 304 Desire for a Boyfriend................................................................................................... 304 Engaging in self-objectification............................................................................. 305 Being concerned about m ens expectations...........................................................307 Subscribing to codes of femininity for attracting (and keeping) m ales................. 308 Experiencing conflict with a negotiated reading.................................................... 309 Contrasting views of the value of a b oyfriend: negotiated and oppositional......... 311 Perception of Recovery.................................................................................................312 Perception Shift: No Longer Value the Thin Ideal............................................................... 314 Perception of Ideal Changes: You Can be Too Rich or Too Thin ................................ 315 I Dont Want to Be Seen As Sick.................................................................................. 316 Questioning the Term Ideal....................................................................................... 317 Suspecting Thin Media Figures of Unhealthy W eight Loss Behaviors........................ 317 Shifting the Nature of the Comparison as a Self-P rotective Opposition Strategy........318 Eating Disorders and Dichotomous Thinking............................................................... 319 Rigid dietary rules.................................................................................................. 320 Extreme fear of fat..................................................................................................321 Good and bad foods................................................................................................322 Rigid exercise routines........................................................................................... 323 Dichotomous thinkers avoided m edia exposure and exercise................................ 324 Conflictedfighting lingering te ndencies for comparison ....................................325 Media encourage fear-based exer cise, not exercise for health ............................... 327


11 Awareness of the Limited Portrayal.............................................................................. 328 Need Normal Represented.............................................................................................335 Some Strides are Bei ng Made, but N ot Enough............................................................ 335 Informed by Normal, Average Models and Celebrities................................................ 337 Seeing celebrities with curves................................................................................337 Dove Campaign for Real Beauty...........................................................................339 Media Ideals Fluctuate.................................................................................................. 341 Historical context................................................................................................... 341 Athletic and toned ideal..........................................................................................342 Media Awareness and Critical Media Literacy.................................................................... 344 Definition of Hegemony................................................................................................345 Media No Longer Trusted Friends................................................................................ 347 Critical Media Literacy.................................................................................................. 348 Broad definition......................................................................................................348 Specific definition.................................................................................................. 349 No Interest in Mainstream Media.........................................................................................351 Media Promoting the Thin Ideal are Worthless............................................................ 351 Selective Exposure to Mainstream Medi a: A Self-Protective P erspective................... 354 Ideal is Not Natural........................................................................................................... ....355 Not Everyone Can Look Like a Model......................................................................... 355 Understanding of Image Manipulation..........................................................................357 Media Imagery Does Not Reflect Mature Womens Bodies......................................... 359 Media promote products and procedur es to elim inate all cellulite................................ 362 Reinterpreting Fashion Messages......................................................................................... 363 Self-Protective Opposition Readings: Info rm ed by Social Comparison Theory.......... 364 Changing Their Focus................................................................................................... 366 Resisting the Fashion Industry...................................................................................... 368 Coverage of Celebrity Lives.................................................................................................369 Wanting to Look Like Thin Celebrities......................................................................... 370 Limiting Media Exposure.............................................................................................. 371 Being Critical of Unwarranted Celebrity Coverage......................................................372 Contrast Illustra tes Benefits of No Interpersonal Attrac tion to Celebrities ................... 373 Understanding of Diet Industry............................................................................................ 374 Eating Disorders Start with Diets.................................................................................. 374 Diets Gone Wild: Media Messages Promo ting Weight Loss are Too Prevalent .......... 375 Not Everyone Needs to Diet.......................................................................................... 377 Diets Are Perceived to be A Rite of Passage................................................................378 Media Promote False Associati on Between Dieting and Health ................................... 378 Media Prey on Despera tion to Lose Weight .................................................................. 381 Feminism Informs Critical Media Literacy.......................................................................... 383 Feminism Learned in Wo m ens Studies Courses.......................................................... 383 Objectification Theory...................................................................................................384 Portrayal of Perfection Renders Women as Objects to Be Admired............................. 385 Concept of Ideal Woman is Absurd.............................................................................. 387 Critical of Media Emphasis on Appearance.................................................................. 388


12 Adopting alternative media.................................................................................... 390 Reading books for self-growth...............................................................................392 Discount Sexist Media Messages.................................................................................. 393 Media Need to Make Image Unattainable..................................................................... 394 Media Demand Elusive Perfection................................................................................ 397 Contradictory Messages in Magazines.......................................................................... 398 Media Promote Diets as a Mechanism for Control....................................................... 399 Femininity is associated with a perfect diet........................................................ 400 Recovery is freedom from obs essive, restrictive thoughts ..................................... 402 Media Promote False Associa tions w ith the Thin Ideal....................................................... 403 Thinness Will Not Make You Happy ............................................................................ 404 Weight Loss Does Not Solve Problem s......................................................................... 405 Attaining the Thin Ideal Does Not Make You Popular ................................................. 406 Focus on Appearance Diverts from Other Activities.................................................... 407 Product Associations are Profit Driven.........................................................................408 Belief in Attainability....................................................................................................409 Perfection is Not Possible ..............................................................................................411 Media Promote a Dangerously Unhealthy Ideal................................................................... 413 Media Equate Thinness with Health.............................................................................. 413 Media Have a Responsibility to Portray a Healthier Ideal............................................ 414 Models Meet Diagnostic Criterion for Anorexia ...........................................................416 Extremely Thin Models Suggest Ther es No Such Thing As Thin Enough .................417 Attribute Responsibility to Individual Celebrities ......................................................... 418 Media Promote Misconceptions about Eating Disorders ..................................................... 422 Media Focus on Appearance and Weight, Not Underlying Issues................................ 423 Publishing Celebrities Weights.................................................................................... 425 Celebrity Coverage Cont ributes to Fine Line ................................................................ 426 Celebrity Denials Blur the Line..................................................................................... 427 Be Skinny, Get Famous.................................................................................................427 Drawing Visual Attention to the Issue Sends Contradictory Messages ........................ 428 Soft News Coverage of Celebrities with Anorexia is Not Taken Seriously ..................431 Lifetime Movies Served as a Lear ning Resource or Trigger ......................................... 433 Pro-Ana Sites.................................................................................................................436 Coverage of Extremes Can Prevent Detection.............................................................. 439 Bulimia More Recognizable Than Anorexia................................................................. 441 Treatment is Not Accurately Portrayed......................................................................... 442 Resisting the Dominant Ideology......................................................................................... 446 Empowerment Fuels Anger Channeled at the Media........................................................... 447 Three Stages for Challenging Body Wars............................................................................ 447 First Stage: Individual Level......................................................................................... 448 Second Stage: Cultivate Personal Value System........................................................... 448 Third Stage: Activism....................................................................................................449 From Private to Public: Leve ls of Participant Activism ....................................................... 449 Using Their Voice......................................................................................................... 450 Supporting Others and Creating A wareness.................................................................. 451 Providing Support Online.............................................................................................. 452


13 Writing to Educate Others and Create Awareness........................................................456 Writing to Effect Social Change.................................................................................... 457 Speaking Publicly to Educate Others............................................................................ 462 Contacting the Media Directly...................................................................................... 463 Forming Preventive Programs....................................................................................... 464 Empowerment through Counter-Hegemonic Activity.................................................. 467 5 DISCUSSION.......................................................................................................................471 Five Types of Readings........................................................................................................ 471 Participants Previously Had Domina nt Readings of the Thin Ideal .............................. 472 Predominant Participant Readings: Self -Protective and Concern for Others ................473 Typology Provides Abstract Conceptual Understanding..................................................... 474 What are Typologies?....................................................................................................475 How Are Typologies Constructed?............................................................................... 475 Overview of the Typology for the Particip ants Readings of the Mediated Ideal ................476 Thin Ideal Continuum.................................................................................................... 476 Private Realm to Public Realm...................................................................................... 478 How the Typology Will Be Presented........................................................................... 480 Common Characteristics for Each of the Categories ............................................................ 481 Nine Categories....................................................................................................................482 People Pleasers/Romantics............................................................................................ 482 What drives their readings?.................................................................................... 483 Level and type of concern for others...................................................................... 483 Level of thin ideal internalization.......................................................................... 483 What is their main concern?...................................................................................483 Conflicted Negotiators................................................................................................... 483 What drives their readings?.................................................................................... 484 Level and type of concern for others...................................................................... 484 Level of thin ideal internalization.......................................................................... 484 What is their main concern?...................................................................................485 I know the media is not real life, but it definitely seem s like it is............................. 485 Conflicted Feminists...................................................................................................... 485 What drives their readings?.................................................................................... 485 Level and type of concern for others...................................................................... 486 Level of thin ideal internalization.......................................................................... 486 What is their main concern?...................................................................................486 Self-Protective Independents......................................................................................... 486 What drives their readings?.................................................................................... 486 Level and type of concern for others...................................................................... 487 Level of thin ideal internalization.......................................................................... 487 What is their main concern?...................................................................................487 Need Normal Represented.............................................................................................487 What drives their readings?.................................................................................... 487 Level and type of concern for others...................................................................... 488 Level of thin ideal internalization.......................................................................... 488 What is their main concern?...................................................................................488


14 Semi-Activists...............................................................................................................488 What drives their readings?.................................................................................... 489 Level and type of concern for others...................................................................... 489 Level of thin ideal internalization.......................................................................... 489 What is their main concern?...................................................................................489 Cest La Vie................................................................................................................... 490 What drives their readings?.................................................................................... 490 Level and type of concern for others...................................................................... 490 Level of thin ideal internalization.......................................................................... 490 What is their main concern?...................................................................................490 Supportive Opposers..................................................................................................... 490 What drives their readings?.................................................................................... 491 Level and type of concern for others...................................................................... 491 Level of thin ideal internalization.......................................................................... 491 What is their main concern?...................................................................................491 Activists.........................................................................................................................491 What drives their readings?.................................................................................... 491 Level and type of concern for others...................................................................... 492 Level of thin ideal internalization.......................................................................... 492 What is their main concern?...................................................................................492 Implications for Treatment................................................................................................... 492 Importance of Media Literacy in Treatm ent Centers.................................................... 493 Using Counter-Attitudinal Reactions to Strengthen Resistance.................................... 495 Critical Media Literacy as a Com ponent of Outpatient Therapy.................................. 496 Suggestions for Future Research.......................................................................................... 497 Media Literacy: TV Versus Magazines.........................................................................497 Media Diary Provided Valuable Information................................................................ 498 Introducing Feminism at an Early Ag e May Reduce Self-Objectification ................... 498 Need for Specific Focus on Empowerment................................................................... 499 Limitations of the Study....................................................................................................... 500 Benefits of an Emic Perspec tive and Data Triangulation ..................................................... 504 Revisiting the Place of the Researcher in the Context of the Research ................................ 505 APPENDIX A DIAGNOSTIC CRITERIA..................................................................................................510 B SCRIPT FOR KEY INFORMANTS.................................................................................... 512 C INFORMED CONSENT......................................................................................................514 D MEDIA DIARY.................................................................................................................... 516 E DISCUSSION GUIDE......................................................................................................... 517 Media Usage.........................................................................................................................517 Recovery Questions............................................................................................................. .518


15 LIST OF REFERENCES.............................................................................................................519 BIOGRAPHICAL SKETCH.......................................................................................................560


16 LIST OF TABLES Table page 3-1 Breakdown of ages with m ean and median..................................................................... 161 3-2 Names and ages of the participants..................................................................................161 4-1 Factors influ encing the like lihood of oppositional readings............................................ 208


17 LIST OF FIGURES Figure page 4-1 This poem shows the various stages of the participants r ecovery process.....................207 4-2 During her interview, Isabel shared an inde x card with m e that she had kept when she was anorexic to record measurements of her body....................................................401 4-3 I traveled to several locations around the c ountry to interview wom en for this study....454 4-4 Photo of Kristin at the F ebruary 2008 L.U.L.A. scale smashing event........................... 467 4-5 The L.U.L.A. (Love Ur Life Always) Handbook ........................................................... 469 4-6 A lette r that was included in EDINs L.U.L.A. Handbook ..............................................470 5-1 Nine categories with descrip tive labels for the typology ................................................. 477 5-2 Description of the two endpoints of the thin ideal internalization continuum .................477 5-3 Second key dim ension, the private to public continuum................................................. 479 5-4 Relationships am ong the public and private realms........................................................ 480 5-5 People pleasers/rom antics................................................................................................ 483 5-6 Conflicted negotiators ...................................................................................................... 484 5-7 Conflicted fem inists......................................................................................................... 485 5-8 Self-protective independents ............................................................................................ 487 5-9 Need norm al represented.................................................................................................488 5-10 Semi-activists............................................................................................................ .......489 5-11 Cest la vie.............................................................................................................. .........490 5-12 Supportive opposers....................................................................................................... ..491 5-13 Activists................................................................................................................. ..........492


18 Abstract of Dissertation Pres ented to the Graduate School of the University of Florida in Partial Fulfillment of the Requirements for the Degree of Doctor of Philosophy FROM THINSPIRATION TO OPPOSITION: HOW DO WOMEN IN RECOVERY FROM ANOREXIA NEGOTIA TE THE THIN IDEAL? By Deborah M. Demre December 2008 Chair: Lisa Duke Cornell Cochair: Debbie Treise Major: Mass Communication This dissertation contributes to the vast body of literature on the relationship among the female body ideal, anorexia nervosa, and the medi a. There are several studies of the medias influence on the female body ideal on self-esteem, and on the deve lopment of eating disorders. Literature in the psychology and health journals also has provided a growing body of knowledge of the recovery process from anorexia. However, this is the first st udy to explore how women who are in recovery (or recovered) from anorexia navigate the media landscape, one that is saturated with dominant ideologies that define cultural ideals of female beauty. Given the prevalence of media messages promoting the thin body ideal, how do women on the trail of recovery maintain their commitme nt to healing from anorexia? This qualitative dissertation explored the challenge s women face in recovery from anorexia, with a specific focus on media influence. Participant media journals and in-depth interviews provided rich insight into the lives of 32 women who have experienced and survived the negative effects of a culturally influenced phenomenon, Anorexia Nervosa. The media collectively serve as a dominant institution, which portrays and perpetuates a


19 powerful cultural message that women should stri ve to attain the thin ideal. Previously, the women in this study had subscribed to that ideal, and in doi ng so, they sacrificed their physical, mental, and emotional health. Part of the particip ants recovery process entailed learning how to negotiate or resist pervasive me dia messages promoting a body type that they now perceived to be unrealistic and unhealthy. The women in this study no longer passively accepted the mediated ideal, but they had varying degrees of resistance informed by their personal life experience. The insight gained from the womens medi a diaries and interviews provided a better understanding of how media are imp licated in the recovery process from anorexia. This type of information could improve the design of treatme nt plans for women seeking long-term recovery from eating disorders. It is crit ical that physical and mental h ealth care professionals develop a better understanding of the factors related to recovery from a norexia, including any relevant socio-cultural factors, such as the media.


20 CHAPTER 1 PREFACE AND PURPOSE OF THE STUDY How do wom en in recovery from anorexia naviga te the media landscape? The media serve as powerful cultural forces that continue to ex ert pressure on women to accept and strive for the thin ideal. Given the prevalence of media me ssages promoting the thin body ideal, how do women on the trail of recovery maintain thei r commitment to healing from anorexia? How do they maintain internal measuring sticks for self -worth and avoid internalizing the thin ideal? This qualitative dissertation explores the challenges women face in achieving full recovery from anorexia nervosa, with a specific focus on media influence. Participant media journals and in-depth interviews provided rich insight into the lives of women who have experienced and survived the negative effects of a culturall y influenced phenomenon, anorexia nervosa. The insight gained from the womens medi a diaries and interviews provided a better understanding of how media are imp licated in the recovery process from anorexia. This type of information could improve the design of treatme nt plans for women seeking long-term recovery from eating disorders. It is crit ical that physical and mental health care pr ofessionals develop a better understanding of the factors related to recovery from a norexia, including any relevant socio-cultural factors, such as the media. Prevalence of Eating Disorders and Thin Ideal The literature has indicated that in the United States, 11 million women and 1 million men suffer from eating disorderseither self-induced starvation or a cycle of bingeing and purging with self-induced vomiting, excessive exercise or laxatives (Dunn 1992; Fairburn, Cooper, & Cooper 1986; Kolodny, 2004; Wolf, 1991). These numbe rs have coincided with the media's portrayal of an increasingly low ideal female body weight that for ma ny women is unachievable


21 (Fallon, 1990; Kolodny, 2004; Tiggeman & Picker ing, 1996). How do women in recovery from eating disorders navigate their everyday lives with pervasive imagery of slender fashion models? In a quest to achieve the th in ideal, American women have been buying into the dieting industry, heavily promoted in a culture that va lues attractiveness, g lorifies thinness and objectifies women's bodies (Hall, 1993, p. 247). Thinness has become synonymous with beauty (Striegel-Moore, McAvay, & Rodin, 1986; Thompson, Heinberg, Altabe, & TantleffDunn, 1999). Research has indicated that fashion models define beauty, and the body is one of the most important factors in assessing attr activeness (Eagly, Ashmore, Makhijani, & Longo, 1991; Englis, Solomon, & Ashmore, 1994; Pipher, 1994). Thinness is not only valued, it has become a measuring stick for assessing a womans value, self-control, and mora l character (Blaine & McElroy, 2002; Bordo, 1993; Campos, 2004; Ciliska, 1993; Crandall, 1988; Gaesser, 2002; Goodman, 1995). Advertising in particular is often guilty of evoking guilt as a powerful, rhetoric al tool (Pedersen, 2002). Steiner-Adair (1994) provides an example of women at lunch saying Lets be bad and have dessert today (p. 385). Furthermore, Richards, MacRury, & Botterill (2000) have contended that the commodity of guilt relief (p. 154) in advertising is equa lly persuasive. Pedersen (2002) illustrates the problem of selling the concept that women shoul d be thin, regardless of how the message is portrayed. For example, an advertising campaign for Kelloggs Special K has pointed directly at womens fears of becoming overweight. The Look good on your own terms campaign has provided an outlet for women to pat themselves of their backs for agreeing with the ads, while still encouraging them to pursue the ideal body image. One particular advertisement portrays a tape measure on an invisible waist, and the copy reads Dont Let It Measure Your Self-Esteem. On a surface level, these advertisements garner


22 womens support in rejecting the me dias promotion of the thin id eal and its manipulative effect on self-esteem. Superficially, the message is that a healthy body is more important than meeting societal beauty standards. Yet, the advertisement also sends the same message s that it pretends to debunk. The ad uses the same enticin g visual techniques for promoti ng a thin ideal, illustrated by the circumference of the tape measure (Pedersen, 2002). Given the value Americans place on slenderness, how do women in recovery from a norexia interpret contradictory media messages such as those presented for a box of cereal? A qualitative study that considers the viewpoint of women recovered or in recovery from anorexia can make a significant contribution to the discourse on tr eatment and recovery programs. This dissertation provi des additional insight and unders tanding of the cultural problem that previous studies have illustrated. Women who have suffered from anorexia, sought help, and achieved some degree of longterm recovery learned first-hand the negative physical, psychologica l, and social effects of the disorder. On the other hand, research has indicat ed that women in recovery have found some aspects of their disorder positively reinforced and valued, which has contributed to their ambivalence about recovery. In particular, resear chers have found that anorexic symptoms, such as the ability to meet cultural pressures of s limness, are a benefit of the disorder (Garner & Bemis, 1982; Serpell, Treasure, Teasdale & Sullivan, 1999; Vitousek, Watson, & Wilson, 1998). Serpell et al. (1999) found th at internal reinforcers (p. 177) might impede full recovery and perpetuate the disorder ( p. 178). A particularly notewort hy example is the sense of mastery and achievement gained through fasting (Serpell et al., 1999, pp. 177-178).


23 Studies have indicated that women are often praised for losing wei ght, achieving a cultural reward in a sense. Media images reinforce the notion that slenderness is a positive achievement (Grogan, 1999; Hall, 1993; Hall & Ostroff, 1999; Kolodny, 2004; Malson, 1998). According to Serpell et al. (1999), fo r women who develop anorexia, the positive reinforcement for losing weight becomes part of a maladaptive schema (p. 184) that links weight loss to success, regardless of the extent to which the weight loss is taken. However, when weight loss becomes extreme and harms an indi viduals overall health and well-being, she no longer receives positive reinforcem ent. Typically family members and friends intervene and take measures to restore normal weight (Hall, 1993; Kolodny, 2004). Once a woman is nourished well enough to benefit from therapy, she may star t the emotional healing path on the road of recovery. This dissertation expl ores the challenges women face in achieving full recovery from anorexia nervosa, with a particular focu s on the role media play in perpetuating body dissatisfaction and feelings of inadequacy, Placing the Researcher in th e Context of the R esearch Having personally struggled with body image i ssues from the age of 13, I have taken an active part in the thinness mania (Seid, 1994). In the last 20 years, I also have developed a personal and professional level of media literacy to critique th e medias relentless messages of the thin body ideal. My personal pr ocess of recovery has led me to wonder what other women in recovery focus on? Part of my recovery journey involved acquiring an extensive lib rary of resources to absorb as much knowledge as possible. I searched for solu tions to an issue that seemed to take on a life of its own, distracting me, and many women I have come to know, from more meaningful pursuits in life. One book in particular, Full Lives: Women Who Have Freed Themselves from Food & Weight Obsession served as an inspiration for this dissertation.


24 The book was written by Lindsey Hall, a wo man who has recovered from anorexia and bulimia nervosa. As an extension of her rec overy process, Hall has published several books on eating disorders and recovery. With her hus band Leigh Cohn, Hall also founded Grze Books, the worlds leading publisher for information about eating disorders. Full Lives tells the story of 16 wome n, many of whom are best-selling authors, wellrespected clinicians, public speakers, and dire ctors of national associ ations dedicated to preventing eating disorders and encouraging women to let go of their connection to the societal obsession with thinness. All 16 women personally ha ve struggled with attaining the thin ideal, either through chronic dieting or by developing an eating disord er, but each one has recovered, overcoming the tyranny of the quest for the thin body ideal. What made this book particularly intriguing to me was that the idea for a similar study had already occurred to me. Two days later, I was browsing through a magazine in the doctors office. When the doctor came in, she commented on the slenderness of one of the female magazine models. I had been planning to writ e my dissertation on eat ing disorders and the media, which she knew, but I had not found a unique angle. It was then that she shared she had recovered from anorexia several years ago, and although she currently has no remaining behavioral issues, she continued to have powerful urges to be th in whenever she saw beautiful, slender female magazine models. Her comment was couched in nostalgic terms, I used to be that thin. I was not happy. In fact, I was miserabl e, and Id never want to go back to the way I was, but sometimes I think Id like to lose a little weight again. The discussion with the doctor, along with several passages in Full Lives inspired me to bridge my personal and academic pursuits: How do women in recovery from anorexia nervosa negotiate media messages of the thin ideal? Wome n who recover from an eating disorder may no


25 longer buy into or absorb the thin body ideal, but there is no immunization for exposure to the perfect woman's body, as powerful media sources continue to hammer out their support for slenderness. Graduate school exposed me to reception th eory, developed by Stuart Hall, a cultural theorist who is well-known in academic realms. Th e essence of the theory is that the audience is actively involved in negotiating meaning from media messages. The approach in reception theory differs from previous media theories that perceived the audience to be a passive message receiver. Hall further develope d active audience concepts in his model of encoding and decoding, which left the interpre tation of media messages, incl uding accepting, negotiating, or rejecting a message, in the hands of the audience. The most important and dissert ation-relevant concept from Ha lls approach is that the theory removes some of the medias perceive d dominating power. Viewed through a reception theory lens, messages are not viewed as having the power to audience interpretation; rather messages merely can serve as an influence on the likelihood of certain audience interpretations (Baran & Davis, 2003; Ross & Nightingale, 20 03). As Ross and Nightingale (2003) have explained, Interpretation was unde rstood to depend on the generosity of the audience who make time to engage with it and re produce it in th e contexts of their ev eryday worlds (p. 37). Halls paradigm has guided my personal approa ch to analyzing media messages of the thin ideal. Over time, I have developed negotiate d or oppositional readings of the media messages in magazines, radio, television, a nd the Web as opposed to blindly accepting the textual meaning intended by the producer or editor. Negotiating medi a messages requires personal vigilance, as the media rarely reflec t sincere acceptance of different body shapes and sizes, tending instead to prom ote the perfect, thin ideal.


26 Even with a relatively high degree of media li teracy, I struggle to remind myself that many messages are consumer-oriented and profit-driven. As a graphic designer, I know the power of Adobe Photoshop to enhance images, yet I sti ll find myself comparing my body to touched-up images in fashion magazines and on television. Background on Eating Disorders and Recovery There are two main eating disorders associat ed with the chronic pursuit of thinness, anorexia nervosa and bulimia nervosa. Anorexia nervosa is characterized by the refusal to eat enough to maintain body weight over a minimal nor m for age and height, an intense fear of gaining weight, body image disturbances, and possible amenorrhea (temporary cessation of menstruation); bulimia nervosa is characterized by a pattern of bingeing (eating large quantities of food over short periods of time) followed by attempts to compensa te for this excessive caloric intake by vomiting, using laxative s, severe restrictive dieting or fasting, or over exercising (American Psychiatric Association, 2000). Most health care professiona ls use the Diagnostic and Stat istical Manual of Mental Disorders to help them correctly diagnose their patients. The definition of anorexia nervosa for this study is the one used in the most recent ve rsion of the Diagnostic an d Statistical Manual of Mental Disorders, the DS M-IV-TR, published in 2000. A summary of the diagnostic criteria for anorexia nervosa includes intentional weight loss leading to a sustained body weight less than 85% of the minimal normal weight for age and height. Even with the underweight status, anorectics have an inte nse fear of gaining weight or becoming fat and often have a distorted view of their body weight or shape. Typically, the diagnosis includes denial of the seriousness of the low weight and an obsessive preoccupation of weight on self-evaluation. An additional criterion is amenorrhea for at least three consecutive menstrual cycles.


27 Within the anorexia nervosa diagnosis, th ere are two types, re stricting and binge eating/purging. The latter regularly engages in self-induced vomiting or th e misuse of laxatives, diuretics, or enemas, symptoms that also are used to diagnose bu limia nervosa, described below. I have chosen to include the diagnostic criteria for bulimia nervosa because many women who recover from anorexia develop symptoms of bulimia (Grogan, 1999; Hall, 1993; Hall & Ostroff, 1999; Fallon, Katzman, & Wooley, 1994). Like anorexia, it [bulimia] is fueled by a dual obsession with both thinness and food. In fact these two eating disorders have been called Cinderellas stepsisters and ar e often referred to as flip side s of the same coin (Kolodny, 2004, p. 78). Research has indicated that many women who recover from anorexia develop symptomology of bulimia (Brown, 1993; Hall, 1993; Kolodny, 2004), and according to Kolodny (2004), some women with eating disorders flip back and forth between bulimia and anorexia, bingeing for a while, then restricting, and resor ting to bingeing again (p. 19). The pattern of behavior is not surprising when one acknowledges that extreme die ting is really just a form of starvation, and the bodys natural re sponse to starvation, especially endured over a long period of time, is to eat. The DSM-IV-TR diagnostic criteria for bulim ia nervosa include r ecurrent episodes of binge eating, characterized by eating a larger am ount of food than most people would eat during a similar period of time and under similar circumst ances. The episode is further characterized by a sense of lack of control over how much is ea ten. The binges are accompanied by compensatory behaviors to prevent weight gai n. Those who fit the purging type criteria engage in behaviors such as self-induced vomiting or misuse of la xatives, diuretics, or enemas. The non-purging type engages in other compensatory behaviors, su ch as fasting or excessive exercise. To meet


28 the diagnostic criteria, the binge/purge cycle mu st occur on average at least twice a week for three months. Similar to anorexia nervosa, t hose afflicted with bulimia nervosa place undue influence on body shape and we ight in self-evaluation. Eating Disorders on a Continuum Eating disorder diagnoses are not always clear-cut. Most he alth professionals view eating disorders on a continuum (Brown, 1993; Esherick, 2003; Hall, 1993; Hall & Ostroff, 1999; Hesse-Biber, 1992; Kolodny, 2004; Lwe et al., 1996; Peters & Fallon, 1994; Root, 1990; Thomsen et al., 2002) from debilitating, life-threat ening symptoms to mildly annoying ones that are not life-threatening per se, but negatively impact your quality of life (Kolodny, 2004, p. 21). Tossed into the continuum are t hose who experiment with eating disorder behaviors such as self-induced vomiting, diet pills or laxatives, w ithout actually making the practice a long-term behavior (Story et al., 1998; Lwe et al., 1996). Brown (1993) ha s contended that a continuum perspective allows researchers to challenge th e traditional notion of anorexia as simply a diagnosable mental illness, distinct from a culturally-fueled preoccupation with weight. According to Orbach (1978), many women diet throughout their lives, repeating cycles of gaining, losing, and regaining weight. In addition, researchers have found that even women who do not fit diagnosable standards of an eating disorder exhibit an unheal thy preoccupation with body image. Weiner (2003) has contended that most people in the United St ates have disordered eating, if not clinical eating disorders. While it is important to acknowledge the pr evalence of body dissatisfaction and disordered eating, for the purposes of this study, the focus is on women who are in recovery from clinically diagnosed anorexia nervosa. What is interesti ng to note is that the psychiatric criteria are socially defined and have transformed over time. For example, Brown (1993) has noted that the criteria for anorexia have become less stringent (p. 59 ). With the percentage of body


29 weight lost decreasing from 25% to 15% between 1980 and 1987 respectively, more women are able to fit the diagnostic label (p. 59). To add to the cultural confusion, a woman who maintains a weight 15% below ones normal body weight for ag e and height is diagnosed with a disorder, but society accepts and the fashion industry prom otes role models who routinely maintain a weight 20% below their normal we ight (http://www.aedweb.org/). Recovery Defined In order to study women who are in recovery from anorex ia, a definition for recovery also must be establishe d, due to the lack of consensus in the literature (Serpell et al., 1999). Some researchers have conten ded that full recovery is an achievable state, indicated by freedom from all diagnostic crit eria in the DSM-IV-TR, including the statement about allowing self-evaluation to be unduly influenced by body shape (Goldfein, Walsh, & Midlarsky, 2000). Other researchers perceive that bo th the onset of and the recovery from an eating disorder is a process, not an isolated, meas urable event (Brown, 1993; Fallon et al., 1994; Hall & Ostroff, 1999). For the purposes of this dissertation, recovery is viewed as a process, not an end product. Even after behavioral symptoms subside, women in recovery from anorexia continue to face powerful socio-cultural factors that consistent ly challenge their development of healthy perspectives on the media-perpet uated thin ideal. More in-depth information on how recovery was defined for the selection of participants in this study will be provided in Chapter 3. This next section will provide evidence for the prevalence of the potentially harmful media messages promoting the thin body ideal. As the firs t two chapters will indi cate, the rich body of literature is lacking one key ingr edient, particularly for women in recovery. What has not been studied is how women who ar e in recovery from anorexia negotiate media messages.


30 Seriousness of Anorexia Research has indicated a long-term trend of rising rates of anorexia nervosa (Lucas, Crowson, OFallon, & Melton, 1999). Eating disorders are serious a nd can be lethal. They are also one of the most common psychiatric disord ers affecting young women (Kendler et al., 1991; Whitaker et al., 1990), with anorex ia nervosa having the highest pr emature death rate in 15-to24-year-old females of all mental disorder s (Keller, Herzog, Lavori, Bradburn, & Mahoney, 1992; Signorini et al., 2007; Sullivan et al., 1998). Mortality es timates range from 5.1% to 19% with causes of death including suicide and direct effects of self-induced starvation, such as cardiac arrhythmias (Crisp, Callender, Halek, & Hsu, 1992; Lwe et al ., 1996; Pompili et al., 2004). Anorexia damages womens friendships, family interactions, relations hips, school or work performance, and self-esteem (Hall, 1993; Ha ll & Ostroff, 1999; Ko lodny, 2004; Wolf, 1991). In addition, women who live through anorexia nervosa face a debilitating and often chronic illness that has become a serious threat to women's health in Western societies. Several researchers have documented the medias contribution to the devel opment of anorexia, as well as the long-term negative impact on womens physical and psychological well-being (Brumb erg, 2000; Keller et al., 1992; Kolodny, 2004; Fallon et al ., 1994; Sharp & Freeman, 1993). This dissertation may offer useful informa tion to other women seeking recovery from anorexia or prevention from rela pse. The findings also are likely to create more awareness of how the media contribute to the problem. In addi tion, the study may offer insight in terms of how women can become more resistant to the thin id eal message that is so pervasive in todays media.


31 Challenges with Recovery There is no instant cure for anorexia nervos a. Treatment is not easy, and even individuals who are released from inpatient treatment do not always maintain longterm recovery. Some individuals diagnosed with anorex ia nervosa fully recover after a brief episode: some experience fluctuating patterns of weight gain and loss, foll owed by partial or complete relapse; and others experience a chronic struggle with the illness for many years (Ame rican Psychiatric Association, 2000). Statistical results have varied in terms of improvement and full-recovery rates from anorexia. Some researchers have found full reco very rates ranging from about 30 to 62% (Lwe et al., 2001; Steinhausen, 1995; St einhausen, Rauss-Mason, & Seidel 1991; Yager, 1988). Other researchers have indicated that a bout a third of patients continue to meet diagnostic criteria for anorexia nervosa five years and longer after initial treatment, even after making significant strides toward recovery (Fairburn, Cooper, Do ll, Norman, & OConner, 2000; Herzog et al., 2000; Strober, Freeman, & Morrell, 1997; Su llivan, Bulik, Fear, & Pickering, 1998). On a more positive note, research has indica ted that given the right conditions, treatment programs can be effective in what is considered the most difficult psychiatric condition to treat (Brumberg, 2000; Richards et al., 2000). For exam ple, in a follow-up study of a population of anorectics enrolled in a unive rsity treatment program, Strobe r et al. (1997) found a 75.8% recovery rate. Recovery rates are important to consider be cause while some women are able to achieve long-term recovery from anorexia, many women only achieve partial recovery (Esherick, 2003; Kolodny, 2004; Richards et al., 2000). Some relapse or develop sy mptoms of other disorders, such as bulimia or binge eating (Kolodny, 2004; L we et al., 1996; Sullivan et al., 1998, Tozzi, Sullivan, Fear, McKenzie, & Bulik, 2003. Accordi ng to Kolodny (2004), about 50% of anorectic


32 women develop bulimia or bulimic symptoms, wh ile still retaining a primary diagnosis of anorexia nervosa (Sullivan et al., 1998). Those who are fortunate enough to fully surv ive the physical effect s and symptoms of anorexia invest a significant amount of time, money, and emotional energy fighting the illness (Esherick, 2003; Fallon et al., 1994; Hall, 1993; Kolodny, 2004). Trea tment is expensive, with many inpatient centers charging more than a th ousand dollars a day. In addition, even with clinical treatment it can take women from 57-79 m onths to achieve full recovery. Recovery also can become a vicious cycle because the longer a woman suffers from an eating disorder; the longer the recovery process takes (Esherick, 2003; Hall, 1993; Hall & Ostroff, 1999; Kennedy & Garfinkel, 1992; Kolodny, 2004; Richards et al., 2000). Given the medias proven contribution to the development of self-esteem, body image and disordered eating in women (Field, 2000; Harrison, 1997, 2000, 2001; Harrison & Cantor, 1997; Heinberg & Thompson, 1995; Hofschire & Gree nberg, 2002; Grogan, 1999; Irving 1990; Irving, 2000; Kalodner, 1997; Thompson et al., 1999) it is important to understand how those in recovery negotiate the powerf ul messages of the thin body id eal. Even once the behavioral symptoms subside, the women must learn how to navigate healthful lives in a culture consumed with the attainment of thinness. Women in recovery must work vigilantly to maintain moment to moment awareness (Hall, 1993, p. 247) and listen to their inner truth, rather than absorbing socially acceptable notions of beauty and returning to self-destr uctive eating patterns. Why Women? This study explores women in particular because studies have indicated that approximately 90 to 95% of diagnosed cases of anorexia are female (Hsu, 1989). Despite the increasing pressure on men to conform to a muscular, V-shaped body (Mishkind, Rodin, Silberstein, and Striegel-Moore; 1986; Labre, 2004; Law & Labre, 2002), research universally has indicated that


33 regardless of age, anorexia nervosa affects many more female s than males (Grogan, 1999; Hsu, 1989, 1990; Kolodny, 2004; Malson, 1998). Statistics from academic and professional res earch have indicated that this is true, and some investigators have exam ined why women are so much more vulnerable than men. One reason is that when female adolescents reach puberty, their body shapes tend to deviate away from the American body ideal, whereas male body shapes tend to change towards the cultural ideal. To achieve the ideal body, more women turn to diets, become preoccupied with body size, and display more symptoms of eating disorder behavior than men (Kilbourne, 1994; Thompson et al., 1999). Clinicians and social science research in se veral fields have indicat ed that women tend to use eating and appetite suppression as a form of expression, much more so than men do (Brumberg, 2000). Rather than appr opriately expressing anger, fr ustration, discontent, or any other uncomfortable feelings, women with a norexia develop a coping technique (appetite suppression) that numbs and masks their true emo tions. As their bodies wither away, family and friends gradually realize that a problem exists, but the anorexia has been used as a tool for suppressing healthy emotional expression (K olodny, 2004; Malson, 1998; Peters & Fallon, 1994). According to Malson (1998), amenorrhea, which is one of the symptoms for diagnosing anorexia, is associated not simply with a refusal of womanhood but also with avoiding emotions (p. 117). As a woman with anorexia becomes progressively thinner, she becomes increasingly emotionally detach ed, as a coping mechanism for a voiding feelings and expressions of those feelings. Malson (1998) has indicated that for women who have anorexia painful thoughts and feelings and traumatic memories are covered over, suppressed and replaced by numbers on weighing scales (p. 168).


34 Esherick (2003) found that women in rec overy from anorexia progressed through three phases: self-discovery, self-acceptance, and se lf-expression. In the first phase, women in recovery from anorexia nervosa work on recognizi ng and getting in touch with feelings as well as developing a sense of self. In the second pha se, women learn to accep t themselves and their feelings. In the third phase, women start to express their feelings to significant others in their lives, such as close friends and family. They also work on developing their newly recognized sense of self and expressing assertive remarks in a manner that remains true to their self. Cultural Ideal Women also receive a powerful message to conform to the cultural ideal (Grogan, 1999; Kolodny, 2004; Malson, 1998). The encouragement to diet to achieve this thin ideal is relentless, for women much more so than for men (Ande rson & DiDomenico, 1992; Gaesser, 2002; Hall, 1993; Kolodny, 2004; Silverstein, Perdue, Peters on, & Kelly, 1986). In fact, Malson (1998) has illustrated that womens magazines provide step -by-step instructions and day-to-day diets for beautification (p. 111). Se veral studies have examined th e relationship between the thin body ideal portrayed in the media and the in creasing prevalence of dieting, body image dissatisfaction and eating disorders (Harrison, 2000; Harrison & Cantor, 1997; Hofschire & Greenberg, 2002; Levine, 2000; Levine & Smolak, 1996; Levine, Smolak, & Hayden, 1994). Socio-cultural pressures are t hought to play an influential role in the prevalence of body dissatisfaction in contemporary Western society (Franzoi & He rzog, 1987; Levine et al., 1994; Malson, 1998; Seid, 1989; Tiggeman & McGill, 2004). An increasing incidence of body dissatisfaction and eating disorders has coincide d with changes in socio-cultural norms for females over the last few decades. Todays Americ an ideal female body is thin, tall, and longlegged, and there is a pervasive belief that women n eed to fit this ideal to be socially accepted and professionally successful (Levine & Smolak, 1996; Malson, 1998; Stice, 1994). Proponents


35 of the socio-cultural th eory (Thompson et al., 1999; Tiggema n & McGill, 2004) have contended that current societal beauty standards place exce ssive emphasis on thinness, the level of which is impossible for many women to achieve in a healthy manner. The Socialization Process Some researchers have contended that women are more likely to develop eating disorders because they are socialized to rely on their body for admiration. Messages about the ideal female form are conveyed though various means, includi ng family, peers and the mass media (Garner, Garfinkel, & Olmstead, 1983; Pike & Rodin, 1991; Stice, Schupak-Neuberg, Shaw, & Stein, 1994). Seid (1989) has suggested th at from a young age, girls are encouraged to think about how they appear to others, from their clothes, hair and smile, to their body. Th ey are socialized to focus on their physical appearance for others to admire, a quality that later can transform into a pathology such as an eating disorder because thei r bodies have been one of the few avenues of expression reliably open to them (p. 78). The mass media infiltrate our everyday lives making them a particularly powerful force for influencing social attitudes. With a mode rate level of body dissatisfaction now viewed as normal among females (Rodin, Silberstein, & Striegel-Moore, 1985), many researchers have examined the media as contributing forces for di sseminating of notions of a desirable, slender body (Botta, 1999; Heinberg & Thompson, 1992; Heinberg & Thompson, 1995; HendersonKing & Henderson-King, 1997; Levine et al., 1994; Myers & Biocca, 1992; Posavac, Posavac, & Posavac, 1998; Stice et al., 1994; Tiggemann & Pickering, 1996). In general, American society has adopted positive associations with thinness and negative associations with anyone who is overweight (Botta, 1999; Harrison, 1997; Hei nberg & Thompson, 1992; Heinberg & Thompson, 1995; Kolodny, 2004).


36 Positive Associations with Thinness Research has indicated that American wo men have widely adopt ed the socio-cultural notion that achieving the ideal body grants rewards such as happi ness, self-esteem, health, and even love (Bruch, 1973, 1978; Bordo, 1993; Brown, 1993; Grogan, 1999; Kilbourne, 1994; Thompson et al., 1999). The thin ideal has been so widely adopted that some normal women have jokingly said they wished they could have anorexia nervosa for just a little while (Brumberg, 2000, p. xvii). Women have made great strides since the re pressive Victorian era, but centuries later females are still contending with the medias portray al of them as inferior beings whose primary value lies in their physical appearance and sexuality (Bordo, 1993; Wolf, 1991). Perhaps more than any other time in history, we are preoccupied with beauty: its power, its pleasures, its style, and its substance (Bordo, 1993; Friday, 1996; Kilbourne, 1994; Schefer, 1997; Thompson et al., 1999; Wolf, 1991). The predominant view in Western culture is that a woman who is thin is also healthy, happy, intelligent, and successful. She has restricted her diet and exercised sufficiently to have attained the ultimate standard of beauty, slenderness. Women who achieve the thin ideal are viewed as more attractive to the opposite sex, more popular, likable and good (Brown, 1993; Englis et al., 1994; Hall, 1993; Goodman, 1995). It is not only men, but also women who judge female body attractiveness based on thinness (Barber, 1998). In general, our culture has positive associations with slenderness. Several feminist scholars fault the culturally influenced diet industry for encouraging women to subscribe to the idea that wei ght loss is the key to solving problems in their lives (Brown, 1993; Myers & Biocca, 1992; Malson, 1998; Orbach, 1978; 1993; Steiner-Adair, 1994).


37 Beauty may not be the most important of our values, but it affects us all today more than ever. We live in a media age where our visual landscape changes in seconds; our first reaction to people is sometimes our last. Given this reality, the so-called trivialit y of beauty suddenly seems not so trivial after all (Schefer, 1997, p. 9). Women in recovery from anorexia still ar e surrounded with slender media images that have positive associations in our culture. Peters and Fallon ( 1994) found that one of the most difficult areas of recovery for women was learning to reconcile their imperfect bodies with omnipresent reminders of what is valued by th e culture (p. 344). Reducing the perceived power of thinness would allow women in recovery from anorexia to maintain a healthy weight, rather than feeling ambivalent about their body size. As Steiner-Adair (1994) ha s suggested, our culture needs to challenge the media-promoted notion th at a womans primary source of power is her ability to attain thinness. If women were less concerned with losing weight, they could act on deeper passions (p. 389). Negative Associations with Fat Not only are there incentives to attaining a th in body, but there are also punishments when the cultural standard is not achieved. When the body doesnt meas ure up [to societal pressures to be thin] most women feel they themselv es dont either (Brown, 1993, p. 54). Womens lack of control over their body size and weight leads to self-loathing as well as subtle or more overt loathing from others. Researchers have found th at overweight women evoke negative emotional reactions from others ranging from unspoken th oughts of pity, fear, a nd disgust to outright hostility (Bordo, 1993; Gaesser, 2002; Good man, 1995; Weiner, Perry, & Magnuson, 1988). The literature has suggested that in American society slenderness is nearly a pre-requisite for women interested in a roman tic relationship. In particular, h eavy women are stigmatized with regard to issues of sexuality and dating (C hernin, 1981; Goodman, 1995; Grogan, 1999; Orbach,


38 1986; Regan, 1996; Wiederman & Hurst, 1998). In general, physical attractiveness is significantly more important for men than fo r women when seeking a relationshipsexual, short-term, or long-term (Buss, 1994; Feingold, 1990; Wiederman & Hurst, 1998). Men also are hesitant to enter a long-term commitment with a woman who is perceived as unattractive. Romantic relationships are not the only realm affected by weight. Thinness is a quality so highly valued by our culture that prejudice agains t fat people has remained socially acceptable (Bordo, 1993; Campos, 2004; Ciliska, 1993; Gaesser, 2002; Good man, 1995; Grogan & Wainwright, 1996; Orbach, 1986; Steiner-Adair, 1994). As Hall (1993) has contended, The possibility of becoming fat and enduring the prej udice and discrimination against people with large bodies which pervades our society keeps ev en naturally-thin individuals on guard against their hunger (p. 130). When a thin woman overc omes hunger, she is viewed as possessing strength or control. On the oppos ite end of the spectrum, a fat woman is weak. She lacks inner strength, giving in to hunger and indulging herself with food (p. 130). Steiner-Adair (1994) has captured the importa nce of thinness in Western culture and the implied shame with being overweight: Since the sexual revolution of the 1960s, thinness has replaced virginity in its representation of goodness in women. Obesity is regarded with th e scorn previously reserved for sexuality. Heads no longer turn in moral righteousness when a scantily dressed woman walks down the street, and we hear the same language of moral condemnation applied to the obese woman that used to be directed toward the sexually active woman: She has no self-re spect, Shes out of control, How could she let herself go? She's destroyed herself, and so on. (p. 386) Ten years later, the fear and loathing of fat have continue d. Campos (2004) has contended that Americans view a fat body, or even the very idea of fat as a fashion faux pas associated with disgust and moral failing (p. 227). As several studies have indicated, women who are


39 considered overweight in America struggle to gain a sense of self-worth in a culture that consistently degrades anyone outside the mold of th e thin ideal. As Seid (1989) has argued, in modern America, being fat is as shameful as being dirty. We seem to believe that slenderness is as attain able as cleanliness and as crucial to respectable grooming (p. 7). Current American culture has maintained a widely held belief that if a woman is overweight, it must be her fault. She is viewed as lazy, lacking the willpower to adhere to her ideal weight (Goodman, 1995; Hall, 1993; Ha rris, 1990; Seid, 1994; Wooley & Wooley, 1979). Laziness is a particularly distasteful charac teristic in an American society that values personal responsibility, hard wo rk, and self-discipline (Campo s, 2004; Ciliska, 1993; Gaesser, 2002). Heavy women are viewed with disdain when they attend parties, head to the gym, go grocery shopping, eat in rest aurants, and even collect food stamps (Goodman, 1995). Not only do these women feel the emotional toll but research also has indicated they also face obstacles to advancement in their ca reers (Bordo, 1993; Campos, 2004; Goodman, 1995; Rand & Kuldau, 1990; Rothblum, 1994; Rodin et al., 1985; Stei ner-Adair, 1994). For example, Rothblum (1994) found that women pe rceived as thin tended to earn a higher salary than others, and Steiner-Adair (1994) contende d that weight affected per sonnel decisions in hiring and promotion (p. 385). Imagine the struggle a woman in recovery from anorexia faces. She lives in a society that has praised her initial weight loss and hunger co ntrol. But she reaches a turning point when anorexia starts to control her life, upsetting her with constant thoughts of food (Serpell et al., 1999). After crossing the line into diagnosable di sorder and seeking help, clinical treatment forces her to regain weight, stri pping her of her previous sense of control over food. In treatment,


40 she no longer has full control over what she chooses to put into he r body, especially if shes been forced into a treatment program (Brumberg, 2000; Kolodny, 2004; Steiner-Adair, 1994). Healthy recovery offers women alternative sens es of control, diminishing the focus on selfevaluation by weight and size. How do women in recovery from anorexia, with a full commitment to healing, interpret the dualitythe c ontrol versus lack of co ntrol, or sense of it? How do they negotiate negative societ al associations with fat, or even more subtly, their loss of positive attention from others for having the ab ility to control their weight so precisely? Ideal Not Attainable Seid (1994) has offered a particularly insi ghtful, critical persp ective on our countrys distaste for fat women. She also pointed to the consequences of the false notion that everyone can achieve the ideal. The health industry embraced the questionable con cept of ideal weight the idea that the weight associated with optimum health and longevity could be determined by height. It was then decreed that everyone of the same height and bone structure should meet this ideal. But this injunction assumed that body wei ght and the ratios of fat to lean tissue were direct functions of exercise and eating habits. The obvious corollary was that everybody should reduce to ideal weight and that everybody could eas ily do so if they exerted enough willpower. (p. 7) The concept that all individuals can achieve the Western American socio-cultural body ideal is erroneous (Harrison, 1997) For example, some researchers have noted some women's, physiological somatypes (body shapes) conflict w ith the body ideal (Grilo Wilfley, Brownell, & Rodin, 1994). Teasing. Socio-cultural messages ov erpower the physical impossibilities of altering body shape, and many American women ha ve accepted the thin societal ideal as a goal and the false message that all bodies can be al tered (Campos, 2004; Hall, 1993; Hall & Ostroff, 1999; Kolodny, 2004; Wolf, 1991). The media continua lly perpetuate the myth that body shape and weight are easily malleabl e (Thompson et al., 1999, p. 87).


41 At least some of the message that slenderne ss is a realistic goal for everyone is fueled by the lucrative diet industry. Campos (2004) has in dicated that the American weight loss industry is a fifty-billion-dollar-per-year con game, which for many deca des has provided its customers with totally ineffective cures for an imaginary disease (p. 218). Cam pos (2004) has contended that obesity research is little more than a s cam masquerading as a science (p. 221). He also has argued that obesity researchers ar e keenly aware of the economics of the fielda field that is wholly funded by the weight-loss industry. The marketing of weight-loss products contribu tes to the impression th at weight is easily controllable and that anyone w ho is heavy, especially a woman, can lose weight if she only makes an effort (Crandall & Martinez, 1996). R ecently researchers also have found that the media contribute to weightism, or prejudice agai nst heavy people. Blaine DiBlasi, and Connor (2002) found that weight-loss infomercials in part icular promote the (largely erroneous) belief that the thin ideal is easily achieved. Interestingly, Blaine et al. (2002) also found that when heavy people lost weight their negative attitude s toward other heavy people increased. The media message, fueled by the weight-lo ss industry, is clear. The increas ing rates of anorexia nervosa reflect the spirit of Americas cultural aversi on to fat. As Kitch (1998) has argued, media imagery is a powerful lens through which we may c ontinue to zero in on moments of change in American history that are simultaneousl y social, economic, and cultural (p. 258). Americans have an ambivalent relationshi p with food. Food is widely available and excessively advertised, but there is a tacit, and sometimes more explicit, societal expectation to limit consumption. The media messages Americans receive are rife with conflict. On the one hand, advertising expenditure for the food industry has approached $4 million, more than what is spent on most other products and services in this country (Aaker, Batra, & Myers, 1992). Yet,


42 the abundance of culinary choices is matched by an equal number of dieting media messages to be fit and trim (Brumberg, 1997; Garner, Garf inkel, Schwartz, & Thompson, 1980; Seid, 1989; Wiseman, Gray, Mosimann, & Ahrens, 1992). The medias advertising and editorial content reflect Americans hedonistic attitude toward food, tempered with a diet obsession. Women in particular get the strong message that food impulses must be reigned in and controlled (Garner et al., 1980; K ilbourne, 1994; Klassen, Wauer, & Cassel, 1990/1991; Seid, 1989; 1994). The media offer a convenient solution to weight control, encouraging women to participate as much as possible in the flourishing diet industry. Hall (1993) stated that 50% of all women are di eting at any moment a nd $36 billion is spent on dieting and weight loss products each year. According to Wolf (1991), a dvertising and the media indoctr inate the consumer in these ideals to the detriment of most wo men. Diet products, fitness, and the fear of fat are encouraged and promoted to the extent of marketing unhealthy addictions (Campos, 2004; Chernin, 1981; Goodman, 1995; Wolf, 1991). Polivy and Herman (1987) agree that dieting has become common, to the extent that what is considered normal eating by many female adolescents may actually border on what would trad itionally be diagnosed as eati ng disordered. In a recent poll, 500 women were asked what they feared most in the world, and 190 of them replied, getting fat (Chernin, 1981, pp. 36-37). Hall (1993) and Campos (2004) have contended that the most problematic aspect of the dieting epidemic is that people th ink that if they tried hard enough, they could adhere to the thin ideal. Rather than seeing the promotion of die ting and weight loss as the problem, people think of diets as the solution and themselves as failures. As Gaesser (2002) state d, Diets dont fail, we are told, dieters do (p. 34). The acceptance of dieting, al ong with the widening gap between the


43 cultural body norm and the average womans body reality, has led to a diet-crazed society that has diminished American womens self-esteem (Hall, 1993). Most eating-disorder specialists agree that chronic dieting and low self-esteem is a direct consequence of the social pressure on American females to achieve a nearly impossi ble thinness (Hesse-Biber, 1989; Strober, 1986; Hall, 1993). Harrison (1997) has coined the term ideal self-discrep ancy to indicate the difference between a womans perceptions of her actual physical attributes and those she would like to have or, based on family, fr iends, and the media, thinks she should have. Hall (1993) poignantly illustrated the powerful role of the thin cultural ideal, and the role it may play in the lives of women in recovery from anorexia. An impossible ideal is set up for us that we can never attain and the result is frustration, sorrow, and self-hatred. We could all work very hard on abuse that is family related, we could spend years in therapy, we could feel heal thy and strong, but we still have to live in a culture that demeans the very essence of who we are. We need to be aware of how crazy the culture is and that it plays an essential role in how we feel about ourselves. (pp. 250-251) Media Set the Norm As previously noted, the driving force behi nd the flourishing diet i ndustry is the cultural expectation for American women to be physical ly attractive, specifically by attaining or maintaining a thin body (Brumberg, 1988; De Jong & Kleck, 1986; Franzoi & Herzog, 1987). This sentiment is echoed and reinforced in the media. Freedman (1986) has used a quotation from a Bloomingdales ad to illustrate our curre nt conception of the ideal female body: She is bean lean, slender as the night narrow as an arrow, pencil thin, get the point? (p. 150) Most people are likely to have learned about the female body ideal through the mass media, including television, magazines, books, m ovies, the Internet, and other forms of massproduced media. Some studies have found that expos ure to the thin ideal portrayed in the media


44 are linked to the drive for thinness among women and the preference, among men, for thinness in women (Hargreaves & Tiggeman, 2004; Harrison & Cantor, 1997; Stice et al., 1994). Women not only have to contend with their own or their female peers expectations of the thin ideal; they also are faced with media-in fluenced male expectations. Hargreaves and Tiggeman (2003) found that the media might indirectly impact females body image by influencing male expectations and evaluations of the average womans appearance. Exposure to idealized images of women alters mens percepti ons of beauty standards and provides an illusion that the ideal is easily achievable. Other res earchers have provided further evidence of the illusion. For example, in an experimental st udy, Kenrick and Gutierres (1980) found that men who were exposed to attractive actresses rated an average-look ing woman as less attractive. There are several public reward and punish ment systems in place designed to signify womens place on the attractiveness continuum. Ha rrison (2000) found that there were more below average weight and thin-ideal characte rs in television and magazines. In addition, overweight characters were the objec ts of ridicule and punishment. Television offers a taste of how people ar e likely to be perceived based on weight. According to Fouts & Burggraf (1999, 2000), be low-average weight female characters in television received more male attention and prai se regarding weight and body shape than normal weight characters. Given the power of television to reflect and transmit social values of the predominant culture on viewers (Bryant & Zillman, 2002), is it any wonder that women continue to pursue the thin ideal? Television programs are just one media outle t representing the thin female body ideal. Magazines compound the problem, offering deceptivel y altered images on glossy pages. Several researchers have demonstrated a causal link of exposure to magazi ne images with thin, attractive


45 women and increased body and weight dissatis faction (Irving, 1990; Posavac et al., 1998; Richins, 1991; Shaw, 1995; Stice & Shaw, 1994; Turner, Hamilton, Jacobs, Angood, & Dwyer, 1997). Other researchers have f ound that college women in particular tend to compare themselves to fashion models (Harrison & Cantor; Tiggeman & McGill, 2004). Furthermore, Tiggeman (2003) studied media exposure of fema le college students a nd found that the amount of magazine reading was positively correlated with internalization of the thin ideal. Even novels and films reflect our cultures we ight anxiety. What is culturally accepted as beautiful is achieved only with great artificephoto croppings, camera angles and composite bodies are necessary to get the pictures we now see of beautiful women (Pipher, 1994, p. 56). In the best-selling novel, Bridget Jones Diary Bridget is supposed to be a self-sufficient, career woman, yet each diary entry expresses her inability to maintain the ideal weight, and her days are categorized as good or bad depending on her calori c intake. The film vers ion reiterated the fat phobia and obsession in our culture as well as the distorted view we have of what is considered overweight. As Campos (2004) has noted, Ren e Zellweger is a s lim actress who made headlines by being willing to gain weight in order to become fat enough to play the role. Her typical weight is 109, so at 5'4" Zellweger qualified as fat and was congratulated for her bravery it must have taken to sacr ifice so much for her art (p. 11). The danger in the portrayal of what is ideal is that media consumers develop a skewed vision of what is normal. For women with eati ng disorders, the skewed vision is exacerbated, especially given their changing views of normality over time. Changes in American Weight Standards Data using body mass index indicates that Americans are becoming heavier, despite our apparent focus on dieting and weight loss. The tr end toward an increasingly slimmer ideal in the media over the last few decades has coincided with larger average body weight in women in


46 Western societies (Berg, 2000). Several empirical studies illustrate the paradoxas the standard has thinned, the average weight (in relation to height) of American wo men under age 30 actually has risen (Garner et al., 1980; Wiseman et al., 1992). While it may be true that Americans are becoming heavier, the federal guidelines for acceptable weight have altered as well. Pressure from insurance companies has decreased the weight that qualifies someone as fat or obese (Campos, 2004; Kolodny, 2004; Seid, 1989). The actual term ideal weight was coined in 1897 when the insurance industry designed a table to gauge mortality risk (Gaesser, 2002). In 1942, uniform weight charts and guidelines were implemented to identify ideal weights. In the last 20 years, obesity rates have risen dramatically in North America, with the United St ates gaining the unenviable status of fattest nation (World Health Organi zation, 2002). At the same time, guidelines based on body mass index (BMI) have suggested an increasingly lower ideal weight over the years. For example, in 1942, for a woman 25 and over and about 5' 6," the ideal was between 130 and 140 pounds. Seventeen years later, the ideal weight fo r the same age and height dropped to 124-139 (www.nationaleatingdisorders.org, 2002). In 1985, new federal guidelines reduced the weight guidelines again and suggested that women ages 18 to 25 sh ould weigh between 118 and 150 pounds (Kolodny, 2004). The next section will provide a brief ove rview of the ideal female body standards over time, illustrating how female ideal body standards have changed, but the pressure on women to alter their bodies to adhere to a socially acceptable size and shape has remained the same. Historical Standards for the Female Body Ideal Over tim e, the Western body ideal has transfor med, influenced by biological, historical, and cultural factors. What has remained the same is womens pursuit of the current ideal (Brumberg, 2000; Englis et al., 1994; Heinberg & Thompson, 1995; Mazur, 1986; Pipher, 1994;


47 Seid, 1989, 1994; Thompson et al., 1999). According to Brumberg (2000), anorexia nervosa has historic social and economic roots dating back to the 1870s, and the contemporary cultural environment that contributes to a norexia today is an indication of history repeating itself, rather than a new phenomenon. Anorexia was born in the nineteenth century; it flourished at the end of the twentieth, and its staying power seems uncom promised as we cross the bridge into the new millennium (Brumberg, 2000, p. xvii). During the Victorian era, the term fasting girls was used to refer to women who had stopped eating regardless of the cause. For some people, the term was used for those who ate small amounts, irregularly, or ju st outside the normative food categ ories. The nineteenth century marked a time when female fasting behavior was viewed in different ways, from religious piety, holiness and empowerment to witchcraft, superstition or mental illness (Brumberg, 2000). Evidence of anorexia dates back to Charles Lasgues 1873 LAnorexie Hysterique, the first documentation of anorexia nervosa. A member of early French psychiatry, Lasgue said that l'anorexie hysterique typically began between ages 15-20 and had three stages In the first stage, a young woman might express general unease after ea ting and use this discomfort as a reason for eating less. During stage two, anorexia becam e more of an object of preoccupation and conversation for the young woman, though a physician wa s not an active part of her life. In the last stage, the young womans physical well-being ha d deteriorated to such an extent that if family and friends already had not done so, th ey sought the help of an experienced medical professional (Brumberg, 2000). France was not the only country to recognize anorexia. Britain and the United States also recognized and named eating disorders in th e 1870s, a time when body image began to be associated with social class. The upper classes wanted to distinguish themselves from heavier


48 women in the working class. Thinness became an indicator of socioeconomic status, despite sufficient availability of food. Fo r some women, attempts to indi cate their social status through their body size have been a factor leading to extreme eating beha vior (Brumberg, 2000; Thompson et al., 1999). Many of the current pressures young women face t oday at least partially can be attributed to positive economic and technological progress. With medical advances, for example, females today pay more attention to hygiene and appearance. In addition, young women experience sexual maturation several years younger than girls did in the late 1800s a nd often do so before they are emotionally mature (Brumberg, 1997; 2000; Pipher, 1994; Thompson et al., 1999). Another dimension of the change in America is our societal concept of community. Pipher (1994) has contended that communities are not as tightly woven as they once were, contributing to an increased focus on attractiveness as define d by our current cultural ideals. Our society has moved away from communities in which people knew each other to a culture defined as more distant, full of secondary relationships. In a city of strangers, appearance is the only dimension available for the rapid assessment of others. Thus, it becomes incredibly important in defining value (Pipher, 1994, p. 183). The media, and advertising in particular, brought about ne w sources of information for developing standards of beauty. Prior to mass media, people relied on limited access to art and literature to define the ideal body. With the advent of advertising, women had more immediate access to visual images that provided a social co ntext for standards of beauty. Researchers also have found evidence of a cycli cal pattern of media-perpetua ted standards for the ideal body (Fangman, Paff, Ogle, Bickle, & Rouner, 2004; Kitch, 1998).


49 The difference in current standards is that most recently, our society has developed a standard of beauty that is unattainable and unhealthy for most people. When unnatural thinness became attractive, girls did unnatural things to be thin (Pipher, 1994, p. 194). Today, women are facing increasing appearance-related pressures, w ith particular attention to the attainment of a thin body. In Westernized societies, the pressure to be thin is apparent in various realms of communication, from interpersonal communication, including peer and familial influences, to mass communication through media such as televi sion and magazines. The pressure for women to be thin is particularly evident by our cult ures prejudicial treatme nt of overweight women, the social lepers of our cu lture (Pipher, 1994, p. 184). In fact according to Pipher (1984), one study found that % of Americans would abort a fetus if they we re told it had a tendency to obesity (p. 184). The transformation in socio-cultural definitions of what constitutes beauty has led several researchers to investigate the link between me dia and the female body ideal over time. In a recent study, Fangman et al. (2004) found convinci ng evidence that editorial and advertising content published in two 1920s womens magazines, Ladies Home Journal and Vogue promoted the thin female body ideal of that era. The findings of Fangman et al (2004) reveal an undeniable parallel between the female beauty standards of the 1920s and those of se veral more recent decades, including the 1960s and 1990s. As the next few paragraphs will illust rate, the 1920s, 1960s, and 1990s all offered an extremely slender, nearly androgynous body as the desirable figure. In addition, Fangman et al. (2004) have noted the striking si milarities in the body shapes of the flapper, Twiggy, and Kate Moss, whose appearances were symbolic of id eal female beauty in the 1920s, 1960s, and 1990s, respectively (p. 246).


50 Before discussing the historical evolution of the female body ideal, it must be reiterated that during each era, popular cultural institutions such as the mass media have played an important role in constructing thinness as th e primary measure of a womans attractiveness (Brumberg, 2000; Garner et al., 1980; Silverstei n et al., 1986; Silverstein, Peterson, & Purdue, 1986; Thompson et al., 1999). Typically, the me dia messages regarding body shape and size transmit ideas about what is socially, physicall y, and morally acceptable. In addition, the media have not always been consistent about the messa ge conveyed with regard to the body and issues of weight control. Over the years, women consistently have received conflicting messages about the risks of being overweight, as well as the ri sks associated with media-promoted weight-loss techniques specific to each time period (Brumberg, 2000; Thompson & Haytko, 1997). These types of conflicting messages can create conf usion about the most acceptable body shape and size (Ogle & Damhorst, 2004), particularly for wo men in recovery from eating disorders. Another important aspect to consider when reviewing historical body ideal trends is the economics of the time period. In decades where the beauty standards were extremely thin, American society was more affluent. Brumberg (2000) has suggested that during times of affluence, voluntarily restricting food consumption has been used as a strategy for defining an identity. As Brumberg (2000) has noted, women of higher social classes encoded their bodies with the correct social messages regarding social class, fashion, and gender identity. Of similar contextual importance are th e changes over time in womens sexual and professional roles. Several researchers have c ontended that in times of expanded opportunities and choices, some women may ha ve felt overwhelmed by a pressure to too much pressure to attain a superwoman ideal. In searching for some mechanism for control over their lives, some women may have played out their need for contro l by controlling their bo dies, particularly in


51 terms of size and shape (Brumberg, 2000; Friedan, 1963). Viewed within this socio-cultural framework, including the influences of the media, economics, and ot her social contexts, a history of female beauty standards can more fully be appreciated. The eighteenth century portrayed a female body ideal that was large, tough, muscular and stronguntil the advent of mass-reproduced wome ns fashion magazines, most notably, the Ladies Home Journal introduced in 1897. The introduction of the Journal was a pivotal point in media history because in its initial year of publication, the magazine reached approximately 850,000 readers; and in 1893, it was the first magazi ne to reach a circulation in the millions (Kitch, 1998). More importantly for the topi c of this dissertation, the Journal was one of the first magazines to take advantage of printing tec hnology that offered mass production of artwork, including imagery of women. As Kitch (2001) has noted, the Journal offered a visual commentary on genderon what an American Woman looked lik ein a truly national mass medium (p. 243). Until the 1890s, plump and volupt uous was in, with extra weight on women serving as a sign of being rich and healthy (Campos, 2004; Seid 1989, 1994). As Seid (1994) has commented: What we today shudderingly call cellulite was considered desirable, a stored-up force, equated with reserves of energy a nd strength. Plumpness was deemed a sign of emotional well-being; it was identified with a good temperament, with a clean conscience, with temperate and disciplined habits, a nd above all with goo d health. (p. 5) The Rubenesque ideal was tailored in the early 20th century to a Victorian hourglass figure, achieved only with tight, c onstricting corsets, making womens waists artificially tiny and accentuating the hips and buttocks. Not only were the corsets uncomfortable, they also were unhealthy, causing problems w ith breathing and digestion.


52 By the 1920s, the hourglass preference was replaced with a thin flapper, flat-chested, slimhipped, and androgynous. Women who were unfor tunate enough to be well endowed bound and restrained their breasts to achieve a flattened profile. Women had more active lifestyles, and surplus body fat was viewed as inefficient, self -indulgent, and a hindrance to energy and vitality. Thinness was the new sign of wealth. Dieting became a pastime, as bathrooms and kitchens were adorned with scales (Brumber g, 2000; Kitch, 1998; Seid, 1989; Thompson et al., 1999). The 1920s also was the era of the initial commercia l diet industry. In a ddition, mass circulation magazines appeared, followed by the increasing popularity of movies and film stars (Kitch, 1998). The ideal of the 1930s and 1940s was full-bodi ed women with an emphasis on legs and bust (Mazur, 1986). Plumpness and curves were th e fashionable female shape of these two decades. This was the era of the depression, and food was scarce. Well-nourished movie stars were more respected and well-received by the public. Magazines emphasized women with a more maternal image, a symbol of families making it through difficult times together. Models and movie stars had noticeable breasts and a curvy figure (Kitch, 1998). In the 1950s, women still were encouraged to become more voluptuous and curvaceous. Womens images in Playboy magazine reflected the ideal (T hompson et al., 1999). A large bust line was considered most attractive, and th e new standard for women resembled Marilyn Monroe, cover girl of the era, and a size 16 (Brumberg, 2000; Seid, 1989; Thompson et al., 1999). Ironically enough, Marilyns body type woul d be unacceptable for a magazine cover now (Kitch, 1998). By the 1960s, the cultural indicator of physical attractiveness reverted back to slenderness, reflecting the thin and waif look of model Tw iggy, with the figure of a prepubescent boy. The


53 waif look led to a long-term tr end in Americans co llective taste (Garner et al., 1980) with a slight shift in fashion in the 1980s when ther e was a period of backla sh against the women's rights movements. Shows like Family Ties and Thirty Something became more popular with their images of maternal women and families (Kitch, 1998). In addition, Raphael and Lacey (1992) noted the shift to an impossible body shape, I n the 80s the shape cha nged again, this time to broad shoulders and noticeable breasts grafted unnaturally and sometimes surgically onto an emaciated frame (p. 294). The 1990s revisited the flat, near-emaciated preference that has served as a long-term trend, with Kate Moss setting the tone of the ideal body in the 1990s, and more recently, body shapes like Calista Flockharts are what women strive for (C ampos, 2004; Seid 1989, 1994). Hall (1993) has contended that today's fashion magazine s illustrate that the Twiggy look has made a comeback, that models who look like adolescent boys are parading as women, and that this is how beauty is being defined again (p. 248). Media history indicates that mass media aim for striking a balance when social change occurs, often erring on the side of dominant societ al values. The media have a financial need to connect with the audience, while not making the majority of the audien ce uncomfortable with images of powerful women. This economic-driven reality often translates into making women tiny, whether they are central char acters on television or fashion m odels in magazines. A recent example was illustrated with Calista Flockhart on Ally McBeal. She was a girlish, almost asexual central character (Kitch, 1998). With todays standards of attractiveness, wome n are expected to be thin, but also muscular (Grogan, 1999). The goal is to achieve a delicate balance of thinness without appearing to be merely skin and bones. The curr ent ideal standard also calls for curvaceous breasts, curve-


54 free or minimally curved at the waist, with a taut abdomen and slim hips and thighs (Kolodny, 2004, p. 31). To achieve these standards, many women must resort to breast augmentation, liposuction, or other surgical procedures (Kolodny, 2004). The ideal is reflected in todays Barbie doll measurements as well. Back in 1905, the popular Gibson Girl doll had proportional measurements of 38-27-45 (bust-waist-hips). In contrast, todays Barbie doll s thin human measurements wo uld be 38-18-28 (Sarwer, 2003). Over the years, many women have used painful strategies to achieve the societal ideal of the time period (Grogan, 1999; Mazur, 1986). Brownmiller (1984) and Grogan (1999) have contended that todays intense pressure to diet is analogous to other painful and mutilating traditions that women have engaged in the past. This [extreme dieting trend] is clearest in relation to procedures such as foot binding and wearing of restrictive corsets, where wome n suffered discomfort and immobility in the name of particular fashions. In Western society in the 1990s we have replaced these practices with strict diets (which weaken and debilitate) and cosmetic plastic surgery (where women undergo painful procedures to tr y to attain culturally defined attractive body shapes. (Grogan, 1999, p. 25) Where Do We Learn What Ideal Is? The media, advertising in particular, has b een vilified for upholding, perhaps even creating, the emaciated standard of beauty by which girls are taught from childhood to judge the worth of their own bodies (Freedman 1986; Nichter & Nichter 1991; Orbach, 1978, 1993; Pipher, 1994; Solomon 1992). Women learn the ideal through many media sources and the concept is often reinforced in their personal and professional li ves. As Solomon (1992) commented, the pressure to be slim is continually reinforced both by advertising and by peers.We are continually bombarded by images of th in, happy people (p. 226). Studies with girls and women have indicated that exposure to media that promote a thin ideal of beauty is associated w ith body dissatisfaction, dieting, and di sordered eating (Field et al.,


55 1999; Harrison & Cantor, 1997). Furthermore, expe rimental research has shown that direct exposure to thin ideal media imagery causes women to feel dissatisf ied with their bo dies (Irving, 1990; Stice & Shaw, 1994). Rebecca Ruggles Radcliffe, founder and executi ve director of Eating Awareness Services and Education (EASE) and author of Enlightened Eating was one of the 16 women interviewed in Full Lives While she did not have a diagnosable eating disorder, she has struggled with weight and body issues her whole life. It was not until she became vice-president of the Renfrew Center, a leading treatment facility for eating diso rders, that she realized her own personal, inner struggles. Following is a segment of her contribution to Full Lives: I didnt feel particularly uncomfortable about my body, because the counterculture celebrated the naturalness of all female body sh apes. But the images of my Barbie doll and Twiggy had sunk deep, and in the back of my mind, I still believ ed that thinner was better. (Hall, 1993, p. 135) Media Do Not Reflect Diversity The overly thin depiction of the female body shape in magazines and on television is hugely distorted and fails to represent the real diversity of female body shapes. As young women survey todays media landscape, only a sma ll percentage has found self-reflections. The omnipresent ideal female body that is represente d in the media is unattainable for most women without resorting to extreme di eting or exercise behaviors (G aesser, 2002; Goodman, 1995; Hall, 1993; Hall & Ostroff, 1999; Kolodny, 2004; Thomps on et al., 1999). According to Wolf (1991) the average model, dancer, or actress is thinne r than 95% of American women. Thirteen years later, Kolodny (2004) noted that the average American woman is 5' 4" and 140 pounds, while the ideal portrayed in the media are 5' 11" a nd weighs 117 pounds. In addition, todays fashion models are more slender than 98% of American women (Kolodny, 2004).


56 According to Campos (2004), industry data indicates that the average American woman wears a size 12 or 14, but the average stor e window mannequin wears a size 4, and most fashionable womens clothing stores offer sizes reflected in the media, ranging from size 0 to size 6, with a few 8s, 10s, and maybe a 12 tossed i n, not representative of the general population. The bulk of young womens clothing sizes offe red only can be purchased by 20% of the womens market. What is Body Image? There is no uniform definition of body image, but most researchers agree on the general concept. The most basic definition was stated by Thompson et al. (1999): Body image is the term that has come to be widely accepted as the internal representation of your own outer appearanceyour own unique perc eption of your body (p. 4). Cash (1990) has referred to body image as th e view from the inside as opposed to an external rating, the view from the outside (p. 51). Along the same lines, Kolodny (2004) has captured the implications of the emotional tie to body image, how comf ortable and satisfied you are with the size, shape, and appearance of your body (p. 27). Furthermore, Thompsen et al. (1999) indicated that positive body image might boost self-esteem, while negative body image may weaken confidence, sufficientl y to eliminate any possibility of leaving the safe confines of your home (p. 4). What all these definitions sh are is the idea that body image is an individually perceived concept that incorporates per ceptions of how others might vi ew ones body. Body image is also closely related to ones level of self-esteem, especially fo r young females. Young women who internalize the pressures of a dolescence and have low self-esteem are at a higher risk for developing a negative body image, which can increase the likelihood of developing an eating disorder (Martin & Gentry, 1997; Mart in & Kennedy, 1993; Pipher, 1994).


57 The importance of self-esteem and the li nks to American cultural values and body dissatisfaction are not to be taken lightly. Y oung females are especially sensitive to social acceptability, and many take up the burden of self-c riticism especially w ith respect to their body image (Pipher, 1994, p. 57). As Steinem (1992) stated, Self-esteem is nt everything; its just theres nothing without it (p. 26). Body Dissatisfaction Psychologists have suggested that when the media serve as a reference point for comparison, self esteem may decrease, which in turn may lead to body dissatisfaction (Brown, 1993; Thompsen et al., 2000). Se veral researchers have conten ded that at the heart of body dissatisfaction is a discrepancy between the persons perceived body and the cultural ideal. Failure to achieve the ideal leads to self-critici sm, guilt and decreased self-worth (Fallon et al., 1994; Harrison, 2001; Kilbourne, 1994). Body dissatisfaction is encouraged by media depictions of women (Botta, 1999; Campos, 2004; Fouts & Burggraf, 1999; Heinberg & Thompson, 1992; Heinberg & Thompson, 1995; Kilbourn e, 1994; Kolodny, 2004; Wolf, 1991). Body dissatisfaction has become so common in girls and women it has been called normative discontent (Cash & Henry, 1995; Tiggemann & Wilson-Barrett, 1998). In other words, in our culture, many view it as normal or t ypical for women to reject or hate their bodies. For this reason, several researchers have contended that long-term recovery from anorexia necessitates not just behavioral changes in ea ting patterns, but a more global improvement in body image and self-esteem (Bruc h, 1962; Thompsen et al, 2000). Most women in Western society consume a st eady diet of the ideal female body image, including women in recovery from anorexia. As Chapter 2 will illustrate, the effects of media consumption and exposure have been well docum ented, supported by the no tion that electronic and print media pervade adolescents and young adu lts lives. The next ch apter also will provide


58 an overview of the findings in the literature linking eating disorders to the media as well as discussing the theoretical perspectives that re searchers investigating this phenomenon have incorporated into their studies. This dissertation contributes to the vast body of literature on the relationship among the female body ideal, anorexia nervosa, and the medi a. There are several studies of the medias influence on the female body ideal on self-esteem, and on the deve lopment of eating disorders. Literature in the psychology and health journals also has provided a growing body of knowledge of the recovery process from anorexia, includi ng both statistical data fr om longitudinal studies and more qualitative research w ith individual womens experiences However, this is the first study to address how women in recovery from a norexia negotiate media messages. To date, no studies have linked recove ry with the media.


59 CHAPTER 2 REVIEW OF THE LITERATURE Several studies have established that the medi a play at least some role in the development of eating disorders (Botta, 1999; Brown & Jasper, 1993; Grogan, 1999; Harrison, 1997, 2000, 2001; Harrison & Cantor, 1997; Heinberg & Th ompson, 1992; Myers & Biocca, 1992). As a social influence, the media are powerful, but do not act as an isolated forc e. Anorexia usually is initiated by a combination of factors unique to each individual woman (Kolodny, 2004). This chapter briefly will cover some potential influe nces on the development of eating disorders, however the focus in this chapter and in this dissertation as a whole will be on the medias contribution as a cultural influence on women in recovery from anorexia. The media contribute significantly to the creation and perpetuation of eating disorders by continuously promoting the thin ideal, one that is unattainable by most women. Overview Over the last several decades, women have become increasingly dissatisfied with their body shape and size, influenced by socio-cultural factors such as the mass media (Garner, 1997). Mass media transmit the idealized body shape of a thin physique for women, which may negatively impact peoples values, norms, and physical standards for beauty (Cusumano & Thompson, 1997; Hausenblaus, Janelle, Gardne r, & Hagen, 2002; Hausenblaus, Janelle, Gardner, & Focht, 2004; Irving, 1990; Silverst ein et al., 1986; Thompson & Heinberg, 1999). This idealized standard is pervasive and unachievable for most individuals without excessive dieting, exercise, or both (C usumano & Thompson, 1997; Thompson et al., 1999). Furthermore, womens inability to achieve th is ideal body may manifest into body-image disturbance or an eating disorder (American Ps ychiatric Association, 2000).


60 Survey and experimental findings reveal that socio-cultural factors play a role in the development of body-image disturbance (Har rison & Cantor, 1997; Thompson & Heinberg, 1999). Several researchers have examined the eff ects of acute exposure to the medias portrayal of the ideal body on womens psychological well-bei ng. In general, studies have concluded that viewing images of the ideal female body leads to decreased body satisfact ion (Groesz, Levine, & Murnen, 2002; Heinberg & Thompson, 1995; Irving, 1990; Posavac et al ., 1998; Richins, 1991), decreased self-esteem (Irving, 1990; Pipher, 1994 ), increased body size distortion (Hamilton & Waller, 1993; Kalodner, 1997; Waller, Hamilton, & Shaw, 1992), and increased mood disturbance including anxiety and depressi on (Cattarin, Thompson, Th omas, & Williams, 2000; Kalodner, 1997; Pinhas, Toner, Ali, Garfinkel, & Stuckless, 1999; Stice & Shaw, 1994; Wegner, Hartman, & Geist, 2000). Previous research has provided preliminary evidence that the medias portrayal of the idealized female body negatively impacts wome ns psychological well-being (Bordo, 1993; Brumberg, 1997, 2000; Stice et al., 1994). Given the increase in body image disturbance (Garner, 1997), further research on the socio-cultural infl uences of the ideal body on womens emotional responses is needed, particularly fo r women in recovery from anorexia. Structure of the Chapter As Wolcott (2001) has suggested for qualitati ve dissertations, this chapter will draw on the relevant work of others (p. 74) to provide context for the topic of inquiry for this dissertation: How do women in recovery negotiate media messages? The relevant literature taps into several fields of stu dy including mass communications psychology, and sociology. The diverse fields of study provided a wealth of info rmation with limited points of intersection. What did emerge from the review of literature was the concept that each author presented information


61 from a particular theoretical perspective, a nd that perspective fram ed the nature of the methodological approach as well as th e interpretation of the findings. The conceptual bridges of th e literature are best expressed from a topical and theoretical perspective. However, the structure of this chapter merely serves as an organizational tool for presenting information in a more coherent ma nner. This study follows Wolcotts (2001) prescription not to impose any particular theory on the study. In the true spirit of qualitative research, I took a grounded theory approach and allow the themes to emerge from the participants in the study. This approach allows the data to be developed inductively, grounded in the experiences of the participan ts, rather than taking an aprior i orientation (Glaser & Strauss, 1967; Strauss & Corbin, 1990), The first segment of this chapter will cover th e most relevant literature, with a focus on the media, the most powerful socio-cultural infl uence. As Heinberg, Wood, and Thompson (1995) have noted, socio-cultura l theory has the strongest empirical support for studying the influence of societal factors on body image and eating disord ers. This theory includes a strong media component as the pervasive and pop ular transmitter for todays societal standards of the thin body ideal (Tiggeman & Pickering, 1996). The literature also lent itself to a natural organization, in te rms of first addressing the role of the media in all womens lives, their percep tions of media images, and the implications of the thin ideal. The experiences and perceptions of women who have developed anorexia, as well as those in recovery from the diso rder, are discussed more specifi cally after providing an initial, broad context for understanding the relations hip among media, women, and body image in general.


62 The perspective in this dissertation is that all women are immersed in a complex sociocultural environment, with several factors infl uencing how an individual interacts with the media. After discussing the media-oriented theo retical frameworks that have guided empirical studies in the field, the chapter briefly will turn to other factors that warrant some attention, recognizing that the media are not the only influence in womens lives The literature has noted three broad factors that may influence womens body image and their likelihood of developing an eating disorder, family and peer influences psychological influences and genetic/biological factors. Read individually and viewed collectivel y, the literature has painted a broad, but incomplete picture. My disserta tion topic adds a segment to the discussion of how the media are implicated in the recovery process from anorexia. Socio-Cultural Influences This study recognizes the importance of unders tanding women with anorexia in a social context. Research on eating disorders has pointed to external standard s of body aesthetic, size, and shape in the media as factors in developing eating disorders (Brumberg, 2000; Harrison, 2001; Stice, Spangler, & Agras, 2001). Research has indicated that the media ha ve an extremely powerful influence on the promotion, development, and maintenance of high rates of body dissatisfaction and eating disorder pathology exhibited in Western soci eties (Botta, 1999; Fallon, 1990; Grogan, 1999; Heinberg, 1996, Heinberg et al., 1995; Seid, 198 9; Striegel-Moore, Silberstein, & Rodin, 1986; Tiggemann & Pickering, 1996; Wolf, 1991). Fe males absorb the fundamental, cultural importance of appearance through media messages, a nd they learn that the standards for societal success include attaining the thin body ideal (Striegel-Moor e et al., 1986). In a longitudinal study, Morgan (1982) found a strong relations hip between media use and gender-role


63 endorsement. Furthermore, as the strongest messe nger of beauty standard s, the media exert the most pressure on women to be thin (Ha rrison & Cantor, 1997; Stice et al., 1994). Effects Theories Applied in the Literature The effects theories that most frequently have been used in the literature on m edia, body image and eating disorders include socio-cultural theory, social comparison theory and social learning theory. Studies with gi rls and women have indicated th at exposure to media that promote a thin ideal of beauty is associated with body dissatisfaction, dieting, and disordered eating (Field, Cheung, Wolf, Herzog, Gormaker, & Colditz, 1999; Harrison & Cantor, 1997). Furthermore, experimental research has shown that direct exposure to thin ideal media imagery causes women to feel dissatisfied with th eir bodies (Irving, 1990; Stice & Shaw, 1994). Researchers applying the effects traditi on to their work have used three main methodological approaches, content analysis, surv eys and experiments. Content analysis has been used to examine the body types portrayed on television (Botta, 1999; Fouts & Burggraf, 1999), in fashion magazines (Garner et al., 1980 ; Harrison & Cantor, 1997; Percy & Lautman, 1994; Stice & Shaw, 1994; Stice et al., 1994). Surveys have resulted in correlation studi es, which do not permit causal inferences, but provide important information about the potential relationships between media use, body dissatisfaction, drive for thinness, eating disorder symptomology, and the recovery process. Several researchers have conducted studies of th is nature (Harrison & Cantor, 1997; Hofschire & Greenberg, 2002). Survey studies also have examined the likely influence of media celebrities on womens evaluations of their own bodies. These st udies have indicated that there is a positive correlation between attraction to celebrities a nd body dissatisfaction (H arrison, 1997; Heinberg & Thompson, 1992).


64 Socio-Cultural Theory Socio-cultural theory posits that wom ens body dissatisfacti on stems from three primary factors: the thin body ideal that is disseminated in Western societies; wo mens tendency to adopt an orientation of their body as an object; and the assumption that thinness is socially rewarding, while fatness is unattractive. Researchers have contended that the strongest conveyors of each of these assumptions are the mass me dia (Stice et al., 1994). Furthermor e, research has suggested a relationship between rising rates of anorexia nervosa, and the cultu ral expectations of women in Western society to pursue an idealized, pe rfect body (Bordo, 1993; Bruch 1978; Brumberg, 1997, 2000; Gordon, 1990; Kilbourne, 2003; Or bach, 1986; Wooley & Wooley, 1979). Thin Ideal Endorsed in Media Television, movies, and magazines endorse th eir support for the female thin ideal via increasing portrayals of underwei ght women. Content analyses ha ve indicated a cultural move toward a thinner body ideal (Garfinkel et al., 1980; Kaufman, 1980; Silverstein et al., 1986; Striegel-Moore et al., 1986; Wiseman et al., 1992). Over time, the percentage of overweight, female characters on prime-time television has decreased. Kaufman (1980) has found that only 12% of prime-time TV characters were overweight, a percentage less th an the proportion of overweight individuals in the general population. Six years later, the percentage of ove rweight characters in prime-time TV declined even more to 5%, with 69% of the female characters rated as thin (Silverstein et al., 1986). These figures suggest a trend toward an increasingly thinner representation of the female body on television. The ideal body shape portrayed in television also is slimmer for women than it is for men (Silverstein et al., 1986) underscoring the concept that women feel mo re pressure than men to be


65 thin. Womens magazines also contain more wei ght-loss messages in womens magazines than mens magazines (Malkin, Wornian, & Chri sler, 1999; Silverstei n et al., 1986). Movies have participated in reflecting and promoting the thin ideal as well. From 1966 to 1986, the bust-to-waist ratio of popular movie actresses has decreased significantly from 1966 to 1986 (Silverstein et al., 1986). Several researchers have tried to determine what role weight, waist-to-hip ratio (WHR), breast size, and hip size play in mens ratings of womens phys ical attractiveness. Studies repeatedly illustrate that men rate women with low WHRs as being more attractive, feminine and healthy. Men also rate women as more attractive when they have a slender figure, small hips, and large breasts (Grogan, 1999; Singh & Young, 1995), a combination that eliminates most women without the aid of plas tic surgery (Grogan, 1999). Fueled by media messages promoting the th in body ideal and the mushrooming dieting industry, weight has become a Westernized measuring stick fo r self-worth, character, and personal and professional succes s (Brown & Jasper, 1993; Fallon et al., 1994; Freedman, 1986; Grogan, 1999; Hall 1993; Hall & Ostroff, 1999; Kilbourne, 1994, 2003; Kolodny, 2004; Pipher, 1994; Seid, 1989, 1994). Trying to attain perfectioni st standards for thinness and encountering media images of the thin-ideal, most women do not measure up. They are caught in a vicious cycle in which eating control efforts lead to in creasingly perfectionist an d unattainable goals for weight and body size or shape (Brown, 1993; Charles & Kerr, 1986; Grogan, 1999; Hall, 1993; Joiner, Heatherton, Rudd, & Schmidt, 1997). How Television Contributes Research has documented how television pr ogramming reflects and transmits the social values of the dominant culture and has a soci alizing influence on view ers (Bryant & Zillman, 2002). Bryant and Zillman (2002) ha ve indicated that television is American societys most


66 preferred medium and the primary source of so cialization. According to Kilbourne (1994), the average American will spend 1 1/2 years of their lives watching television and view more than 1500 ads every day. Thus, television has the potentia l to be a persuasive source of socio-cultural information. Researchers have examined the messages fr om television programs and their role in promoting a thin standard of bodily attractiven ess for women. Silverstei n et al. (1986, p. 531) have noted that, women who look to the major mass media are exposed to a standard of bodily attractiveness that is slimmer than that presented for men. Several researchers have found that television also serves to establish what women see as realistic ideals, indirec tly encouraging females to endorse a thin ideal (Bot ta, 1999; Hall, 1993; Hall & Ostroff, 1999; Heinberg & Thomps on, 1992; Kilbourne, 1994, 2003; Kolodny, 2004). According to Botta (1999), it is only those w ho do not look toward television for their ideals, and who do not believe women need to be th in, whose questioning leads to fewer eatingdisordered behaviors (p. 37). Body dissatisfaction is encouraged by media depictions of women. So me researchers have used Fallon and Rozins (1985) body scale to determine what body size is most often portrayed on television. Content analyses have revealed that below-average weight female television characters are overrepresented. Furthermore, the percentages of below-average weight females in prime-time situation comedies increased from 33% in 1999 to 76% in 2000 (Fouts & Burggraf, 1999, 2000). Research also has indicated that abov e-average weight female characters are underrepresented on prime-time television, with pe rcentages decreasing from 7% in 1999 to 5%


67 in 2000 (Fouts & Burgraff, 2000). In contrast records from the 1999 National Center for Healthcare Statistics indicate that 61% of adults in the United States were overweight or obese. How Magazines Contribute Researchers have examined magazine message s and their role in promoting a thin body standard of attractiveness for women. Magazine s, especially those aimed at adolescents and young women, serve as a source of cultural transmission, with many researchers suggesting that magazines play at least some ro le in triggering eating disorder ed behavior. The literature has indicated that young women who read beauty and fashion magazines are more likely to embrace the American thin body ideal. Once internalized, the thin body ideal becomes something that women become motivated to attain (Brown, 1993; Brown & Jasper, 1993; Duncan, 1994; Eskes, Duncan, & Miller, 1998; Fallon et al., 1994; Goodman, 1995; Hamilton & Waller, 1993; Harrison & Cantor, 1997; Kilbour ne, 1994, 2003; Shaw, 1995; Silverst ein et al., 1986; Stice et al., 1994; Thomsen, Weber, & Brown, 2002). As a contributor to the socialization proce ss, womens beauty and fashion magazines are a source for learning about gender roles, forming one s identity, and develo ping values and beliefs (Arnett, 1995; Ferguson, 1983; Hermes, 1995; Hofschire & Greenberg, 20 02; Klein et al., 1993; McCracken, 1993). Magazine reading al so contributes to the early cu ltivation of the thin ideal, and young females carry these messages with th em from adolescent years into young adulthood (Ferguson, 1983; Guillen & Barr, 1994). Thomsen et al. (2002) has cited recent circulation figures reported by the Standard Rate and Data Service indicating that more than 6.5 million adolescent females read Seventeen Teen and YM each month. According to Ferguson (1983) womens magazines contribute to the broad cultural processes that define what it means to be a woman. In her view, womens magazines dont simply reflect cultural values, they collectivel y comprise a social inst itution which serves to


68 foster and maintain a cult of femininity.They are also supplying one source of definitions of, and socialization into, that role (p. 184). Researchers typically have used content an alyses to capture what is presented in magazines. Content analyses of womens magazi nes, ranging from teen magazines such as Seventeen and YM to more traditional womens magazines such as Redbook and Womans Weekly. Researchers also have studied several di fferent categories of magazines, including fashion and beauty, news, and health (Ande rsen & DiDomenico, 1992; Cusumano & Thompson, 1997; Ferguson, 1983; Goodman, 1 995; Guillen & Barr, 1994; Nemeroff, Stein, Diehl, & Smilack, 1994). Some researchers have analyzed the body shapes and sizes portrayed in the magazines most frequently read by female college students (Cusumano & Thompson, 1997; Harrison & Cantor, 1997). Using combined methodologies, Ferguson (1983) supplemented content analyses of womens mag azines with interviews of female magazine editors, journalists, artists, publishers, and managers. Content analyses have provided a wealth of information about womens magazine messagesin the text, imagery, and advertising. Interviews, surveys, and experiments have offered insight about perceptions of cultural impact on magazine readers, from the audience perspective, as well as the perspectiv e of magazine employees and publishers. Some researchers have found empirical evid ence that womens magazines contribute to body dissatisfaction and eating disturbance (B otta, 2003; Harrison & Cantor, 1997; Stice & Shaw, 1994; Stice et al., 1994; Thomsen, Gustafson, McCoy, & Williams, 1998; Thompson, Weber, & Brown, 2002; Tiggemann, & McGill, 2004) Botta (2003) examined the relationship between magazine reading and adolescents body image and eating disturbances (BIED). As defined in Chapter 1, body image is a concepts with multiple dimensions, including thoughts,


69 feelings, and attitudes regarding ones own body (Thompson et al., 1999). Several authors have contended that women have problem s with negative body image, at le ast in part because they are judged by their level of thinness (Bordo, 1993; Brumberg, 2000; Grogan, 1999; Pipher, 1994). Magazines can exacerbate womens insecurities about their bodies by providing examples of successful, beautiful, perfectly sculpted role models to envy or emulate (Ferguson, 1983, p. 9). Research also has found magazine reading to be a consistent pred ictor, not only of body dissatisfaction, but also of eating disorder symptoms, even more so than television (Harrison & Cantor, 1997). Levine et al. (1994) found that increased reading of beauty and fashion magazines was strongly related to increased body dissatisfaction and eating disordered symptoms. Harrison (2000) also found a relationship between high exposure to thin bodies in magazines and increased eating disorder symptoms for adolescent females. Content analyses of womens magazines pr ovide some explanation for the link between magazine reading and BIED. Several researcher s have found womens magazines to be filled with images of unrealistically thin women, many of whom meet the body mass index (BMI) for anorexia. Womens magazines al so are packed with both diet and exercise articles and advertising, and the focus tends to be on changing and improving oneself (Andersen & DiDomenico, 1992; Cusumano & Thompson, 1997; Ga rner et al., 1980; Ma lkin et al., 1999; Nemeroff et al., 1994; Schlenker, Caron, & Halteman, 1998; Wiseman et al., 1992). Magazines targeted to adolescent girls and young women typically approach the topic of self-improvement by focusing on fashion dressing and physical beautific ation (Evans, Rutberg, Sather, & Turner, 1991). McCracken (1993) has c ontended that this type of consumptionoriented focus contributes to a culture in which altering physical a ppearance and purchasing products advertised in womens magazines can solve ones probl ems. McCracken further argues


70 that beauty and fashion magazines create and then exacerbating insecurities about womens bodies and sense of self in orde r to sell products. From an early age, women are taught to be critical of their bodie s and ashamed of the parts that do not fit the established model (McCracken, 1993). Fashion magazines also teac h young women to aim for the creation of an ideal or perfect self (Hermes, 1995). According to Botta (2003) disturbed body image feelings and perceptions include dissatisfaction with ones body and overestima ting ones body size. The thought component includes obsessive thinking about weight and body image; and the BIED actions include excessive behaviors symptomatic of diagnosable ea ting disorders, such as restricting to lose weight, excessive exercise, and binging and pur ging. Exposure to thin models in womens magazines increased body dissatisfaction, insecurity, guilt, shame, stress and depression (Stice et al., 1994). As Brumberg (2000) has noted, in our obesophobic society, women have allowed hunger denial to become part of their identity, feeling guilty when they enjoy non-diet foods or view images of females in the media who are able to attain the thin ideal and control their appetite. Ideal is Thinner over Time Media content analyses have indicated that the mass media tend to portray the female form as much thinner than the averag e body size in the populat ion, particularly in the last twenty-five years (Garner et al., 1980; Ka ufman, 1980; Percy & Lautman, 1994; Silverstein et al., 1986; Wiseman et al., 1992). Pipher (1994) also has il lustrated evidence for our national cult of thinness (p. 184). A comparison of the Rock mi neral water girl from 1950 to 1994 provides an excellent example. The mode l has transformed from 5'4" and 140 pounds to 5'10" and 110 pounds. Some researchers indicate that even anorexic s are thinner than they used to be (Gardner, 2003; HealthSCOUT, 2002).


71 Historically, women have tried to alter th eir bodies to conform to a culturally-accepted standard of beauty of the era (Ehrenreich & English, 1978). Lakoff and Scherr (1984) have contended that an effective way to trace trends in ideal beauty over time is to examine portrayals of beauty in the media, from art and liter ature to photographs and advertisements. In the early twentieth century, womens bodies were valued for their leanness. Aesthetically, women in the fashi on industry were viewed as more attractive if they attained smooth, sleek, austere, hard edges in thei r facial and body shapes. In 1908 a Vogue correspondent in Paris announced, The fashionable figure is growing straig hter and straighter, less bust, less hips, more waist.... How slim, how graceful, how elegant women look! (Gordon, 1990, p. 77) As art and womens fashions shed the weight of tradition, the slim figure of the flapper became the quintessential popular image of the ne w woman. Half a century later, women in unprecedented numbers developed anorexia, carrying to life-threatening extremes their contempt for excess flesh and unmanaged desire. Anorex ic women today seek in thinness not only physical perfection but autonomy and emotional pur ity, which they describe as a triumph over feminine passivity and sentimentality (Gordon, 1990). In a study of English fashion models from 1967-1987, Morris, Cooper, and Cooper (1989) found that the ideal body shape fo r models progressed to a more tubular shape, with female height and weight increasing in size, while bust and hips decr eased. Silverstein et al. (1986) measured changing body ideals as represente d in the media by examining photographs in Ladies Home Journal and Vogue. Their study has indicated that the bust to waist ratio of magazine models decreased significantly ov er 20 years, almost regressing ba ck to the lowest point of the mid-1920s.


72 Another significant study that relied on media portrayals as a measure of the ideal image was a well-known study by Garner et al. (1980). Th ese researchers compared the ideal female body as portrayed in Playboy magazine and in the Miss America Pageant with the average womans body size. The main finding from the study was that over a 20-year period of time (1959-1978), the average weights of Playboy centerfolds and Miss America contestants declined. More importantly, using actuarial tables, Wiseman et al. (1992) extended the study by Garner et al., (1980) examining data during the years 1979-1988. The same six womens magazines were examined for diet articles, and the study also examined Playboy centerfold and Miss America data. The results of their study supported the id ea that the cultural ideal for womens body size has become thinner over time. Mi ss America contestants continued to decrease in body size and the size of Playboy centerfolds decreased slightly until th ey plateaued at an extremely low weight based on ratio of body m easurements and hip size. These authors have reported that 69% of the Playboy centerfolds and 60% of the pageant contestants weighed at least 15% less than e xpected based on age and height, according to actuarial tables. Of particular no te is that being at least 15% be low ones expected body weight is symptomatic of anorexia nervosa (Ame rican Psychiatric Association, 2000). Similarly, Morris et al. (1989) examined the re presentations of female fashion models from 1967 to 1987. Their results confirmed a tendency for models shapes to become less curvaceous and more tubular. Percy and Lautman (1994) examined magazine advertisements in McCalls from 1905 to 1978 and found that the portrayal of women became increasingly slimmer. Silverstein et al. (1986) c onducted an empirical study conf irming the connection between the changes in the thin ideal and progress with womens equality. When women become more empowered in the workforce and society in genera l, the media reflected a higher prevalence of


73 the slender body ideal. The study found that the female body ideal, as reflected in issues of Ladies Home Journal and Vogue became slimmer during the years in which the number of women in managerial positions and professiona l positions increased, the 1920s and late 1960s. From a feminist perspective, Wolf (1991) ha s contended that a cultural fixation on female thinness is not an obsession about aesthetics or beauty. Rather it is an obsession about female obediencedieting is the most potent political sedative in womens history (p. 187). Link to Eating Disorders Some studies have indicated a link between the medias portray al of slim fashion models and the incidence of eating disorders. The fact that increasing numbers of eating disorders have coincided with a decreased ideal female body wei ght portrayed in the media does imply a strong connection (Garner et al., 1980; Morris et al., 1989; Wiseman et al., 1992). The combination of the findings from empiri cal content analysis studies provides strong evidence for an overall emphasis on an increasin gly slim ideal over a 30-year time period. Furthermore, Lucas, Beard, OFallon, and Kurl and (1991) studied anorexia nervosa among 1019 year-old girls during a 50-year period and found that the rate s of anorexia nervosa were highest when the thin ideal permeated the fashion industry. Silverstein et al. (1986) confirmed this trend, noting that when the flapper look was so popular in the 1920s there was an epidemic of eating disorders comparable to that in recent years. Content analysis alone does not lend itself to establishing a causal relationshi p, but it is possible that the resu lts of several studies may offer some insight into the increasing number of diagnosed eating disorders in women. Increase in Diet Articles and Advertisements Garner et al. (1980) demonstrat ed that while the trend has be en toward thinner models, the weight of the average American woman actually has been increasing. The discrepancy between the real shape and size of women and the idea l portrayed in the media were accentuated by an


74 additional finding of the study, an in crease in the number of diet fo r weight loss articles in six leading womens magazines, Harpers Bazaar, Vogue, Ladies Home Journal, Good Housekeeping, Womans Day, and McCalls increased during the same era, from 1959-1978. The more pronounced emphasis on weight loss in purs uit of the media-prom oted thin female body coincides with several studies that have docum ented increased numbers of diet articles in womens magazines (Andersen & DiDomenico, 1992; Garner et al., 1980; Silverstein et al., 1986; Stice & Shaw, 1994; Wiseman et al., 1992). In 1986, Silverstein et al. (1986) compared diet food ads in 96 popular magazines, 48 womens and 48 mens. In the womens magazine s, they found 63 diet food ads, compared to only one in the mens. Six years later, Anders en and DiDomenico (1992) examined the 10 most popular mens and womens magazines. Their fi ndings revealed that womens magazines contained 10.5 times more dieting and weight loss ads and articles than the mens magazines, the same sex-ratio reported by Andersen (1990) for eating disorders. Wiseman et al. (1992) also found a dramatic increase in diet articles from 1959-1988, though the level of diet articles declined somewhat in 1981 as exer cise articles replaced them. Furthermore, the media have promoted diets to the extent that girls as young as 5 to 7 are starting diets and developing desire to become thinner (Bruch, 1978; Campos, 2004, Grogan, 1999; Kilbourne, 1994; Kolodny, 2004). Brown (1993) ha s contended that theres only a matter of degree that distinguishes women who diet, work out, and obsess about their body shape and calorie intake from the more extreme beha viors of anorexia and Bulimia (p. 54). With the widening gap between the cultural body norm and the averag e womans natural, biological reality, women have tu rned to dieting. The industry ha s flourished and continues to grow. Schroeder (1991) has estimated the revenues of commercial diet ce nters to have reached


75 two billion dollars in 1990. In addition, Schroeder (1991) found that 85 to 90% of the diet centers clientele are women, most of whom regain weight they lose within two years. According to Wolf (1991), a dvertising and the media indoctr inate the consumer in these ideals to the detriment of most wo men. Diet products, fitness, and the fear of fat are encouraged and promoted to the extent of marketing unhealth y addictions (Anders on & DiDomenico, 1992; Kilbourne, 1994; 2003; Striegel-Moore, 1993; Wolf, 1991). Dieting among women has become somewhat of an epidemic (Gaesser, 2002), with about 95% of women dieting at some point in their lives (Ogden, 1992). The numbers of women w ho take dieting to its extreme and develop anorexia have reached chilling proportions (Kolodny, 2004). A portion of Americans are overweight to a degree that will impact their health, but many more people diet than need to do so, and most diet for aesthet ic reasons as opposed to those relating to health (Gr ogan, 1999). As Ogden (1992) has argue d, the dieting industry has created the perfect marketing tactic b ecause it invents a problem, dissa tisfaction with body weight and shape, and then offers a solution, dieting. The problem is that dieting leads to different outcomes for different people, but most often it is not a long-term solution (Campos, 2004; Gaesser, 2002) Researchers have found that dieting, even for obese people who need to lose weight for health reas ons, only has significant long-term weight loss for about 25% (Brownell & Rodin, 1994). In non-obese dieters, the longterm results are less successful, with about 5% losing weight long-term (Brown & Rodin, 1994). Viewed from another perspective, the remaining 95% are likely to feel they have failed (Grogan, 1999; Hall, 1993). Feel Fat? The diet industry is one of the most powerful forces in Western societys promotion of the thin ideal. There are diet plans and books all mark eted to a public that feels fat (Grogan, 1999).


76 Ironically enough, inpatient eating disorder treatment programs sp end a significant portion of time undoing this thought pattern in women who are seeking recoveryb ecause fat is not a feeling (Kolodny, 2004). Once a woman is nourished well enough to benefit from therapy, she may start the emotional healing path on the road of recove ry (Brumberg, 2000). Often, the healing process involves restructuring the woman s thought patterns, including teaching her to connect emotions with the source of the problem, rather than engaging in eating disordered be havior as a substitute (Hall, 1993; Hall & Ostroff, 1999; Kolodny, 2004). More than one therapist I have had has referr ed to eating disorders as feeling disorders. Much of the time I spent in treatment had more to do with identifying feelings I was experiencing, particularly when I was feeling fat or had urges restrict f ood intake. As a woman in the initial stages of recovery from eating disorders, I was taught that feelings included emotions like hurt or anger or sadness, but that fat is not a feeling. I also was encouraged to think about what I really was feeling when I felt fat. Ofte n the answer was unworthy or unhappy. Thinking back on my treatment, and having re ad about the dieting industry from a more academic perspective, I now see more clearly how the dieting i ndustry takes full advantage of providing the concept of and solution for unworthiness. Losing weight didnt truly solve any of my problems, no matter what diet I tried or what size pants I was able to fit into. Recognizing that the participants in this study may offer a dive rsity of experiences, th is dissertation explores the challenges women recovered or in recovery from anorexia face in a culture permeated by media sources that continually feed the thin ideal message. Brumberg (2000) has captured the problem with modern dieting in an eloquent statement: In contemporary society young wo men easily attach themselves to dieting precisely because it is such a widely practiced and admired form of cultural expression. A pathology


77 such as anorexia nervosa is not caused by di eting alone, but the centr ality of dieting and appetite control in the lives of women is a critical context for explaining the disproportionate number of female anorectics in late-twentieth-centu ry America. (p. 229) Social Comparison Theory Som e researchers have viewed social co mparison theory as the most appropriate framework for understanding how exposure to thin media images relates to body image and the potential of harmful weight cont rol behaviors. Proposed by Festinger (1954), this theory suggests that humans have a drive to self-evaluate, a nd lacking an objective mechanism for evaluating oneself, individuals use social comparisons to meet this drive. Festingers (1954) social comparison theory asserts three primary components. The first component is that individuals have a drive to evaluate their opin ions and abilities. The second is that when individuals do not have access to objective, nonsocial cr iteria, they engage in social comparison via comparing their opinions and abiliti es to those of other individuals. The third component of the theory is that whenever possible, social comparisons are made with similar others. Social comparison theory has been revised several times since its original conception, though a critical component has remained stable over timethat social comparison involves judgments individuals make about their own attri butes compared to others. The comparisons are central to self-evaluations and depend more on how an individual judges herself in relation to others on a particular attribute than on objective circumstances (Wood, 1989). A significant revision to the theory is that social compar ison may occur on dimensions such as physical appearance and eating habits (Wheeler & Miyake, 1992). Central to social comparison theory is the indi viduals choice of a referent, or the person an individual will use as a basis for comparison. The nature of the comparison choice, including attributes and characteristics will shape an individuals response (Kulik & Ambrose, 1992). For


78 example, if an individual compares herself to an idealized image that is unachievable, she will note a discrepancy between her ow n appearance and the ideal imag e, increasing the likelihood of a negative self-evaluation. Another significant change in social compar ison theory is that comparisons may occur, even when individuals do not seek them. For example, Roberts and Gettman (2004) found that subtle media exposure produced an adverse affect on women, and Wheel er and Miyake (1992) have contended that social comparisons are of ten subtle and fleeting (p. 767). Milkie (1999) further has illustrated how the pervasiveness of media imagery does not always allow for the freedom to select comparisons: Theoretically, given freedom of comparison, pe ople could use selec tivity to escape media images that they dislike or to which they compare negativelyby ignoring or discounting them and by not using such images as a basis for social comparison. Yet because of the pervasiveness of media, and th e way in which people believe that media affect others, it may be difficult to avoid some social compar isons with media images and felt evaluations (reflected appraisals) based on th e media-depicted world. (p. 193) Milkie (1999) further has c ontended that the pervasive medi a imagery may alter concepts of what is socially acceptable or ideal. Consistent exposure via th e media to the thin ideal also may affect what an individual perceives others to believe is socially a cceptable or ideal, thus offering a standard of comparison that indi viduals might not otherwise have sought. Target Characteristics The person used in the comparison process does not necessarily have to be a similar individual (Martin & Kennedy, 1993). Another significant addition to social comparison theory is what is referred to as target characteristics, either universalistic or particularistic. Universalistic targets are distan t sources of influence such as a fashion magazine, or any other form of mass media. Particularistic targets ar e more intimate sources for comparison, such as friends, peers, and family members. Of the two, uni versalistic targets are t hought to elicit greater


79 pressure on women to conform to idealistic standard s of attractiveness than particularistic targets (Irving, 1990). The comparisons can be with media figures peers, or some combination of the two. Striegel-Moore et al. (1986) have found that college women engage in frequent comparisons with their peers to establish an idea of their weight status. Hesse-Biber & Marino (1991) also have suggested that college women who engage in comparisons with thin-ideal peers are at higher risk for developing eating disorders. Fes tinger focused primarily on interpersonal social comparisons; however several researchers have ap plied social comparison theory to mass media images (Botta, 1999; Heinberg & Thompson, 1995; Irving, 1990; Martin & Gentry, 1997; Pinhas et al., 1999; Richins, 1991; Stic e et al., 1994; Stice & Shaw, 1994). Social comparison theory has been widely a dopted as a fundamental framework to explain how people process idealized body images in th e media and how such processing can cause body image disturbance. The theory has suggested th at exposure to attractive body images in the media tend to force audiences to compare at tractive body images with their own bodies. Several researchers have examined body image disturbance using social comparison theory as a framework (Botta, 1999; Heinberg & T hompson, 1992a). As applied to body dissatisfaction, social comparison theory posits that people will compare themselves and significant others to people and images whom they perceive to represent realistic goals to at tain (Botta, 1999, p. 26). Furthermore, the theory suggests that after comparison, people will be motivated to meet the goal and that they cannot av oid making comparisons. This comparison process can negatively aff ect self-perceived physical attractiveness as well as evaluation of others phys ical attractiveness (Richins, 1991). Posavac et al. (1998) found


80 that women compare themselves to images of wome n even when they arent asked to do so in a research study. Social comparison theory would predict that women would have lower self-esteem if they compare themselves to images in the media, and perceive themselves to fall short. Research has supported this hypothesis, indicating that women do feel more shameful, guilty, anxious, and depressed after viewing thin-build models (Botta, 1999; Cusumano & Thompson, 1997; Foster, 2002; Grogan et al., 1996; Heinberg & Thompso n, 1992a; Kalodner, 1997; Richins, 1991; Stice & Shaw, 1994). Upward and Downward Comparisons As social comparison theory has sugges ted, young women commonly use the mass media as tools to compare themselves personal and physical traits, ab ilities, and opinionsto the cultural ideal. An upward comp arison would be to superior, whereas a downward comparison would be to an inferior othe r on a particular dimension (Fes tinger, 1954; Martin & Gentry, 1997). Research has suggested that social compar isons of physical appearance tend to be upward (to a person superior on a dimensi on), rather than downward (to some one inferior on a particular dimension. Such comparisons usually make women feel worse about themselves, reducing selfevaluations of attractiveness (Botta, 1999, 2003; Field et al., 1999; Martin & Kennedy, 1993; Richins, 1991; Wheeler & Miyake, 1992). Some scholars have suggested that comparisons of body image with media images are driven by three basic motives: se lf-evaluation, self-improvement and self-enhancement (Martin & Gentry, 1997; Wood, 1989), Sel f-evaluation and self-improvement tend to be the most common motives for young women, driven by a desi re to compare their physical attractiveness to models or other women who are considered to be superior in appearance (upward comparison).


81 Research has indicated that upward comparis on to idealized images in magazines has led to increased endorsement of thin ideals and dr ive for thinness (Field, 1999; Levine et al., 1994). Young women who regularly read fashion magazi nes view magazines an important source of beauty and fitness information and tend to have a strong interest in emulating fashion models (Levine et al., 1994). Often, upward comparisons lead women to fantasize about their ability to adopt ideal characteristics, and in doing so, tend to make women more vulnerable to body dissatisfaction (Field, 1999; Martin & Gentry, 1997; Wheeler & Miyake, 1992). Magazines and other print images are not the only source for comparison. Borzekowski, Robinson, and Killen (2000) found that the numbe r of hours spent watching music videos was related to adolescent gi rls concerns about appearance a nd weight. The authors found that frequent music video use may be a risk factor for increased perceived im portance of appearance and increased body weight concer ns among adolescent girls. Other researchers have studied upward co mparisons with television characters or celebrities (Botta, 1999; Richins, 1991). Studi es have indicated that such comparisons have a negative impact body satisfaction. Botta (1999) found that comparisons with television celebrities were significantly related to body dissatisfaction, drive for thinness and bulimic behaviors. Several studies have found that adoles cents who watch more television, or who try to emulate popular media figures, report more body dissatisfaction and are more prone to eating disorders than adolescents who do not watch as much television (Felts, Tavasso, Chenier, & Dunn, 1992). The most powerful mechanism for television to affect females body image is to provide images for young women to compare themselves to. The more the women see the body ideal portrayed on television, the more they want to lo ok like the women they see, and the greater their


82 desire to be thin. According to Botta (1999), the comparisons are goal-driven; they provoke adolescents to feel dissatisfied with their bodies, increase thei r drive to be thin, and motivate them to engage in eating-di sordered behaviors (p. 38). A downward comparison to an inferior othe r is triggered by self-enhancement motives. Social comparison theory posits that a downward comparison will enhance subjective well-being (Wheeler & Miyake, 1992). An example of downward comparison would be an individual comparing oneself to someone worse off on a pa rticular dimension. In terms of female body weight, a woman might compare herself to an image of someone who is heavier, and in doing so, would feel better about herself. Sociologists and psychologists have used several different instruments to measure body satisfaction, the most common of wh ich is the female silhouette figur e rating scale. The scale is a set of nine female figure drawings, arranged fr om extremely thin on the left, to obese on the right-hand side (Stunckard, Sorensen, & Schulsi nger, 1983). Several media researchers (Fallon & Rozin, 1985; Lamb, Jackson, Cassiday, & Priest, 1993; Tiggemann & Pennington, 1990) have used the scale for a quantitative meas ure of womens body dissatisfaction. Body Satisfaction Measurement Typically, women have been asked to indicate their ideal figure their current figure and the figure most men would find attractive. In general, the body satisfac tion studies have indicated that women picked a heavier figure for their current figure than they picked both for the ideal figure and the figure most men would find attractive The studies have been done with several different populations: American college women (Fallon & Rozin, 1985); a mixture of American college women, American public school teachers, and middle-class American women (Lamb et al., 1993); Australian college women (Huon, Morris, & Brown, 1990; Tiggeman & Pennington, 1990); and British women (Wardle, Bindr a, Fairclough, & Westcombe, 1993).


83 What all the studies have in common is that most women would like to be slimmer than they perceive themselves to be, and that most women perceive themselves to be heavier than what men would find attractive (Grogan, 1999). According to Demarest and Allen (2000), women also tend to guess that men prefer female shapes that are significantly thinner than those actually reported by men. Caucasian women, the target of much advertising and media attention, expressed the most distorted views of what men find attractive (D emarest & Allen, 2000). Women judge female body attractiveness based on thinness (Barber, 1998), while men prefer a more curvaceous figure with a small waist, but larger hips (Singh, 1995). Experimental research has indicated that exposure to the thin ideal ev en affects self-proclaime d feminists, who have negative attitudes toward stereo typical media images of women (Lavine, Sweeney, & Wagner, 1999). The media promote and reflect the current mainstream cultures standards for body shape or size and importance of beauty. The images of thinness are linked to concepts of prestige, happiness, love and success for women (B ordo, 1993; Brown & Jasper, 1993; Bruch, 1973, 1978; Brumberg, 2000; Goodman, 1995; Grogan, 1999; Kilbour ne, 1994; Thompson et al., 1999). Repeated exposure to the thin ideal via the va rious media can lead to the internalization of this ideal (Stice et al., 1994). Exposure also renders thin body images as achievable and real (Brumberg, 2000; Grogan, 1999), and women who have high internalization of societys messages are more affected by thin ideal magazine exposure than those w ith low internalization (Cusumano & Thompson, 1997; Heinberg & Thom pson, 1995; Heinberg, Thompson, & Stormer, 1995; Lokken, Worth, & Trautma nn, 2004; Stice et al., 1994). Given the vast amount of literature indicating the medias s upport for and promotion of the thin body ideal, women in recovery from anorexia are not likely to seek encouragement for body


84 acceptance in media sources. One woman who has recovered from anorexia has explained her struggle with exposure to the media: I had to have faith that my body would regulate my appetite and weight, but there were no guarantees it would work. The mass media certainly didnt encourage faith in my body. Instead it promoted self-cont rol and thinness at any cost (Hall, 1993, p. 111). Mediating Factors for Social Comparison Theory Many feminists contend that exposure to sl enderness in the medi a have a universally negative impact on female body satisfaction (Chernik, 1995; Chernin, 1981, 1985; Freedman, 1986; Jasper, 1993; Kilbourne, 1994, 2003; Nich ter & Nichter, 1991; Orbach, 1978; 1993; Pipher, 1994; Seid, 1989, 1994; Waller & Shaw, 1994; Wolf, 1991). But research has indicated that individual and social fact ors mediate the effects of expos ure to thin ideals on body image and self-esteem. Some of the key factors include body image, body sa tisfaction, level of exposure, cognitive and emotional processing of imagery, and demographic characteristics such as age and ethnicity. Consequently, exposure to slim ideals may have negative consequences for some women, but not for others (Botta 1999; Field, 1999; Henderson-King & Henderson-King, 1997; Irving, 1990; Myers & Biocca, 1992; Posavac et al., 1998; Richins, 1991; Shaw & Waller, 1995). Not all women who see images of the thin ideal will become dissatisfied with their body, nor will they all develop eating disorders. Studies that have investigated differential impact have suggested that the medias eff ect on body satisfaction is not uni form across all women. Certain groups of females may be more vulnerable than others. Discrepancy between real and ideal Research has indicated that when young wo men use the media for self-socialization, unrealistic body standards are cu ltivated (Collins, 1998; Grogan & Wainwright, 1996; Guillen &


85 Barr, 1994; Hamilton & Waller, 1993; Levine & Sm olak, 1996; Levine et al., 1994; Pinhas et al., 1999; Shaw, 1995; Stice et al., 1994). Until the me dia present women with representative body images, women will continue to measure themselv es against an unrealistic ideal. Their figure deviates from the ideal, and rese arch has indicated that women perceive themselves to be bigger than they actually are, thus re sulting in body dissatisfaction (Fallon & Rozin, 1985; Lamb et al., 1993; Tiggeman & Pennington, 1990). Some researchers have studied the medi a through content anal ysis, allowing for speculation about medias role in influencing and reflecting soci etal values regarding body image (Goodman, 1995; Guillen & Barr, 1994; Silverstein et al., 1986). Overall, st udies have indicated that the media present the fe male body ideal (through fashion m odels) as increasingly thin, creating a continual and widening discrepancy between the size of the average American women and the size of fashion models (Garner et al., 1980; Spitzer, Henderson, & Zivian, 1999; Wiseman et al., 1992). Researchers have illustrated that the disc repancy between womens real body shape and the ideal portrayed in the media erodes women s self-esteem, often lead ing to obsession with weight and appearance, increased body dissatisfaction, and taken to another level, may lead to dangerous behaviors, such as eating disorders in young wome n (Garner, 1997; Harrison, 2001; Pipher, 1994; Posavac et al., 1998; Stice et al., 1994; Striegel -Moore et al., 1986). Harrison (2001) has researched the underlying issues of the relationship between exposure to thin ideal media and eating di sorders. Viewed through the lens of self-discrepancy Harrison (2001) conducted a two-part study with a sample of 366 male and female adolescents. Selfdiscrepancy as it relates to the topic of this di ssertation relates to the thin body ideal. An ideal self-discrepancy reflects the difference between a womans perceptions of her physical attributes


86 and the attributes she ideally would like to have. Harrison (2001) also examined the ought selfdiscrepancy, which reflects the difference be tween a womans actual phys ical attributes and those she believes significant othe rs in her life think sh e ought to have. Part one of this key study used a survey to measure typical media exposur e, self-discrepancies, affect, body dissatisfaction, and eating disorder symptomology. The findings of the first study supported the hypothesis that exposure to television and magazi nes depicting and promoting th e thin ideal was related to disordered eating. Harrison (2001) also confirmed that ideal self-discrepancies mediated these relationships. Part two of the study, which was conducted a week later with the same participants from part one, took an experimental approach with videos. Harrison (2001) conducted the study with both males and females, but for the purposes of this dissertation, only the results of the female portion of the study will be discus sed. The videos showed three examples: a thin female being socially rewarded, an obese female being punished, and a female whose body was obscured engaged in neutral interactions. As with th e first portion of Harris ons (2001) study, selfdiscrepancies were shown to mediate the eff ects. The higher the ideal self-discrepancies, anorexic symptoms, and body dissatisfaction were, the more strongly affected the participants were by the body-salient videos. The study also indicated that exposure to a thin-rewarded representation triggered ideal di screpancies; whereas exposure to a fat-punished representation triggered ought discrepancies. Internalization of socio-cultural pr essures to be beautiful and thin Women are more likely to notice discrepa ncies between their own body and the mediaperpetuated ideal if they have internalized the pressure to be a ttractive. Henderson-King, Henderson-King, and Hoffman (2001) have demonstr ated that the importance that women place on physical attractiveness influences the eff ects of comparisons with media images.


87 Furthermore, research has indicated that internalization of socio-cultural pressures to be thin mediate the likelihood of eating diso rdered symptoms (Heinberg & Thompson, 1995; Heinberg et al., 1995; Stice et al ., 1994). In a pivotal study, Stice et al. (1994) found that genderrole endorsement, ideal body stereotype interna lization, and body satisfaction mediated the level and nature of eating disorder symptoms. The resu lts of their study support the notion that women who internalize messages to attain the thin ideal are more likely to experience adverse effects, including engaging in behaviors ch aracteristic of anorexia and bu limia. Stice et al. (1994) also suggested that the likelihood of women reporting attitudes and behaviors characteristic of anorexia nervosa and bulimia was directly related to their level of exposure to media with ideal body images. Endorsement of thin ideal Women may realize the importance of the thin ideal, but another mediat ing factor of social comparison is their endorsement of that ideal. Recent research has suggested that women who endorse traditional female roles may be more susceptible to the impact of thin-ideal media. In a study on the association between re ported media exposure and body dissatisfaction, Stice et al. (1994) investigated the influence of individual character istics in mediating the effects of thin-ideal media exposure on body satisfa ction. They found that greater exposure was associated with increased acceptance of traditiona l female gender roles, which in turn lead to increased acceptance of the th in ideal, which was in turn associated with greater body dissatisfaction. This study indica tes an indirect route from exposure to negative body image, where the characteristics of the person viewing the idealized images influence the extent of the impact. Botta (1999) examined the connection between television viewing and eating disorders. She found that comparison with and endorsement of thin ideals mediated adolescent females


88 likelihood of developing eating disorders. Accord ing to Botta (1999), the most important factor for developing an eating disorder was not the in dividuals media usage or predispositions, but rather how their own body image was processed. Fu rthermore, some researchers have found that women who are struggling with identity issues or with low self-esteem are more likely to internalize the socio-cultural standards of thinness (Katzman & Wolchik, 1984; SchupakNeuberg & Nemeroff, 1993). The importance of endorsing the thin ideal also may explain why individuals who are heavy media users may not necessarily compare themselves to thin body images in the media. Cusumano and Thompson (1997) found no direct relationship between media exposure and body image disturbances, such as body dissatisfaction, disordered eating, or lower self-esteem. Rather, the individuals eating dist urbances were significantly influenced by how they perceived thin ideals as an acceptable societal standard of appearance pressure. Importance of target comparison Along the same lines, researchers have found the importance of the comparison target to mediate the effects of social comparison. He inberg and Thompson (1992a) surveyed college students about how often they compared themselves to peers, celebrities, and family members on appearance and nonappearance traits They also measured how important those comparisons were to the students. The results indicated that college females were more likely to experience increased body dissatisfaction, increased drive for thinness, and in creased bulimic behaviors if they considered celebrities an important comparison group. Heinberg and Thompson (1992b) also conf irmed the importance of the comparison group to the individual in the social comparison proces s. Their study examined the impact of body-size feedback that varied on two dimensions. The firs t dimension was negative (being larger than the comparison target) versus positive (being sma ller than the comparison target). The second


89 dimension was particularistic (being compared to an average student at their university) versus universalistic (being compared to a national average). The co mparisons were done using a mirror, and the women who were compared to th e average student at th eir university reported more physical anxiety and discomfort when view ing their bodies than did the women who were compared to the national average student. This finding was true regardless of whether the first dimension was negative or positive. Heinberg and Thompson (1992a) concluded that the comparison process itself was threatening wh en the comparison target was important. Other researchers have suggested similar notionsthat an indivi duals preference to compare oneself to a similar other may indicat e that a particularistic comparison is more important to the individual, a nd therefore more threatening (Kruglanksi & Mayseless, 1990; Miller, Turnbull, & McFarland, 1988; Wood, 1989) Levine et al. (1994) found that female adolescents who viewed fashi on magazines as important sources of beauty and fitness information were more likely to engage in wei ght management behaviors such as exercise and skipping meals than those who considered such magazines to be not at all important. Body weight Most women are exposed to the media-promoted thin ideal, but only a small proportion of them develop eating disorders. Moderating factors may include biology, cognitions, and personality (Stice et al., 1994). For example, a wo man who is genetically predisposed toward a heavier body weight might be especially challenged with achieving the thin cultural standard. To achieve the goal of weight loss, she may be more inclined to resort to extreme methods, characteristic of eating disorders. Experimental research has indicated that heavier women, who already had lower self-p erceptions of attractiveness, experienced greater declines in body satisfaction and weight concerns after viewing thin ideal imag es of women (Henderson-King & Henderson-King, 1997; Posavac et al., 1998).


90 Level of body-esteem and satisfaction One of the most critical mediating factors in social comparison theory is a womans level of body-esteem and satisfaction. Women who ar e most susceptible to developing eating disorders are those who experience extreme body image dissatisfaction, which can arise from several factors, one of which is the discrepanc y between the womans real body and that of the ideal portrayed in the media. Body image dissatisfaction often l eads to dieting, which taken to an extreme can transform into eating disorder symptoms, including restri ctive eating, excessive exercise, and/or binging and purging (Harris on, 1997; Garner et al ., 1980; McKinley, 1998; Thomsen et al., 2002). Research also has indi cated that women are more vulnerable to developing eating disorders when their actual body size is in conflict with a mediated ideal body image and they have an unstable, self-perceived body image (Harrison, 2001; Myers & Biocca, 1992). Some researchers have contended that media portrayals of perfect beautiful, and thin women are largely responsible for high levels of body dissatisf action (Fallon, 1990; Heinberg & Thompson, 1992a; Rodin et al., 1985). In the mass media, shape and weight define perfection, but what our culture has come to accept as ideal is far from the physiologic norm. Television stars and supermodels are born with a specific body type, and what the general public is not told is that no diet can help them achieve a ne w body shape (Mortensen, Hoerr, & Garner, 1993). Typically, women do not aim to be anorexic; they slip into the diagnos is by slowly decreasing their intake of food, absorbing media and cult ural messages that rewa rd dieting (Brumberg, 2000). In Western culture self-esteem is cl osely tied to body image (Kolodny, 2004, p. 42). Continual exposure to images of thin, beautiful models presented as the norm contributes to low self-esteem in young women who inevitably fall short of the ideal. Failure to attain the ideal


91 body size is especially problematic when young wo men define their sense of self by their body size. If thinness is the only op tion, and their natural body type deviates from this social norm, their self-esteem plum mets (Garner et al ., 1980; Harrison, 2001). Experimental studies have confirmed th is notion. Irving (1990) found that subjects exposed to slides of thin models consistently had lower self-eva luations than subjects who had been exposed to slides of average and oversize models. In a similar study Posavac et al. (1998) observed that college women who initially had low body satisfaction were significantly more concerned about their weight following exposure to slides of fashion models compared to women exposed to neutral images. Several studie s have found a connection with eating disorders and concern about weight (Cooper, Taylor, Cooper, & Fairburn, 1987; Wilson & Smith, 1989). Furthermore, researchers have found perceived ideal body size, body dissatisfaction, self-esteem, and depression to be strong predictors of disordered eating (Gardner et al., 2000). In her best selling book Reviving Ophelia Mary Pipher introduced the plight of American adolescent girls to a broad audience. A clinical psychologist, Piphe r has suggested that we live in a media-saturated, girl-poisoning culture that makes females miserable who do not meet the cultural ideals. Pipher (1994) has contended that girls who allo w the culture to define who they should be lose their true sense of self, and as Simone De Beauvoir (1952) wrote, To lose confidence in ones body is to lose co nfidence in ones self (p. 57). Feminist scholars have emphasized the negati ve impact of the culture of thinness (Brown, 1993; Chernin, 1981, 1985; Malson, 1998; Orbach, 1986; Striegel-Moore, 1993; Wolf, 1991). Images in the mass media constantly reinforce th e latest ideal and maintaining a full-time eating disorder diverts womens energy from other, more important focuses in life (Chernin, 1985; Kolodny, 2004; Seid, 1985; Wolf, 1991). Brown (1993) has contended that if a womans sense


92 of self is measured by body image, and she focuses her attention on he r body dissatisfaction, she is displacing her genui ne source of unhappiness. Self-esteem and marketing appeals For decades, marketing and advertising have appealed to the consumers sense of self worth with carefully-crafted appeals (Brenkert, 1998; Rosenthal, 1992). Skousgaard and Patti (2004) have noted several slogans that reflect brand positioning of an appeal to self-worth. For example, LOreal has used b ecause youre worth it (p. 1). This area of study specifically relates to this dissertation because research has indicated that women with anorexia tend to have low levels of self-esteem, an issue they continue to work on in the process of recovery. Researchers have suggested that individuals with low self-esteem may be especially vulnerable to persuasive ma rketing appeals (Janis, 1954; Skousgaard & Patti, 2004). Furthermore, Martin and Kennedy (1993) have found that individuals with lower selfesteem have a greater tendency to compare th emselves to idealized advertising images. According to Smith and Cooper-Martin (1997), vulnerable consumers are those who are more susceptible to economic, physical, or psychological harm in, or as a result of, economic transactions because of characte ristics that limit their ability to maximize their utility and wellbeing (p.4). Brenkert (1998) has expanded on the defin ition of vulnerable consumers by proposing four types of personal characteristics that impede [the ability] to participate in normal adult market activities (p. 13). The types most relevant for the population of this disse rtation are the latter two: motivational vulnerability and social vulnerability. Accord ing to Brenkert (1998), those who fit the category of motivati onal vulnerability cannot resist ordinary temptations and/or enticements due to their own individual characteris tics (p. 13). Social vu lnerability is described by Brenkert (1998) as when the consumers socia l situation renders them significantly less able


93 than others to resist various enticementswhich may harm them (p. 13). In other words, people with lower self esteem may be more motivated to improve their self-worth; thus finding it more difficult than others to resist ordinary temptations, particularly when advertising messages promote enhancement of self-esteem via marketin g appeals, such as pur suit of the thin ideal. Women in recovery from anorexia may be especially vulnerable to self-enhancing marketing messages. However, their level of vulnera bility as well as their level of self-esteem is likely to vary depending on the individuals personal values, current perceptions of the thin ideal, situational variables, supportive interpersonal relationships, as well as how far theyve progressed in recovery. Critical viewing What also appears to be a key factor is not just the quantit y of thin-ideal imagery a woman is exposed to, but how a woman processes the media images. One of the important mediating factors for developing eating disord ers is whether or not the women see media images as realistic ideals. Botta (1999) has suggested that women w ho have outside information telling them they do not have to live up to the thin ideal are less vulnerable to negative effects on body image. The impact of endorsing a thin ideal s eems to be more about how adolescent girls process thin images than about how much they view those images (p. 37). Researchers have shown that questioning images and choosing not to endorse the thin ideal is a mediating variable in th e effect of the media on women. Faber, Brown, and McLeod (1979) have suggested that adolescents can avoid making comparisons to portrayals of the thin ideal that they are capable of being critical and choosing to disregard th e ideal that has been established for them. Botta (1999) found that women who dont buy into the thin ideal arent as likely to engage in eating disorder behaviors, but the portrayal of the thin ideal still increased the thinness drive


94 and body dissatisfaction. In one study, even the girls who engaged in critical viewing or questioning the perfecti on of the characters bodies still admi red and strove to achieve the thin ideal (Botta, p. 39). Age Research also has indicated that age and cri tical viewing may be mediating factors in terms of vulnerability when exposed to idealized images. Shaw and Waller (1995) found that adolescents showed greater body dissatisfaction after viewing fashion images than did adult females. Keating (1990) has suggested that women in the later stages of adolescence (some of whom are college age) are more likely to have developed the cognitive skills to discern the realism of media images. Along the same lines, Botta (1999) suggested th at there may be two dimensions of critical viewing th at reflect the difference between questioning images but living up to them and questioning images and refusing to live up to them (p. 40). Ethnicity, socioeconomics, and culture Ethnicity, socioeconomics, and cultural backgr ounds have been shown to affect the value placed on thinness as well as th e likelihood of developing eating disorders. Many women are exposed to the thin ideal in the media, but not all the women who view slender models develop an eating disorder. Other factors must be play ing a role, as adolescen t girls and female young adults handle the pressure to adhere to the thin ideal in different ways. Several researchers have suggested that the perceptions of body shapes an d aesthetic values of weight are culturally relative (Brown & Gilligan, 1992; Duke, 1999; Fine & Macpherson, 1992; Frisby, 2004; Goodman, 2000, 2002; Grogan, 1999; Hesse-Biber, Howling, Leavy, & Love joy, 2004; Milkie, 1999). The media are omnipresent, and women of all ethnicities are continually exposed to messages promoting thinness, but not every woman ev en compares herself to the images she sees


95 in magazines and on television. Social comparis ons are usually made with women whom she perceives to be similar to herself. By the same token, people are less likely to compare themselves with others who are perceived as be ing different or too di vergent (Festinger, 1954, p. 120) because that would make it impossible for an individual to obtain an accurate selfevaluation. Some researchers have pointed to the concept of similarity as a crit ical component in the social comparison process. For instance, Frisby (2000) found that exposure to Caucasian models in magazine ads did not affect female African Americans self-e steem, perhaps because AfricanAmericans perceive Caucasian models as different from themselves. Pompper and Koenig (2004) gathered per ceptions of magazines idealized body image standards among two generations of Hispanic women using focus groups and telephone interviews. Pompper and Koenig (2004) found th at Hispanic women compared their body image to magazine standards, but the degree of comp arison was affected by how the women related to the imagery in the magazines. Women who were more assimilated socio-economically into the Caucasian culture had higher levels of social comparison to the magazine images. The dimension of similarity varies according to an individuals perceptions. For example, researchers have found males to compare themselv es with financially successful female models in ads, despite gender differences (Gulas & Mc Keage, 2000). For the males in that study, the similarity dimension was examined in terms of financial success. Another component in social comp arison theory is the individuals desire to be similar to others. Festinger (1954) has sugge sted that individuals may co mpare themselves with people who are not similar when there is an attraction to those who are different or when individuals wish to be similar to the unfamiliar others.


96 Socioeconomics plays a mediating factor in th e value of the thin ideal and the likelihood of developing an eating disorder. Res earchers also have found that the societal pressures to attain slimness in Western countries increases with soci oeconomic status and the overall wealth of the country. Eating disorders have tended to occur more frequently in Westernized or industrialized countries where physical attractiveness is eq uated with thinness (Orbach, 1986; Rosen, 1992; Silverstone, Gordon, & Stunkard, 1969). However, these trends have been cha nging over time. As Kolodny (1994) has noted, Eating disorders dont discrimina te (p. 19). Anorexia used to be perceived as affecting only middleor upper-class American Caucasian wome n. More recent resear ch however, indicates that while middle-class, white females remain the population most affected by eating disorders, the incidences of eating disorders are on the rise for other ethnicities, socioeconomic groups, and cultures. Studies indicate that the American thin id eal is infectious and has spread to nations that once valued more curvaceous features in wo men (Abrams, Allen, & Gray, 1993; Altabe, 1998; Harris, 1994; Hesse-Biber et al., 2004; Kolodny, 1994; Nasser, 1997; Sahi-Iyer & Haslam, 2003). As American media and values seep into countries around the world, researchers have found increasing numbers of eating disorders even in countries that for years have been concerned with basic sustenance (Becker, Burwell, Gilman, Herzog, & Hamburg, 2002; Efron, 1997; Gunewardene, Huon, & Zheng, 2001; Haavio-Mannila & Purhonen, 2001; Nasser, 1997; Tiggemann & Rtel, 2001). American media reflect a country where food is plentiful, but rejected, and the desire to attain thinness appear s to be spreading globally as several countries absorb Western ideals through media imagery.


97 In the past ten years, researchers have found cases of food restriction to attain thinness in several Asian cities of all socioeconomic and ethnic backgr ounds, including Seoul, Hong Kong, Singapore, Taipei, Beijing, and Shanghai. Even in countries such as the Philippines, India, and Pakistan where hunger remains a problem, res earchers have found cases of women who fit criteria for anorexia. According to Dr. Ken Ung of the National Univ ersity Hospital in Si ngapore, Thin is in, fat is out. This is interesting, because Asians are usually thinner and smaller-framed than Caucasians, but their aim now is to become even thinner (Efron, 1997, p. 35). For example, in 1996, anorexia hit Asian headlines with the death of a 21-year-old, National University college student who died of complications related to anorexia (Efron, 1997). Anorexia was first documented in Japan in th e 1960s, and now afflicts an estimated one in 100 young Japanese women, about the same percentage as in the United States. If Asia is a reliable indicator, eating diso rders are going global (Efron, 1997, p. 35). In fact, Brumbergs (2000) Fasting Girls was translated into German and Japa nese, providing proof that Americans export eating disorders along with McDonalds hamburgers (p. xv). In summary, social comparison theory s uggests that women examine media images to learn what is beautiful, determine social standa rds for how they should look, compare their own appearance to the media-portrayed ideal, and gain motivation to alter their appearance to match the women portrayed in broadcas t and print media. Research ha s indicated that through this process, young women become dissatisfied with their natural bodies a nd resort to unhealthy eating behaviors. Social Learning Theory Social learning theory was introduced as an alternative to operant learning theory as developed by early behaviorists such as B. F. Skinners stimulus and response work, which did


98 not account for social and human variables. According to Ban dura (1994), things that people experience in their environments, such as mass medi a, can affect their behaviors in ways that are additionally influenced by a range of personal factors specific to each individual. Simply put, learning is a socially mediated experience. Social learning theory suggest s that much of what we lear n takes place through the direct and indirect observation of others The theory has contended that learning is primarily a social process. Both people and their environments ar e reciprocal determinants of each other, and humans learn from deliberate or inadvertent observation of be haviors modeled, including those presented in the media (Bandura, 1971, 1977, 1994) Furthermore, human thought, affect, and behavior can be influenced dram atically by observation (vicarious learning), as well as by direct experience. As humans, we are self-regulating, determining our own behavior. Social learning theory (Bandura, 1977) also has co ntended that we select, organi ze, and transform stimuli from our environment. This theory is more recently known as social cognitive theory and primarily has been applied to the effects of televisi on violence, but more recently, it ha s been used in other areas of media effects (Bandura, 1994; Severin & Tankard, 2001). As applied to television, social cognitive theory posits that viewers can le arn appropriate behavi ors by observing which televised behaviors (or media char acters) are rewarded and which are punished. Implicit in this theory is the assumption that human behavior is guided by a desire for rewards (Bandura, 1971, 1994). Therefore, the theory predicts that people will be more likely to emulate the behavior of others when those models are rewarded for thei r behavior. Social lear ning theory also has suggested that seeing a model punished for a beha vior will reduce the like lihood that an observer will model that behavior, an inhibitory effect (Baran & Davis, 2003, p. 194).


99 Most people have been socialized to understand that violence and aggression are unacceptable ways of behaving and acting in those manners typically will lead to punishment or other negative outcomes. When an anticipated negative outcome exists, as is the case for most violent behaviors, seeing the behavior go unpuni shed increases the likelihood of modeling by observers (Bandura, 1977). This type of effect is referred to as disinhi bitory (Baran & Davis, 2003, p. 195), whereby the omission of an anticip ated negative outcome may function as a significant reward in its own right. Vicarious Reinforcement Social learning theory also has contende d that vicarious reinforcementpositive or negativeis central to the learning process and affects the likelihood that observers will choose a certain behavior. If someone views a behavior rewarded on televisi on, there is a greater likelihood that individual will have a positive association with that behavior. For example, if women compare themselves to media figures who are rewarded for their thin appearance, the women are likely to be motivated to engage in behavior, such as dieting, that theyve been taught will lead to the ideal body type. According to soci al learning theory, the observer may feel that they, too, will be rewarded and beco me happier by attaining a thin body. Television sitcoms portray an unrealistic wo rld of thinness, and in doing so, they allow viewers to observe consequences of body si ze. Fouts and Burggraf (1999, 2000) found that below average weight female characters in television received more male attention and praise regarding weight and body shape than normal weight characters. According to Bandura (1969, 1977) the combination of modeling and vicarious reinforcement on television is one of the most powerful influences on viewers. Thus, the fi ndings by Fouts and Burggraf (1999, 2000) may at least in part, account for the in ternalization of the thin ideal by young women and increase their risk for body dissatisfaction.

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100 Vicarious Punishment The opposite also is truedirec tly or vicariously experienci ng punishment will lead to a negative association with a particular behavior (Baran & Davis, 2003). For example, a woman might be teased if she is overweight. She also ma y witness characters on television or in her peer group who are treated poorly beca use of their heavier weight. Fouts and Burggraf (1999, 2000) found that average and above-average weight female characters received negative comments about their body weights/shapes from male characters, with the comments usually (80% of the time ) followed by audience la ughter. In addition, Harrison (2000) has found that ove rweight television characters fre quently were the objects of ridicule and punishment. Fouts and Burggraf (200 0) have suggested that hearing an audience laugh at negative comments about womens bodies may be conceptualized as reinforcement of reinforcement (p. 927). The audience reaction implies social approval of such comments and provides vicarious punishments for viewers as the programming models that it is acceptable to make fun of or harass females who are above-average in weight. The acceptable body size limits vary for men and women. Fouts and Vaughan (2002) found that overweight males are underrepresented in television, but they also have suggested that it is more socially acceptable for men than for women to be overweight in television. Similarly, Goodman (1995) has noted that movies typically portray heavy male characters as normal and attractive, while heavy women have been pr esented as disgusting slobs, loud, brash and overbearing, tubby, ove rpowering, and a real cash cow (p. 59). Prevalence and Incentives Harrison and Cantor (1997) emphasized tw o components of the social learning model relevant to this dissertation topi c to explain how dieting behavior s and desire for thinness can be learned from the mass mediaprevalence and in centives. As DeFleur and Ball-Rokeach (1989)

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101 have contended, the media offer an easily accessib le source of thin, attractive models, providing a fertile ground for media effects that can be explained with social learning theory. The prevalence of situation comedi es is reflected in their popu larity (Fouts & Burggraf, 1999). Furthermore, their popularity increases the like lihood of influencing more viewers (Liebert & Sprafkin, 1988). Tiggeman and Pickering (1996) offered an expl anation for an incentive for social learning. They found body dissatisfaction and drive for thi nness associated with high exposure to thin idealized images on television, bu t they also have noted that correlation is not the same as causation. An alternative scenario, for example, might be that thos e most dissatisfied with their bodies or wishing to be thinner, seek out or are more interested in particular types of television (p. 202). This phenomenon might bett er be explained by uses and gr atifications theory, which is discussed within the active learni ng section of this chapter. Along the same vein, some studies have que stioned how and to what degree advertising involving thin/attractive endorsers is linked with chronic dieti ng, body dissatisfaction, and eating disorders in American females (Peterson 1987; Richins 1991; Solomon, 1992). Richins (1991) found that exposure to ads with hi ghly attractive models increased womens dissatisfaction with their facial and overall attractiveness, but did not appear to increase dissatisfaction with body shape in particular. Before being shown the ad s, the women who participated were far less satisfied with their physique than with their f ace or overall attractivenes s. Thus, Richins (1991) observed, it may be that college-age females ar e already sufficiently dissatisfied with their bodies that advertising expos ure has no impact (p. 81). In fact the body dissatisfaction and medi a relationship may be reversed, though this phenomenon has not been studied empirically. Fe males who are dissatisfied with their bodies

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102 may respond more positively to products in ad s featuring thin, physica lly attractive female models than women who are satisfi ed with their bodies (Richins, 1991). This concept is one that Thomsen, McCoy, and Williams (2001) also have suggested, which is further discussed in the section of studies of women with eating disorders. Social learning concepts may be applied to the medias portrayal of the thin ideal in several respects. As Baran and Davis ( 2003) have noted, when we see a television character rewarded or punished for some action, it is as if we ourselves have actually been rewarded or punished (p. 195). Viewed from the social learning perspective, the prime-time television audience not only has observed modeling of the thin ideal, but also has witnessed vicarious punishment for having average or above-average body shapes. Identification with Media Characters Hofschire and Greenberg (2002) found that fem a le respondents identi fication with female models and female television stars positively co rrelated body dissatisfaction. In other words, media exposure to media characters leads to hi gher body dissatisfaction if women identify with the characters. According to Baran and Davis (2 003), identification is a form of imitation that does not involve direct reproducti on of observed behavior, but rath er is defined by wanting to be and trying to be like an obs erved model relative to some broa der characteristics or qualities (p. 192). Harrison (1997) conducted a study to ex amine the link between college womens interpersonal attraction to fema le media personalities of vari ous body sizes, and disordered eating symptomology. She defined female media pers onalities as thin tele vision characters and magazine models, and operationali zed interpersonal attraction as a combination of liking, feeling similar to, and wanting to be like these individuals.

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103 The theoretical proposition supporting Harrisons (1997) study was that attraction to social agents facilitates modeling of these agents behavi or. The results of the st udy have indicated that interpersonal attraction to thin media personalities is an important element, beyond the influence of mere media exposure. While these studies indi cate that there is a negative influence when women compare themselves to media personalities, much of the data is self-reported, and social comparison research does not demonstrate that the media cause negative body image in females. Rewards for Losing Weight Studies have indicated that women are often praised for losing wei ght, achieving a cultural reward in a sense (Grogan, 1999; Hall, 1993 ; Hall & Ostroff, 1999; Kolodny, 2004; Malson, 1998). According to Serpell et al. (1999), fo r women who develop anorexia, the positive reinforcement for losing weight becomes part of a maladaptive schema (p. 184) that links weight loss to success, regardless of the extent to which the weight loss is taken. However, when the weight loss consumes their thinking and is take n to an extreme level that harms their overall health and well-being, the positiv e reinforcement is replaced with measures to restore normal weight (Hall, 1993; Kolodny, 2004). Ironically enough, some studies have indica ted that articles in womens magazines intended to warn women of the da ngers of eating disorders actual ly have been used by women with anorexia to support and va lidate their eating-disordered t houghts and behaviors. To some women, media coverage of anorexia has glamorized the disorder (Thompsen et al., 2001). Furthermore, according to Thompsen et al (2001) the medias attempt to educate the audience about the dangers of eat ing disorders may backfire, part icularly if the medium sends contradictory messages, or se rves to glamorize eating di sorders for at-risk young women. Women who are looking for role models may not see an article about Mary-Kate Olsen having

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104 anorexia as a punishment. She may in fact view th e coverage of Mary-Kates eating disorder as a socially desirable result, and stri ve even more to achieve the type of publicity celebrities attain. Self-Schema Theory Self-schem a theory (Markus, 1977) places emphasis on how individuals process the content of media messages, with particular atte ntion to how the message affects the individuals self-concept. A womans self-schema is an individuals cognitive representation of characteristics that make her unique. The characte ristics are used to di stinguish herself from others and to develop he r own sense of self. According to Markus (1977), an individuals se nse of self develops through a combination of ways: reflection on ones own behavior, obser ving reactions of others to the self, and processing socio-cultural information about whic h aspects of the self are most valued. The unique ways that audience members interact with the media also is addressed by schema theory, which focuses on how individuals cognitively process information. This theory acknowledges the importance of stored knowledge gleaned from previous experiences to the processing of new information (Graber, 1988). Myers and Biocca (1992) used an adapted version of the theory as a tool to explain the pressure women feel regarding body image. View ing body image as one aspect contributing to an individuals sense of self, Myers and Biocca (1992) have examined body image as a personal mental construction, not an out siders objective evaluation. The researchers also have devised a mode l of reference points from which a young woman tends to construct her mental c onstruct of self. The model include s: media-portrayed ideals; peer and family influences on what constitutes th e ideal body; an individua ls actual body shape and size; and the internalized id eal body, which is a compromise between the actual body and the socially-portrayed ideal.

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105 Myers and Biocca (1992) have suggested that body image is elastic (p. 108) and open to change with alterations in social cues, refe rence points, and the c ontext of the mental construction. Furthermore, if the discrepancy between the actual body an d the internalized body is too great, a woman may criticize herself, a nd her self-esteem may decrease (Myers & Biocca, 1992). Myers and Biocca (1992) studied 76 female uni versity students on the effect of television commercials on body image. Their results have indicated an elastic body image (p. 115) suggesting that women are more vulnerable to developing eating disorders when their actual body size is in conflict with a mediated ideal body image and an unstable self-perceived body image. The study did indicate that watchi ng even 30 minutes of TV programming and advertising can alter a womans perception of the shape of her body. However, contrary to their hypothesis, Myers and Biocca (1992) found that watching appearance-related programming and advertising decreased body si ze overestimations and depression levels in females. The authors explained the unexpected findings by suggesting a two-stage process of selfevaluation. In the first stage, the women may have envisioned themselves as having the ideal body in the tape, thus perceiving the ideal as more attainable. Myers and Biocca (1992) suggested that this initial stage also has a shor t-term effect of tapping in to the internalized ideal body aspect of the womans mental construction, temporarily boosti ng her body-esteem. The second stage of the self-evaluat ion involves more self-criticism when the woman realizes her actual body size and becomes di ssatisfied with her body. In contrast, Heinberg and Thompson (1995) found that women became more depressed, angry, and had higher degrees of body image disturbance following exposure to appearance and thinness-related television advertisements. Women with high levels of disturbance became more

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106 dissatisfied with their weight and overall appe arance following exposure, suggesting that some individuals may be especially vulnerable to negative effects of appearance-related media. Myers and Biocca (1992) have not yet examined the l onger-term effects of viewing ideal body images, so further research is needed in the elastic body portion of the literature. Perse (2001) has noted that pre-existing sche mas influence an individuals categorization, perception, and retention. In addi tion, how an individual processes a message is related to the schema that is primed at the time (Perse, 2001). Schema theory suggests that the readers existing knowledge, based on interpersonal relationships as well as familial and cultural background, serves as a filter through which media messages are processed. Thus, the schema theory framework suggests that women recovered, or in recovery from anorexia may interpret media message in different ways, including ones that were not necessarily intended by the message sender. Personal characteris tics such as level of recovery, strength of support network, body size, existing body image preoccupation, personality, motivations for media consumption, and several ot her variables are likely to a ffect the way in which media content and imagery are interp reted and acted upon. As some scholars have noted, media messages are easily influenced by an individuals selective interpretation of them (Baran & Davis, 2003; McQuail, 1987). Given the likelihood of a variety of media message interpretations, I chose to use a methodology that combined a media diary with in-d epth interviews. The rationale for combining these two methods is discussed in greater detail in Chapter 3. Cognitive Dissonance Theory Thompsen et al. (2001) found that the tim e period when media usage was the most influential was after a woman developed anorexia. Some of the participants in the study expressed that they notic ed models in magazines after the onset of their ea ting disorder. Based

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107 on this finding, Thompsen et al. (2001) suggested that the media may play a role in reducing cognitive dissonance. According to Festinger (1954), cognitive dissona nce occurs when information is presented that is inconsistent with an individuals alre ady-held values and beliefs. This inconsistent information creates psychological discomfort, or dissonance. Lazarsfeld found that people appeared to seek out media messages consistent with the values and beliefs of those around them, (Baran & Davis, 2003, p. 145) implying that individuals tried to pr eserve their existing attitudes by avoiding messages that challenged them. Body Objectification Theory For many females in Western cu ltures, appearance is central to their self-definition. They are socialized early to learn that their bodies s hould be used to attract others (Brumberg, 2000; Thompson et al., 1999, Wolf, 1991). As a result, they learn to see themselves as objects to be looked at and evaluated based on appearance. Objectification theory posits that the perv asive objectification of women in our culture encourages body dissatisfaction, eating problems, and other mental health concerns among females (Brumberg, 2000; Fredrickson & Robert s, 1997). Researchers have indicated that women and girls are objectified in the media (Fredrickson & Roberts, 1997), that girls and women experience a high rate of body dissatisf action and eating problems, and that exposure to objectified media images of wome n is related to the experience of self-objectif ication and body shame among women (Brumberg, 2000). In the media, womens bodies are more likely to be shown to advert ise products and there is often a focus on parts of the body, rather than the whole body, which reinforces the portrayal of a woman as an object (Kil bourne, 1994). Images of women in the media also are often

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108 sexualized, which sends the message that men may possess womens bodies (Fredrickson & Roberts, 1997; Rudman & Verdi, 1993; Signorielli, McLeod, & Healy, 1994). Women learn, both directly and vicariously, that looks do matter, that others evaluations of their physical appearance can determine how they are treate d, and that appearance has the potential to affect life social ly and economically. Proponents of objectification theory have contended that females may become preoccupied with their own physical appearance as a coping mechanism for controlling their social treatmenta n effect termed self-objectification. Several researchers have illustrated th e psychological and emotional da mage of self-objectification (Fredrickson & Roberts, 1997; Fredrickson, No ll, Roberts, Quinn, & Twenge, 1998; McKinley & Hyde, 1996; Noll & Fredrickson, 1998). Influenced by the culture of their upbringing, fe males have learned to adapt to th e socially acceptable practice of dieting, regardless of a hea lth-related need to lose weight (Bruch, 1978; Wooley & Wooley, 1979). Wooley and Wooley (1979) have suggested that females are socialized from a young age to view obesity as shameful and to accept a dangerously thin standard for beauty. The self-des tructive dieting behavior charact eristic of anorexia also is culturally supported, regardless of how much progress women have made in what many feminists consider to be a patria rchal society (Steiner-Adair, 1994). Orbach (1986) has argued that women are f aced with confusing soci al expectations, and suggested that for women, dieting may be a sort of disciplinary practice to achieve an ideal body image within a male-dominated society. Along th e same lines, Selvini-Palazooli (1986) has suggested that the contradictory roles (professi onally successful, yet physically thin) of the modern woman have contributed to the increas ing numbers of anorexia Women are taught to

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109 take advantage of opportunities previous genera tions have afforded them, yet the same women are told to focus on issues of beauty and the thin ideal, that they still ar e objects to be admired. One of the primary costs of self-objectific ation is the developm ent a form of selfconsciousness that is characterized by a preo ccupation with the bodys aesthetic appearance as opposed to its health or well-bei ng. Research has indicated that this perspectiv e of the self increases the opportunity for negative emotions such as shame and anxiety, which also may contribute to eating disorders (Fredrickson & Roberts, 1997). Several researchers have found that when i ndividuals evaluate themselves relative to cultural ideals and fail to live up to such ideals, they experi ence a sense of shame (Lewis, 1992; Tangney, Miller, Flicker, & Barlow, 1996). Feminist theorists have described this failure to live up to the cultural ideals as a cycle. The dominant culture creates the ideal body image and encourages women to monitor their own bodies as objects. As a result, women feel shame when they do not live up to these standards (McK inley, 1998). Tangney (1993) has contended that people who are ashamed feel a heightened concern with others opinions. Objectification theory posits that the continual compar ison many girls and women make to media-promoted body ideals is a recipe for body shame (Fre drickson & Roberts, 1997). According to epidemiological data from the U.S. Department of Health and Human Services (2004), only a minority of American wo men is actually overweight. The data report that 31% of adults over 20 and 15% of adolescents are overweight. Even though most of the population is of average weight or less, most women report fee ling fat and experiencing a sense of personal failure at not attaining the thin ideal emotions which have been shown to lead to feelings of shame (Crandall, 1994 ). Empirical studies also ha ve suggested that women who

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110 monitor their body and compare it to cultural ideals experience more body shame (McKinley & Hyde, 1996). Body objectification theory suggests that a ny situation that makes body image salient may result in a negative body experience, esp ecially for women (McKinley & Hyde, 1996). Combined with schema theory, media portrayals of the thin ideal are likely to produce negative affective consequences, particularly for wo men who have struggled with anorexia. According to Higgins (1987), self-discrepan cies are perceived gaps between different aspects of the self-concept. Disc repancies between actual self ( how a person sees herself) and ideal self (how a person ideally would like to be) have been s hown to lead to negative affective consequences, including anxiety (Higgins, 1987). In addition, Perse (2001) has noted that the salience of self-discrepancies may be responsive to situational influences, so individuals may be concerned about them to a greater or lesser extent at different times. Several researchers discussed above have illustrated that priming the medias portrayal of thin models causes women to worry about appearance-related selfdiscrepancies between an actua l bodily self and a thin body image ideal, producing weight and body dissatisfaction, as well as decr easing self-esteem. Self-discrepancies in terms of thinness are likely to be chronic for many women, as very few attain the thin ideal body size. Third-Person Effect Baran and Davis (2003) have described the th ird-person effect as th e idea that media affect others, but not me (p. 30). This concept describes how people tend to feel that they are independent-minded individuals; so others are much more likel y to be influenced by media (Paul, Salwen, & Dupagne, 2000). As Perse (2001) has noted, the third-person effect is an individuals perception that media messages are persuasive, and others are prone to be

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111 influenced; but that individual is immune ( p. 121) to the influence. People overestimate medias influence on others and underestimat e their influence on themselves (p. 121). Active Audience Theory Active audience theories are useful for illust rating how women interpret thin ideal media messages. The media need audiences in order to realize their full potential for meaning. Therefore, a media message ultimately has more than a single meaning; it has a range of possibilities created and defined by both the message itself as well as its audiences. In other words, meaning is not just in the message, but also in the interpretation (Hart, 1991). Theoretical paradigms have transformed over time, and active audience theories can be better understood placed in historical context. Th e early 20th century was the era of mass society theory (Baran & Davis, 2003). Many cultural, po litical and academic leaders viewed the media as corrupt forces with the power to undermine social order. Proponents of this paradigm have contended that the average person was a passive, defenseless receiver of media messages. Under the mass society theory umbrella wa s the hypodermic needle theory or magic bullet theory which refl ected the metaphoric concept of medi a as needles (dangerous drugs) or bullets (deadly weapons) that directly and immediately penetrated their ideological representations into the public s mind (p. 377). During this ti me period, the dominant media paradigm reflected not only the idea that audience s were passive, but also that they could easily be manipulated (Baran & Davis, 2003). Early theories in media research presumed a powerful effect on a passive audience, but more current theories and paradigms view the au dience as more active, capable of interpreting media messages on a more individual basis. Theori es that conceive a more active audience also take into account demographic variables such as gender, age, race, ethnicity, socioeconomic level and educational level. Social influences also play an active role including relationships

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112 with family, friends, and peers (Baran & Davis, 2004). As noted by Perse (2001), these audience variables can act either as a ba rrier to media effects or as a lens to enhance the likelihood of media effects (p. 35). One of these audience-based perspectives orig inated in the 1960s and 1970s from the work of cultural studies scholars at the University of Birminghams Centre for Contemporary Cultural Studies. Proponents of this perspective have conducted audience reception studies, which examine how audiences interpret media texts and how these interpretations are influenced by social and cultural factors (Alasuutari, 1999). Stuart Hall is a cultural theorist who is we ll-known in academic realms for being a strong proponent of reception theory. The essence of the th eory is that the audience is actively involved in negotiating meaning from media messages. Th e approach in reception theory perceives the audience as an active participan t in the message dissemination process. Hall (1999) further developed active audience concepts in his mode l of encoding and decoding, which leaves the interpretation of media messages, including accepting, negotiating, or rejecting a message, in the hands of the audience. As proposed by Halls model, a media text can be decoded, or interp reted, in three ways. The first position has been termed dominant-hegemonic, which means the viewer decodes the message following the preferred meaning and inte ntions of the message producer. A viewer who adopts this position implies acceptance of the dominant ideology encoded in the message. According to Hall (1994), the second position, ne gotiated, is what most people do most of the time (p. 265). A viewer adopting the negotiated position approaches a message recognizing the encoded ideology, but decides to partially accep t it. The third position of Halls model is the oppositional perspective, wh ich results in the viewer opposing the message. From this

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113 perspective, the viewer recogni zes the encoded dominant ideol ogy, but decodes the message with an opposite framework of reference, thereby reconstituting the intended message. Halls encoding/decoding model underscores th e importance of the concept that viewers do not always interpret encoded messages as the media producer intended. Individuals have the power to decode messages, tran sforming them from passive receiv ers to more active members of the audience. Along the same lines, Hall has conte nded that media content is polysemic, or open to multiple interpretations. Thus, individu als may interpret messages in different ways, informed by their socio-cultural environment (Alasuutari, 1999). The most important and relevant concept from Halls approach is that the removal some of the medias perceived dominating power. Viewed through a reception theory lens, messages are not viewed as having the perceived power to dete rmine audience interpretation; rather messages merely can serve as an influence on the likelihood of certain audience in terpretations (Baran & Davis, 2003; Ross & Nightingale, 2003). As Ross and Nightingale (2003) have explained, interpretation depends on the generosity of th e audience who make time to engage with it and reproduce it in the contexts of their everyday worlds (p. 37). Halls paradigm has guided my personal approa ch to analyzing media messages of the thin ideal. Over time, I have developed negotiate d or oppositional readings of the media messages in magazines, radio, television, a nd the Web as opposed to blindly accepting the textual meaning intended by the producer or editor. Negotiating medi a messages requires personal vigilance, as the media rarely reflec t sincere acceptance of different body shapes and sizes, tending instead to prom ote the perfect, thin ideal. Uses and Gratifications Theory This passiv e audience perspective change d over time. Initially developed by Paul Lazarsfeld and Joseph Klapper in the 1940s and 1950s, uses and gratifications theory was

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114 intended to serve as an alternative to th e effects model (Grogan, 1999). Early uses and gratifications research was criticized for being too descriptive and categor y-oriented, particularly Herzogs 1944 study regarding three types of gratifications audi ence members sought and gained from watching soap operas (Baran & Davis, 2003). Over time, however, media researchers increasingly acknowledged that the medias effects were powerf ul, but limited. Elihu Katz, Jay Blumler, and Michael Gurevitch revisited the us es and gratifications model in the 1970s and 1980s (Baran & Davis, 2003). Uses and gratifications theo ry postulates that people decide which media messages and products interest them. The audience has more of an active role, engaging with media messages they are interested in, and rejecting messages they do not want to accept. The theory also recognizes the important role of peoples motives when selecting media options. The nature of individual interests produces different motivations with resp ect to processing the same mass produced messages (Baran & Davis, 2003). Researchers who have adopted the uses and gratifications approach focus attention on individual interpretations and media usage goals as a primary influence on how media affect an individual (Griffin, 2003). Rather than lumping audience members into one target for the media to hit, uses and gratifications theory posits th at the individual motives for using media messages are a more useful tool. As Griffin (2003) noted, audience members actively select media messages, and they do so with particular goals in mind (p. 198). Grogan (1999) has suggested that viewers act ively seek out informa tion relevant to body image in the media to evaluate their body shape and size. In this sense, the audience is actively using media imagery and thinness messages to inform their body image. In a series of interviews,

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115 Grogan and Wainwright (1996) found that women were active meani ng producers, critical of the media images of models and actresses as being too thin and unrealistic. According to Grogan (1999), uses and gratifi cations theory also w ould explain why some women are affected by the thin ideal message portr ayed in the media and others are not. Some women may view the imagery and see the message, but because they actively reject the message, it has no significant influence on them. Communication scholars continue their struggle to account fo r the diverse interpretations of audiences who react differently to the sam e media messages. Condit (1989) has rejected the totalizing concept of resistance (p. 117). Like Fiske ( 1987) and other scholars, Condit has concluded that some audience members might be mo re resistant than others to the dominant interpretation of a media message that, for example, seems to promote the thin ideal. I agree with Condit that the participants in the study, as consumers of at least some media, might share a common understanding of many f eatures of a media message, while still attaching different values or interpretations to those messages. Cons equently, the participants in this study may not simply be classified as adhering to a dominant or a re sistant reading. Reading a popular magazine article in US Weekly Seventeen Cosmopolitan or People Weekly does not guarantee a woman will adopt eating disorder behaviors; nor does watching a regular dosage of television that promotes the th in ideal. According to Condit (1989), decoding of media messages depends on where viewers fall among the wide range of groups with a wide range of investments in the system they share (p. 118). In this dissertation, I explored the range of interpretations of media messages by women who are recovered, or in recovery from anorexia. Some women re gularly watched television that promotes the thin ideal, subscribed to several fa shion magazines, and consumed other media that

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116 promote notions of culturally accepted standard s of beauty. Some participants exposed themselves to media messages perpetuating the th in ideal, acknowledge th e risks of their media consumption, but still considered the cultural ideal of beauty to be important. Other participants chose to limit their exposure to th e thin ideal as much as possible, or had some other strategy for interpreting media with potentially relapse-triggering messages. Condits (1989) notion of polyvalence offers in sight into the potential findings of this study, Audience members share under standings of the denotations of a text but disagree about the valuation of those denotations to such a degree that they pr oduce notably different interpretations (p. 106). As Fiske (1991) has acknowledged, media messages offer a terrain whereon the struggle for meanings may be engage d (p. 465). It is this terrain that this dissertation will explore, from the perspectiv e of women recovered, or in recovery from anorexia. Women with Eating Disorders: In teractions with the Media As mentioned at the beginning of the chapter, the literature has indicated that women with an eating disorder, or in the beginning stages of recovery, interact with the media in a noticeably different way than other women. The following s ection will provide more specific examples of studies that illustrate how women with anorexia or bulimia negotiate media messages. The material is organized in a manner similar to the beginning of the ch apter, by theoretical approaches. Social Comparison Viewed from another perspective, Thomsen et al. (2001) have contended that the time when women are most vulnerable to media messages is after the onset of eating-disordered symptoms. At this time, the media have the most potential for harmful influence because women with anorexia turn to the media, womens b eauty and fashion magazines in particular, for

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117 support and reinforcement (p. 61). According to Thompsen et al. (2001), these magazines provide easy access to support for the thin ideal in stories, ads, and pictures. Once she already has developed symptoms of anorexia, the women us e magazines to feel that they are part of a supportive community in which the cult of extrem e thinness is accepted and prevails (p. 61). Some researchers have focused on compared the ratings of women with eating disorders to those who did not have eating disorder symptoms. In an experimental study, Waller et al. (1992) found that women with eating disorders overestimated th eir body size and shape significantly more than the control group. Th e researchers showed a series of photographs from female fashion magazines to 24 women w ith eating disorders and 40 wome n who served as a normal control group. The women in the eating disordered group were more susceptible to the negative effects of media exposure. The study had also m easured the level of seve rity of the 24 womens eating disorders, but found that body size overe stimation after viewing fashion models was not related to the severity of the womens eating disorders. Similarly, Hamilton and Waller (1993) c onducted a study on the influence of medias portrayal of the ideal woman on womens estimation of their ow n body size. Their results have indicated that women who suffered from anorexia or bulimia nervosa were more likely to overestimate their own body size after viewing models from fashion magazines than women who did not have eating disorders. Thus, women with eating disorders a ppear to negotiate portrayal of idealized female bodies in a manner that negatively affects their body satisfaction. Thomsen et al. (2001) found that women with anorexia most frequently used beauty and fashion magazines for comparison. Furthermore, the womens use of magazines for comparison purposes appeared to be an exte nsion of previous behavioral pa tterns. The women interviewed in the study began comparing their bodies to those of other women as early as elementary school.

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118 This type of physical and aes thetic comparison further deve loped as the women entered young adulthood and participated in social or athletic activities that emphasized body size or shape. As the women became older, they used beauty and fashion magazines as a primary source of comparison, primarily motivated by self-evalu ation. Often, the women in the study focused on specific body parts of the models, su ch as their legs, that the wome n viewed as ideal. Thomsen et al. (2001) noted the way in which the women were drawn to specific ads a nd seemed to express a familiarity with many of the models. They kne w the models names and also were able to provide their height, weight, and biographical information. As several authors have not ed, young women often use magazi nes for self-comparison, but Thomsen et al., (2001) contended that women with anorexia may take the comparison to another level, viewing themselves in competition with th e magazine models. Some of the women in the study told of their obsession ( p. 56) with cutting out pictures of thin magazine models and placing them in a location for easy viewing, such as their bedroom wall, the refrigerator, or in a neatly organized scrapbook. The cut outs were part of the womens comparison rituals (Thomsen et al., 2001, p. 56), and some women vi ewed their magazine consumption as an addiction of its own. Some of the findings by Thomsen et al. ( 2001) are particularly relevant for this dissertation. All of the participan ts in their study were in intens ive outpatient therapy and would not have been considered recovered from anorexia. Yet, some participants had made enough progress in their recovery to be aware of their triggers. They desc ribed conscious efforts they had to make to avoid certain magazines, including Teen and any health and fitness magazines. Some participants would allow themselves to view ma gazines, but were mindful of the need to be selective and careful in their choices.

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119 One of the most striking results from the study was that some wome n developed anger and hatred for particular magazines. Thomsen et al (2001) noted the similarity between women in recovery from anorexia and rec overing alcoholics. They learned to avoid those situations that would create temptations too great to overcome (p. 59). How do women in recovery interpret fashi on magazines? Media diaries and interviews with women in recovery from anorexia shed light on their media consumption and their perceptions of fashion magazines and models. Cognitive Dissonance Many of the women who participated in th e study by Thomsen et al. (2001) described situations where they were in conflict with family and friends over food issues. As the level of the womens anorexia intensified, family and friends told them they were too thin and encouraged the women to eat more. The comments in their personal lives were tempered with the reassuring media messages the women consumed, typically in beauty and fashion magazines, which encouraged thinness and offere d dieting tips (Thom sen et al., 2001). Based on findings from qualitative interviews, Thomsen et al., (2001) have contended that women with anorexia may use imagery of thin models and celebrities not only as motivation for weight loss, but also as a me thod for reducing cognitive dissonance Viewing extremely thin role models made it much easier for the women with a norexia to cognitively distort the reality of having a life-threa tening disorder. Thomsen et al. (2001) found that beauty and fashion magazines provided support for women with anorexia, and in a rather convoluted sense, reassurance in the patients minds that their ultra-thin ideal or fantasy self may be attainable (p. 60). The women with anorexia used the magazines for specific purposes, one of wh ich as dissonance reduction. For these women, magazines became a soothing voice in a storm of conflict, confrontation, and confusion (p.

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120 60). Having overcome the symptoms of anorexia, how do women recovered or in recovery from anorexia view the reality of the thinness-promoting media messages? Self-Discrepancy In addition, self-discrepancies are likely to be stronger in wome n who have strongly internalized the cultural ideal of thinness. This self-discrepancy perspec tive may help to explain the anticipated variance in response from the part icipants in the study. It is likely that women who maintain long-term recovery from anorexia have found a mechanism for alleviating chronic appearance-related self-discrepancies and may be le ss responsive to external influences in their concept of self. Uses and Gratifications Several researchers have examined eating disorders and the media with a uses and gratifications lens. For some women, beauty a nd fashion magazines fulf ill a specific need of women with anorexia. Images of the thin ideal provide women with anorexia with a goaldirected purpose of comparison and motivation for dieting and food restri ction (Thomsen et al., 2001). Women in recovery from anorexia may ha ve their own uses for beauty and fashion magazines, or for health and fitness magazines. Or they may not have a need for any of the information offered in these publications. This st udy will explore the participants uses of media messages. In addition to socio-cultural factors, several studies have indicated the role of more individual psychological, environmen tal, and biological factors that affect the likelihood of an individual developing issue with body image or clinical anorexia. As discussed previously, anorexia is a severe problem, and the number of women who develop the disorder is on the rise.

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121 However, the fact that there are stil l a large percentage of women who do not develop eating disorders points to the role of factors beyond the media. Family and Peer Influences A complex set of factors cont ributes to the development of eating disorders, one of which is the family environment. Researchers have examined relationships with various family members in the development of eating disorders, but most of the focus has been on the role of the mother and the father. This section also will discuss peer influences, as research has indicated that peers have a significant role in college womens lives. Mothers Influence Some of the pressure women feel to fit a societal body ideal may be attributed to their mothers influence. Research also has indicate d that an individuals perception of how much importance both parents place on achieving the thin idea l plays a significant role in initial dieting behavior (Field et al., 2001). Another critical influence in the development of and recovery from anorexia is the entire familys relationship with food and attitudes ab out weight loss (Bruch, 1973; Field et al., 2001; Hall, 1993; Hall & Ostroff, 1999; Kolodny, 2004; McCabe & Ricciardelli, 2001; Orbach, 1986; Pike & Rodin, 1991; Rozin & Fallon, 1988). Davison, Markey, and Birch (2000) found that mothers who had weight concerns tended to enco urage their daughters to engage in weight-loss efforts to fit the societal id eal. Field et al. (2001) have suggested the same dynamicthat mothers play a role in transmitting cultural valu es about the ideal body to their daughters. Their study found that children whose mothers were frequent dieters were more concerned about their daughters weight status. Research has illustrated that body image distor tions and eating disorders tend to be handed down from one generation to th e next (Bruch, 1973; Pike & Rodin, 1991; Rozin & Fallon, 1998).

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122 Mothers who reject their own bodies and experi ence self-hatred delineate weight concerns to their daughters, including telling their daughters th ey should lose weight to be more socially acceptable (Pike & Rodin, 1991; Rozin & Fallon, 1998). Fathers Influence Several researchers also have documented the role a father ma y play in the development of an eating disorder. While the mothers of female s with anorexia are usually intolerant and hypercritical, the fathers have tended to be emoti onally absent, overprotective, authoritative, and belittling (Calam, Waller, Slade, & Newton, 1990; Humphrey, 1989; Noller & Fitzpatrick, 1993; Selvini-Palazzoli, 1978). Botta and Dumlao (2002) have suggested that many of the thoughts and feelings adolescent females have about communication with their fathers continue into young adulthood, and often longer, unless the communication pattern with their father is remedied. Skilled conflict resolution and open communicatio n between fathers and their daughters may offset eating disorder behaviors, particularly anorexic symp toms. The opposite has also proven to be true, as conflict and communication problem s are typical in young adults w ith eating disorders (Botta & Dumlao, 2002; Seiffge-Krenke, 1995). Researchers have found that conflict between parents and young female adults can have a powerful effect on a womans personal and social adjustment, including lowering her self-esteem (Canary, Cupach, & Messman, 1995; Gecas & Schwalbe, 1986; Montemayor, 1983). As discussed earlier in this chapter, wome n who have a lower sense of self-esteem are more vulnerable to internalizing media messages (Fine & Macpherson, 1992; Henderson-King & Henderson-King, 1997; Irving, 1990; Steinem, 1992; Striegel-Moore et al., 1986; Tiggemann, 2001; Tiggemann & Wilson-Barrett, 1998) McKinley (1998) also has found that low self-esteem and internalization of societal ideals can lead to higher levels of body dissatisfaction, which in

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123 turn, can lead to increased likelihood of de veloping an eating disorder. In addition, internalization of the thin ideal has been shown to impede the recovery process from anorexia (Cusumano & Thompson, 1997; Heinberg & Th ompson, 1995; Heinberg et al., 1995; Lokken, Worthy, & Trautmann, 2004; Stice et al., 1994). Having just attributed some of the developmen t of eating disorders to parents, it can not go without saying that mothers and fathers also can serve as one of the key supportive factors in womens recovery process. Research has indicat ed that women with the shortest duration of eating disorders reported having loving and s upportive parents who in tervened early and maintained support for their daughters (Woods, 2004). Woods (2004) also has suggested that reco very from eating disorders, with minimal clinical treatment, can occur wh en an empathic peer or signi ficant other recognizes early symptoms and serves as a safe harbor for reco very (p. 369). In an open-ended, online survey with people who had recovered from anorexia and bulimia, Woods (2004) found that friends and boyfriends of women in recovery from eating disorders were signifi cant resources, particularly in the early recovery stages. Peers Influence Unfortunately, the power of peer influence also can serve to create some of the factors that lead to poor body image and the development of eating disorders. In the transition from adolescence to young adulthood, women tend to rely on peers as a primary source of social influence. In doing so, female young adults seek wa ys to become more attr active to their peers, the harshest critics they face. Peers can place a significant am ount of pressure on women to conform to societys standards, and women ofte n compare and rate their bodies against their peers. As Pipher (1994) has contended, Beauty is the defining characteristic for women. Its the necessary and often sufficient condi tion for social success (p. 183).

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124 Brumberg (1997) further has contended that the body is the central personal project of American females and has become the primar y mechanism for self-expression. In the 1920s, most women strived for a thin body because of the positive social messages it conveyed (Brumberg, 2000). The same communication mechanism can be seen today, with body shape and size serving as an expression of identity. The socially acceptable body is one that is fit and trim. To avoid being become ostracized, talked about, or teased, women turn to techniques to achieve the normative body. The psychology literature has indicated that peers can have a profound effect on young womens likelihood of developing eating disorders. For young wo men, a large part of their identity is the perception of their body. How they see themselves and, sometimes more importantly, how others perceive them, beco mes critical. And for many young women, their ability to accept themselves ma y be based on how well their body f its the socially acceptable mold (Steinberg, 1993). According to Murray, Touyz, and Beumont (1996) most women have indicated that they are aware of the social pressures to be thin created by media messages, but anorexic women are much more likely than other women to report being influenced by those pressures. StriegelMoore (1994) has suggested that th e pressure of fitting in is so great for some adolescent females that they will attempt to alter their physical appearance with eating disorder behaviors. To this end, body image becomes a critical concern for many young women (Forman-Brunell, 2001). Research has indicated that the onset of anorex ia most often occurs during adolescence, an important period of socializa tion and identity development in young women (Arnett, 1995; Larson & Richards, 1994). Interp ersonal relationships establis hed while growing up affect a young adults sense of self (Sullivan, 1953).

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125 Friends and family play a crucial role as adolescents undergo thei r identity formation, serving as sounding boards for what they s hould and should not do. As Gilligan (1982) has suggested, females identities depend significantly on relationships. Furthermore, Erikson (1968) has contended that young women need a safe pla ce to experiment with different identities. Women not only have to contend with their internal expectati ons or those of their female friends. They also are faced with media-influenced expectations of males. Some researchers have indicated that the widespread representation of unrealistic body ideals co ntributes to females negative body image and influences males expectat ions and evaluations of females appearances (Hargreaves & Tiggeman, 2004; Lavine et al., 1999). During young adolescence and continuing on to college years, appearance and social acceptability becomes a primary concern, making young women more susceptible to the pressures and influences of the media (Collins, 1998; Forman-Brunell, 2001). This pressure to conform to the thin ideal is fu rther perpetuated by media and cu lture (Garner & Garfinkel, 1980; Striegel-Moore et al., 1986). Fe male college students experience an increasingly greater degree of conflict and unease about their bodies and appearance. They also spend a significant amount of time talking about weight, calories, body size, a nd fat. Some researchers and clinicians have referred to this dialogue as f at talk, finding fault with th eir bodies and those of others. (Brumberg, 2000; Seldman, 2003; Weiner, 2003). Women in college who are in recovery from a norexia still face these types of discussions, even if they are not seeking them out. For exam ple, Weiner (2003) has co ntended that women in general, and college women in particular, often enga ge in fat talk in public settings. One of the primary locations for this type of talk is in public bathroom s. According to Weiner (2003), women often will ask other women opinions about their body, even when they do not know the

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126 other person. This type of dialogue points to the fact that women in recovery from anorexia are not always able to select what they are exposed to, in the media or in everyday conversations. When women in recovery hear othe rs engaging in fat talk, how do they react? To what extent do they choose to participate in me dia and culturally-i nfluenced body talk? Several researchers have used the phrase normative discontent to refer to the increasingly common body dissatisf action in girls and women. It has become socially acceptable for women to express discontent with their body, to the extent that not dieting and liking ones body might appear abnormal (Brown, 1993; Ha ll, 1993; Polivy & Herman, 1987; Tiggemann & Wilson-Barrett, 1988; Weiner, 2003). Hall (1993) has illustrated the normative nature of dieting: Dieting has become almost a right of passage for adolescent girls. Their role models and peers are all weight conscious, and they are relentlessly bomba rded with media images of beautiful, thin women (many of them only girls themselves and some anorexic at that). Whats more, changing ones body is one of th e most (if not the most) widely publicized ways for a woman to improve herself. (p. 216) Young women also experience significant soci al changes, with the most notable ones typically being transformations in family and p eer relationships. College students tend to be on a quest for autonomy from their parents, while seek ing close friendships with their peers as well as more intimate, romantic relationships. Many young women feel they are under tremendous peer pressure, which for some, becomes the largest in fluence in their lives. They also start facing important decisions and assuming larger responsi bilities as they make decisions about their future. College-age women are partic ularly susceptible to engagi ng in a personal body war, often allowing weight preoccupation a nd body dissatisfaction to underm ine their physical and mental health. They face pressures to succeed academi cally and socially as they transition into adulthood and reach a new level of independe nce from their previous, familiar home life

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127 (Abrams et al., 1993; Hart & Maureen, 1997; Ka lodner, 1997; Striegel-Moore, Silberstein, Frensch, & Rodin, 1989; Thomsen et al., 1998). Brumberg (2000) has explained how the college setting can be particularly challenging for women with proclivities for a norexia nervosa. For many young wo men, college life offers much less structure than a home environment, especia lly in terms of meals. A diet-conscious female can choose to eat alone, easily skipping meals until the pattern becomes habitual and potentially addictive. Brumberg (2000) also has suggested that women in this age group learn from the media, as well as their peers, about me thods for attaining an ideal body type. For some college-age women, peer pressure becomes a large influence in their lives. During adolescence and into the college years, p eers play an integral role in establishing body image, especially for young women who look to ot hers to help define themselves (Friedman, 1996; Pipher, 1994). Young adulthood is also a time when individuals experience a high degree of self-consciousness (Conger & Galambos, 1997). Its a difficult transformation stage because young women experience heightened vul nerabilities that may lead to declines in their self-esteem and body image as well as higher rates of depr ession and anxiety (Brumberg, 2000; Kostanski & Gullone, 1998; Pipher, 1994; Steinberg, 1993). Prevalence studies have shown that it is common for 15% or more of college campus women to meet diagnostic criteria for anorexia nervosa or bulimi a nervosa (Heatherton, Nichols, Mahamedi, & Keel, 1995; Hesse-Biber, 1989). Howeve r, researchers also have documented that a majority of American college women exhibit at least a few of the symptoms of disordered eating, even if they dont have a clinically diagnosed eating disorder (Hesse-Biber, 1989). During the transition from home to life on ca mpus, women learn to negotiate their sense of self in several ways. Those who lack a solid identity may become prey for the onslaught of

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128 media messages designed to target womens inse curities for financial gain (Abrams et al., 1993; Hall & Ostroff, 1999; Kolodny, 2004; Kalodner, 1997; Mortenson, Hoerr, & Garner, 1993; Rosen, 1992). Chernin (1985), Friedman (1996), and Orbach (1986) all have suggested that one of the central struggles fo r an anorexic woman is the development of a self. More specifically related to the topic of this dissertati on, women who are struggling with identity issues are more likely to internalize cultural standards of thi nness (Katzman & Wolchik, 1984; Schupak-Neuberg & Nemeroff, 1993), and resear ch has indicated that internalization of the thin ideal mediates the lik elihood of developing an eating disorder (Heinberg & Thompson, 1995; Heinberg et al., 1995; Lokke n et al., 2004; Stice et al., 1994). Furthermore, internalization of the thin ideal can lead long-term body im age dissatisfaction (Cusumano & Thompson, 1997), making recovery a challenge. Research has indicated that the longer a woman has an eating disorder, the more challenging it will be for her to achieve long-term recovery. In a ddition, if she achieves recovery only in terms of physical symptoms, but has not made strides toward improving her body image and self-esteem, the literature suggests that she will relapse. Women who relapse from anorexia and do not get back on track immediately are more likely to experience a re volving door effect in terms of recovery from anorexia (Rastam, Gillberg, & Wentz, 2003; Kordy et al., 2002). Thomsen et al. (2001) found that some women with anorexia used womens magazines to obtain information about adult roles and respons ibilities that was not available from their families. According to Thomsen et al. (2001), th ese women relied on media as tools for acquiring developmental skills, and their media usage appeared to be an attempt to moderate the fear of feeling unprepared for the adult roles and responsibilities demande d of them [by society] (p. 57).

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129 The medias current emphasis on excessive thinness for women is one of the clearest examples of advertisings power to influence cultural beauty standards and consequently manipulate individuals behavi ors, thoughts, and feelings (Campos, 2004; Kilbourne, 1994, 2003; Seid, 1989, 1994; Wolf, 1991). In the spirit of consumerism, advertising takes advantage of young womens heightened vulnerabilities, pr oviding manipulated images of thinness and linking this imagery to symbols of pr estige, happiness, love and success. The media also create the illusion that medi a images are real and achievable. The problem is that repeated exposure to the thin ideal can lead to the intern alization of an unattainable goal. One of the most important transformations a co llege student undergoes is the maturation of her body. Her body develops a more womanly shape, a nd she no longer can naturally maintain the waif look she may have had in high school. Until women are confronted w ith realistic images, they will continue to measure themselves ag ainst an unachievable id eal (Harrison & Cantor, 1997; Levine et al., 1994; Myers & Biocca, 1992; Richins, 1991; Silv erstein et al., 1986; Stice et al., 1994). Psychological Influences Young women are especially vulnerable because they are in the process of forming their identity. Teenage and college years are a time wh en individuals negotiate their identity, with themselves and others. It is a period in life where individuals are expected, and sometimes encouraged, to try different roles on for size (Conger & Galambos, 1997). Young women also start facing important decisions and assuming larger responsibili ties as they make decisions about their future. Perfectionism That is not to say that college women who de velop anorexia are unable to succeed in their courses. Research indicates that women who develop anorexia have perfectionist tendencies, and

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130 tend to strive for high achievements in every realm of their lives (Brown, 1993; Brumberg, 2000; Bulik et al., 2003; Hall & Ostroff, 1999; Joiner et al., 1997; Slade, Newton, Butler, & Murphy, 1991; Warner, 2003). Research also has shown that some women even compete within the eating disorder realm, vying with each other to become the thinnest or smallest. Some college women also learn dangerous lessons from their peers on strategies for achieving the thin ideal, including encouragement and instructions on how to engage in unhealthy behaviors, such as dieting and eating disordered patterns (Brumberg, 2000). Working as a team of researchers, Bulik et al. (2003) uncovered a pers onality trait uniquely associated with anorexia nervosa and bulimia ne rvosa. The researchers identified perfectionism as a genetically influenced trait that might pred ispose a person to eating disorders. Perfectionism is a personality trait characterized by a tendency to be overly critical of ones own performance. While high achievers are driven by a goal to achieve, perfectionists tend to be driven by fear of failure. Perfectionists also tend to have an unusually high need for approval from others as well as a great fear of making mistakes (Bulik et al ., 2003). Based on the findings of this study, what might differentiate women who develop an eating disorder from those who merely diet is an intense fear of gaining weight or becoming fat. Wome n who develop anorexia also might fear failure to attain the perfect body ideal (Grogan, 1999; Hall, 1993). Several researchers have examined the tendency of an anorexic woman to be perfectionistic. She has high standards and demands for herself, fueled externally, internally or both. Often, she strives for high achievements, and has a strong desire to please others, yet these desires conflict with an inner feeling of inadequacy that make s her feel helpless (Brown, 1993; Bulik et al., 2003; Hall, 1993; Slade et al ., 1991; Thompsen, McCoy, & Williams, 2001).

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131 Trying to attain perfectionistic standards for thinness and encountering media images of the thin ideal, most women set themselves up for failure. They are caught in a vicious cycle in which eating control efforts lead to increasingl y unattainable goals for weight and body size or shape (Hall, 1993; Joiner et al., 1997). Rothenberg (1986, 1990) has confirmed the concept that women with anorexia are concerned with perfec tionism. Their drive for perfection leads to the point of obsession when things go wrong. A woman with anorexia who is striving to meet the thin ideal becomes obsessed, not only with achie ving thinness, but with being perfect in her efforts (Rothenberg, 1986, 1990). Research has indicated that even after eight to 10 years of recovery from anorexia, women maintain some perfectionist characteristics (Casper, 1990). Srinivasagam et al. (1995) found that women who recovered from anorexia still had symp toms of perfectionism, but the symptoms had lessened compared to when the women were fully immersed in the disorder. Srinivasagam et al. (1995) suggested that weight loss exaggerates the intensity of c oncerns with perfection, but the core personality characteristic remains the same. The concept that personality characteristics such as perfectionism are maintained, even after a woman has achieved long-term recovery from anorexia is not surprising when placed in a socio-cultural context. No only do wo men with anorexia contend with a personal tendency to seek outside approval for perfection, they also are encouraged by the media to do so (SteinerAdair, 1986; Wolf, 1991). Bordo has contended that peer pressure, perfectionism, and bodyimage distortion exist in cultural time and space along with all those other elements of individual and social beha vior that clinical models have tend ed to abstract and pathologize (pp. 119-120).

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132 People Pleasing Some of the perfectionist characteristics of women with anorexia also transfer to their social interactions. Research has indicated that women who de velop anorexia often have not learned how to deal effectively with conflict, an d they tend to turn to people pleasing as a coping strategy for interpersonal interactions. Acco rding to some researchers, people pleasers try to make others think highly of them, and more importantly, are concerned with not being disliked or rejected (Bruch, 1973; Hall, 1993; Kolodny, 2004). This type of personality may lead to an increased likelihood of st riving for ideal body images portr ayed in the media. As Bruch (1973) has noted, women with anorexia tend to be overly concerned with conforming to social expectations. In an experimental study, Casper, Hedeker, and McClough (1992) found that women with anorexia had greater self-contro l, inhibition of emotions, and conscientiousness than control subjects. Several researchers have noted that such characteristic s are indicative of someone who is likely to be a people pl easer. Women with anorexia seek approval of others, and mechanisms for doing so include exuding an unobt rusive personality as well as earning praise through high academic achievement (Bru ch, 1973; Crisp, 1967; Strober, 1986). Research has indicated that women with anorex ia have not learned how to deal effectively with conflict (Botta & Dumlao, 2002; SeiffgeKrenke, 1995). Women who do not learn how to deal with conflict often turn to people pleasing as a coping strate gy in their social interactions (Hall, 1993; Kolodny, 2004). Furthermore, resear chers have found that lack of conflict management skills can powerfully affect a woma ns personal and social adjustment, including Lowering her self-esteem (Canary et al., 1995 ; Montemayor, 1983; Su llivan, 1953). One woman in recovery from anorexia has illustrated the struggle she has faced with low self-concept and self-esteem:

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133 We had learned to please our friends and family to the exclusion of ourselves. In fact we had been so busy paying attenti on to the desires of others, that we didnt know ourselves very well. We did not get the nurturing we needed earlier in our lives, and it made us overly sensitive, vulnerable in relationships, and willing to lose ourselves by trying too hard. (Hall, 1993, p. 138) More directly related to the dissertation topi c, Striegel-Moore et al. (1993) have found that women who have higher needs for external approval are at higher risk for developing eating disorders. American culture promotes the image of the superwoman, at taining and maintaining a stereotypical thin, attractive, and artificial be auty standard. Women who are highly attuned to social standards are keenly aware that thei r bodys appearance and weight is a significant factor in how others percei ve them (Maine, 2001, p. 130). With a culturally encouraged focus on body shape and size, women who develop anorexia may struggle with the duality of maintaining hea lth and meeting the cultura l ideal. Garfinkel and Garner (1982) have contended that a woman who is seeking the ideal thin body will have her weight-loss behavior positively reinforced, which in turn, provides her not only with a sense of accomplishment and self-control, but also social approval and attention from others. In addition, some researchers have found that women who are in recovery from anorexia have difficulty letting go of the need for external approval from others, particularly when thin body standards are portrayed so pervasively in the media, a powerful and sometimes inescapable force (Esherick, 2003; Peters & Fallon, 1994; Thomsen, McCoy, & Williams, 2000, 2001). Desire for Identity/Control Some researchers have contended that at the core of anorexia is a woman who is struggling for a sense of identity and control over he r life (Bruch, 1973, 1974; Garfinkel & Garner, 1982). Brown and Gilligan (1992) have noted that adolescent girls in particular experience a period in their life where they lose their voi ce. An adolescent with a vulnerab le sense of self may turn to anorexia as a mechanism to achieve autonomy (Bruch, 1973).

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134 Bruchs theory has centered on the notion that at the core of anorexia is a lack of personal identity, and by focusing on losing weight and gaining control over her body, a woman with anorexia develops a sense of gratification, self -control, and achievement. For some women, pressures in college may be too much, and they tu rn to anorexia as a coping mechanism. If a woman focuses all her time and energy on calories a nd weight, she will not have time to focus on the real source of her stress. As her weight dimini shes, she may start to f eel like losing weight is the one thing that marks a clear success and culturally-rewarded accomplishment. This sense of achievement is not long-term. Eventually, th e anorexia takes contro l, and any woman who desires recovery must acknowledge that the anorexia no longer serves a positive role in her life (Esherick, 2003). Competitiveness Another contemporary characteristic of women with anorexia is a sense of competitiveness (Brumberg, 2002; Burckle, Ryckman, Gold, T hornton, & Audesse, 1999). Brumberg (2000) has contended that women with anorexia compete in several realms of life, but their bodies themselves become an instrument of competition (p. 252). According to Brumberg (2000), a woman treated by Hilde Bruch expressed her discont ent with other girls who were the same size as her or thinner. Another woman who had recove red from anorexia expressed her need to excel among her peer group in terms of clothing size. Maintaining a sma ller size than anyone else had been part of her identity, and she felt common in a size 5 or 7, like she was just one of the crowd (p. 253). According to researchers, this sense of compet itiveness remains, even once a woman has recovered from the behavioral symp toms of anorexia (Bur ckle et al., 1999). Genetic and Biological Influences Several researchers have inve stigated genetic and biological influences on the development of eating disorders. As the numbers of women di agnosed with eating disorders continues to rise

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135 (Gordon, 1990; Steiner-Adair, 1986; Striegel-Moore et al., 1986), so has the genetic research, in part to find a cure or more effective medication-oriented treatment. The literature is vast, and a comprehensive review of the findings warrants an entirely new dissertation topic. Thus, the findings will be reviewed briefly, with just the main points covered. One biological factor that re searchers have identified as a predictor of body dissatisfaction and is body type or body composition. As not ed above, body dissatisfaction increases the likelihood of a woman developing an eating disorder. Body Mass Index (BMI) is the most prevalent means of measuring weight. Research ers have found that women who have a higher BMI are more likely to report body dissatisfact ion (Dionne, Davis, Fox, & Gurevitch, 1995; Mortenson et al., 1993). McCabe and Ricciardelli (2001) found th at women with a higher Body Mass Index (BMI) perceived their mothers to have encouraged weight loss and to have provided negative feedback in gene ral regarding their bodies. The Voices of Women in Recovery After reviewing the multi-faceted nature of body image, body dissatisfaction, and the development of eating disorders, one can see that the recovery process from anorexia may be equally complex. Clinicians and researchers ha ve acknowledged that recovery from eating disorders is a complex process (Brown, 1993; Brumberg, 2000; Hall & Ostroff, 1999; Kolodny, 2004; Peters & Fallon, 1994; Root, 1990), but few st udies have explored the various aspects of the process (Esherick, 2003; Peters & Fallon, 1994; Malson, 1998; Thomsen et al., 2001; Woods, 2004), and none have examined how women in recove ry from anorexia experience recovery with a specific focus on how media are implicated. Much of the research has focused on the etiology and treatment of eating disorders (American Ps ychiatric Association, 2000; Kordy et al., 2002; Levitt & Sansone, 2003; Strober et al., 1997).

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136 Research examining women with eating di sorders primarily has focused on treatment outcome with a focus on behavioral alteration (Hesse-Biber, Marino, & Watts-Roy, 1999; Kordy et al., 2002; Jordan, Redding, Troop, Treasure, & Serpell, 2003; Rastam et al., 2003; Steiner & Lock, 1998; Richards et al., 2000; Strober et al., 1997; Wentz, Gillberg, Gillberg, & Rastam, 2001). As Herzog, Hamberg, and Brotman (1987) have noted, they focus on what the person does rather than what she feels or who she is (p. 546). The emphasis in treatment outcome studies has been on quantifying alleviation of the symptoms of the disorder. Quantitative measures are useful for making specific variable comparisons, but they leave no allowance for recovered women to be an active participant in the st udy and reveal factors about the recovery process that are meaningful to her. Even feminist theorists have acknowledged the complexity of eating disorders, the recovery process, and the wome ns meanings of the symptoms, but few studies have empowered women in recovery from anorexia to teach us what is involved in the process of recovery (Peters & Fallon, 1994, p. 340). As several studi es have indicated (Esherick, 2003; Grogan, 1999; Malson, 1998; Steiner-Adair, 1994; Peters & Fallon, 1994; Thomsen et al., 2001), the most convincing data in qualitative inquiry resides in the womens voices, those who have made the journey through recovery and can speak mo re directly to the core issues. Peters and Fallon (1994) conducted a qualita tive study with a semistructured, dialogue method of interviewing (p. 340) The focus of the study was to examine womens experiences with treatment of bulimia and what recovery m eant to them. The women were self-identified as recovered or in the process of recovery, with an average asymptomatic time period of 1 year, 3 months. The main findings that emerged from the study were the psyc hological and social changes in the womens lives.

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137 In particular, the women talked about thr ee main ideas. The first concept involved the womens transformation from denyi ng the eating disorder to accepti ng the reality of the need for changein their thought patterns regarding body image, food, a nd eating behaviors. The second main concept to emerge from the study was r econnecting with others in healthy, social relationships that allowed them to express feelings. Gaining a sense of personal power was the third concept, which meant that the women were less passive about their lives; they made goals for their futures and developed str ong attitudes about the cultural standards for beauty in terms of acceptable weight and size. In gaining awareness of the societal factors that contributed to their disorder, the women expressed ange r. They were angry about the cu ltural expectati on to be thin, angry about the media perpetuation of the thin id eal, and angry about the pressures from the diet industry. Peters and Fallon (1994) found that the most di fficult aspect of recovery for the women in their study was learning to be more accepti ng of their natural body shape and size. The participants also expressed th e challenge of developing a stro ng enough sense of self-esteem to ignore the media reminders about the thin body ideal. To avoid regressing to the normative discontent, the women recognized that when they were feeling unhappy, they needed to acknowledge the true source of their emotions, rather than allowing the media-promoted body dissatisfaction to slip in. As Kolodny (2004) has contended, an eating disorder is a symptom, a signal that something is wrong in a persons lifean eating disord er usually masks what really needs to be corrected (p. 21). Interpreting the findings of thei r study from an active audience perspective, Peters and Fallon (1994) noted th at when the women were exposed to media messages encouraging body dissatisfaction, their thoughts needed to be decoded (p. 344) to reject the cultural values imposed on them.

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138 Peters and Fallon (1994) also found themes reflecting a feminist ideology. The participants in the study acknowledged their need to develo p new, assertive communi cation skills. Rather than merely being valued for their compliance to cultural standards, th e women had to unlearn the importance of appearance and ta ke stock in their ability to be direct, articulate, expressive women. Anger and distrust were the predominan t emotions expressed by the women who had recovered from bulimia. Several women expressed outrage at media messages promoting the thin ideal. Peters and Fallon (1994) noted their skepticism and overt anger at what the women now perceived to be a sexist bill of goods (p. 351). Thomsen et al. (2000) conducted an 18 -month study with 28 participants using ethnographic interviews conducted at an eating di sorder treatment facility. The women were at an outpatient treatment center, but were not nece ssarily actively engaged in a recovery process. In fact, the terminology used to describe the women in the study indicates that the women identified themselves as anorexics as opposed to women in recovery. The goal of the study was to understand the imp act of the mass media in the patients lives and the ways in which these women have used the media to shape their identities and to reinforce their eating-disordered cognitions and behaviors. More specifically, the authors were interested in anorexic womens experiences with womens beauty and fa shion magazines and television programs that promote a thin ideal. The rese archers choice of qualitative methodology was guided by their interest in e xploring and understanding how thes e outpatients had the women used the media and how that use had influenc ed the onset and continuation of their eating disordersfrom the patients perspectives.

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139 The primary focus of the study evolved into an examination of issues related to selfreported data provided by anorex ic outpatients. Thomsen et al., (2000) were particularly concerned with trustworthiness and credibility be cause research indicates that anorexic women have skewed, distorted images of themselves as well as the world around them. Their paper included outcomes of the interviews, but the bu lk of the paper described methods employed by the authors to enhance credibility and trustwor thiness of their analysis. The authors took the perspective that they needed to proceed cautious ly and skeptically with self-reported data from anorexic women because they have an intense desire to present a pa rticular public persona (Thomsen, McCoy, & Gustafson 2000). Research i ndicates that women still suffering from anorexia are notoriously protective of thei r private experience (Vitousek, Daly, & Heiser, 1991, pp. 647-648) and those who are still in denial ma y omit, conceal, distort, or misrepresent facts related to their behaviors and internal experiences (Thomsen et al., 2000). These concerns and others expressed in the study reflect the assumption that the women in the study were still entrenched in their eating di sorder and though some of them may have started the recovery process, they we re at the denial en d of the continuum (Peters & Fallon, 1994, p. 342). In fact, Thomsen et al. (2000) make referen ce to starvation serving as a potential threat to trustworthiness because the par ticipants would not be capable of thinking clearly, and their ability to provide an accurate account of th eir experiences might be hindered (Polivy, 1996; Vitousek et al., 1991). The skepticism of the research ers indicates that the women w ould not be considered to be in recovery as this dissertation has operationalized the term. While the nature of the participants in the Thomsen et al. (2000) study was different some of the methodological concerns discussed

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140 provide useful guidance for this study. A study with women who have been recovered for at least six months will yield insightful information and add to the body of litera ture on this topic. Woods (2004) conducted a qualitative, open-ende d, electronic email survey investigating the experience of recovery from anorexia nervosa and bulimia nervosa for people who did not seek extensive professional treatment. Her met hod of recruiting participants was unique, but there were several limitations to her study that did not allow for ri ch, insightful data. To gather participants, Woods (2004) plac ed several hundred survey flyers on bulletin boards throughout a midwestern university campus. The flyers headline read: Recovery from Eating Disorder Study If you have recovered from an eating disorder without extensive outpatient or inpatient clinical treatment, and would assist with a study on your ex perience of recovery, please contact (e-mail address). Th is eight-question e-mail study is confidential and can be answered anonymously. Your input is im portant and greatly appreciated. (p. 362) At the bottom of the survey were tear-o ff e-mail address tab strips. Throughout the semester student assistants monitored and repl aced the flyers. After communicating with people who expressed interest in participating, Woods ( 2004) sent an eight-question survey online. She also included a survey cover page with the study purpose, an e xplanation of confidentiality, a short demographic section, inst ructions on paper mail-in for anonymity assurance, and a statement thanking the participant for his or her time and generosity. Despite referring to the study as qualitative, the people who participated in the study were termed respondents. In addition, the questions were all grand tour in nature, with no follow-up prompts: (1) When did your eating disorder symptoms begin/emerge? (2) How did they start? (3) What factor(s) led to the development of your behavior? (4) What behaviors did you engage in? (Please list or describe all behaviors.) (5) Wa s there a key turn ing point in the initiation of your recovery? (6) Did you see/c onsult with any of the following: physician(s) therapist(s) or dieticians(s)? If yes, please describe: W ho was consulted? How often? Length of treatment? (7) Do any physical a nd/or psychological aspects of your eating

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141 disorder persist? Please describe. (8) What and/or who do you find most helpful in keeping you from your former behaviors? (p. 362) Another limitation of the study was the dive rse, yet small sample size. Twenty-two respondents completed the e-mail survey. Four re spondents had been in hospital and inpatient treatment programs prior to recovery, so they were not included in the findings. Of the 18 respondents who reported recovery without treatment, 16 were female, and two were male. Seventeen of the respondents were white, and one female respondent was African-American. Eight females and one male reported suffering from purging type bulimia, six females and one male reported restricting anorex ia, and two females reported binge-eating/purging type anorexia nervosa. The respondents also star ted their disordered behavior at different ages, ranging from 12 to 17. All respondents were competitive high sch ool athletes, but their sports varied. For example, ten of the participants were in gymnastics or cheerleading, one person was an elite junior level figure skatin g, four females and one male particip ated in cross country or track, one female played softball, and one male played football. There were some characteristics that were the same. For example, all respondents were 1821 years of age and full-time students. All re spondents also met the DSM-IV (American Psychiatric Association, 2000) diag nostic criteria for anorexia ne rvosa or bulimia nervosa prior to recovery. The respondents also reported so me level of excessive exercise throughout the duration of their disorder. Despite some of the methodological issues in the study, a few findings are interesting and relevant to this study. For example, even after re covery, thirteen of the female respondents noted that accepting a higher weight or larger clothi ng size remained difficult, even troubling even after recovery (Woods, 2004, p. 365). This finding underscores the emphasis on socially acceptable clothing size for women typical ly perpetuated in the media.

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142 The results of the study also supported noti ons of socio-cultural theory, despite the questions not addressing specific issues of pressure to be thin. According to Woods (2004), respondents expressed concepts that eating diso rders were culturally produced and culturebound syndromes (p. 366). A common theme found in all the female responses was the importance of being exceptionally slender and f it in order to compete, gain positive attention, and win love and admiration (p. 366). Woods ( 2004) also noted that the respondents expressed the normative nature of their disorder, that even after recovery, the respondents did not question the necessity of meeting ideal standards (p. 367). Woods (2004) also drew a connection between the respondents participation in athletics, and their coaches either overlook ing or praising the respondents weight loss. According to Woods (2004), the respondents had described beha vior in the mid 1990s, when eating disorders were well recognized and widely publicized in the general press. The coaching attitudes described by the respondents in this st udy should be rare exceptions (p. 367). The Challenge of Recovery In general, researchers have found that the longer a person suffers from an eating disorder, the more challenging it may be to recover (Esherick, 2003; Hall, 1993; Hall & Ostroff, 1999; Kennedy & Garfinkel, 1992; Kolodny, 2004; Richards et al., 2000). Clinicians are still trying to determine the best method of treatment for long-te rm recovery, particularly given the rates of relapse and mortality (Esherick, 2003; Richards et al., 2000). Several researchers have conducted follow-up studies, ranging from six months to 21 years, with women who have been treated for an orexia. The research indicates a continuum of recovery, ranging from full recovery to death. So me women achieve full recovery, with a strong commitment to ending all symptoms of anorex ia, as well as working on underlying emotional

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143 and cognitive issues. Some wo men recover from the dangerous physical symptoms, but never fully resolve underlying issues (Keel et al., 2003 ; Lwe et al., 1996; Rich ards et al., 2000). Research results vary for mortality rates, w ith the highest estimates at about 10% within 10 years of initial diagnosis (Richa rds et al., 2000; Sullivan et al., 1998). According to Sullivan et al. (1998), the mortality rate due to complications from anorexia is 12 times greater than the general death rate for women aged 15-24. Quantitative studies have found several factor s most frequently linked to relapse in recovery from an eating disorder. Feelings of anxiousness, nervousness, depression, loneliness, disappointment, or anger may lead to a relapse. Other factors incl ude an inability to cope with ones feelings, relationship probl ems, or failure at something important. Research also has indicated that factors frequen tly triggering relapse include we ight gain, marriage, divorce, a change in ones social support network, a new jo b, financial difficulties, or any other significant life change (Palmer & Roberson, 1995; Root, 1990; Woodside, Kohn, & Kerr, 1998). What the research has lacked was a more in-depth understanding of how the media may have contributed to the relapse or death rates. Women may recover from anorexia, but they still must live in a world bombarded with continuous messages about the thin ideal. The Recovery Process In her dissertation work, Esherick (2003) c onducted in-depth interviews with 14 formerly anorexic women to gain a better understanding of how women recover from anorexia. Her approach was from a more cl inical psychology perspective, so her questions did not ask specifically about media use and exposure. Th rough the interviews, she gathered useful information about factors pertaining to recovery that may be relevant for this study. Common themes evolved pertaining to motivation to recove r as well as factors that helped the women achieve full recovery. Factors related to the motivation and desire to change included the

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144 perception of unconditional love, acceptance and c oncern from others; an increased awareness and frustration of the negative impact anorexia had on their lives; and a sincere hope for the future. Esherick (2003) found that once the motivati on to recover was in place, the women had to work on several personal identity issues as well as learning mechanisms to cope with their feelings. Esherick (2003) saw th e womans recovery work as pr ogressing in three phases. The first phase was one of self-discovery, learning how to get in touch w ith their feelings and developing a sense of self. In the second phase the women learned to accept and value their feelings and personal identity. Se lf-expression defined the third stage of recovery, when the women started to express their fee lings to others without using food as their vo ice. In this phase, the women also developed a more assertive communi cation style that allowed them to stay true to their sense of self. According to Hsu, Crisp, and Callender (1992) a patient with anorexia must make a conscious decision to get well, and she must be willing to embark on the journey of recovery. What leads to women wanting to achieve recovery? Researchers differ in their perspectives. Some researchers have indicated that a patient hi ts rock bottom or decides that maintaining the eating disorder has become too draining (Rort y, Yager, & Rossotto, 1993). Others have found that women find strength and motivation to recove ry because they grow out of their need to express emotions through a disorder and become more confident and secure in achieving a more mature, adult role in life (Collings & King, 1994) Their self-esteem may have increased, they may have severed an unhealthy relationship, or the health risks of maintaining the disorder begin to outweigh their fears of medical social, or professional conseque nces (Hsu et al., 1992; Rorty et al., 1993).

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145 In a secondary data analysis, Woodside et al. (1998) have explored the non-media, qualitative aspects of the recovery and relapse pr ocesses of anorexia and bulimia nervosa. They have studied factors that played a role in the motivation, mainte nance of recovery as well as factors that let to relapse, tem porary and more long-term recovery. After studying the literature and running an aftercare group for women with eating disorders, Woodside et al. (1998) had the opportun ity to observe several hundred patients who had been admitted and released from a hospital program for eating disorders. Their observations have provided critical insight in to the factors affecting recovery and relapse in women who have had anorexia nervosa. The treatment programs, the researchers observed, both day and inpatient, were intensive. They studied the patients over a 6-month period of time as the women progress, recovered, or relapsed. Following this time period, Woodside et al. (1998) had noted some repetitive patterns, and were able to identify four patterns of recovery. Pattern one represents patients who maintain a good, stable outcome, follow their meal plans and use appropriate strategies to avoid eati ng disorder behavior. Her weight remains stable, and she returns to normal life ac tivities, school or work rela ted. Pattern one also involves creating meaningful relationships with others and disconnecting from relationships that cannot be salvaged or are unhealthy. Pattern two, as indicated by Woodside et al. ( 1998), involves immediate relapse, with rapid cessation of recovery efforts and no significant period of normal eating. This group of patients immediately begins weight loss, despite retaining attachment to treatment resources. Usually relapse occurs within two weeks of discharge from an inpatient program. Women in recovery who fall into pattern three experiment a little with their recovery plan and may initially lose some weight, but they quic kly realize that the costs of the experiment

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146 outweigh the benefits and get themselves back on track, either on thei r own or with some therapeutic help (Woodside et al., 1998, p. 235). If the women get back on the recovery track within 6-8 weeks, then the ini tial weight loss would be consid ered a slip (p. 238) and not a long-term relapse. Those women who fall into pattern four resemble a partial relapse or slip, but rather than getting back on track, they c ontinue to lose weight, and eventually may disconnect from treatment altogether. For all patients in recovery from eating disorders, Woodside et al. (1998) have found that the first 3-6 months following treatment are the most critical time period for determining long-term outcome. Limitations of Previous Research As discussed in this chapter, research i ndicates the common depiction of the fem ale body in the mass media are unrealistically thin, and th at females are frequently exposed to these images and often make negative comparisons with themselves. The evidence is unclear whether media exposure causes body dissatisfaction in all women. However, there is compelling evidence to suggest that exposure to idealized images of slender women is more likely to harm the body satisfaction of certain groups of female s and those who have certain individual vulnerabilities. Further research is needed to explore all of the possible vulnerability characteristics so that efforts at reducing body dissatisfaction in young females and women can be targeted a ppropriately. To date, no one has explored how women recovered from or in the latter stages of recovery from anorexia negotiate media messages. Exis ting studies primarily have been surveys or experiments. Surveys have offered some unders tanding through correlation data, but have not talked to the women about their interpretations of the thin ideal message. Experimental research has illustrated instantaneous media effects with stimuli in a controlled, unnatural setting. Some

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147 qualitative studies have intervie wed women who are in inpatient f acilities or are in the initial stages of outpatient treatment. Some researchers have intervie wed women who are in recovery from any eating disorder or bulimia, but with no age restrictions and no specific focus on the media. Furthermore, no studies on this topic have combined qualitative interviews with a methodology such as a media diary. As Chapter 3 w ill discuss in more detail, the media diaries guided the construction of the inte rview questions for this study. In addition, the diaries allowed me to examine media usage patterns of the wo men and gather qualitative information on their interactions with and th oughts about the media. Contributions of This Study To the researchers knowledge, this is the first study to com bine the methods of a media diary with interviews about how women negotiate thin ideal media messages. As a result, the study contributes to a better understanding of how women who have overcome this dangerous disorder navigate their way in a media-saturate d world. Their thoughts and feelings about todays media messages provide key insights for treatment and recovery programs.

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148 CHAPTER 3 METHODOLOGY The purpose of this research is to explore, within a cultural context, the media experiences of women who are in recovery (or recovered) from clinically diagnosed anorexia nervosa. Qualitative inquiry allowed me to gain insight into the environmental climate in which the female participants in this study came to understand, respond to, and makes sense of their experience with the medias poten tial contribution to the onset of and recovery from their eating disorder. Research Question and Benefits of this Study A qualitative approach is most appropriate for exploring the research questions for this dissertation: How do women who are in recovery from anor exia negotiate media messages about the thin ideal? How do they interpret medi a messages, what do they attend to, and what do they find meaningful? As indicated in the previous two chapters, th e thin ideal is a socio-cultural value that is reflected, created, and perpetuated in the American media. This dissertation explores the potential media influence, both positive and negative, on the participants recovery process from anorexia. Low recovery rates (Keller et al., 1992), and high mortal ity rates (Herzog, Keller, & Lavori, 1988) for eating disorders, underscore the need understanding how media literacy can play a role in eating disorder prevention programs, which are still in an infancy stage (Irving & Berel, 2001; Shisslak & Crago, 1994). Some resear chers even have questioned the usefulness of prevention programs, given powerful sociological factors such as the medias emphasis on the thin ideal (Shisslak & Cra go, 1994; Vandereycken & Meermann, 1984). The rich data gained from this qualitative study provides support fo r educational prevention programs and also may

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149 provide clinicians and inpatient treatment programs with insight ful and relevant information on more effective eating disorder treatment plans. Justification for Using Qualitative Methodology The majority of the research on body image, women, and the media has been experimental in nature. Studies with experi mental methodology typically have exposed women to media that have a high proportion of thin ideal body images and measured the effects on self-esteem, body dissatisfaction, eating disorder symptomology or some combination thereof. Some researchers have used womens fashion magazines, body-orie nted television shows, or videos to expose subjects to imagery (Harrison, 2001; Heinbe rg & Thompson, 1995; Myers & Biocca, 1992; Richins, 1991; Stice et al., 1994; Stice & Shaw, 1994; Waller et al ., 1992). Others have used photographs or slides of thin women or fash ion models as a stimulus (Grogan, Williams, & Connor, 1996; Hausenblaus et al., 2002, 2004; Henderson-King & Henderson-King, 1997; Irving, 1990; Posavac et al., 1998; Waller et al., 1992). This dissertation is qualit ative in nature because qualitative methodology is most appropriate for exploring and understanding socio-cultural, medi ated phenomena. As McCracken (1988) has contended, Without a qualitative un derstanding of how culture mediates human action, we can know only what the numbers tell us.Qualitative rese arch is useful because it can help us to situate these numbers in thei r fuller social and cultural context (p. 9). Qualitative analysis results in a different type of knowledge than does quantitative inquiry. Whereas quantitative researcher s seek causal determination, pr ediction, and generalization of findings, qualitative researchers instead seek i llumination, understanding, and extrapolation to similar situations (Strauss & Corbin, 1990). Qualitative research is often characterized by its emergent design (Charmaz, 2006; Glaser & Strauss, 1967; Strauss & Corbin, 1990, 1998), in which the investigator proposes a flexible

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150 plan for the study based on concepts generated from the participants as well as the investigators own evolving thought process. The researcher is free to adapt data -gathering methods and analytic strategies to the emer ging themes of the study. This t ype of design is particularly appropriate for this study because it empowered th e participants, allowing them to have a voice in the process and outcome of the research (Fallon et al., 1994). Qualitative researchers also tend to use inductive analysis of data, meaning that the critical themes emerge out of the data (Charmaz, 2006; Corbin & Strauss, 1990; Daymon & Holloway, 2002; Denzin & Lincoln, 2000; Lindlof & Taylor, 2002; Lincoln & Guba, 1985; Patton, 1990). The challenge of qualitative analysis lies in the abili ty of the researcher to put the raw data into logical, meaningful categories; to examine them in a holistic fashion; and to find a way to communicate this interpretation to others. It is in the spirit of a feminist appro ach to research that I selected the methodology for this study. Striegel-Moore (199 4) has contended that qualitativ e researchers need to make a serious effort to hear womens voices (p. 440) and use a broader sp ectrum of methods. In addition, as Peters and Fallon (1994) have contended, it is important to include interviews that are collaborative enough to allow participants to inform resear chers of what is most meaningful to them, allowing for a more textured analysis (p. 340). An emergent design is particularly important in the field of eating disorders because the disorder itself reflects complex psychological and socio-cultural issues (Peters & Fallon, 1994). Grounded Theory Grounded theory is one of the most widely us ed approaches to quali tative social science research (Locke, 2001). It offers a mechanism for generating theories about areas of research for which there is little already known, or for which, there are few existing th eoretical explanations (Goulding, 1998, 2002). Its usefulness is also rec ognized where there is an apparent lack of

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151 integrated theory in the lit erature (Goulding, 2002). Grounded th eory also adapts well to capturing the complexities of the context in which the action unfolds (Locke, 2001, p.95). According to Gales (2003), the process of grounde d theory assists the researcher in retaining connections to broader social contexts. While there is an abundance of literature regarding body image, eating disorders, and the media, there is a paucity of qualitative research in this area, particularly with regard to women in recovery from anorexia and how they negotiate media messages, making this dissertation topic fertile ground for grounded theory. Participant Requirements In order to be included in this study, the women needed to have a previous clinical diagnosis of Anorexia Nervosa, no current diagnosis of any eating disorders, and evidence that they were in recovery or we re recovered. The women were all previously diagnosed with Anorexia Nervosa based on the criteria defined in the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV-TR), most recently published in 2000. They also no longer met the clinical diagnosis for anorexia nervosa or for any other eating disorder. (See Appendix A for diagnostic criteria for Anorexia Nervosa, Bulim ia Nervosa, and Eating Disorder Not Otherwise Specified.) Women with anorexia often have purging tendencies, and for many of these women, their disordered eating behaviors transform into bulimia, particularly after an extended time of food deprivation (Brown, 1993; Hall, 199 3). After a discussion with a key informant, I decided that women in this study also may have been diagnosed with bulimia or another eating disorder, but at some point in their life, they must have been diagnosed with anorexia. This participant requirement is based on the notion that to be diagnosed as anorexic, the women would have had to not only desire a thin body, what the media portr ay as ideal, but also have achieved that goal.

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152 Interviewing women with this experience allowed me to tap into a unique perspective regarding the medias portrayal of thi nness as a desirable trait. The women in this study also were required to be in recovery (or recovered) from anorexia. The basis for this decision was that the women wo uld have experienced what it is like to have a thin body, gone beyond what is considered to be healthy weight loss, and then gained enough weight back to be considered physically hea lthy. After speaking with my key informant, I defined recovery more specifically. The partic ipants needed to have worked through the underlying reasons for their eating disorders e nough to understand that eating disorders are a coping mechanism (Brown, 1993; Hall, 1993; Jo hnston, 1996; Maine, 2001; Siegler, 1993). Participants for this dissertation were wo men, primarily in their 20s, a population for which eating disorders and the recovery proce ss are most predominant (American Psychiatric Association, 2000). Increasingly, females are strugg ling with anorexia, an eating disorder that often starts at puberty, or around age 18 (Beau mont & Touyz, 1985; Bruch, 1981; Garner & Garfinkel, 1980; Seldman, 2004; Shisslak, Crag o, Neal, & Swain, 1987; Striegel-Moore, 1993). Discussion of Recovery and Relapse Given the lack of consensus in the literatu re of what constitutes specific terminology with respect to eating disorder rec overy, a discussion of the termi nology is warranted. Kordy et al. (2002) provided a general framework for the ope rationalization of the terms episode, partial remission, full remission, recovery, relapse, and r ecurrence. An episode is a period of time An episode is a periodduring which the patien t is consistently within the full symptomatic range on a sufficient number of sy mptoms to meet syndromal criteria for the disorder. A partial remission is a period during which the individual is no longer fully symptomatic, but continues to show evid ence of more than minimal symptoms. A full remission is a periodduring which an improvement of sufficient magnitude is observed that the individual is asymptomatic (i.e ., has no more than minimal symptoms). A recovery is a full remission that last s for F days or longer. A relapse is a return of symptoms satisfying the full syndrome criteria for an ep isode that occurs dur ing the periods of

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153 remission, but before recovery. A recurrence is the appearance of a new episode of the disorder and thus, can occur only after a recovery. (p. 835) Kordy et al. (2002) also have found the lite rature to contain two primary components for their definitions of recovery terms. The first co mponent was what symptoms change and to what degree. For example, researchers might have focuse d on the severity of wei ght loss as well as the magnitude of anorexic attitudes toward weight an d food using a particular measure. Wentz et al. (2001) required the sustained absence of we ight deviation, compensatory behaviours, and deviant attitudes regarding weight and shape, including weight phobia (i.e., the absence of constant worry or rumination over weight, the possibility or immine nce of weight gain, or need for vigilance over eating and weight control) (p. 615). Their definition of recovery also required a relaxed attitude towards eating in general (no tension at mealtime and the ability to enjoy eating with other people) (p. 615). The second primary component in the literature was the length of the change. Strober et al. (1997) have defined full recovery with respect to eating disord er symptomology as individuals who have been free of all criterion symptoms of anorexia nervosa or bulimia nervosa for not less than 8 consecutive weeks (p. 345). Other researchers (Ras tam et al., 2003; Wentz et al., 2001) have provided more time with respect to length of recovery, requiri ng individuals to have been free from eating disorders symptomology for more than six months. The criteria for the participants were based on the suggestions in the literature (Rastam et al., 2003; Wentz et al., 2001). I required the particip ants to have been free of clinical diagnoses for at least six months. Lack of clinical dia gnosis for anorexia nervosa also meant that the participants maintained a body weight at or abov e a minimally normal weight for age and height (more than 85% of that expected). The participants no longer had an intense fear of gaining

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154 weight or becoming fat. Their body weight or shape had minimal influence on their selfevaluation, and they had consecutive menstr ual cycles for at least six months. Definitions of Recovery There is a lack of consensus about the definiti on of recovery in the l iterature. This section will provide some useful perspectives on definitions of recovery that guided my view of how to select the most appropriate participants for this dissertation. The following definition is a perspective I learned as I have proc eeded through my recovery process. It [recovery] is unique to each person, but in every case demands commitment, determination, and willingness. It means expl oring new behaviors, developing new ways of thinking, and sitting with some inevitable emotional and sometimes physical discomfort. It requires hard work and a great deal of risk takingnot just in terms of food and weight. Recovery obliges you to open up, to discover an d share parts of yourself, and to connect with the people in your life. It is a dynamic, constantly-evolving process with perspectives that continually shift. (Hall & Ostroff, 1999, p. 54) This perspective views recovery as an ongoing processthat individuals who are in recovery gain continual self-awareness and may achieve and maintain periods of being asymptomatic through their lives Those who adopt this recovering model emphasize the necessity to remain alert and aware that their eating disorder, or perhaps some other addictive behavior, could return during period s of stress. While women in rec overy firmly assert that while their eating disorder may no longer impede their ab ility to live life fully, they also acknowledge that it will always be a part of them (Hall & Ostroff, 1999). According to Miller (1993), a woman in reco very from an eating disorder, has expanded on the recovering or in recovery model, as it pertai ns to eating disorders. Her view is similar to one adopted in 12-step and addictions groups: While I believe that it is entirely possible to overcome an eating disorder and create normal, guilt-free eating patterns, I also think that it is very hard for an addictive person to avoid switching to another mood-altering obsession, whether it be spirituality, sex, shopping, caffeine, alcohol, drugs, or exercisi ng. These are the deep-s eated roots that led me to abuse food in the first place, and because Ill always be the same type of personality,

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155 Ill always be in a recoveri ng state of mind, open to new i ssues, new possibilities, new growth. (p. 148) These models of recovery offer advantages to individuals who are committed to healing, but continue to struggle with issues in thei r recovery process. For women who occasionally relapse, the recovering model allows for an o ccasional, temporary sli p, without encouraging women to berate themselves for not being strong or committed enough. The recovery model allows room for self-acceptance and gentle forg iveness as women make strides toward healthy eating. The philosophy can be particul arly helpful in the early stages of recovery, when eating in a healthy manner feels more like a loss of cont rol. Recovering anorexics are encouraged to maintain a meal plan and abstain from foods or situations that might tr igger their restricting behavior, similar to the abstinence a pproach in drug and alcohol programs. There are other models of r ecovery, including the recovered model, which has indicated that individuals can become completely free from anorexia. This model takes a more hard-lined approach, viewing recovered indi viduals as able to eat a wide variety of foods, including those that they once adamantly refused to touch. The recovered individual al so has eliminated her obsession with starving, purging, ca lorie counting, weight, and body shape. Both the recovery and the recovered model necessi tate rigorous work, but those who adopt the recovered model have asserted that all negativ e thoughts and self-des tructive behaviors re lated to the eating disorder can be completely worked th rough and become part of the past. For the purposes of this study, the participants were selected using the recovery model, but each womans experience with and approach to recovery is unique, and some participants considered themselves to have progressed far enough along the recovery continuum to have achieved what the recovered model would cons ider complete recovery. Women in recovery from anorexia were defined as women who are far enough along the recovery continuum to

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156 have made a commitment to healing and maintain ing awareness of their em otions. In all cases, the women were aware of foods or situations that might trigger their eating-disordered behavior (if they still had any), and were aware of how their eating disord ered behavior was symptomatic of underlying issues. The women all had learned to use recovery tools as opposed to turning to their eating disorder as a coping mechanism. All the women were at a medically healthy weight, and their eating disorder was not at a stage wher e it impeded their ability to live life fully. Many of the women were fully recovered, meaning they were no longer symptomatic, and they had worked through all their underlyi ng issues. Some women were close to that st age with an occasional relapse. Serpell et al. (1999) conducted a study of le tters written by women with anorexia about the positive and negative aspects of their disorder. The researchers found an equal number of prodisorder and anti-disorder th emes (p. 179). Both themes provide useful information for a measuring stick of recovery for this study. For example, of the 10 negative themes, the women most commonly wrote about three: a food theme, a social theme, and a control theme. The food theme included feeling controlled by food or bei ng upset by constant food thoughts. The social theme included descriptions by the women of losing friends and relationships because of the anorexia. The control theme included the womens descriptions of the power and control of the anorexia, including a sense that the disorder had taken them over. Of the 10 positive themes in the study, six were most frequently described: safety, attractiveness, confidence, a sense of being special, structure, and emotion avoidance. The safety theme included women describing the disorder as helping them to feel safe, cared for, and protected. The attractiveness theme was purely about physical beauty, in terms of meeting perceived cultural expectations. The confidence theme was closely related, in that the women

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157 expressed feeling confident about having achieve d a culturally defined body ideal. The sense of being special included a feeling of being different from or even superior to others who were unable to meet the cultural pressure of slim ness. The structure theme was coded when women expressed the anorexia as providi ng structure or control in thei r lives. The last of the most commonly expressed themes was avoiding uncom fortable emotions. This theme included womens descriptions of anorexia serving as a nu mbing device or distraction, allowing them to avoid addressing painful emotions. In terms of helping to define recovery, the findings by Serpell et al. (1999) can be quite useful. For example, a woman who is truly recovered from anorexia would no longer use the eating disorder as a crutch or tool to deal w ith everyday issues and emotions. She would have overcome obsessive thoughts about food and no longer would feel as if anorexia controlled her life. In addition, she would have made strides in the social and persona l realms of her life, patching up old friendships and re lationships, or adopting new, mo re healthy ones. A woman in recovery from anorexia also woul d have a sense of safety and s ecurity in the world, but not due to the distraction of her disorder. She would ha ve gained a sense of self-worth and strength through personal insight and developed confidence in her ability to achieve reasonable and realistic personal goals. Most importantly, a wo man in recovery would have developed the ability to identify and appropriately express positive, negative, and uncomfortable emotions. Certainly, no one is capable of achieving comple te control over emotions all the time, but women in recovery from anorexia should at least have established a sense of trust in their ability to do so as an alternative to engaging in eating disorder behavior.

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158 The participants re cruited for this study had achie ved recovery from the physical symptoms of anorexia. They also had overc ome undue obsession and preoccupation with their weight and have found alternative m eans to fuel their self-worth. Recruiting the Participants Central to gaining insightful data for this dissertation was my ability to ensure that the participants felt comfortable enough to share their sincere feelings thoughts, and reactions with me. To establish a sense of trust, I initially recruited the partic ipants through two therapists: Dr. Roberta Seldman, Counseling Psycho logist for the University of Florida Student Health Care Center and UF Athletic Associ ation, and Dr. Ellen Emerson, Ph.D., Assistant Director for Clinical Services at Georgia Southern University in Statesboro, Georgia. Drs. Seldman and Emerson served as key informants (Daymon & Holloway, 2002; Lincoln & Guba, 1985; Warren & Karner, 2005). They assi sted with the recruitment of appropriate volunteers to participate in the study: women wh o have recovered or are in the process of recovery from anorexia. Conducting interviews with sensitive populations often pos es a number of problems for qualitative researchers. Access is often the gr eatest challenge (McCrack en, 1988). As the key informants, Drs. Seldman and Emerson had intimate knowledge of some women who served as participants. Their involvement with the wome n as therapists put them in an excellent, trustworthy position to recruit appropriate volunteers who are far enough along in the recovery process to participate in the study. In a pos itive therapeutic relationship, a psychologist establishes a sense of trust, which made the pa rticipants more comfortable when Drs. Seldman and Emerson asked women if they woul d like to participate in the study. As recommended by Denise Long, a Grants Sp ecialist at the University of Florida Institutional Review Board, I pr epared a script for Drs. Seldman and Emerson to use when

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159 asking appropriate women if they would like to participate in the study. The script is included as Appendix B. The script fulfilled the requirements of the I RB, but ultimately Drs. Seldman and Emerson told me that they would prefer not to read the script to the women. Their therapy sessions had time limitations, and they suggested that I provide them with a hard copy of my criteria and my contact information. In addition, they suggested that I post a Web site with additional information so the women could review what par ticipation in my study enta iled and determine if they were interested in contact ing me. The Web site just provided a brief introduction of who I am, my contact information, why I was doing th e study, and the type of participants I was looking for. It also provided information about what participation in the study would entail, a media journal example, and some informed consent material. The key informant at Georgia Southern al so asked me if the women she referred as participants could have clinical diagnoses ot her than eating disorders. To avoid excessive variation in my sample, I decided that in ad dition to being recovered from anorexia, the participants could not have other severe clinical psychiatric sympto mology that interfered with social, occupational or school functioning. Many women in recovery from eating disorders discover that they have other underlying issues, which are not severe, particularly when treated with therapy and/or medication, su ch as depression, anxiety, or obsessive compulsive disorder (Bardone-Cone et al., 2007; Bulik et al., 2003; Godart et al., 2006). To ensure that I was not interviewing women with severe psychiatric symptoms, I instituted minimal requirements in terms of wh ether the women who participated in the study were currently in therapy. If they were in therapy, and most of them were, the work needed to be on an outpatient basis and no more frequent than once per week.

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160 About the Participants A total of 55 women contacted me about pa rticipating in my dissertation. Of those, 18 women chose not to participate in the study for various reasons. Some women initially thought they would have time to participate, but then they got caught up with school work (usually graduate school) and decided that they would not have enough time to participate. Other women slipped back into their eating disorders or had other personal issues develop in their life that precluded them from pa rticipating. In addition, there was one woman I chose not to interview because she did not meet the criteria for the study. Pseudonyms I used pseudonyms to protect the confid entiality of the participants. Most of the participants selected their own pseudonyms. For participants who did not have a pseudonym in mind, I randomly selected and assigned one. I was the only person who had access to the information linking the pseudonyms to the participants identities. Age The women ranged in age from 18-51, with age 27 as the mean and age 25 as the median. The most common age for the participants was 22, illustrated in Tables 3-1 and 3-2. Purposeful Sampling My research employed purposeful sampling, an approach that has been recommended by several researchers to select participants who shared rich and in-depth information central to the purpose of the research (Daymon & Hollowa y, 2002; Lindlof & Taylor, 2002; Patton, 1990). Grounded theory explores complex phenomena wh ere little understanding exists. Sampling typically is not be planned in detail prior to the study, but rath er is directed by the emerging theory (Goulding, 1999). As concepts were identified and the theory started to develop, I realized

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161 that additional data was necessa ry to strengthen the findings, which led me to theoretical sampling (Coyne, 1997; Goulding, 1999; Patton, 1990) discussed below. Table 3-1. Breakdown of ages with mean and median Age No. of participants 18 3 22 7 24 2 25 4 26 3 27 2 28 1 31 3 32 1 34 3 39 1 46 1 51 1 Mean 27 Median 25 Table 3-2. Names and ages of the participants Name Age Name Age Name Age Abigail 26 Eliza 22 Metkit 46 Alexandra 24 Faith 25 Michelle 27 Amanda 25 Grace 31 Molly 28 Barbara 27 Isabel 22 Nicole 22 Charlotte 31 Jamie 34 Noah 34 Christina 22 Jane 34 Ramona 26 Courtney 22 Jordan 25 Rylie 18 Diamond 26 Kerry 25 Sarah 24 Eda 51 Kristin 18 Sunshell 22 Emma 31 Lulu 39 Veronica 22 Enchantment 18 Lindsay 22 Typical Case Within the broad category of purposeful sampling, Patton (1990) has identified 16 specific types, one of which is typical case sampling ( p. 173). I originally had planned to use only this category of sampling to illustrate or highlight case s that are not extreme, deviant, or intensely

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162 unusual (p. 173). According to Patton, typical ca se sampling is often used with the cooperation of key informants, in this case, two therapists, w ho were able to assist with identifying what was typical for women in r ecovery from anorexia. Through typical case sampling, I was able to gain six participants for my study. Dr. Seldman mentioned my study to several women over the course of several months, and of those women, three contacted me to participate in the study. One woman was a senior at the University of Florida who was completing her internship at a local hospital in Gainesville, Florida (Christina). Another woman was a freshman at the University of Florida, who had been started taking courses on campus during the summer prior to her the official start of the Fall 2005 semester (Rylie). The third woman Dr. Seldman referred to me was a high school senior. She had been seeing Dr. Seldman in her office at the Univ ersity of Florida, but had just recently ended her therapy sessions because of the leve l of her recovery (Enchantment). In the meantime, I was in contact with Dr. Emerson, and we met on two separate occasions to discuss my dissertation and to prepare docum entation for the Georgia Southern University IRB. Once I had approval from Georgia Southern s IRB, Dr. Emerson and I met one additional time in person to clarify the exac t type of participants I was l ooking for. (See section on Criterion Sampling below.) We continued to communicate via e-mail and phone for several months while Dr. Emerson referred several women to my study, three who contacted me and participated. One of the women was a current student taking gradua te courses at Georgia Southern (Diamond), one woman was completing her requirements for her B.S. in nutrition off campus in the Atlanta area (Sarah), and one woman had recently gradua ted from Georgia Southern (Jordan). The population I chose to research turned out to be much more difficult to access than I originally had anticipated. Given the limited number of participants I had re cruited with just two

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163 key informants, I needed to incorporate additi onal sampling strategies to reach a point of theoretical saturation (Glaser & Strauss, 1967, p. 110), a critical part of grounded theory approach. Theoretical saturation is reached in the data collecti on, when no new information arose and no new themes or concepts emerged (Daymon & Holloway, 2002; Glaser & Strauss, 1965; Lincoln & Guba, 1985; Lindlof & Taylor, 2002; Patton, 1990). Consequently, I employed four additional sampling strategies, thus taking the 16th approach to purposeful sampling as discussed by Patton (1990, p. 181), combination or mixed purposeful sampling. My sampling methods certainly were tempered by recognition of practical tactics as Patton (1990, p. 73) has suggested. Lacking an id eal situation with unlimited, plentiful access to appropriate participants, I chose to incorporate a combination of the most appropriate sampling strategies to provide me with as many information -rich cases to illuminate the research questions for this dissertation. The additional sampling st rategies included: snowball or chain sampling, theory-based or operational construct sampling, stratified purpos eful sampling, confirming and disconfirming cases and opportunistic sampling. Each one is briefly discussed below. Snowball or Chain As I progressed in the research and had diffi culty gaining sufficient participants through my initial key informants (see below), I shif ted to what Patton (1990, p. 176) refers to as snowball or chain sampling, which generate s a study sample through referrals (Daymon & Holloway, 2002; Lindlof & Taylor, 2002; Pa tton, 1990). The snowball sampling method is useful for sensitive subjects and allowed me to gain access to participants that otherwise might not have been accessible. Researchers with simila r research topics have used this method of participant recruitment combini ng therapist referral with th e snowball method (Esherick, 2003; Malson, 1998; Peters & Fallon, 1994; Thomsen et al., 2000).

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164 The two key informants referred me to qualified colleagues, some of who were able to assist with the selection of additional appropriate participan ts (Biernacki & Waldorf, 1981; Daymon & Holloway, 2002; Patton, 1990). Dr. Emerson provided me with several referrals to qualified professionals that allowed me to expa nd the number of participants for my study. Dr. Emerson discussed my study with her colleague s at the Counseling a nd Career Development Center at Georgia Southern and asked them to refer any appropriate women to my Web site. She also referred me to several other therapists in the immediate and surrounding area who might be able to identify additional participants. Three co lleagues of Dr. Emerson each referred one or two women to my study, one of whom was the first pa rticipant for my dissert ation (Isabel). Another participant was a senior psychol ogy student at Georgia Southern (Lindsay). The third woman recently had transferred to Georgia State Univer sity (Veronica), and the fourth woman (Noah) had recently completed her Ph.D. in psychology at another institution, but was in Statesboro in August for a friends wedding. Another one of Dr. Emersons colleagues, Terry Till, R.D. L.D. referred several women to my Web site, but only one woman participated (C harlotte). Dr. Emerson referred me to four colleagues outside Georgia Southern University. The first person she referred me to was Barbara Harris L.P.C., a therapist in Statesboro, who had worked with one woman who was in recovery and was interested in participat ing in the study (Courtney). Dr. Em erson also referred me to two therapists in Savannah, Drs. Ann Davis and Wood s Miller. I met with bo th of them in person, and they had worked with several women who would be appropriate for the study. Ultimately, one woman participated who was referred by Dr. Davis (Eliza) a nd one woman participated who was referred by Dr. Miller (Eda).

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165 I joined the Academy for Eating Disorders (AED) Forum as recommended by one of Dr. Emersons referrals. At the time, people who were on the listserv included professional psychologists and psychiatrists, as well as graduate students working on various degrees in psychology. Initially, I just read the e-mails that came in to get a sense of the nature of discussions on the listserv. When a string of messages about r ecovery from eating disorders started, I sent a note out about my study, request ing that any therapis ts who knew women who were in recovery (or recovered) from anorexia refer appropriate people to my Web site, which had additional information about my study. This email proved to be fruitful. I received four or five responses from therapists on the listserv co mmenting on how valuable my research would be and letting me know that they would refer appr opriate women to my Web site. Over the next several months, I received seve ral e-mails and phone calls from women expressing interest in participating in my study, 10 who participated (Abigail, Alexandr a, Barbara, Grace, Jane, Kerry, Molly, Nicole, Ramona, and Sunshell). Theory-Based or Operational Construct Theoretical sampling is often the most appr opriate type of sampling for grounded theory (Daymon & Holloway, 2002; Glaser & Strauss, 1967; Patton, 1990). As the data is collected, and ideas begin to emerge, the researcher then determines what the most appropriate sample is to study next. I did start with typi cal case sampling, but after comp leting some initial interviews with similar participants, I realized that I needed to select some different types of individuals to explore new ideas and extend some emerging theories. I interviewed a woman who had completed a su mmer program at UF an d was about to start her freshman year in college. Rylie definitely f it the criteria of having recovered from anorexia, but in the interview she indicated significant body dissatisfaction. I hate my body but I see past the external, you know, I just hate my body. I hated my body when I was wearing a size 0, and I

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166 hate my body now that Im a size 8. Rylie also mentioned her older sister having gained weight as a freshman: My sister went here actually fo r her first year. UF, a nd she gained a lot of weight; she gained the freshman 50. (She laughs.) Just kidding, no she didnt gain that much. Shortly after the interview with Rylie, Dr. Se ldman referred me to a girl who was a senior in high school (Enchantment). She provided insi ght regarding how age relates to media usage and interpretation, which is discussed in the findings. Stratified Purposeful I later interviewed another wom an who was 18 and a senior in high school, which Patton (1990, p. 174) likely would describe as stratified purposeful sa mpling. The sample size was too small for generalization or statistical represen tativeness, but it did capture some insight in terms of age variation and level of education (Patton, 1990, p. 174). The two high school participants sharply cont rasted with an interview I conducted with a woman who was in her young 30s and had a child. Originally, I had not thought about how much having a child might alter someones media c onsumption and percepti on. I hadnt given thought to marital status or motherhood as consideratio ns for my population. Then, I was referred to a woman who had a 3-year-old daughter, and I real ized that a few more interviews with women with young children might help to capture majo r variations (Patton, 19990, p. 174) that might emerge from the participants with young children. At this stage, I selected participants at least partially on the basis of a theory that was emerging from the initial analysis of the data (Patton, 1990; Strauss & Corbin, 1990) not to provide a perfect description of an area, but to develop a theory that accounts for much of the relevant behavior (Glaser & Strauss, 1967, p. 30). Of the 32 participants I interviewed, three of them had children, all under the age 4. The participants from the AED forum led me to incorporate stratifie d purposeful sampling to capture another pote ntial major variation (Patton, 1990, p. 174). Two of the women referred

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167 to me by a therapist on the AED forum were lesbia ns. I decided to include four additional lesbian participants to explore any potenti al variation based on sexual orienta tion. A sample size of six is too small for generalization or statistical re presentativeness (Patton, 1990, p. 174), but the findings have indicated that there were not any differentiation s in the participants perspectives based on sexual orientation. Confirming and Disconfirming Cases One of Dr. Emersons colleagues referred me to a woman who was 51 (Eda). At that point in the data collection, I realized that it would be interesti ng to contrast the younger participants with someone who had been diagnosed with Anor exia Nervosa in the 1960s, at a time when the diagnosis was relatively rare. I wa s at a point in the research when I was testing my initial ideas and examining potential emerging patterns in the findings (Patton, 1990). Eda served as a disconfirming case, and Patton (1990) has sugg ested that such cases can be exceptions that prove the rule or exceptions that disconfirm and alter what appear ed to be primary patterns (p. 178). According to Glaser and Strauss (1967), theory generation does not require several cases. Even just one case can be used to generate conc eptual categories, and a few more participants can be used to confirm the categories. Opportunistic The last of the additional sampling strategi es I incorporated wa s opportunistic which allowed me to take advantage of new opport unities (Patton, 1990, p. 179). I came to this decision because I had recently moved to Atlanta and become involved with the Eating Disorders Information Network (EDIN). In addition to working as a therapist with Powers Ferry Psychological Associates in Atla nta, Dr. Zeckhausen also is the founder of Eating Disorders Information Network (EDIN), a non-profit organi zation dedicated to awareness and prevention

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168 of eating disorders. Through her work with EDIN as well as her job as a therapist, she had access to many women who were in recovery from eating disorders. In fact, Dr. Zeckhausen informed me that all of the 50 EDIN volunteers had either recovered from an eating disorder themselves or were close to someone who had. At this point in my research, I had interviewed 24 women, but given how long it had taken me to gain access to those particip ants, I could not turn down an additional key informant who had access to several women who, not only fit the criteria for my study, but also would allow me to explore some emerging themes. As a result, I met with Dr. Zeckhausen a couple times to discuss the goa ls of my dissertation and the criteria for the participants, and she referred the remaining ei ght participants (Amanda, Emma, Grace, Jamie, Kristin, Lulu, Metkit, an d Michelle) to my study. Later in my research, I interviewed a woma n who was 46 (Metkit). Not only was she close in age to Eda, but she also had two children, a 6month-old and a 2-year-old, so she added to the stratified purposeful sampling of women with young children. As Gl aser and Strauss (1967) have noted, at times its good to gain sensitivity to differences between groups and establish a more definite set of conditions when a category can exist. In addition, Metkit was extremel y intelligent and articulate. Wh en I initially spoke with her on the phone, she had indicated that her faith in God was instrument al in her recovery process, which was an emerging theme in my research. During our initial phone call, Metkit also had shared that she had been a victim of rape, and she had just realized the connection between the rape and her development of her eating disorder. Most of the women I interviewed had been victims of rape or sexual assaul t, which reflects the literature (Smolak & Murnen, 2002; Treuer, Koperdak, Rozsa, & Fredi, 2005).

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169 Methods Patton (1990) has suggested that there is a rich menu (p. 65) of alternative methodological options for qualitative research. In that vein, I selected a combination of methods that expand the boundaries of traditional methods to explore part icipants experiences. To investigate the research question, two qualitative methodologies were employed: media diaries and semi-structured interviews. Media Diaries Media diaries have the potential to offer inva luable insights from the participants point of view directly after media consumption while th eir thoughts and immediat e interpretations are fresh. Daymon and Holloway (2002) have indicated that diaries allow the researcher to collect data about the responses of informants according to their interpretations and within the worlds in which they live (p. 221). As suggested by Da ymon and Holloway (2002), I decided to use a loose structure, with an open format for the me dia diaries to encourage participants to record thoughts and feelings about media messages that were personally meaningful to them. I posted a Web site for the potential particip ants so they could learn more information about the study. As suggested in Lindlof and Taylor (2002), I provided participants with instructions regarding th e type of information to include in the diary. I also provided a sample media diary so the participants would better und erstand the type of information to include. Appendix C illustrates the media journal example as well as what one of the blank sheets looked like for a day of the week. When participants in itially contacted me, I also shared my personal interest in the topic, provided a clear sense of purpose for the study, provided participants with clear reasons why they had been contacted, desc ribed the goals of the study, and explained how the study was going to be conducted (Corbin & Strauss, 1990; Daymon & Holloway, 2002; Lindlof & Taylor, 2002).

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170 Recruiting enough participants for the study was a challenge, so I wanted to make the media journal as easy as possible for the partic ipants. The Web site included a blank sheet for each day of the week that they could print out an d write in, but I encourag ed the participants to alter the format of the media journal to whatev er was easiest for them. Many of the women did use the sheets from the Web site. Some wome n typed up organized, color-coded documents in Microsoft Excel or Microsoft Word. Others ma de their own hand-drawn charts on construction or notebook paper. One woman co mpleted a 6 x 9 spiral-bound notebook with her information for each day. At some point in the research process, a pa rticipant commented that the media journal was much less complex to complete than the Web site made it appear. This comment led me to simplify the description of the media journal that I had on th e Web site. I also told the participants that the media journal could be as simple or complex as theyd like it to be. When a woman contacted me about participa ting in the study, I e xplained the purpose of the media journal either on the phone, or in pe rson, depending on the where the participant lived. I also had the information included on the Web s ite. I explained that the intention of the media journal was to allow the participant to pay more attention than she norma lly would to her media exposure. By recording her media exposure, sh e might notice things she normally would not think about, such as glancing at a magazine while in a checkout line or casually browsing through a magazine while in a doctors office. I also explained that I was looking for what a typical week looked like for the participant in terms of media usage. Even if the week that sh e completed the media journal was not typical, I let her know that I would cover that in the in terview with the second question: What might a typical week look like for you in terms of media usage?

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171 In addition, I made it clear that there was no n eed for the participant to intentionally expose herself to certain media if that was not typical for her. I made it clear that I was trying to get a sense of what media participants typically were exposed to by choice or circumstance. I allowed for days when they might not be exposed to an y media, and as much as possible, encouraged them to act as they normally would during any other week. The media journal served as a tool for me to capture a slice of the participants typical media exposure and perceptions. There were six components to the media journal: date, time of day, medium, the participants loca tion, activities, and thoughts. Th e time of day was included to get a sense of when the participants had th e most media exposuremorning, afternoon, or evening. The location and activities portions were included to see if th e participants were actively or passively consuming media. With regard to the thoughts section, I told the participants to jot down thoughts if they had any. I explained that not everyone has thoughts at all when watching TV or reading a magazine, that so metimes we are completely tuned out. As much as possible, I encouraged the participants not to write anything that felt forced. As stated earlier, the participants kept a media journal for seven days, starting on any day of the week that was convenient. One week was a time frame long enough to gather meaningful information, but not so long that the women felt that particip ation in the study was taxing on their time. The diaries allowed me to examine media usage patterns of the women and gather qualitative information on their interactions with and thoughts about the media. I also used the information in the media diaries to guide the construction of semi-structured interview questions. The media diaries served as a catalyst to f acilitate the womens reca ll of their media usage during the interviews. Having the women record information for a week prior to the interviews

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172 encouraged the participants to reflect on how they experience the media a nd aided their ability to better articulate their media usage. The media diary can provide a wealth of rich information about peoples daily media consumption. According to Lindlof and Taylor (2002) letters, diarie s, journals, notes, scrapbookscan provide insights into the cons truction of personal beliefs, identities, relationships, and communicative styles (p. 117). Furthermore, the media diary can provide information to account for a third-person theory effect, which is the idea that media affect others, but not me (Baran & Davis, 2003, p. 30). In previous studies, women have expressed patterns indicating a third-person theo ry effect (Thomsen et al., 2000). While this study did not indicate a third-person effect, I did notice that some participants tended to have more oppositional readings in their interviews than they did in their media journals. While this was not true across the boar d, it may warrant further examination in a future study. Additional discussion of the media jour nals may be found in Chapters 4 and 5. Asking the women to record their media us age and express their thoughts and observations over a one-week time period allowed me to tap in to their routine daily lives, as opposed to a recollection of their experiences, which might ha ve cause them to overlook any media influence. In addition to recording their actual media usage, I asked participants to include any thoughts or observations they had. This technique follows th e suggestions of Lindlof and Taylor (2002) for participants to share their reac tions to media content, usually in a free narrative (p. 118). Media diaries can offer a significant source of information when combined with other methods, in this case, in-depth interviews (Lindlof & Taylor, 2002; Patton, 1990; Riessman, 1993; Strauss & Corbin, 1990). As suggested by Lindlof and Taylor (2000), I conducted the

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173 interviews the interviews shortly after the part icipants completed their media journal so they were able to recall the details they included in the journal. The choice to use media journals was base d in part on a study by Steele and Brown (1995). To learn more about teenage girls use of the ma ss media, the researchers had participants spend one month recording in journals whatever th ey saw or heard in the media about sex and relationships. When the girls completed the jour naling, the researchers in terviewed each girl her media usage and interpretations. Steele and Brown (1995) have indicate d that the personal journals and photographs the girls shared opene d up an unexpectedly rich vein of information about adolescent identities and media use (p. 551). In a similar manner, this dissertation combined media diaries with in-depth interviews to provide access to rich information about womens recovery process from anorexia and how they negotiate meaning from the media on a daily basi s. Both the journals and any supplementary material the participants chose to include help ed me to reconstruct past events or ongoing processes that are not availa ble for direct observation (Lindlof & Taylor, 2002, p. 117). Interviews The primary purpose of the interviews was to serve as a follow-up to the questions in the journal, and to prompt for furthe r detail, with the goal of getti ng past the formal and ordinary descriptioninto the hidden soci al and cultural realities (McC racken, 1988, p. 72). Initial ideas for the prompts are included as a discussion gui de in Appendix E, but the questions altered somewhat based on concepts the participants in troduced in their media journals. As mentioned previously, this dissertation has an emergent de sign, so after I reviewed the media journals, I slightly refined or adjusted the questions for the discussion guide as appropriate. I conducted the interviews in a location that was most co mfortable for the individual participants. I encouraged them to select a loca tion that would allow them some level of privacy

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174 and would be conducive to using a tape recorder. The location of the interviews included: my Georgia Southern office, the participants home, coffee shops, a church, and outdoor parks. Initially I interviewed women in Gainesvill e, Florida and Georgia (Statesboro, Savannah, and the Atlanta area). Then, as I expanded my sampling strategies, I al so expanded the region where the interviews took place. The areas I flew to included: Omaha, Nebraska; Seneca Falls, New York; Glastonbury, Connecticut; Providence, Rhode Island; Kansas C ity, Missouri; Seattle, Washington; Springfield, Illinois; and Baton Rouge, Louisiana. After completing the interview process, I usua lly felt connected in a meaningful way to the participants. We both had shar ed intimate information abou t ourselves, and I ended each interview with a hug. Typically th e interviews lasted about two hours, but there was a period at the beginning where we spent time getting to kno w each other, and after the interview was over, wed often spend time talking as well. In some cases, not including the interviews for which I traveled, I talked with th e participants for three or four addi tional hours. Many of the participants expressed a desire to keep in t ouch, and I have been in contact w ith most of them via e-mail and phone. The interviews allowed me to obtain a personal narrative from the participants. Riessman (1993) has indicated the value of the individual story through pers onal narrative, enabling culture and history to speak itself (p. 5). In addition, qualitative research ers have contended that it is necessary for the researcher to facilitate the interview in such a manner as to encourage participants to share meaningful information. Re searchers also have stressed the importance of asking interview questions that open topics for discussion in a collaborative manner and allow participants to answer in wa ys they find meaningful (Holst ein & Gubrium, 1995; McCracken, 1988; Mischler, 1986; Riessman, 1993). Thus, the questions for the interviews were designed to

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175 allow the participants consider able freedom in their responses, while providing enough guidance to stay focused on the research topic at hand. Initially, I asked grand tour questions followe d by mini-tour questions that went into more depth (Daymon & Holloway, 2002; Lindlof & Taylor, 2002; McCracken, 1988; Riessman, 1993). The discussion guide also included some time-line questions, memorable-tour questions, and experience questions (Lindlof & Taylor, 2002, p. 198). As the term grand tour suggests, the interviewer goes along on a t our through the wordpictures painted by the participant.The participant educates the resear cher by pointing out the key features (Lindlof & Taylor, 2002, p. 197). The grand tour questions we re intended to provide a starting point for the in-depth interviews. As necessary, I followed up with additional questions to provide clarity or ask for more specific information. The most appropriate data for this study are the personal narratives of the participants, and the combination of the media diary and interv iew allowed women who are in recovery from anorexia to recount their hist ory in their own words. As Peters and Fallon (1994) have contended, Women who have recovered from bulimia are essential sources of information for clinicians and researchers who hope to understand and treat eating disorders successfully (p. 352). Along the same vein, it was critical to hear the stories of the partic ipants in this study to understand how they negotiate th e meaning of media messages. Several researchers have incorporated semi -structured interviews when studying women in recovery from eating disorders (Esherick, 2003 ; Malson, 1998; Peters & Fallon, 1994; Thomsen et al., 2000; Tolman & Debold, 1994). This t ype of methodology has allowed previous researchers to further understand the complexity and intricacies of the recovery process. In

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176 addition, Peters and Fallon (1994) found that the women whom th ey interviewed felt empowered by being viewed as the experts (p. 340). As Malson (1998) has indicated, the semi-str uctured interviews a llowed her to deviate from the view of the thin woman as an object of medical discourse to the everyday discourses that constitute and regulate womens experiences of eating and not eating, of losing and gaining weight, of embodiment, gender and identity (p. 103). Malson (1998) has expressed the value of the qualitative research approach, particularly when exploring womens experiences and the p roduction of gender ( p. 103) within a sociocultural context. In the quotation below, she has e xpressed that the researcher is an integral part of the study, viewing qualitativ e interviews as a discourse or dialogue, as opposed to a more rigid, structured interview. As with other discourse-analytic studies, these interviews were not viewed as a means of eliciting facts about anorexia. Rather, they we re social and emotional interactive processes in which we discussed experiences and ideas about anorexia and about femininity and in which my own subjectivities bot h as interviewer and as fairly thin woman were also significant. First the sharing of various subject positions may have diminished the inevitable power differential that exists be tween researcher and researched. And these shared discourses, subjectivities and experiences will have had some effect on the dynamics of the interview process, on the ways in which the intervie wees articulated their ideas and experiences and later on the ways in which I analysed the interview transcripts. (p. 103) The complexity of the recovery process from eating disorders was captured with the voices of the women, providing them with the opportunity to describe what was healing and challenging to them. Research indicates th at recovery from eating disorders involves much more than stopping the behaviors of restri cting for anorexia and bingein g and purging for bulimia. In addition to ceasing the physical symptoms, recovery also entails making strides toward health and well-being psychologically and socially (Hall, 1993; Hall & Ostroff, 1999; Kolodny, 2004; Serpell et al., 1999).

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177 During my research, I did find that I needed to slightly alter the phr asing of the questions and the methodology because some of the findings that were emerging indi cated that additional material would be useful for developing a well -conceived, reflexive-participant-based theory. For example, I added in a couple questions rela ted to movies and the Internet. This notion reiterates why it is so important for qualitative researchers to ma intain an open mind, and to be mindful, not allowing their research lenses to be colored, or even lightly tinted, by any preexisting ideas, ones own, or those of others. The discovery process is encouraged in true qualitative research, as researchers explore unkn own territory to further understand concepts or find concepts and ideas they didnt previously know existed. The narrative itself leads to verstehen (Corbin & Strauss, 1990). The idea is to allow for all possibilities. Establishing Trustworthiness and Credibility Qualitative research has some inherent weakne sses, but I took measures suggested in the literature to prevent anything that might undermin e the trustworthiness a nd credibility of the findings (Campbell & Stanley, 1963; Lincoln & Guba, 1985; Lindlof, 1995; Lindlof & Taylor, 2002; Riessman, 1993; Thomsen et al., 2000). One of the proven techniques for credible, dependable data is triangulati on, which involves a comparative assessment of more than one form of evidence about an object of inquiry (Lindlof, 1995). For this dissertation, I used multiple methods (Lindlof, 1995; Lindlof & Tayl or, 2002), including media diaries and in-depth interviews. Some of the participants also include d samples of the media they had reacted to in their media journal, and we discussed their interp retations in further detail during their interview. In addition, several participants ga ve me articles, research papers or artwork they had done that pertained to our discussi ons in the interview. Several researchers have i ndicated the importance of having empathy and insight to achieve understanding, or verstehen, of the participants view (Boyle, 1994; Daymon &

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178 Holloway, 2002; Patton, 1990). According to Patton ( 1990), a qualitative researcher can develop empathy from personal interaction with interv iew participants. Empathy also involves being able to take and understand the stance, position, feelings, experiences, and worldview of others (Patton, 1990, p. 56). Max Weber introduced the concep t of verstehen to the social sciences to underscore the importance of understanding the mo tives and feelings of people in a socialcultural context (Patton, 1990, p. 57). At the age of 13, I was diagnosed with anor exia nervosa, and I have been working on recovery from this disorder for the last 23 year s. My personal experience with anorexia provided me with an emic, or insider approach when I initi ally interacted with the participants and when I collected the data for this dissertation. This pers pective also proved useful in the final stages of analyzing the data. After years of struggling with recovery from anorexia, I ha ve developed an insiders perspective (McCann & Clark, 2003, p. 10) wh ich provided me with an invaluable understanding of the participants ideas, feelings, experiences, and perceptions, rather than imposing an etic or researcher/outsider perspe ctive (p. 10). This perspective was helpful in terms of allowing the participan ts to feel connected with me, by having shared a common, personal experience. In fact, I found that the mo re I shared with the participants about my personal experience, the more willing they were to share intimate details about their eating disorder, as well as their recovery process. Thes e details were helpful during the process of axial coding. Researchers also have indicated the need to balance the emic approach with an etic one when interpreting participan ts perspectives (Daymon & Holloway, 2002). According to Daymon and Holloway (2002), the res earcher is part of the world she is studying and is affected

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179 by it. Combining the etic and emic perspectives pr ovides a rich insight, one that is deeper than would be possible solely from the participants or just from myse lf. In this type of qualitative inquiry, theory emerges from the reflexive nature of the study. Analyzing the Data According to Lincoln and Guba (1985), there mu st be a belief in the assumption that what is knownbe it an existent realit y or an interpreted realitysta nds independent of the inquirer and can be described without distortion by the in quirer (p. 6). Qualitative researchers seek credible, quality data (Lincoln & Guba, 1985). To ensure the me rit and validity of the data, I used data triangulation (Cre swell, 1994; Lindlof, 1995). Member checks (Lincoln & Guba, 1985) served as an opportunity for me to take the information back to the participants to check for accuracy on concepts and interpretations (Morse, 1994; Lindlof, 1995). Member checks also enabled me to compare my interpretation with the perceptions of the participants involved in the study. I was able to determine if I was presenting the realities of the participants in a manner that was credible to them, and I provided them with an opportunity to correct errors. The member checks also challenged my initial ideas to ensure the accuracy of the theories I generate d and the rigor of the work as a whole (Daymon & Holloway, 2002). Lincoln and Guba (1985) discuss the importa nce of trustworthiness, meaning, How can an inquirer persuade his or her audience (including self) that the findings of an inquiry are worth paying attention to, worth taking ac count of? Truth value (p. 290) refers to how the researcher establishes confidence in the accuracy of the findi ngs, given the research question, the nature of the participants and the context of the study. Th e key to the truth va lue is in establishing credibility in how the research is conducted and ensuring the findings are credible to the constructors of the original mu ltiple realities (p. 296). Truth also reflects the degree to which

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180 the researcher is confident that she has accurate ly represented the multiple realities revealed by the studys participants (Lindlof & Taylor, 2002) The findings must not only be accurate to the researcher, but also to the participants. As discussed above, credibility ca n be established with member checks to ensure the participants recogn ize the findings as true or accurate (Lincoln & Guba, 1985). In addition, the resear cher met with the key informants to discuss and review the preliminary findings. Several researchers refer to the theoretical sensitivity of the researcher (Glaser, 1978; Strauss & Corbin, 1990). Strauss and Corbin believe that theoretical sensitivity derives from a number of sources, including pr ofessional literature, professi onal experiences, and personal experiences, all of which I tapped into while working on this dissertation. Theoretical sensitivity refers to a personal quality of the researcher. It indicates an awareness of the subtleties of meaning of data. [It] refers to the attribute of having insight, the ability to give meaning to data, the capacity to unders tand, and capability to separate the pertinent from that wh ich isnt. (Strauss & Corbin, 1990, p. 42) To guide the coding process, I used the grounded theory approach (or the constantcomparison method) pioneered by Glaser and St rauss (1967) and detailed in other sources (Daymon & Holloway, 2002; McCann & Clark, 2 003; Strauss & Corbin, 1994). In grounded theory, researchers develop theories based on conceptual understandings that emerge from the study through an inductive process. The theories are grounded in the part icipants experiences, but researchers add their own insight into why those experiences exist. The notion of inductive reasoning is one of th e most central and distinguishing feature of the grounded theory approach (Charmaz, 2006; Damon & Holloway, 2002; Glaser & Strauss, 1967). Charmaz (2006) has provided a succinct, clear definition of what is meant by induction: a type of reasoning that begins with study of a range of indi vidual cases and extrapolates patterns from them to form a conceptual category (p. 188).

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181 Rather than claiming neutrality from the res earch subject, Glaser (1992) has recommended that researchers avoid commitment to any specific pre-existing theory when entering the research site; rather, researcher s should use their theore tical sensitivity (the ir knowledge, understanding and skill) to generate concepts from the data. The goal of this dissertation was to generate theory by constant comparison analysis. In discovering theory, one generates conceptual cate gories or their properties from evidence, then the evidence from which the category emerged is used to illustrate the concept (p. 23). Using the constant comparative method, I ascertained patte rns in the data from the media journals and interview transcripts, which led me to develop general concepts. According to Glaser and Strauss (1967), these concepts can then be built into broader theoretical propositions. I completed all stages of the grounded theory approach, starting with open coding to identify themes that emerged from the raw data to the stage at which the category set became theoretically saturated (Glaser & Strauss, 1967, p. 110; Strau ss & Corbin, 1990). As suggested by Strauss and Corbin (1990b, p. 6), data collection and analysis are interrelated processes, and the research process itself led me to some unpredictable avenues of exploration and understanding. Grounded theory is a method of disc overy, one that grounds a theory in reality (Glaser and Strauss, 1967). I followed open coding with the next stages of analysis as suggested by Strauss and Corbin (1990), axial coding and selective coding. Coding focused on the medias role in the recovery process through the indivi dual media diaries as well as th e transcripts from the in-depth interviews. Memos Mem os are short documents that the researcher writes (or types) as she analyzes the data (Charmaz, 2006; Glaser & Strauss, 1967; Strauss & Corbin, 1990) I wrote initial code notes and

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182 theoretical notes as I was transcribing the interv iews. As I continued to further analyze the data, both the media journals and the transcripts, I continued to write and integrate my memos to assist me with developing the emerging themes. As dictated by traditional graduate school disse rtation formats, Chapte r 2 includes a review of the existing literature, which Strauss and Corbin (1990) would recommend. However, Glaser and Strauss (1967) have suggested th at an effective strategy is, at first, literally to ignore the literature of the theory and fact on the area under study, in order to assure that the emergence of categories will not be contaminated by concepts mo re suited to different areas (p. 37). In his later writings, Glaser (1992) has emphasized th e importance of ensuring th at the literature be used later in the research, during the final analysis stages, when the researcher is more certain of the emergent categories and the re levant literature, as well as the researchers own personal experience can act as data. In completing this dissertation, I incorporated the spirit of both approaches. As I began the process of analyzing the data, I set aside the lite rature and let the data itself guide the emerging categories to generate su bstantive theory and ultimately form al theory. The data analysis was inductive in nature, meaning that the critical themes emerged out of the data (Patton, 1990). As Glaser and Strauss (1967) have suggested, I be gan by generating substantive theory from the data and then allowed formal theory or alteratio ns to existing formal theory emerge from the substantive theory, as opposed to using deductive logic. Generalizability and Theoretical Validity As I anticipated, the experience s of the participants were si milar in some cases, but were not uniform. The repetitive themes and patterns allowed me to build theory, which may be applicable to people similar in nature to the particip ants in this study (Strauss & Corbin, 1998).

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183 Generalizability refers to th e applicability of a theory to other, more universal contexts (Auerbach & Silverman, 2003, Maxwell, 1992). In ternal generalizabil ity refers to the generalizability of a theory within the specific situation or population studied, while external generalizability refers to the generalizability of a theory beyond that specific context (Maxwell, 1992). The grounded theory approach provides two le vels of theoryabstrac t and specific to the situation (Auerbach & Silverman, 2003). Abstract theory has exte rnal generalizability, and is more holistic in nature, allowing for concepts and patterns that can be more broadly applied. Theory specific to the situation has internal gene ralizability, and is develo ped from the repetitive themes and patterns that emerge from the finding and may be applicable to similar situations. However, the applicability of theories specifi c to the situation is affected by the unique characteristics of the situa tion (Auerbach & Silverman, 2003). Qualitative research is based on subjective, interpretive and contextual data (Auerbach & Silverstein, 2003; Glaser & Strauss, 1967; Maxwell, 1992; Strau ss & Corbin, 1998). To increase internal validity and genera lizabilty, I compared the emerging concepts and theorized relationships among the concepts to the relevant existing literature. This process provided me with confidence that the theoretical constructs fit the existing liter ature, thus providing theoretical validity (Auerbach & Silverstei n, 2003; Maxwell, 1992). When appropriate, I included relevant literature in Chapters 4-9 to provide context for the results. Presenting Grounded Theory The presentation of grounded theory can be don e in various ways. According to Glaser and Strauss (1967, p. 31), grounded theory can be pr esented either as a well-codified set of propositions or in a running theoretical disc ussion, using conceptual categories and their properties. As is the preferen ce of the founders of grounded theo ry, in Chapter 4, I present the

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184 main categories in a more discussion-oriented form at. However, as Chapter 4 will illustrate, the women in this study engaged in readings of the thin ideal that were diverse, complex, and sometimes contradictory. Consequently, in Chapter 5, I present a theoretically grounded typology to illuminate the most the most signi ficant and meaningful aspects of the data.

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185 CHAPTER 4 FINDINGS The purpose of this study was to explore how women in recovery (or recovered) from anorexia negotiate the mediated th in ideal, a topic that has not been researched, particularly from a qualitative perspective. The findings from this study also illustrate the increasing importance of research about the influence of the advertising, fashion, diet, health, and exercise industries on our culture as a whole, a nd women in particular. The goal of this dissertation was to genera te grounded theory based on the media diaries and in-depth interviews of women in recovery (or recovered) from anorexia. According to Glaser and Strauss (1967), grounded theory is a general method of compar ative analysis that provides relevant predictions, explanations, in terpretations, and applications. The media serve as a dominant instituti on, which portray and pe rpetuate a dominant cultural message that a thin body is the ideal for women. The women in this study had subscribed to that ideal, and in doing so, they eventually developed anorexia. Part of the participants recovery process entailed learni ng how to negotiate or resist media messages promoting the thin ideal. The intent of the study was not to establish cause and effect relationships, which are more a ppropriate for quantitative stud ies (Creswell, 1998). Rather, analysis of the data allo wed me to identify various factors that serve to aid or hinder the ability of women in recovery from anorexia to refashion, reinterpret, or resist media messages promoting the thin ideal. Perspectives of the Study This dissertation is informed by socio-cultural theory and a feminist perspective, both of which will be discussed in further detail below. In addition, there will be a brief discussion of attractiveness as defined in Western society.

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186 Many young women have dominant readings of the media, agreeing with and accepting ideology of the messages and the subjectivity that they produce. The women in this study were no exception. Previously, the participants had viewed media, particularly magazines, as a reliable resource for information about relationships, b eauty, and fashion advice. In fact, many of the participants described how they us ed to view magazines as a bib le, a how-to guide, or even an instruction manual for life. Nearly all the women in this study made refe rence to magazines they read prior to their development of anorexia or in the midst of th eir active disease. Some of the most commonly mentioned magazines were Cosmopolitan, Glamour, Seventeen, Self, Shape, and Fitness The participants described how they had poured through the pages, trying to learn how to be more beautiful, and thus, socially acceptable. As young adolescents, the participants had used magazines to inform themselves of where they fell in the scheme of the appropriate or acceptable body shape and size. Most of the wome n in this study no longer read magazines of this nature, or they tended to gravitate to content related to health and fitness. The women in this study had worked so hard to attain mediated ideals of femininity that they sacrificed their health and well-being, eventu ally falling prey to anorexia. Once in recovery, the nature of their media interp retations altered. As the women in this study came to understand how the media were implicated in their obsession with the attainment of the thin ideal, and to the widespread body dissatisfaction in women, they developed ne gotiated, alternative, or oppositional readings. This dissertation is based on the premise that individuals are able to negotiate meaning from media messages. Negotiation is a term generally associated with reception studies and Stuart Halls article Encoding/Decoding (1980) in which he has cont ended that all readings are

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187 negotiated to some degree as opposed to passive acceptance of the preferred meaning. The women in this study certainly have indicated that they no longer passiv ely accept the mediated ideal, but they had varying degrees of resistance informed by thei r personal life experience. The women in this study had attained the thin ideal, and in doing so, they sacrificed their health and risked becoming a sta tistic in the high mortality rate for anorexia (Staresinic, 2004; Walsh & Klein, 2003). Through a feminist perspectiv e, this dissertation e xplores how the women in this study became increasingly resist ant to the inescapable mediated ideal. Socio-Cultural Theory Several researchers have sugge sted that socio-cultural theory has the strongest empirical support for the medias role in affecting womens body image (Grogan, 1999; Harrison & Cantor, 1997; Thompson et al., 1999). The essence of socio-cultural theory is that there are a number of social, cultural, politi cal, and economical factors that influence the role of media on how women feel about their bodies and what their relationship is with food. Most of the research in this area has approached the topic with this concept in mindthat the media do not act in isolation. The media do not directly cause a woma n to develop an eating disorder; they are merely viewed as contributing factors to some womens negative body image. There are several other cultural a nd societal factors involved, incl uding family, peers, ethnicity, identity, biology, and psychology. In terms of this study, some of the same factors that contributed to the development of the womens eating disorder also played a role in their current interpretation of media messages with regard to body image and th e extent to which they were able to unravel their internal ization of the thin ideal. Many media theories would fall under the effect s tradition, which fo llows the traditional model of communication, assuming a relatively passive audience as a receiver of information. Critical theorists, and more recentl y, cultural theori sts, propose an active audience, one that

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188 interacts with the content of the message and nego tiates its meaning. Stuart Hall, originally from the University of Birminghams Center for Cont emporary Cultural studies, is the foremost proponent of cultural studies. Known for developing reception studies, Hall proposed that there is an encoding and decoding process with media messages. The me dia sender disseminates a message, and the audience can decode the meaning of the message in at least three differe nt ways: the dominant, hegemonic meaning (in which the viewer decodes the message in accordance with the intentions of its producerspreferred readingthereby a ccepting the dominant/hegemonic ideology with which the message was encoded), the negotiated meaning (the message the sender intended with some alterations on the part of the audience ), and the oppositional meaning (the audience interpreting the message in a manner opposite of what the message sender intended). Hall (1980) argued that while a dominant ideology constitutes th e preferred reading of a media text, this is not automatically adopted by readers who may produce negotiated or oppositional readings based on their social position. Based on the findi ngs from this dissertation, prevention of the development of eating disorders, and prevention of relapse once a woman is in recovery may lie in how women decode media messages. An important factor in formul ating resistant readi ngs of media messages is the concept of polysemy, the presence of multiple meanings in a single text. However, polysemy does not mean that those meanings are equiva lent. As Hall (1980a) has expl ained, Connotative codes are not equal among themselves. Any society/culture tends, with varying degrees of closure, to impose its classifications on the social and cultural and political world. These constitute a dominant social order, though it is neither uni vocal nor uncontested (p. 134).

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189 Condit (1989) has contended that the representations of females in mass media messages are often structured to support th e dominant ideology, one that of ten is oppressive and puts some degree of constraint upon the audience members ab ility to formulate their own interpretations of these messages. Feminism As a Filtering Lens We are immersed in a patriarchal culture in which womens social, economic and political power are inextricably linked to appearance. Th rough their recovery pro cess, the participants gained various tools to resist the dominant thin ideal as well as cultural-constructed messages about the importance of appear ance for women. One of those tools was the adoption of a feminist ideology. As MacInnis ( 1993) has contended, The ideal body is a sexist construct that serves to control women (p. 74). The participants typically learned about fe minism through womens studies courses taken at the college level. However, some women in th is study were introduced to feminist concepts by a therapist, nutritionist, or ot her member of their treatment team. Those participants who indicated they had taken at least one womens studies course tended to have more oppositional readings, particularly in terms of the overall im portance of appearance, as well as media imagery contributing to female objectification and sexualization. A feminist identity afforded the women in this study with some resiliency and resistance to media messages that contribute to womens subor dination. The definition of resistance for this study was informed by Exploring Feminist Womens Body Consciousness a 2004 article by Rubin, Nemeroff, and Russo. Commonly expressed cultural ideologies abou t womens bodies in Western culture that support and perpetuate womens subordination include: (a) Wome ns bodies are never fine as they are; (b) Women should be constantly aware of, and attending to, their bodies; (c) Women should suppress their bodily appetites (i.e., for food, sex, emotions); (d) Womens bodiestheir size, shape, styl e, and comportmentare text s through which their morals

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190 and values will be read; (e) Womens bodies are objects and comm odities; (f) Womens bodies exist to serve others; and (g) Beautiful women are th in and Anglo-featured (see Bartky, 1988; Bordo, 1993; hooks, 1992; and Kilbourne, 1994, for a more extensive review of these id eologies). (p. 28) Feminism provided the women in this study with an alternative framework for interpreting media messages about womens bodi es. Furthermore, adoption of feminist ideology supplied the participants with strategies to resist dominant ideologies about women s appearance on personal and societal levels. As one of the most powerful influences in Am erican culture, the media have the ability to influence societal understandings of what constitutes female beau ty. The participants indicated that knowledge of feminism allowed them to be more conscious of how media messages implicitly define standards of attractiveness thro ugh limited representations of women. Feminism also allowed the women in this study to questi on culturally constructed representations of the ideal and to negotiate thei r own thoughts about their body and overall appearance. Adoption of a feminist ideology allowed the pa rticipants in this st udy to become aware of how the media reinforce body ideals that oppress women as a group through persistent exposure to thin ideal images, and the lack of alternative acceptable body types. Although the women in this study learned to recognize the thin ideal for what it is, unreal istic and unattainable for most women, this did not eliminate their desire to adhere to the ideal. As some research has indicated, women may be able to critique media imagery promoting female beauty standards, while still feeling bound by such standards (Engeln-Maddox, 2005; Milkie, 1999; Rubin, Nemeroff, & Russo, 2004). Women who were able to progress beyond awareness to a more critical analysis were better able to deconstruct the mediated ideal a nd tended to have less body dissatisfaction. From a feminist perspective, body dissati sfaction is of concern because it may contribute to excessive

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191 focus on appearance-related issues, which detrac t from the intellectual and financial resources that could be spent on more empowering activ ities (Bordo, 1993; Kilbourne, 1994; Wolf, 1991). Central to the feminist perspective is the notion of deconstr uction, which involves a critical analysis of media messages (Denzin, 1989; Du ffy, 1985). Those participants who were more media literate were better able to deconstr uct media messages and adopt more oppositional reading positions. Such oppositional readings tended to be informed by outrage at the patriarchal construction of unattainable ideals, which previously worked to the participants detriment. Furthermore, the women in this study expre ssed concern for the vulnerability of young women who lacked the knowledge that the participants had gained as they matured over time and progressed in their recovery process. Feminism Not a Shield Once the participants had started their recovery process, they worked hard to resist cultural messages about womens bodies, such as media messages that define what constitutes female beauty. Most of the women in this study became increasingly resistant to media messages that encouraged women to focus primaril y on their appearance or weight. In general, the participants discourse indica ted that feminism provi ded an alternative way to interpret cultural-constructed messages about gender and attractiveness. Feminism also seemed to serve as a tool for many of the wome n in this study to reframe potentially negative thoughts about their body image. However, as Rubin et al., (2004) have found, adoption of feminist ideology did not serve as a shield to their feelings about their own appearance and mediated beauty ideals. Overall, feminism did not serve as an innoculation for the socio-cultural pressures to achieve the thin ideal. Research has indicated th at belief in feminist ideology may allow women to criticize the need to conform to the thin ideal (Rubin et al., 2004; Tiggemann & Stevens,

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192 1999). The findings from this study support this notion; however the participants discourse suggests that feminism did not serve as a tool to outright reject the thin ideal and its associated benefits. Several participants expressed ambivalen ce about opposing the importance of appearance, though they thought it was their feminist obliga tion to do so. Some of the underlying reasons for the womens conflicted feelings are explored further in two particular sections of this dissertation: Still Value the Thin Ideal and Eating Disorders and Dichotomous Thinking Attractiveness Equated with Thinness Attractiveness is important in Western soci ety, and one of the primary determinants of attractiveness is ones body shape and size. In our current society, attractiveness has been equated with thinness (Bordo, 1993; Brumberg, 1997; Goodman, 1995; Grogan, 1999; Seid, 1989; Striegel-Moore, 1994). The female ideal body is one that is slender, has long legs, is somewhat toned (and more recently) big breasted (Grogan, 1999; Harrison & Cantor, 1997; Seid, 1994). In addition, a thin female body symbolizes sexuality (Garner et al., 1980), intelligence (Silverstein, Perdue, Peterson, Vogel, & Fantina, 1986), and se lf-control (Nasser, 1988). The media collectively serve as a powerful socio-cultural force because of their omnipresent nature. It is difficult to escape th e media messages that are pervasively transmitted in Western society. What are those messages? In terms of body image and eating, the message today is that to be socially acceptable, well liked, and successful, a woman must be attractive and thin (Bordo, 1993; Seid, 1994). According to Bordo (1993), the media disseminate two female body ideals, a spare, minimalist look and a solid, muscular, athl etic look (p. 191). Although the two seem incongruent, both standards require a flab-free, firmly controlled body as reflected in the media. Simply to be thin is not enoughthe fles h must not wiggle (Bordo, 1993, p. 191).

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193 What is the Ideal? The Participants Perspectives The women in this study echoed all of these thoughts. Their impression of the ideal female body that the media portray was one that is thin, tall, and toned. The participants perception of the degree of thinness varied. Some women define d the ideal as thin an d lean, not sickly, but healthy thin, while others indicat ed that the ribs poked through just a little b it, or that shes so skinny that you can almost see her ribs. The women uniformly agreed that there was more of an emphasis on an ideal woman l ooking like she definitely works out and is toned up with lean muscle. In general, the participants also distinguished between the ideal for models and celebrities. They tended to perceive runway models to st ill be extremely skinny or gaunt and sickly looking, while they viewed the ideal standard fo r television and movie cel ebrities to be thin and maybe athletic or in shape. The participants also tended to think that models were tall, while celebrities can be short, but theyre still really tiny or small. There were several other type s of descriptions th e participants used to describe their perception of the ideal. One surprising theme th at emerged from this study was that the participants described the mediated ideal as tan. Other factors that participants saw as defining the ideal were not really a lot of anything, a really nice, tight butt, a flat stomach, long, thin legs, thighs not touchi ng, no arm flabbies, a clear complexion, nice looking hair usually with blond highlights, and no fat to be seen anywhere. Clothing size seemed to be a key factor with relationship to the thin ideal, and most participants viewed the media as portraying the ideal size as a 00, 0 or possibly a 2 or 4. Though some of the participants did not see bi g breasts as the ideal, the majority of the women in this study thought the media portrayed a woman with sizable breasts or boobs that dont seem proportional to their body size. This is likely due to the growth in breast

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194 augmentation (American Society for Aesthetic Plas tic Surgery, 2007). As Eda stated, I think the ideal has partially changed due to technology, like being able to get boob jobs. This study explores how women in recove ry from anorexia resist media messages promoting an elusive ideal that remains linked to valuable social and economic rewards. Several researchers have noted that the body standards are unachievable for most women without the aid of plastic surger y or other unhealthy wei ght loss techniques, such as dieting or exercising to excess (Grogan, 1999, Thompson et al., 1999). This dichotomy presented a challenge for women in recovery from anorexia who already had attained the thin ideal, and suffered health consequences as a result. Media Journal Contributed to Increased Awareness As part of their recovery pr ocess, the women in this study had become more aware of the powerful influence of the media, even on a subtle level. They also learned about the degree to which the perpetuation of the thin ideal had serv ed as a negative influence and continued to present a daily challenge in their lives. The media journal served as a useful tool to gauge media exposure, for the participants and for myself. In fact, the women indicated that the media journal itself allowed them to realize the extent to which they were exposed to media me ssages, which typically was more than they had expected. Molly expressed her surprise at the am ount of media she consumed on a daily basis. Molly: I didnt think I spent that much time with the TV on even if its just for background noise! I didnt think th e media influenced me at all. After the week, I realized that Im surrounded by such unrealistic standards constantly !!! Even when I dont normally notice it! I didnt think the media we re going to be around me as much as it is. For some women, participating in this study al lowed them to realize how pervasive the thin ideal is, despite attempts to minimize or avoid exposure. For example, one of Abigails journal

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195 entries indicated that pa rticipating in this study had made her more aware of the pervasiveness of media messages. Abigail: Thursday 1/19/06 Additional thoughts or notes. Ive not really paid that much attention to these things, but it has been really eye opening thus far. I guess I never realized how much sub-consciously I th ink about these things. I m ean, its just becoming more aware of whats going on around ya. I m ean, you just become so used to it. In the process of completing her media journal, Courtney also learned more about her media consumption habits. During her interview, Courtney discussed what she had learned. Courtney: When I was writin down some stuff [for the media journal], Id notice, Oh gosh I did think that about Angelina Jolie that shes skinny and attractive. I guess its always kind of been there. I just hadnt real ly had an opportunity to pay attention to it. By participating in this study, Enchantmen t gained a better u nderstanding of the pervasiveness of the mediated ideal. For example, she wa s perusing through some fashion magazines, and she wrote in her media jour nal: All these girls in the magazines are so skinny. What does that tell adolescents? During her inte rview, Enchantment shared her thoughts about keeping her media journal. Enchantment: It was interesting. I rea lly didnt know that there was so much images out there that promoted being thin a nd losing weight. I thought there was some but not that many. And now, it makes better sense that so many people wanna be skinny, and they think that they can be popular that way too. Prior to her participating in this study, Enchantment had not given much thought to the influence of the mediated ideal on young girls. She shared her current perception: It makes me mad. Cause its doing all that to people, especially young girls.it seems manipulative. Overall, the media journal allowed the participants to better understand the power and prevalence of the mediated ideal. Mollys comm ents reflect what many of the participants expressed: It makes me so sad and angry that we are surrounded with it. Its impossible to

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196 escape completely! Molly had been in recove ry for six years, and she described how her perspective of the media transformed over time. Molly: Something interesting that I found was how much of the media Ive trained myself to tune out since Ive been well! I guess maybe after six years of forcing myself to not buy into all the crap we are surrounded with maybe its become such a habit that Im not even conscious of it. Participant Readings of the Mediated Ideal This sec tion will explore the womens perspec tives of the thin ideal as portrayed by the media, a powerful reflection of a nd contributor to Western culture, values, and ideals. In general, our culture has positive associations with slendern ess, subscribing to the idea that weight loss is the key to happiness, popularity, and success. Prio r to the onset and durin g the midst of their eating disorder, the participants engaged in more dominant decoding of messages, particularly with regard to attractiveness as equated with the thin ideal. However, during their recovery process, when the participants gained enough wei ght to restore their cognitive abilities, their perception of the thin ideal altered, and over ti me, with increased media literacy, their decoding process did as well. The women in this study learned to critiq ue pervasive messages promoting the thin ideal, and they began to interpret the same messages in a more resistant manner. In general, the more advanced the participan ts were in terms of the recovery continuum (Brown, 1993), the more likely they were to decode messages in an oppositional manner, rejecting the intended media message completely, adopting their own, more healthy perspective. The reverse also was true. Women in this study who were in the more initia l stages of recovery interpreted media messages about womens bodies in a more negotiated manner, accepting most of the preferred reading w ithout completely embracing it.

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197 Premise for Five Types of Readings This dissertation is based on the prem ise th at an audience creates meaning through an active process of interpretation, rather than by passive assimilation. In other words the meaning of media messages exist in th e reading, not in the text itself (Hall, 1980; Hart, 1991). Women who attain excessive thinness typically gain social and economic rewards, which reinforce the desire to be thin (Bordo, 1995; Orbach, 1986; Seid, 1994). However, individuals read media texts on the basis of social and cultur al constructions as well as personal experiences, so their interpretations do not always reflect the dominant belief that excessive thinness is natural, achievable, or desirable (F iske, 1986; Gramsci, 1980; Radway, 1984). Women in recovery from anorex ia may not be able to complete ly avoid imagery of the thin ideal, but they indicated that an understanding of the media industry provided them with a valuable sense of agency that influenced the na ture of their readings. As Faith said, I didnt choose my eating disorder, but I can now make a choice about how to respond to messages that may have negatively influenced me in the first place. This section discusses the pa rticipants various types of r eadings, which, for the purposes of this dissertation will be divided into five categories, three of which already have been proposed in the litera ture: dominant/hegemonic, negotiate d, and oppositional. The other two categories emerged as part of the grounded theory approach employed in this dissertation, and they are subsets of oppositional readings: self -protective opposition and opposition informed by concern for others. The categories are di scussed in increasing order of opposition. Dominant The first category is one of the three ways that Halls (1980) encoding/decoding model has proposed that a media text can be decoded or in terpreted. It is the dominant-hegemonic position

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198 (the meaning the message sender intendedthat th e female thin ideal is good and people should diet and exercise). Some participants did not interpret the thin ideal in a dominant wa y, but they did so for other aspects of the ideal body im age that the media represent. For example, many participants expressed the desire or perceive d need to be toned or tan beca use they saw that as the ideal. Other participants also rejected the thin ideal, but th ere was something they wanted to alter about their appearance to fit the ideal, such as larger breasts or blond hair. Christinas comments serve as a useful illust ration. She had seen an attractive, thin woman on a Bacardi billboard, and she described her reaction during her interview. Christina: The woman on the Bacardi billboa rd was blond. And blonds really get to me. (She laughs.) I think I really wanna be a bl ond. But I tell myself through therapy, Im a brunette. And I should be happy with being a br unette. And someone should like me, not just because of my hair. Other examples of dominant readings are discussed in Media Ideals Fluctuate For the most part, the dominant readings did not refl ect the participants current perceptions, and typically such readings were used to illustrate a transf ormation over time. Negotiated The women in this study de scribed a transformation of th eir use and interpretation of media as they progressed from the initial stages of anorexia through the various stages of their recovery process. In the initial stages of recovery, the women seemed to have developed some sense of media literacy, but not enough strength in their recovery process to decode the powerful media messages in an oppositional way, leaving them with more negotiated interpretations. According to Hall (1994), most people tend to negotiate media messages, meaning they accept some of the message, but realize that not the entire message is useful, accurate, or pertinent to them. Women in this study who were in the more initia l stages of recovery tended to

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199 interpret the mediated ideal in a negotiated ma nner, accepting some of the dominant message, while rejecting other portions of that message. Many of the women in this study indicated that they were aware that a ttainment of the thin ideal was not a healthy goal. They also realized that it was dangerously unhealthy for them to engage in behaviors to achieve th e ideal. Such awareness, however, did not mean that they easily could toss years of cumulative internalization of the thin ideal. What most of the women struggled with was a sense of cognitive dissonance. At some core level, they knew that imagery of thin women did not repr esent reality and that thinness did not equate with happiness or indicate health; but they still battled a nagging desire to be thin, primarily because thinness is so highly valued in American society. In addition, several of the women in this study described a nostalgia for the positive feelings they had felt when they were anorexic, such as feeling special or having a sense of control. Despite their desire to be thin, the women in this study could not afford for their dominant attitudes to give way to weight loss behavior. Glaser and Stra usss (1967) constant comparison method showed that many of the participants beliefs and attitudes came from primarily dominant readings of the mediated ideal, but they had more negotia ted or self-protective readings with regard to behavior, primarily because they could not afford to engage in behaviors to attain the ideal. The women who engaged in more purely nego tiated readings had more conflicting views of their self-concept and appearance. They also te nded to be more critical of their bodies because they still felt a lingering need to subscribe to cultural body ideals, at least to some extent. Participants who engaged primarily in nego tiated readings had let go of the behavioral aspects of anorexia, but a significant part of them still missed the identity of being thin. For

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200 example, Eda said, I always want to be very thin. I just dont act on it. For women like Eda, appearance still was of primary importance, and th ey longed for the days when being thin was a mechanism for compliments. A negotiated reading allowed so me women in this study to a void sliding back into their eating disorder, but they had to remain vigila nt. In addition, women who had more negotiated readings tried to avoid potentially trigge ring media messages as much as possible. Opposition Informed by Concern for Others Through their recovery process, many of the women in this study developed an awareness of the media as powerful socializ ing forces. While the participants felt that they had developed strategies to resist the medi ated ideal, they were concer ned for young women who lacked the knowledge or skills to do so. This concern for ot hers allowed women in this study to have more oppositional readings to potentially harmful media messages. Discourse of this nature was so prevalent in the interviews that it even tually warranted a category of its own. Nearly all of the women in this study expressed concern for others, but the underlying degree of opposition varied. In vi vo coding after the development of this category revealed that, to some degree, the language of the participants indicated their level of opposition. Participant readings in this category ranged from sad to livid, but these emotions were not mutually exclusive. For example, Molly often expresse d concern for young people along with outrage at the media with comments such as, It breaks my heart to know that people are so desperate to lose weightIt makes me livid that there ar e people that prey on peoples desperation. For the most part, however, the level of opposition underlying the concern for others was mediated by the extent to which the participant truly had un-internalized the thin ideal. For example, some participants expressed concern fo r others, but they still tended to interpret messages about the thin ideal for themselves with a dominant or negotiated attitude. For these

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201 participants, making oppositional statements about the media out of concern for others was easier than internalizing that same opposition for th emselves. They still valued the thin ideal, but they no longer actively engaged in weight loss behaviors. As part of their recovery pr ocess, the women in this study explored the underlying causes of their eating disorder. In doing so, they learne d that the dominant messages they previously had consented to were unhealthy. They also came to r ealize that other people were unlikely to have the knowledge that the women in this study had gained during their recovery process. For example, Christina still engaged in comparisons w ith celebrities and models, and in general, she expressed a desire to look like them (as long as they were heal thy). Yet, she knew that others might not be aware that achieving the thin ideal was unhealthy or unrealistic. She described her reaction when she learned about airbrushing duri ng her recovery: I was like just like, WHOA! I was so naive. I wish I had known this back when I was like a teenager. I did not know. In addition, Christina used to believe marketing messa ges that linked product us age to an attractive appearance, and she feared others might do so. Christina: The Bacardi ad, with the thin and beautif ul woman, its just this huge billboard up there (she says with disgust). And everyone can see it. Im sure that other people are like, Oh wow! Like, Im sure some people thin k that if I drink that it will make me look attractive. Other women in this study expressed concern for others, but they tended to have more oppositional readings for themselves as well. The overall discourse of the latter group suggests an increased un-internalization of the thin ideal. These participants also tended to use words such as hate when describing their reaction to a message. For example, Michelle discussed her anger about the excessively skinny image propagated in the media. She no longer engaged in unhealthy comparisons with models, but she feared others might do so.

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202 Michelle: I think that Im able to not let those stick thin images bother me but I hate that theyre affecting kids t oday. And people that are growi ng up that they think that thats what they should look like, when most of the time, its not even possible to look like that, unless youre starving yourself. Self-Protective Opposition The last of Stuart Halls three proposed r eadings is the oppositional, in which the viewer recognizes the dominant codes and decodes them in a contrary manner, reconstituting the message with an alternative framework of refere nce. This counter-hegemonic interpretation of the dominant message can be explained as a conscious act of refusal on the pa rt of the viewer to be framed by the dominant message. However, the types of oppositional decoding that these participants engaged in was not collectively opp ositional, but rather complex and diversified. The most unique finding of this study is th at with regard to the ideal body image, the participants all had a desire to decode messages in an oppositional manner, to reject the intended media message completely and adopt their own, mo re healthy perspective. However, only a few participants in this study were able to engage in what Hall would classify as a purely oppositional readingsdecoding a message in a wa y that completely rejects the dominant ideology encoded in the message. The majority of the participants decoded me dia messages about the thin ideal in a manner that reflected their desire to decode messages in an oppositional way, but their own internal conflicts prohibited them from doing so without significant self talk, a negotiation within themselves, as opposed to negotiating with the external text that the media producer encoded. For the purposes of this dissertation, the phrases self-protecti ve opposition, selfprotective, or protective opposit ion will be used interchangeab ly. Self-protective readings initially appeared to be oppositional in nature, but closer examination revealed that a selfprotective reading is on e in which a participant used stat ements of opposition as a tactic or

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203 strategy to protect herself from accepting the dominant code, which might lead to unhealthy thoughts or behaviors. The women in this study no longer could al low themselves to engage in dominant behaviors to achieve the thin ideal. For these wome n, dieting to attain the ideal had become obsessive and ultimately led to the developmen t of anorexia. To remain in recovery, the participants could not afford to succumb to any temptation to lose weight. Michelles comments during her interview illust rate how important it was to preven t triggering weight loss behavior. Michelle: I try to avoid losing too much weight or purging. Because with either one, it escalates. If my clot hes started getting loose on me, then I would get this euphoria and want to lose more because it feels good, even though I know I shouldnt. With me, purging quickly escalates. If I do it once, then I do it again, then I do it again, and next thing I know, then Im doing it like commonplace. What fueled the participants self-protect ive oppositional readings was the knowledge from their personal experience that the costs of th e thin ideal significantly outweighed the benefits, which was challenging to remember given the pervasiveness of the mediated ideal. Faith comments illustrate a protective oppositional reading. Faith: As much as I would like to look like a s upermodel, I have the choice of whats at stake.What is the goal? How does that make me happy? And really if I sit there and think about it, I wasnt any happier that thin than I was wh en all the issues poured out and I was at a normal weight. So it didnt accomplish anything. To engage in self-protective opposition, the participants tended to focus on one of two thingsthe value of their heal th or the unrealistic nature of media imagery. Self-protective opposition reflected an initial or partial att itudinal acceptance of the mediated body ideal followed by or accompanied with oppositional self-talk to eliminate the potential for thin ideal behaviors (such as excessiv e dieting or exercise). Graces comments illustrate how many of the participants used magazines imagery when they were younger: I used to sit there and cut out my thinspirations the pretty models, that

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204 were stick figures so that I could be inspired not to eat and to run that extra mile. And get rid of all the extra anything on my body. Grace also shared wehr e she put her thinspirations: Notebooks. Or Id cut em out and hide em in my diary so my parents wouldnt see em. And the inside of my closet doors. On my lit tle notebook where Id l og my weight loss. However, in recovery, Grace no longer wa s inspired by such images. Typically, the participants reminded themselves that their health was more important than the thin ideal. Grace: That used to be my ideal.And now, its not about that I mean, would I like to be thinner? Absolutely. But now, its more a bout just appreciating my body my health. I know how miserable and sick I was back then, and I never want to go back. Many of the participants who engaged in self-protective opposition also described situations in which they made an initial upward comparison to a media image, which led them to a brief moment of feeling worse about themselves Then, they would make a conscious cognitive effort to remind themselves that the images were not reality, that the women in the magazines did not truly look like that. Self-protective oppositional strategies served to reduce the cognitive dissonance that many of the women in this study had with regard to the thin ideal. Proposed by Festinger in 1962, cognitive dissonance proposes that individuals atte mpt to reduce discomfort they may feel when their actions do not match their thoughts and be liefs. Some of the mechanisms for relieving dissonance, in terms of interaction with media sources, include: select ive exposure (what media sources people allow themselves or choose to vi ew), selective retenti on (what people choose to remember, what they consider important), selective perception (how peopl e choose to perceive a message, they may receive the same message and interpret it differently), and selective recall (what people personally choose to recall).

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205 The women in this study indica ted that they used these mechanisms to cope with what they knew to be healthy versus what the media presen ted as an ideal that should be achieved. For example, some women relieved their dissonance w ith selective exposure, choosing not to view any magazines, or choosing to avoi d viewing certain magazines that they knew were triggers for them, such as Cosmopolitan or Glamour Oppositional Some of the women were able to engage in what Hall would classify as oppositional readings of media messages, those that complete ly reject the dominant id eology reflected in the message. By engaging in frequent, repetitive oppositional tactics, many of the women were able to more fully internalize an oppositional perspective over time, without experiencing contradictory thoughts. The opposi tional category includes women w ho fully un-internalized the thin ideal. This group of women expressed the most anger at society and the media. In addition, they were the most radical in their reactions to media messages that propagated the importance of attaining the thin ideal. Of all the participants in this study, Molly had the most consistently oppositional readings, in her interview, as well as in her media journa l entries. The following is an example from her media journal. Molly: Wed. 7/12 @ 4:00 PM Magazines at ch eckout; lotions Target Looking for sunscreen. Why do they have to put all those ma gazines at the checkout? They have pictures of sickly thin models and ads for diets then also includ e articles about accepting yourself! They are INSANE! Summary As this section has illustrated, some partic ipants were more capable of resisting the mediated ideal than others. The womens disc ourse was complex and sometimes contradictory.

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206 For the most part, their attitudes and beliefs were negotiated or self-protective, and at times they were oppositional, albeit at varying levels. Rylie tended to have conflicted readings. At times she had completely oppositional readings. For example, she described her percep tion of magazines that promote weight loss. Rylie: If you pick up any f itness magazine like Shape, and even on the cover of Womens Digest So and so lost 25 pounds by walking! I mean, its just all over. You know people are buying this crap. And its frustr ating cause if they subscribe to it, what are they gonna do? Lose weight all the time? You know, go join a gym for $40 a month? In contrast, Rylie expressed interest in losi ng weight at several point s during her interview: Ill look at any magazine. Like I said, I bought Shape. I have common sense, and I just have this all-American side of me thats like, Oh r ead it! (She laughs.) Im like Okay, lets see how to lose weight. There are several contributing factors to Rylie s conflicted readings, including her sense of body dissatisfaction as well as othe r people in her life encouraging her to lose weight. In addition, she had a strong desire for a boyfriend, which is discussed further in the obstacles section of this chapter. There are other factors that may have been influential, which will be discussed in the discussion portion of this dissertation. The women in this study negotiated media messages with a transforming, more media literate lens, that also has the memory of their battle with anorexia imprinted on it. Each woman interpreted media messages throug h a perspective of health. Howeve r their interpretation of what constituted health varied, dependi ng on their personal history, their level of recovery, their level of media literacy, and the extent to which they had adopted a more feminist perspective. In this study, there were some commonalities among the womens perspectives. However, just as each womans experience with their eating disorder vari ed, their media lens varied as well, tempered by several factors in their life experiences.

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207 I have included a poem that illustrates the various stages of the participants recovery process as well as the progression of the particip ant readings from dominant to oppositional. The poem was adapted from Autobiography in 5 Short Chapters by Portia Nelson. Poetry: Progression of Participant Readings Dominant I walk down the street. There is a hole in the sidewalk. I fall in I am lost... I am helpless It isnt my fault. It takes forever to find a way out. Negotiated I walk down the same street. There is a deep hole in the sidewalk. I pretend I dont see it. I fall in again. I cant believe I am in the same place. But it isnt my fault. It still takes a long time to get out. Concern for Others I walk down the same street. There is a deep hole in the sidewalk. I fall in, but I dont want to. Its a big hole. I see someone else about to fall in. I help them to get out. Negotiated I walk down the same street. There is a deep hole in the sidewalk. I see it is there. I still fall in... Its a habit my eyes are open. I know where I am. It is my fault. I get out immediately. Self-Protective I walk down the same street. There is a deep hole in the sidewalk. I walk around it. Oppositional I walk down another street. Concern for Others I walk down the same street. There is a deep hole in the sidewalk. I dont want anyone else falling in. I cant believe they allo w this sidewalk here. Activism I walk down the same street. There is a deep hole in the sidewalk. I dont want anyone else falling in. I cant believe they a llow this sidewalk here. I create a big sign to warn others about the deep hole. Figure 4-1. This poem shows the various stages of the participants recovery process as well as the progression of the participant read ings from dominant to oppositional.

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208 Influential Factors on Participant Readings There were several factors that influenced the participants readings. The most important factor was thin ideal internalization, which will be discussed in detail below. Other factors are illustrated in Table 4-1. Table 4-1. Factors influencing the likelihood of oppositional readings Factors to Increase Factors to Decrease Age/maturity Reliance on others Sense of self/Identity Self-objectification Self-esteem/self-worth Appear ance as most salient factor Value of health Thin ideal internalization Body acceptance Appreciation for diverse body types Body dissatisfaction Fear of fat Media awareness (unrealistic) Social comparisons ( upward, universalistic ) Reject mainstream media Adopt alternative media Exposure to mainstream media Question legitimacy of media messages Understanding of media contribution to ED Perception of media as trusted friends Critical media literacy Admiration of (and attachment to) celebrities ( primarily for appearance ) Understanding of capitalism ( diet & fitness industry, products for $ ) Dichotomous thinking Adoption of feminist ideology (perception of dieting as a control mechanism, beautification proce ss as a diversion) Competitive nature Drive for perfection Empowerment/sense of agency People pleasing Activism Fear of rejection Thin Ideal Internalization There are several mediating f actors in how body image and eati ng attitudes are affected by the media. One of the most important mediating f actors is the internalization of the thin ideal (Cusumano & Thompson, 1997; Halliwell & Dittm ar, 2004; Stice et al., 1994; Thompson et al., 1999; Thompson & Stice, 2001). Thin-i deal internalization refers to the extent to which a person

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209 cognitively buys into the cultura lly defined standard thin as at tractive and engages in behaviors designed to achieve this standard (Heinbe rg et al, 1995; Thompson et al., 1999). Several researchers have examined body imag e and eating disorders from the perspective of objectification theory, which posits that women ha ve been socialized to present themselves to others (men and women) as objects to be admi red for their beauty. Women who internalize the importance of the thin ideal and use their appearan ce as a measuring stick for their self-worth are more likely to experience body dissatisfaction and ta ke measures such as dieting and exercise to come closer to achieving the thin ideal (Fredr ickson & Roberts, 1997; Fredrickson et al., 1998). The nature and strength of the participants oppositional decoding varied, depending on the extent to which they had trul y un-internalized the thin ideal and come to find self-worth in dimensions unrelated to appearance. The results of this study indi cate that there was a correlation between the extent to which the participants plac ed little to no value on meeting the standards of the thin ideal and their ability to decode me ssages in a strongly oppositional manner. Those participants who still desired the thin ideal were able to express their resistance to the dominant ideology, yet their oppositional perspective was not as internalized and was more self-protective in nature. Furthermore, this dissertation suggests that th e more the participants learned to engage in critical inquiry, the more they were able to diffuse the powerful and ubiquitous media messages touting the thin ideal. This finding is important because prevention of the development of eating disorders, and prevention of relapse once a woman is in recovery may lie in how women decode media messages. Prior to their recovery process, the primary focus of the women in this study was attaining and maintaining the thin ideal. In fact, the part icipants used to view thinness as their most

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210 valuable attribute. Now that the women were in recovery from anorexia, one of the most important goals they worked on wa s altering their percep tion of the thin ideal. Participants who no longer valued the thin ideal had the most oppositional readings. All of the women in this study discussed how they no longer found a sickly thin body to be appealing. For example, Metkit said, I dont quite see whats so attractive about being a toothpick! As the participants progressed in their recove ry, they also perceived the thin ideal to be increasingly less important. For example, Jamie said, I dont think being thin is the most important thing anymore, cause I just want to enjoy what life is supposed to be about without focusing all my energy and thoughts on th ings that dont get you anywhere. What are Triggers? For the purposes of this dissert ation, the term trigger will be used to refer to anything that might cause the participants to revert to former unhealthy thought patterns (including low selfesteem or body dissatisfaction) or behaviors (excessive exercise, dieting, or overeating). The term also may be conceptualized as any stimulus that results in a per ception, thought, or emotion with the potential to contribute to an eating disorder behavi or or relapse. As part of the recovery pro cess, the women in this study had learned to identity their eating disorder triggers, and they had learned to deal with them using effective coping methods. Though some triggers may be more common (exposure to the mediated thin ideal), others are more individual, meaning that what might trigger one woman may not affect another. Furthermore, as the women progressed in their recovery process, th e strength of their trigge rs tended to weaken over time. A few participants who said they did not have any triggers related to their eating disorder. Those participants tended to have the most oppositional readings of the mediated ideal.

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211 Explanation of Transcript Excerpts As Poland (1995) has pointed out, Verbal a nd written communication are very different m ediums, incorporating different structures and syntaxes (p. 299). While none of the words in the original transcripts were altered, for clarit y and ease of reading, I eliminated some of the more conversational words, such as ya know, gosh, I mean, or whatever, like, and uhm, which may sound natural in spoken la nguage, but resulted in awkward reading. In the original transcriptions, I included my natural, conversat ional responses, such as em hm, uh huh, and yeah. For ease of reading, I also eliminated those words, unless they added to or changed the meaning of the excerpt. Organization of Findings and Discussion Overall, the findings in this dissertation are presented in increasing order of opposition, starting with key constructs that the participants needed to work on in order to progress in their recovery process. For example, the beginning of Chapter 4 discusses how important it was for the participants recovery not to define their self-worth or identity by their appearance. This chapter also reviews factors th at contributed to the partic ipants increased sense of body satisfaction as well as self-prote ctive opposition strategies the part icipants engaged in to when they were exposed to potentia lly triggering media messages. The next section in this chapter discusses th e obstacles the participan ts faced in unraveling their internalization of the thin ideal, which wa s key to their recovery process and to a more oppositional reading. Many of the obstacles the participants had to overcome were the same factors that had predisposed them to the de velopment of an eating disorder, such as competitiveness and the lack of a sense of self. Pa rticipants who still highly valued the thin ideal tended to miss the identity of being thin. These participants tended to engaged in negotiated or

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212 self-protective opposition st rategies to prevent themselves from engaging in behavior to attain the thin ideal. All of the participants discussed how they were competitive in nature, with themselves, with others in their personal lives, and with imagery of models and celebrities whom they never had met. In order to progress in their recovery process and to have more oppositional readings, the women in this study had to re-direct their competitive energy in healthier ways and realize that there was little value in such comparisons. Those who took m easures to reduce or re-direct their competitive energies had to be careful not to engage in comparisons in their personal lives and with imagery in the media. The importance of reducing comparison is discussed at length in the section about obstacles. There were some unexpected findings in the obstacles section. For example, two of the obstacles included the media-influenced meani ngs of clothing sizes and the desire for a boyfriend. For all of the part icipants in this study, clothing sizes served as a trigger, at least in their initial stages of recovery. The importance of the desire for a boyfriend emerged in the latter stages of analysis, when I was examining potential factors that distinguished participants with the least and most oppositional readings. Some of th ose factors included age and body dissatisfaction (typically related to a higher BM I), but the only consistent factor was how important the attainment of a boyfriend was to the participants in terms of their self-worth or identity. Chapter 4 also discusses the various factors that allowed the women in this study to shift their perception from valuing th e thin ideal to the desire to see more normal, average representations of women. In this section, I discuss how critical it was for the participants to recognize that the thin ideal wa s not healthy. Another important factor is the reduction of dichotomous thinking, which is defined and discussed in this s ection. The remaining factors in

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213 this section relate to the participants percepti ons of the portrayals in the media. There were several factors that provided the women in th is study with hope for a shift in the ideal recognizing the limited portrayal of women, seeing more divers e body shapes represented (i.e., Dove Campaign for Real Beauty), and gaining k nowledge about the historical fluctuation of body ideals. The next section of Chapter 4 includes a disc ussion of the importan ce of media literacy, and the difference between media awareness and critical media litera cy. Critical media literacy allowed the women to question the legitimacy of media messages. The less the participants viewed the media as trusted friends, the more oppositional their readings were. The participants degree of opposition varied. Some participants tended to have primarily self-protective opposition readings, while occasionally strongly opposing media messages that struck a nerve with them. Others had a combin ation of self-protective opposition readings, and they expressed concern for others. And a few participants had all oppositional readings, while also expressing concern for others. These three desc riptions are just a sampling of the variety of ways that the women in this study decoded vari ous media messages. The goal of this study was not to achieve a comprehensive understanding of th e types of reading for each of the individual participants; but rather, to focus on the various ways that women in this study engaged in oppositional decoding, and to explore what factors were associated with readings that were most oppositional in nature. For the most part, the discussion within Chap ter 4 progresses from the least to the most oppositional reading. Additionally, as this chapter progresses, the participants opposition becomes stronger in nature, reflecting an increasing sense of critical media literacy.

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214 The standard and value of the thin ideal st andard and is built into the foundation of our societal structure. As the part icipants in this study came to understand how the media contributed to the development of their eating disorder, they placed varying degrees of responsibility on the media. All of the women in this study felt that the media have a so cial responsibility to portray a healthy, accurate image, and many of the participants expressed that the media producers should be held accountable for potentially damaging repr esentations of girls a nd women. The extent to which the participants held the media accountab le for creating and perpetuating the thin body ideal mediated their degree of opposition. The more the participants held the media accountable, the more oppositional their readings were. Other factors that influenced the degree of the participants opposition are discussed throughout Chapter 4. All of the participants ha d oppositional readings of the medias coverage of eating disorders, particularly with re gard to celebrities. The women in this study indicated that the nature of the media coverage trivialized their personal battle against anorexia and promoted further misconceptions about eating disorders in general. Such miscon ceptions presented the participants with additio nal obstacles to overcome in their recovery process. In addition, the participants indicated that they were concerned that young girls might find anorexia enticing because it is not portrayed as seriously in the media as the disease warrants. Various other factors that contributed to the participants re sistance are discussed in this section. The dissertation concludes with Chapter 5, in which the implications of the findings are discussed with a theoretically gr ounded typology. Suggestions for fu ture research and limitations of this study also are in cluded in this chapter. Eager to share the knowledge they gained fr om their personal battle with anorexia, the women in this study have shared their insight abou t how the mediated ideal was implicated in the

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215 development of their eating diso rder as well as how the media now help or hinder their recovery process. This dissertation provide s the voices of women in recovery from anorexia. It is my hope that readers will recognize the va lue and power of those voices to better understand how the media are implicated, not only in the development of anorexia, but also in the recovery process. Their stories may provide insight not onl y to women in recovery, but also to any woman who has experienced body dissatisfaction as a result of media promotion of unattainable beauty standards. Appearance No Longer Defines Self-Worth/Identity Recovery from an eating disorder involves unraveling tightly wound layers of the importance of appearance and the in ternalization of the thin female ideal. The outer layers were related to the participants comparison to more uni versalistic targets, and the inner layers were more related to particularistic targets. At the co re was the participants self, who they truly are. For nearly all of the participants, the biggest challenge they faced in their recovery process was learning to no longer not to define their sense of self-worth by their appearance. Central to the broad concept of appearance is a womans body, and it was critical for the women in this study to learn to honor and accept their body. Bo dy acceptance not only was critical for the participants recovery process, but it also allowed them to engage in more resistant reading of the thin ideal. One of the key terms these women consistently used in describing how they negotiated the thin ideal was health. As the wo men progressed in their recovery process, they learned to value their health more than the thin ideal, and this allowed them to become more resistant to messages encouraging behaviors that might undermine their health (such as extreme dieting or excessive exercising). As the participants increasingly valued their own health, they began to respect others who did the same. In the past, the participants had admired celebrities because of their appearance.

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216 Once in recovery from anorexia, their source of admiration changed from an appearance-based focus to more substantive qualities, such as talent, intelligence, and political activism. Thus, the next section in this discu ssion describes how the particip ants came to replace their thinspirations with a healt hy respect for celebrities or public figures who engaged in worthwhile, non-appearance related activities. Embracing new types of role models also allowed these women to reaffirm that appearance should not be the most salient factor in their lives. Changing core values is not easy. So the last portion of the section on appearance describes the various self-protective strategies that the pa rticipants employed to negotiate pervasive sociocultural messages that directly conflict ed with their rec overy process. As Wolf (1991) has contended, beauty is currency, (p. 12) and the women in this study had subscribed to that dominant ideology when they were younger. Over time, however, the participants had learned that the benefits they received from focusing their attention on their external appearance were short-lived and unful filling. As Seid (1989) has suggested, girls who succumb to the socio-cultural pressures to place excessive value on their appearance may later develop a pathology such as an eating disorder b ecause their bodies have been one of the few avenues of expression reliably open to them (p. 78). The participants had devoted all of their time, energy, and re sources to the perfection of their external self. But they ne ver achieved the vision of perfec tion that the media had suggested was possible. Rather than fueling their self-worth, their preoccupation with their external appearance left the participants feeling spent a nd internally bankrupt. Thei r extremely restrictive eating behaviors not only had star ved their bodies, but also had de pleted their self-esteem, as well as their ability to function in their everyda y lives. In fact, all of these women described themselves as miserable.

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217 By relying on their body as their only means of expression, the partic ipants had neglected to develop any other aspects of their self, leaving them feeli ng demoralized and hopeless. For instance, Christinas described what initiated her recovery process. Christina: I was trying to commit suicide. I was thinking about it all the time. I wanted to die. Like, I didnt want to be here. I hated myself. I hated ev erything. I wanted to stop this. I felt like I was really suffering. And I said, Either I need to die, or I have to change something. Now that the participants had learned from first-hand experience that their appearance does not and should not define their self-wort h, they became more critical of the excessive societal focus on appearance. For instance, In her medi a journal, Faith reacted to a magazine ad. Faith: Friday 3:00 p.m. Time magazine Docto rs without Dollars article my family room flipping through magazine. I think that it is sad that doctors make more money on cosmetic surgery, diagnostics, and alternative medicine than they do on medical surgery than is really necessary. I just think that it shows how much emphasis is put on appearance and how much people will pay to improve their appearance. Many of the women discussed how challenging it was to no longer ha ve their identity defined by being thin. Enchantment described what initially inhibited her recovery process: I was always the thinnest, and so, at first, I was like, I want to st ay this way. I wanted to be smaller than all my friends. They always bragged on me for it, so I thought I had to keep it up. Similarly, Noah had seen her thin body as he r primary source of identity. She described the leap of faith she had to take at th e beginning of her recovery process. Noah: I was so focused on my appearance and my weight. And I really believed that was the only thing I had built up that I had any value for. I think that at some level, I thought everythings going to be lost if I dont stay this thin pers on. And what I found is that you almost had to live it to really at your core believe that youre loved for not for these superficial things that you think youre loved for. Over time, the participants perspectives altered. Veronicas comments illustrate what many of the participants expressed: I had to learn to redefine my self for who I really was inside, not for being the smallest person in the room.

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218 For many women in this study, the most cri tical change they made in recovery was learning not to define their self worth by their body. T hose participants who were able to make this shift had more resistant readings of the me diated thin ideal. The pe rspectives of Eliza and Molly illustrate this point. Eliza was in the earl y stages of her recovery process, and she tended to have negotiated or self-protective readings: I mean, yeah, I care about how I look. Its just not as obsessive as it was. In contrast, Molly had been in recovery for several years, and she had the most oppositional readings of all the par ticipants in the study. She no longer viewed appearance as the most salient f actor in her self-perception. As sh e said, There is more to life out there than appearances and being thin. Participants who had learned to develop a nd value their strengths in dimensions beyond appearance tended to have more oppositional readi ngs of the thin ideal. During her interview, Faith discussed several ways that her faith in Go d had been helpful in her recovery process, and she shared what she now saw as her most important qualities. Faith: What I that I love about myself is that in my belief system, I do believe that I have the personality and the faith to allow Christ to shine thr ough me through my personality and through my honesty. Many of the participants discussed how their ca reer afforded them with a healthier sense of self-worth and identity than their previous a dherence to the thin ideal. For example, Jane discussed how her job as a physical therapist was beneficial to he r recovery process: I wasnt just Jane the anorexic anymore.Having a meani ngful career definitely keeps me motivated to stay healthy. Several participants discussed how they chose to create environments in their lives that were not focused primarily on appearance. For instance, Faith described how important it was

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219 to surround yourself with people who love you for who you are. She also shared the type of thinking that allowed more resistan t readings of the mediated ideal. Faith: The media make everything about appearance. But, if I was paralyzed from the neck down and in a wheelchair, does this mean anything? (pointing to her body) No. Because where is anything worth anything gonna be coming from? Right here. (pointing to her head) So my brain. So if I was paralyzed from the neck down, it w ould be all about my personality. It would be all a bout my honesty. It would be all about characteristics, about morals. Of just, living the ri ght kind of life.just being a good person. The participants likelihood of engaging in oppositional readings of the thin ideal was influenced by the degree to which they had deve loped a strong sense of self, one in which they truly believed that their worth was based on more than their appearance. Participants who no longer measured themselves by their appearance or adherence to the thin ideal had the most resistant readings. These participants had deve loped a personal value system that sincerely honored their body and accepte d their true self. I Honor and Accept My Body All of the women in this study had engage d in dangerous and of ten life-threatening behaviors to achieve the thin id eal espoused by the media. For th e women in this study, one of the critical components of recovery from a norexia was learning to honor and accept their body. Those who did so had more oppositional readings of the mediated ideal. Honoring and accepting their body, however, proved to be the most challenging aspect of the pa rticipants recovery process, and only a few women in this study truly had reached this point. Body satisfaction affects readings Women in this study who learned to accept their bodies had increased body satisfaction, which was one of the most influential factors in their decoding process. Participants who were dissatisfied with their bodies tended to have th e most dominant or he gemonic readings, which led to increased body dissatisfaction and low self-esteem. These participants often tended to make disparaging comments about their body, and they usually described themselves as being

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220 fat. For example, one day Jane was reading a magazine, and in her media journal, she wrote: These girls are so beautiful. I would neve r look nice in that outfit. Im too fat. None of the participants in this study engaged in extreme weight loss behaviors any more, but this did not mean that the temptation to do so was gone. For instance, Jane described how she still had to deal with lingering body dissatisfaction: I dont act on my feelings, but I definitely hate the way I look and hate my body. I dont know if this will ever change, but I guess if I dont act on it, it wont kill me. Sim ilarly, Eda said, I still have fa t days and thin days. I always want to be very thin. I ju st dont act on it. The media had been so successful at inculca ting the thin ideal, that it took years for the participants to undo its imprint. This was esp ecially true for the women who maintained consistent exposure to mainstream media. It was especially challenging for participants not to define their sense of identity or self-worth on th eir appearance when the media focused so much attention on the appearance of celebrities. The on ly time Eliza saw magazines was in the grocery store or in doctors waiting o ffices, but this limited exposure was enough to serve as a trigger for her: Sometimes I look at the magazines just glance at them, and it seems like they have so much coverage of the celebrities weights. When they lose weight, they seem to be even more popular too. Sometimes it make s me miss being thin. For the most part, Eliza was critical of the media, but this did not mean that she was not influenced by the messages. She also knew that she had room for improvement in her recovery process. During her interview, Eliza talked a bout what her biggest st ruggle continued to be. Eliza: The biggest problem for me is the scale and kind of determining your worth on how much you weigh, which is so bad, I know. I think that the body image is my biggest problem right now. Its not really eating cau se I eat fine. But body image is the problem. Pretty much every day, I have to work on that, cause thats the biggest issue. I guess every woman has to work on that, but for me its really hard.

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221 The pervasive media messages promoting the thin ideal made it more challenging for the participants to feel satisfied with their body. Yet, these wome n could not afford to risk allowing their thoughts to instigate weight loss behaviors. Jamies commen ts point to the challenge the women faced on a daily basis: Its hard to accept your body and what you look like when all you see is the same image in the media. Factors promoting a positive body image The participants had to work extremely hard to let go of their fear of having a less-thanideal body. They also had to find strategies that al lowed them to be less captivated by the images they were bombarded with through advertising, fash ion, and health industries. Lastly, they had to find ways to become less inclined to participat e in reinforcing the dominant, societal gender norms in their own lives and in the lives of those around them. Developing a healthy body image was a key co mponent in this pro cess, and there were several factors that enabled the participants to have a more positive body image. One of those factors was coming to the realization that the media were not the only resource for defining attractiveness. In fact, several of the women discussed how they learned that men actually prefer women who have a more curvaceous, womanly figure. Compliments from men. Several participants in this study discussed how compliments from men allowed them to realize that they did no t have to adhere to the mediated ideal in order to be attractive. During her interview, Diamond discussed how she felt insecure about several parts of her body. She did not lik e that she no longer had a sm all waist, and she also felt uncomfortable with what she referred to as her round bubble butt. She described what alleviated her ins ecurities about her body. Diamond: Comments from guys help. I mean they dont like skinny Kate Moss women. They want a woman that has curves. And they think love handles are sexy. It helps when they say I look good. Or when I used to start to ta lk as if I was fat, theyd look at me like I

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222 was crazy. So Id subtly sometimes throw it out th ere every once in a while, like, I need to lose a little weight. And theyll be like, What are you talkin about? You are crazy (She laughs.) Theyre like, No, you dont need to. Ev ery man that has been a friend of mine or has been a boyfriend has been like that. And they love booty! Several participants found similar strategies to be helpful. For example, Christina shared how she benefited from compliments about her body. Christina: My roommate ___, hes a gay guy, and he tells me that I look absolutely beautiful and wonderful all the time. All the time. And do you know how much thats helped me? Its helped me so much for a guy to tell me that I look good. That has helped me out more than I think anything ever. Like, he tells me that I look pretty. Just randomly hell say something like, Oh, you look so beautiful today. Or that looks so nice on you. Hes like, I like how your back arches. And Im like, Awww. I try to tell myself that Im beautiful so I dont have to go looking for it from somewhere else. But Ive never gotten that before, so its rea lly nice and so helpful. Positive self-affirmations. Several other participants descri bed how they tried to reassure themselves with compliments. Eliza was a little further along the recove ry continuum, and she described the strategy she used: I try to give my self compliments and stuff like that. As cheesy as it sounds, Ill be like, Wow you look great! (sarcastic) Eliza explained why she relied on herself for compliments. Eliza: I try to do that because I dont want to ask other people for reassurance. I dont like to depend on my boyfriend giving me the physical reassurance that I look good and that Im not fat. I like to try to give it to myself cause its not good to depend on anybody for that, so. But its hard. Alexandra also used positive affirmations, but she said that she generally felt positive about her body: Most days I like myself a nd how I look. I do like my face a lot and my body too. However, like most women, she had days when she felt critical of some part of her body: I do have days when I dont like what I see, and I tend to pick on my hips. But I catch myself having those thoughts and quickly remind myself of positive affirmations and so on and those thoughts go away.

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223 I am a woman, not a little girl. Another challenge the women faced in learning to accept their body was overcoming their desire to maintain a girlish figure. Christina described what she was currently working on with regard to her body image. Christina: Accepting my hips and accepting my body. Like, this is me as a woman. Cause I was underweight for so long. I wanted to be a little girl. And I cant be that anymore. So just accepting being shapely. And telling myself, Thats okay. Its body fat. Its not just fat. Its body. Its healthy weight that I need on my body in order to get my period. So thats what Ive been working on. My body image is the biggest thing because this is my new body. This is a lot more wei ght than Ive had on in a very long time. Id say, since I was probably 15. So just trying to look at my body and tell myself that Im beautiful. Beauty comes in different shapes and sizes. As the women progressed in their recovery process, they learned to value the diversity of womens body shap es and sizes, and this allowed them to better appreciate their own body. The pa rticipants described how it was important to become aware of the fact that most women did not look like the images in the media. As Jamie said, I started noticing different types of body shapes and sizes people just throughout daily life just how different people are. Several participants mentioned that traveling had allowed them to see that there are more diverse body types than what the Western medi a portray. As Jordan said, It helped when I finally left college and went a nd worked on a cruise ship and sa w all these, different body types from all over the world. With time, the participants gained the ability to recognize that women do not all look the same, and there is beauty in each of us. For example, Grace described her current perspective. Grace: I think every body is beautiful, no matter what si ze they are. Cause everybody has something special and unique. And beauty isnt about size. It comes in all different sizes and shapes and colors and just how amazing our bodies are? And co mplex? Is beautiful. And to me, its more about that now. Which is not what media show.

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224 Not expecting perfection. The participants indicated that subtle and in creasingly overt messages about the perfect womans body permeate American culture. What was most helpful for women who were further al ong the recovery continuum was accepting that they were not perfect and that no one was. As Amanda sai d, I dont try to prete nd that Im perfect. I know Im not, and I dont expect myself to be. To varying degrees, the participants all ca me to understand that the media contribute to womens body dissatisfaction. Amanda reacted to an unrealistic quick fix offer in a magazine. Amanda: Tuesday March 6, 2007 4:00 pm Self magazine Grocery store isle Checking out groceries. w eeks to a better bikini body. Yeah, right, dont waste your money! During her interview, Amanda elaborated on her media journal entry. She described her perception of the medias contribution to womens body dissatisfaction. Amanda: That kind of stuff. I just think thats crap. (She laughs.) Why waste your money? I mean everybody is going to be dissatisfied with themselves sometimes. I mean, unless you do look like a supermodel, youre proba bly gonna be dissatisfied with some part of your body. I think the media are probably a huge c ontributing factor of that. There isnt some magic trick that will make you satisfied with your body all the time. The participants who were further along in their recovery process had less body dissatisfaction because they no longer expected to look perfect. They had lowered the bar to a more realistic and healthy standard. For example, Molly said, I had to let go of the unrealistic expectations I had placed on myself.There are part s that I like better th an others, but I think thats to be expected. Women in this study may have wanted to improve some part of their body, but they did not do so from the perspective of seeing a flaw or imperfection that must be fixed. Participants who let go of the desire for perfection were more likely to engage in oppositional readings. For instance, Jordan discussed how perfection wa s no longer something she strived for. She

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225 described a turning point in her recovery when she learned to appreciate her body, even with any imperfections. Jordan: I really started to realize that obviously there is no such thing as perfect. And that no matter what, people have flaws. Even now, Iv e got little flaws and a little flab here and there. Now, its kind of endearing to me. And Im like, God bless you for having some meat on you.Im like, Ehh, a little flab he re and a little flab there, who cares? When the participants reached a point of comfort with their natural body shape and size, they were better able to resist the mediated id eal. For example, Metkit was a 39-year-old mother of two children under the age of 4. She had gained some wei ght during her last pregnancy, but she wasnt desperate to retain her pre-baby shape: Im like, I need to lose 10 pounds here. I have all these baby rolls now cau se of my age and my babies. But oh well. (She laughs.) It happens. Less focus on appearance and weight. The participants often discussed how it was detrimental for them to focus too much attenti on on their body image, or to be around others who did. For example, Amanda described why she ha d to intentionally avoid friends who still subscribed to the dominant thin ideal. Amanda: I just have a really hard time being arou nd people that thats all they talk about is dieting or being thin. And I have a group of friends from college that are good people, but I just dont feel like I need to be around them. Like the last time I went to dinner with them I was like, I have to leave because they just were talking about their diets some of which were from magazines and stuff, which I know arent healthy. I mean it was ridiculous. So I said to one of my friends, I realized like six year s ago that you cant live your life like that. And I dont feel like even having these conversations. I just dont understand why we have to get together, and thats all we can talk about. Conversely, the participants benefited from surrounding themselves with women who have positive body images. As Noah said, Its hard being around women that I know are really concerned about their bodies, but Iv e got plenty of girlfriends that arent like that at all, and I cherish being around them. They just have a great body image, and it rubs off on me.

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226 It was important for the women in this study no t to pay attention to minor fluctuations with their body shape and size. During th eir recovery process, they realized that focusing on such changes could be unhealthy. Women who were mo re comfortable with their overall body image tended to be less concerned with minor changes in their body, and they trusted their body to regulate itself. Defining recovery beyond behaviors. The participants pers pective of recovery influenced their overall body image. For example, while Kerry defined recovery more by altering her behaviors and thought processes, Sunshell ha d a broader definition th at included body image. During her interview, Sunshell shared her definition of recovery. Sunshell: Being healthy physically, emotionally, and socially. Being able to eat what you want, without counting calories or watchi ng your weight. Being happy with your body image. Having a well-rounded lif e with healthy relationships Being able to nurture yourself. The participants definitions of recovery varied based on where they were in their recovery process. Those who were in the beginning stages tended to define recovery by the absence of eating disorder symptoms, such as not restricting or purging. Others described recovery as being able to eat when youre hungry and stop when youre full, instead of counting calories. Emma described how her perception of recovery transformed over time. Emma: It really is a process. And I feel like Ive been doing it for so long. At first, the goals, which seemed so huge at the time, were to drink a sip of juice or have 1% milk or have a whole stick of gum. Now I am at the poi nt where I am trying to completely let go of my eating disorder identity, yet integrate the experiences I had and le ssons I learned into my current life in a healthy, productive way. I am working my way toward being a whole person, not a jumble of segmented emotions and body parts. Theres no food thats offlimits for me now, and that took a long tim e to get to. Im very proud of that accomplishment. As the participants progressed in their recove ry process, the concep t of the ideal became increasingly removed from the description of a thin body. For example, Barbara not only defined

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227 the ideal as healthy, but she also did not limit her definition to physical health: I think ideal has to be different for every indivi dual. But that is an ideal, whic h makes sure that the body is healthy, physically and emotionally. Participants who had positive body images were much more resistant to the mediated ideal. Of all the participants, Sunshell, Barbara, and Molly had the most positive body images. As Molly said, I am happy and comfortable in my body. God Created My Body, and I Will Respect It Many of the wom en discussed how instrumental their faith in God was in developing an acceptance of and respect for their body. As Metkit sa id, What motivates me to stay in recovery is God. Similarly, Charlotte described how she now understood a normal and healthy body to be the one that God intended for her, not what the media portray. Charlotte: When I see media images, I think that its just constant and consciously knowing whats healthy. And reminding yourself of whats healthy and whats normal, supposed to be normal, and the weight that God wanted you to be. For some participants, their faith served as a negotiating tool when they were tempted by imagery of the thin ideal. Others used their fa ith to oppose messages promoting the thin ideal. Comments by Eda and Grace illustrate the former strategy. Eda enjoyed fashion, but she knew that seeing certain dress sizes in catalogs sometimes served as a trigger for her. She explained the stra tegy she used to prevent herself from wanting to fit into a smaller size wh en browsing through magazines or clothing stores. Eda: I avoid putting things before my higher power. I dont completely surrender to the next level of bliss, and I remind myself not to get lost in temptations. In Buddism, they talk about desire as the cause of all suffering. Buddahs first noble truth is that there is suffering. Just the idea that if only I was size X, I would be happy. So I tell myself, I can be happy now. God-sized whole. Not dress-sized whole. Grace also relied on her faith to negotiated pow erful messages promoting the thin ideal. In one of her media journal entries, Grace reacted to a TV show.

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228 Grace: Tuesday 10 a.m. Television Gilm ore Girls Full House Bedroom and Living room alone and with roommates doi ng algebra, checking e-mail; talking on the phone playing with my roommates. Why cant I be beautifulsuch striking blue eyes. My roommate cracks me up. Poor DJ she wa s a little heavy. God, he lp me not to care! Help me to surrender my desire for thinness. I dont want to be a chunk. During her interview, Grace elaborated on her media journal entry and explained what she meant by a chunk. She also described how instru mental her faith in God was in terms of learning to accept her body. Grace: A chunk would be having a lot extra. I dont want to be round.I dont think it looks very good. Average is okay. But I dont want to be fat. I still have my issues with being fat. Its okay for other people, but I woul d prefer it if I wasn t. My faith helps. I believe that I was put here for a purpose, a nd I believe that he cr eated my body, and I am not the potter. There are days when I dont love my body, or I am afraid Im becoming too fat. Knowing that I can go to him when Im feeling fat and ugly and yuck gives me great peace. Ill ask him to deliver me from my self -centered desires. My faith in God, I think, has been key To read the Bible, which says that I am created in his image. Thats a much better way to think. And I think th at helps me to stay on track. For several participants, thei r faith in God allowed them to accept their own natural body and to reject the media-induced notion of a si ngle ideal body type. Molly described one of the most helpful strategies she used for resisting the mediated ideal. Molly: Accepting myself and appreciating who I am for who God made me to be. Also, my promise to God that if he could help me recover, I would respect the body he intended me to have no matter what size or shape or weight it is. I would not try to look like the women in those magazines. I had to let go of my expectations to be able to look a certain way. I truly believe that my promise to God made all the difference in the world for me. And I dont think it matters what faith it is faith in the world, or energy, or nature, or God, or another higher power I th ink it does make a huge difference. Similarly, Faith discussed how her faith in G od altered her perspective of the ideal female body. She described a strategy she used to negotiate media imagery. Faith: Because of my relationship w ith God, my perspective is di fferent than it used to be. Its more realistic. I have a realistic picture of what a woma n is supposed to be, and Im not as affected by those media images.I mea n, a woman was created to have children. A woman is supposed to have hips. A woman is suppos ed to have curves. A woman is supposed to carry a little more weight than men because they are supposed to be able to take care their body and anothe r body within them should th ey get pregnant. You know, I

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229 mean, I try to stay in tune more with how a woman is supposed to be. That helps keep it in check, especially when I see media images. In her media journal, Faith shared an exam ple of how she incorpor ated this strategy. She wrote her reaction to an ad prom oting several strategies for wome n to improve their appearance: God made us the way we are for a reason. We are each unique in one way or another. Why should we change that? My Health is More Important than the Thin Ideal As part of their recovery pr ocess, the participants in this study learned to reframe their primary focus to be on health, as opposed to the attainment of the thin ideal. With a focus on health, the participants were be tter able to resist media mess ages suggesting that they view appearance as the primary fact or in their self-worth. All of the participants used the term health to describe their percep tion of recovery. During her interview, Sarah shared her definition of recovery. Sarah: Recovery is a change of mindset. Its the power to change your thoughts and to change how you see yourself. Changing your behaviors and how you deal with life issues. Dealing with those things in your life daily that really are going to cont radict life, a healthy life. Really, its just a change of mindset, consciously deciding in each moment to choose the healthy route. Like Sarah, many of the participants described recovery as a shift in mindset. For example, Enchantment described her perception of th e difference between anorexia and recovery. Enchantment: I think anorexias where you have this mindset that you have to be the thinnest person in the world, and nothing el se matters. Its like the one thing you want more than anything else. And to get it, you have to starve yourself, exercise forever. Youll take diet pills, youll do all this crazy stuff. And when youre in recovery, by the time that you are really dedicated to it, you wanna be healthy. You want the best for your body. You want to feel better. You want to be at a healthy weight. You want your family and friends to see that youre l ooking better, healthier, youre fee ling better. You dont wanna be 70 pounds anymore.

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230 No longer equate the thin ideal with health When the participants had been anorexic, they lost weight under the guise of health, which worked for some time because of the value our society places on the thin ideal. However, after learning firsthand about the health consequences of being extremely thin, the participants no longer could deceive others, or themselves. Fo r example, part of Amandas definition of recovery was acknowledging that th ere is a problem, that what youre doing is not healthy. Similarly, Lindsay described how her focus on maintaining a healthy body now outweighed any desire for the thin ideal, re gardless of media messages. Lindsay: I dont think that I would ever be able to go back and do that again especially knowin how unhealthy it is. You say youre doin it to be healthy or to lose weight and be healthy. But its the most unhealthy thing you can do. So I guess Ive just changed my thoughts about it and changed my perception of myself to focus more on my health. Many of the participants had believed that attaining the thin ideal was healthy, but they learned that this was not the case. In fact, the pr imary reason that most participants provided for the initiation of their recovery process was thei r health. The participants also focused on their health as an incentive for staying committed to their recovery. For example, Diamond shared what said, I really wanted to change. I wanted to be healthy. I really wanted to be healthy. I wanted to be happy. I wanted to love myse lf. I wanted to feel good about myself. Jordans comments illustrate how the medias false equation of dieting with health could be harmful. She described how her desire to be healthy (by dieting) spiraled into a full-blown eating disorder, in which she became fearful of any weight gain, even though she was extremely underweight: Jordan: It just spun out of control. It just went like, Im gonna be heal thier to if I gain five pounds Im gonna freak out. And then it wa s like, Im sick of this. I cant live like this. I dropped so much weight between my sophomore and my junior year. I came back and like the guys were all over me, and the gi rls were like, Oh my gosh! You look so great! I just got all of this really positive atte ntion. And I was like, Oh my god, Maybe I really looked horrible before! My friend also had lost weight, and we were like, Are you

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231 getting all this crazy attention? What the hell is wrong with that? To this day, we joke about how we became one of the beautiful people that year. Magazine usage focused on healthy eating rather than dieting The participants used to read magazine s for tips on how to attain the ideal body. As Ramona said, I used to read a lot of fitness magazines. Try to like, get the perfect body like what they have kind of look. Best wo rk out tips and stuff. (sarcastic) However, once in recovery, they no longer us ed health and fitness magazines as a source for improving their appearance. T hose participants who still read magazines tended to focus on suggestions for healthy eating, as opposed to di eting for weight loss. As Grace said, In the magazines, I like the content about how to take care of yourself better, and how to eat right or exercise. It seems constructive, rather than destructive. And I like to fo cus my energy that way. Several participants discussed how they en joyed reading about new medical breakthroughs for overall health and well-bei ng. Courtney described how she now used health magazines as a health-oriented resource: I like to read stuff on different vitami ns that you should take or what foods are good for you. Im not intere sted in the diets anymore. As the participants progressed in their recove ry process, their per ception changed from I should alter my media usage to the media should alter what they offer, indicating a transformation from a more negotiated or self -protective position to one that was more oppositional in nature. Many participants contended th at the media should focus on health, as opposed to attaining the thin ideal. As Faith stated, The focus s houldnt be on weight or size, it should be about health. Similarly, Metkit described what she th ought would be helpful in terms of preventing the prevalence of eating disorders: Education on health increasing awareness and educating about healthy weights and eati ng habits. Talk about whats healthy

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232 Health as a negotiating tool Women who were in the earlier stages of recovery valued their health over the attainment of the thin ideal, but they initially needed reminde rs because this perspective was not yet part of their natural thought process. When Grace was ha nging out with some friends one night, she noticed herself comparing her body to an actress in the movie they were watching. She shared her reaction in her media journa l: My stomach looks fat. But I am healthy, with wonderful friends, and thats better than being skinny. Like many of th e participants, Grace valued her health, and she used that to negotia te her desire for the thin ideal. What many of these women struggled with was ensuring that they did not have a distorted sense of reality. For example, Jordan described one of her lingering ch allenges when she saw images of the thin ideal. Jordan: Another thing that still, not haunts me, but the thing that I still struggle with is, Im like, Shit! I have cellulite in the back of my thighs. Every once in a while, I have to tell myself, I dont need to be a size zero. Its really probably not even remotely healthy. Several women described how they learned to frame their concerns about weight from a health perspective. During her interview, Jordan discussed ho w she restructured her thought process to avoid becoming obsessed with what wa s really a natural amou nt of cellulite on her legs. Jordan: Its weird, but in a sick kind of a way, knowing that most pe ople in America are obese makes me feel a little bit better about like, Okay, we ll at least Im not having an eating disorder where I eat everything I see, and Im extremely overweight where my health is at risk every day. Th at kind of helps keep me to keep in check too. Like, yeah, I probably could stand to lose you know two more pounds to be a little bit more toned, but at least Im not on the opposite end where Im struggling to literally walk and function. Opposition: Making health the most salient factor Overall, these women learned to interpret media messages of the thin ideal through the logical framework of health, rather a more emo tional focus on their appearance. Those who were

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233 able to do so were more resist ant to the dominant thin ideal. For example, Molly stated, My health is the key factor to me maintaining my health and respecting my body. Along the same lines, Faith described how valuing her health allowed her to resist media imagery. Faith: I think that they [media] portray more of the unrealistic, unhealthy pictures of a perfect appearance like extremely skinny wo men. I dont want to look like that. My health is more important than trying to achieve the medias view of perfection. Molly was consistently oppositional in her readings, as indicated by her multiple exclamation marks in her media journal entries. She expressed frustration with diet messages infiltrating Web sites that were supposed to be committed to health. Molly: Fri. 7/14 @ 8:30 WebMD newsletter and web site My bedroom Looking for updates on migraine research. Even on a web site devoted to health there are more ads for diets and weight loss! Who cares about weightI need my migraine info!! Age and children make health a priority Girls compare themselves to media images at a young age, and the media messages they learn at a young age are carried on into their college years. At some point, however, women tend to be less likely to engage in social comparisons, particularly with models and celebrities (Martin & Gentry, 1997; Martin & Kennedy, 1993, 1994). One of the factors that allowed the women to resist the mediated ideal was having young children of their own. This was partially becau se their media exposure altered to include Sesame Street, Barney and Wiggles In addition, the participants indicat ed that external validation from media sources was not as important as it once had been, particularly when they had other points of reference (their new family ) for their sense of self. In addition, for the women w ith young children, it was especially important to them to focus their energy on being the best mother and role model they possibly could be. In doing so, their focus on appearance and value of the thin ideal diminished. For example, Metkit described one of her motivations for re sisting the mediated ideal.

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234 Metkit: Just a desire to be normal and healthy. And Im a mom now, so I want them [her children] to have a healthy mom, and I want them to have a h ealthy lifestyle and me too. Also with two children, youre not drawn to those thin model things. You do look at things differently. Respect Celebrities for Qualities Not Focused on Appearance As the participants learned to decrease the importance of appearance in their lives, their sources for inspiration in their liv es transformed as well. In rec overy, the participants discussed how they still admired some celebrities, but no t the ones who based their careers primarily on their appearance. As they progressed in their recovery from anorexia, many of the participants thought processes transformed, including how they viewed celebrities. They used to admire celebrities for their appearance because they se rved as a source of inspiration by exemplifying the thin ideal. As Alexandra stated, I used to love Winona Ryder. While I had my eating disorder, she was my idol. She always looked so good and cute. Once the women were in recovery, howeve r, they no longer admired celebrities whose primary redeeming quality was their appearance. Alexandra provided an excellent example, again referring to Winona Ryder: I cared about her before because I lik ed the way she looked, not because of her acting. Now I dont care about her so much anymore because she doesnt have any movies out really. The participants found many other qualities in celebrities much more admirable, including their acti ng ability, personalit y, intelligence, tendency to challenge Hollywoods thin ideal, and ability to serve as a positive role model for others. Opposition to celebrities who rel y primarily on their appearance Many of the participants comments reflect ed an oppositional interpretation of actresses whose careers were too focused on their appearan ce, not their acting abil ity. As Isabel said, Mostly, the actresses toda y, they dont really act that well. Theyre just there because people think theyre pretty. But its like, Come on now. Have some meaning. Along the same lines,

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235 Michelle said, The light romantic comedies with actresses who are just pretty the women that do that all the time they sort of get on my nerves. Like Meg Ryan and people like that. Now that the women no longer placed app earance as the most salient factor for determining their own self-worth, they were more critical of celebrities who merely reinforced the idea that a womans was onl y valuable for her appearance. Jordans comments about Jessica Simpson illustrate this type of oppositional reading: I wouldnt go to something like a Jessica Simpson movie because I dont think she has a lot to her personality. Im just like, Okay youre washi ng a car in short shorts. Yay! Good for you! Thats talent! (sarcastic) Admire commitment to substance, not fluff Celebrities who did not rely primarily on appearance-re lated qualities served as role models for these women. These types of celebriti es allowed the participants to see that women could be valued and respected for qualities beyond merely appearance. Several participants discussed admiration for celebrities who had more inner beauty. For example, Faith described why she respected Melissa Joan Hart. Faith: She was on one of the posters for the Na tional Eating Disorders Association. What I love about her is well, shes got a great pe rsonality. Shes a beautiful girl. And when I say beautiful, I dont mean, like glamor ous, like she can get out of bed and be beautiful. Thats what I mean. You know, its like it comes from within almost. Most of the participants mentioned that they tended to admire celebrities who were not too Hollywoodized. The participants seemed to associate Hollywood with superficial glamour, primarily focused on appearance rather than talent. Several women in this study discussed how they admired Reese Witherspoon and Drew Barrymore because they were authentic, real, and could act well. The participants admired these actresses because they perceived them to be more than just pretty girls. Lindsay described how she perceived Reese Witherspoon as a person who has a well-balanced life and was not caught up in the drama of the Hollywood lif estyle, which to many of the participants in this study, reflected trying to mold their bodies in to the stick thin ideal. As Lindsay said, It

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236 seems like shes [Reese Witherspoon] not out for just like the glory of, you know, the Hollywood lifestyle.Shes passionate about her wo rk. She really just wants to make movies and wants to do the specific job that she has well. Rylie said that Drew Barrymore was one of her favorite actresses. She had seen all of her movies and loved them. Rylie also admired the ac tress because she did not seem like the type of person who just out for the glitz and glamour of Hollywood: Shes one that doesnt seem to conform with the media she stays out of the media more. More than half of the participants said they admired Julia Roberts, not for her appearance, but because she was down to earth and rea l. Diamond described why she respected Julia Roberts: She [Julia Roberts] didnt want to make movies because she was beautiful. She wanted to do them cause shes talented. She didnt wa nt it to be about her physical appearance. Several of the participants also discussed other actresses th ey admired because they were dedicated to their work. For example, Molly described why she respected Julia Stiles. Molly: I admire women who are talented and dedicat ed to their role in movies, not just a stick thin pretty face. For example, Julia Stiles insisted on learning to dance for Save The Last Dance She learned ballet and hip hop dance sole ly for this movie because she didnt want to be doubled! Thats a lot of dedicati on and strength. I really admire her for that. Respect intelligent, talented television and movie actresses Now that the participants were in recover y, they tended to admire celebrities who were intelligent characters on TV shows. Severa l women admired Gillian Anderson from the X-Files. In her media journal, Christina wrote about he r interest in possibly becoming an FBI agent because she had high regard for the characters on X-Files During her interview, Christina explained why X-Files was her favorite television show. Christina: I just thought Mulder was very intel ligent the way he approached things. I mean, Scully was very scientific. And I rea lly thought Scully was act ually a role model for me. Cause like, she never dressed like, she was never scantily clad. She was always very

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237 business like and she was a pathologist I think. A nd I was like, Wow! Shes like an FBI agent! I was just amazed. She came so far. Shes one of my idols. During her interview, Emma discussed why she enjoyed Ugly Betty, one of her favorite shows. Despite being an ordinary girl who does not fit the traditional image of beauty, the main character on the show thrives at her job in the fashion industry because she is hard working and intelligent. Emma described why she enjoyed the show. Emma: I love that the main character is Latina and a normal weight and she likes herself for who she is. She has such self-confidence. She is surrounded by models all day, but they are the ones who are painted as ugly. In television shows, the beautiful people usually win, and I love that Betty is the he ro of the stories because she is kind, smart, incredibly brave and steadfast in her loyalty. And she has men fighting over her and some women wanting to be her. I love that. Overall, the participants discussed how they now admired women who had some depth to their acting. Most commonly, the par ticipants tended to admire cel ebrities such as Meryl Streep, Katherine Hepburn, Charlize Theron, and Ellen Dege neres for their acting ability. Overall, the participants discussed how they had more appreciation for good acting than someone whos just pretty. For example, Emma described how she loved Meryl Streep because she is so grounded and seems committed to substance rather than fluff. Similarly, Michelle described why she respected Ellen Degeneres. Michelle: Shes hilarious.I think shes just a really amazing woman. Shes beautiful, but she doesnt use her appearance to be famous or to be somebody. She really just she uses more of her personality and her sense of humor to really be successful. Many of the participants admi red women who were active in hu manitarian efforts. Some of the most commonly mentioned celebrities incl uded Heather Tom, Angelina Jolie, Susan Sarandon, and Oprah Winfrey. For example, Emma admired Heather Tom because she invests a lot of her time into politics and feminism.

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238 Several participants admired Angelina Jolie b ecause they perceived her to be someone who used her celebrity status to help others. As Jane said, Angelina is such a great humanitarian. She seems like she has committed herself to improving other peoples lives. You cant help but like her. Jordan also was impre ssed with Angelinas humanitari an work. Her comments capture what several of the women found admirable about Angelina. Jordan: I think shes just a really fascinating person from the whole Billy Bob Thorntonwearing blood around her neck to the saving ch ildren in Africa. And shes one of those people who doesnt just donate a car to a poor village in Africa. Like shes living there. She really understands the people. Shes actively helping them and sh es not doing it in a PR kind of way where its like, Hey look what I did! I went to Af rica. I think shes a genuine person. Many of the participants admired Oprah. For ex ample, Kristin said, I think shes really cool. I supported her foundations in Africa. I give money, and I also do work with Third World country campaigns every year to raise money and awareness. Many of the participants admired Oprah becau se she was a source of inspiration for the type of inner work that the participants were doing in their reco very process. For example, Molly shared what she liked about Oprah. Molly: I feel like over the years, shes realized that being authentic and respecting your authentic true self is one of the most important things to do. I admire her strength and how far she has come. She can admit her mistakes and accept responsibility and use that as a tool to learn and grow. She has changed a lot ov er the years. I think her self-acceptance has grown. And she usually has some very profound ways of looking at life events. Admire confident, empowering role models The results of this study indicate that feminism informed the type of qualities that the participants now admired and respected. As teen agers, most of the participants looked to television or magazines celebrities as role models, though their focus was primarily on appearance. Once in recovery, the women had become more media savvy. In addition, many of

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239 the participants had come to embrace feminist ideology, and they tended to admire women who were strong, empowering role models. Most of the participants discussed how they admired women who had confidence and a strong commitment to their beliefs. For example, Emma described why she had followed Anne Heches career since the 1980s: I admire her tenacity and her ab solute courage to listen to her heart even when people around her say shes crazy. The participants also respected female cele brities who served as strong, empowering role models for themselves and others. These types of role models allowed the participants to realize that women can be respected for qualities othe r than appearancethat appearance was not the most salient factor for all women. Many of the women in this study indicated th at they did not have positive relationships with their family members. Furthermore, while some of the participants had re-established a connection with their parents, no t one of the participants descri bed her mother as strong role models in their lives. This seem s to be why many of the partic ipants who had adopted feminist ideology during their recovery process still turned to the media for respectable role models. For example, Emma had become a feminist over the y ears, but her feminist perspective derived more from her womens and gender studies courses in college than through her mothers influence. During her interview, Emma discussed what he r mother was like. Her description provides some insight in terms of why Emma sought role m odels from media sources. Emma: She has very traditional ideas about gender roles. My mom also has a small life, and thats completely great that it works for her, but it would drive me bonkers. She worked outside the home, but her dream was al ways to be a stay-at-home mother. And she felt that was the best role for women to occupy. She believes the man should make the decisions in the relationship, and the woman needs to follow them. She felt that feminism had ruined a lot of things for women and forced them to do more, like work at home and in the workforce. She was also big with things like dinner on the tabl e at five and women doing the housework.

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240 Emma described her preference for women w ho were portrayed in the media as strong, female characters. In particular, she admire d characters who were w ho were active in many dimensions of their life. Emma: Television goes up and down with this, but right now they have several shows with strong, well-rounded female leads, so I love watching these great actresses get work and be able to tell good storie s about multifaceted women who get respect I didnt get along with my mom growing up and I definitely didnt want to live the kind of life she led. For better or worse, a lot of my female role models come from TV. Emma admired Brenda played by Kyra Sedwick, in The Closer. She described how Brenda portrayed a multifaceted woman. Emma: Shes someone who can be tough yet yiel ding, funny, smart. She can be a lot of different things. She works hard. You see he r working and with her boyfriend. So often female characters are used for the looks or fo r jokes. Or you only see them in one sphere work or home. I like that she has both. Some participants expressed that they ad mired specific characters on television shows because of the characteristics they portrayed on the show. Molly had been the victim of physical abuse from both her father and br other. During her interview, Molly also discussed how after her parents got divorced, her brothers violence escalated into sexual abuse, and at times, she was gang raped by his friends as well. After years of treatment and nearly giving up hope, Molly finally began her recovery process. She realized that in order for her to truly heal, she would need to move away from home, far enough so that she could create her own life, separate from that of her family. In one of Mollys media journal entries, she described how she admired a character on Sex and the City because she served as a strong female role model for her: I love how independent and strong Miranda is!

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241 Given Mollys personal experiences, her ad miration for Mirandas personal integrity and independence makes sense. She did not have pos itive role models at home, but she gained enough personal strength through her inpatient and outpatient treatme nt to provide her with the courage to move to a place where she could build a new life for herself, one that allowed her to maintain a sense of integrity and personal values. During her interview, Molly discussed why she identified with Miranda. She described why Miranda was her favorite character on Sex and the City Molly: She is not afraid to be out there on her own. Shes actually proud of it, which is something I realized about myself in the last year. I moved to Kansas City and only had one friend who went into eating disorder treatment a month after I got here. So I really have built my life on my own The clarity she has on her personal values, morals, beliefs and her unwillingness to compromise them. I can be very laid back go with the flow and dont get my feathers ruffled too easily, but I wi ll not change who I am for someone else. I can discuss my beliefs and appreciate othe rs positions. But Im not going to compromise myself, my integrity, my values for someone else. During her interview, Noah said she came to respect women who serve as positive role models because of their admirable achievem ents. She described two women she admired. Noah: I admire certain women. Not fictional characters usually more like women who are doing goodwill in other countries. Women whose work has really changed others lives, and theyve kind of sacrificed a lot. Like Jane Goodall shes done such great work. Strong women. People like Gloria Steinem, who really believed in their cause and stuck with it, and also been a role model for other women. Admire celebrities who dont fear food Several of the participants mentioned their appreciation for female television and movie characters that felt free to eat desserts on televisi on or in a film, what appears to the participants in this study to be a rare occurrence. This pe rception would make sense, given that eating snack food is likely to be associated with someone bei ng heavy or obese, that few female characters on television programs are heavy, and if they are, they tend to be the object of funny or negative comments.

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242 No studies to date have examined whethe r there is a direct connection between an underweight or thin character and the amount of snack foods she is portrayed as consuming on television. However, researchers have found that th inner characters tend to be more likely to be in major roles in television shows (Greenberg et al., 2003; Hofschire, 2001). Greenberg et al., (2003) have found that 33% of television actres ses were underweight, although fewer than 5% of United States women are underweight. In additio n, the study found that 3% of leading television actresses were obese, whereas 25% of U.S. women are obese. Research also has indicated that thinner ch aracters are perceived as more attractive than heavier ones (Greenberg et al., 2003; Hofschire, 2001; Silverstein et al., 1986). In addition, heavier female characters tend to bear the brunt of humor or negative comm ents more often than thinner female characters (Fouts & Burggraf, 2000; Greenberg et al., 2003). Lastly, television has been shown to communicate social norms and acceptable behaviors, especially among adolescents (Field et al. 1999; Greenberg et al., 2003). A couple of studies in particular found that popular television shows have social influences that modify health behaviors, including food and beverage consumption (Ebbelling, Pawla k, & Ludwig, 2002; Hample et al., 2004). A few participants discussed their admirati on for celebrities who challenge the notion the dominant notion that women who consume snacks will become obese. What is important about these comments is that the women noticed fe male characters eati ng on television or film because of its rarity. For example, Mo lly discussed her admiration fo r Sandra Bullock, who snacked on cookies during a movie. Molly: Sandra Bullock is incredib ly funny and real. She had f un with the movie, and food and weight werent the focus the focus wa s the film. She even made some comment about how an office space they were borrowing had awesome cookies in the one cupboard and she ate those cookies all night while they were shooting! She was real.

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243 Emma discussed her admiration for Kyra Sedwick on The Closer. Emma described her appreciation for the main character. Emma: I have liked The Closer a lot this year. Good ensemble cast, but the star is really Kyra Sedwick. She plays a Southern woman who is disorganized but really smart. I guess I identify with her in that way. She also loves candy and sweets and its so refreshing to see a woman eat on television. Of course, her docto r said she had to give up sweets, so well see what happens there. But its wonderful to watch a female character love junk food but not obsess over it or have it be the butt of all the shows jokes. D: Very cool observation. I guess Ive never noticed that not many women eat on TV. When did you realize this? Emma: I never remember not noticing it. Strategies for Self-Protective Opposition In order to escape the dominant notion of the thin ideal, the participants needed to learn to respect and honor their natu ral body shape and size. Some particip ants knew this in theory, but it was hard to allow themselves to stray too far from the thin ideal. For ex ample, Eliza knew that her weight did not determine how happy she would be, but she still battled the lingering anorexic voice in her head: I still struggle. I mean, I know it doesnt matter what size you are. I think that you need to find your healthy weight and healthy size, and be happy with it. Which is hard. Similarly, Amanda said, Just learning to be heal thy at your weight I think it will always be a struggle for me. I dont think its something that Ill ever be like, Oh I dont care about it, you know? I mean Ill never be like, Oh this is pe rfect. I feel wonderful about the way I look. Prevalence contributes to need for strategies The participants perspectiv e seems understandable given th e pervasiveness of the thin ideal. All of the participants in this study discussed how the medi a perpetuate the idea that being heavy is not socially acceptable. Rylies comments illustrate the prevalence of the thin ideal. She described the perspective of a young girl who was autistic, a disorder in which a persons level of social awareness is low (American Ps ychiatric Association, 2000; Wallis, 2006).

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244 Rylie: I knew what the media wanted, I mean ev ery girl does. Well like, through fashion. Down in Miami, I have this older lady friend whos like 40 her names ___, and she has a daughter who has autism, and shes overweight. D: The daughter is? Rylie: The daughter is, her autistic daughter. And shes not like tota lly autistic like shes autistic, but shes not horribly. You know, theres different levels. And even her, shes like, shes 10 or 11, and she reads her moms Cosmopolitans and she said to her mom, Mom, why arent I thin? Something like that. And so, you know, its amazing that even someone like that who doesnt really have a total wrap on like reality is autistic. She still picks up on the fact that shes different and that people arent gonna accept her because of her weight. Or thats the way its portrayed. D: Oh, thats so sad. Rylie: Yeah. So thats what I think of theres always a cognizant ever yone realizes that as they look through these magazines. Its inevitable. Everyone knows what the media want. Its just that I didnt re ally start paying to the attention to the fact that the media, you know, puts it on us until I became anorexic and was recovering. Restricting media exposure One of the participants most common strategies was restrict ing their exposure to media overall. As Nicole said, Staying away from medi a has made a big difference in my recovery. Eliza also described how she found it easier to detach herself from the thin ideal with less media exposure: The less I pay attention to me dia, the happier I feel about my body. Remembering the misery Several participants in this study described st rategies or techniques they used when they were triggered by media images. A common strate gy seemed to be remembering how miserable and sick they were when they had achieved the thin ideal, or beyond. Sara h described what kept her motivated to stay in recovery: Remembering how I was how I felt in those moments, when everything was full-fledged. Just remembering the misery. Charlotte was in a gym, a potentially triggeri ng location for all the participants in this study, and she saw an ad with a thin woman. Her me dia journal entry illust rates how she used her memory of the reality of being thin to engage in self-protective opposition. Charlotte: TuesdaySeptember 27, 2005 10-10:30 a.m Lucky Magazine (like Cosmo) gym on stairmaster a nd elliptical machine. I remember when I was that thin. Then, I

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245 have to remind myself of all the bad things that come along with being that thinbasically being CRAZY. Rylie described how she used her memory of how miserable she was when she was anorexic to combat her lingering desire to be thin. Despite her current level of body dissatisfaction, she knew that things were much worse when she was thin. Rylie: At one time after I was in recovery, I kind of thought, Hmm why dont I starve myself? You know, it always kind of crosses my mind from time to time, especially when I see really skinny women in the media. But I just couldnt do it. I was miserable then. I dont want that again. I don t want that for myself. Eliza missed being extremely thin, especially when she saw fashion models on television. She described a strategy she used when tempted by imagery of the thin ideal. Eliza: I just remember how I feel now compared to how I felt then. My brain works better, obviously. (She laughs.) And Im happier. Ive seen what malnourishment can do just the way you act and feel. I would never want to go back to that its just horrible I never slept. When I was anorexic, I would never sleep. I had the worst insomnia. Thats just one of the many things. I couldnt think straight. I couldnt concentrate. Remembering the lowest point of their life One protective strategy the pa rticipants used was sharing th eir lowest point. In doing so, they took part of the power of shame away, whic h is what had kept them immersed in their eating disorder. By being open about the worst part of their eating disorder, to others and to themselves, the participants held on to a powerfu l memory of why it never would be worth it to buy into the thin ideal. During her interview, Grace shar ed one of her low points. Grace: My heart was ready to stop. And I needed to gain weight. I had been abusing laxatives, and I was dehydrated. My fingers were all puffy. I had starved, puked, threw up in porta potties outside, Ziploc bags. You name it, I did it. And I remember waking up in treatment that night to get water and praying that it was a bad dream, and I wasnt really there. But I was really there. I gained a little bit of weight in treatment. Not a lot. But the fear of food did not go away I mean, I wanted to get better. But I couldnt. That fear of fat of fat and food was all consuming. All of the participants used their personal eating disorder memories to aid their recovery. Some participants had no desire for any aspect of their eating disorder, and these women had

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246 oppositional readings. Other participants had se lf-protective oppositional readingsusing the negative aspects of their eating disorder (being sick and miserable) to combat their lingering desire for the positive aspects (b eing thin and feeling special). Weighing options, Its not worth it The participants now had the arsenal to combat their inner voices. They were weary of the consequences they already had suffered from achieving the thin ideal, and thoughts about those consequences played an important role in their decision to remain strong in their recovery and not fall prey to powerful media me ssages about the thin ideal. Christina described a strategy she us ed when she was tempted to read a Cosmopolitan which she knew was a trigger for her: I know I have to have the self-discipline to not to look at them. I just say, No! You can t read that. Its gonna hurt you more than its worth. During her interview, Faith used a copy of Shape to illustrate the type of conflicted thoughts she had when she saw thin, beautiful woman on a magazine cover. She described a strategy she used when she was tempte d by a portrayal of the thin ideal: Faith: To be perfectly honest with you, I can look at this picture and have two thoughts going through my mind. And one is that its very enticing to me. Very appealing. But on the other hand, I remember just how sick I was at that point in my lif e. And its not worth it. Even though there is a part of my brain that wants to say, Oh, you really want to look like that woman on the cover. There is a realis tic part of my brain that says, You were so sick then. You might as well have had cancer You have to wei gh your options. I mean, really is it that important? The more the women deviated from the th in ideal, the more inner conflict they experienced. Faith was heavier than she would have liked to be, but she worked hard to combat her conflicting thoughts about her body. Faith still longed for the days when she was thin, but she referred to this longing as a feeling one that she was able to battle with more cognitive reminders that acting on her desire to lose weight was not worth the misery she had experienced with her eating disorder.

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247 Faith: Sometimes when I look at those images [in magazines], I feel heavy, but its a feeling Feelings are not always accurate. They are not always accurate. I think there might be a few people out there that have extra weight, and they know it, and theyre okay with it. But I think pretty much everyone else somewhere in th eir brain wants to be slender or thin. Not underweight, not anorexic, but slender or thin. So I th ink in the back of my mind, I will always have the thought, I want to be slender, I want to be thin. But its just that. Its in the back of my hea d. Its not worth what I went through. Invested in their recovery Several participants discussed how they used the memory of their str uggle to recover as an incentive to curb any desire to engage in da ngerous weight loss behavior. For example, after Christina had attempted to hang herself, she had to withdraw from college and go to Renfrew, an inpatient treatment center in Coconut Creek, Flor ida. Christina had no desire to return to Renfrew. As she said: It was absolutely horrible! I hated that place so much. It just was the most horrible thing, and its imprinted in my mind. Christina used her memory of how miserable she was as an incentive to continually remind herself that the media images arent realistic comparisons for her. She also discu ssed how she came to understand that the media do not represent a healthy body image that she should strive for. Christina: One thing that helps me when Im temp ted by those images is just me saying, I do not want to get to that point again, wher e I was so low. Where I had to go to a treatment center. I just, I cant believe I ever had to do something like that. I never thought I would ever have to go to something like that. I didnt think I was ever gonna be that bad. Just me saying to myself, I dont ever want to be at that low point again in my life. I want to move forward and just live a healthy, normal lif e. So I started looking at things like media that were like triggering for me, cause Dr Seldman [her therapist at UF] kept saying, Do you want to go back to Renfrew? Dont slip far down cause we will send you back. That got me. I do not want to ever go back there. So thats what helped me to change how I look at things. Thats when I found out that media were triggering for me. And so, Dr. Seldman helped me say to myself, Look at this differently. This is whats really going on with these media images. Recovery from an eating disorder is extremel y challenging. The partic ipants in this study were committed to their recovery, and they did not want to unravel the progress they had made.

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248 Emma described how the television program Intervention served as a negotiating tool when she was tempted by the thin ideal. Emma: Intervention I started watching very recently. I ha d heard that some of their stories were about eating disorders and I thought I was at a stable enough place to watch them. I really get a lot out of watching the series because it reminds me where I was, how a disorder completely takes over your life, and there is such freedom in recovery. The show is also a reminder that recovery is a lot of work. And I dont want to go back to the place I was. I dont know where I want to go, but its not there. So yeah, Ive done a lot of hard work in recovery and I dont want to undo that. Similarly, Abigail still valued the thin ideal, but she knew that she had invested too much in her recovery process to undo the progress sh e had made. Abigail was 23 when her parents Baker Acted her to a treatment center for anorexia. Abigail also said that she had to pay for her own treatment: They had the money. But it was mainly my thing. I had gotten into it. And they didnt want to pay. They thought that I would valu e it more if I had to pay for it. Abigail also said that in order to pay for treatment, she had to liquidate her retire ment money, drain her savings, and now she was barely living from payc heck to paycheck. In fact, at age 26, Abigail had to live at home because she could not afford to get a place of her own. Abigail described how she used her emotional and financial investme nt in her recovery to prevent herself from engaging in potentially harmful t hought patterns or behaviors. Abigail: If I was to look at a magazine, I would just compare myself, and it would not be dangerous. So Ill be like, I cant do that. I can not go back there. Just because Ive come so far. Ive spent so much money. Thats not what I want my life to be continually. So I have to snap out of it. While the women had gained the undeniabl e knowledge that atta ining a thin body did not grant them happiness, success, or popularity, they still missed some aspects of being thin. Slenderness does reap some benefits, and for many of the participants, there was a lingering sense of pride or accomplishment with having ha d enough willpower to lose weight and fit the medias prescription for the ideal. However, what the women realized that they needed to do was

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249 re-channel that willpower to combat powerful and pervasive messages promoting the importance of the thin ideal. Like all of the participants in this study, Abigail had a competitive nature, and she had channeled her energy into being the lowest weight she could possibly be. She also was competitive with her exercise regiment. For exampl e, Abigail had read online that women with anorexia tend to do sit-ups, and one site desc ribed a woman who did se ts of 50 or 100 situps. During her interview, Abigail shar ed her reaction: Im competitive, so I was like, Hmmm. I bet I can lose five more pounds by Tuesday. And th is is Saturday. (She laughs.) So I was doing 10,000 situps. Abigail chose to redirect her w ill power from being th e best anorectic to strengthening her recovery. Du ring her interview, she described what kept her motivated. Abigail: Its indescribable. I mea n, its a strong desire to live A want to live. I mean because theres so many people that saw me at my worst. And now they see me and theyre like, Youve come so far. Hearing that is good c ause I used to think, I couldve not just been here at all. I couldve been done w ith this. Just disappeared, and then I wouldnt have to fight. But thats not me. Im not gonna roll over and give up. Just because Im so competitive. (She laughs.) Redirecting their focus from the thin ideal to th e value of health Many of the participants in th is study no longer trusted the me dia to convey messages that truly were healthy or normal. Charlotte descri bed how she had to consistently remind herself how the media were implicated in her interpretation of a normal, healthy body. Charlotte: I think for me personally, when I see media images, I think that its just constant and consciously knowing whats healthy. And reminding yourself of whats healthy and whats normal, supposed to be normal. But its funny, cause now that you make me think about all this stuff. (She laughs .) I didnt really realiz e that during the day I tell myself all that stuff about eating. Or ev en seeing the media like I tell myself, Well thats not normal, thats not healthy. I didnt really realize that I do consciously do that, Like I kind of was thinking even before I talked to you, Im cured. Im normal. I dont have any kind of problems now. But I didn t realize what I tell myself all day. Now that the participants were in recove ry, their health was their most important consideration. When they were tempted by imagery of the thin ideal, they reminded themselves

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250 of the consequences they had suffered when they had been anorexic. For example, Enchantment shared a strategy that made the mediated ideal less appealing. Enchantment: I usually just think about my health. Im like, Well I need to be healthy. Ill think of it that way. And if it [an image] ma kes me not want to eat, Ill remind myself that food is good for my body, rather than just looking at my body and its appearance. Just knowing what starvation does to your body, to yo ur mind and everything. I mean yeah, itll make you really skinny, but it also makes all your hair fall out. And you have all these health problems. And you lose all your muscle and stuff. I was really muscular when I started, and then I got an eating disorder, and I just lost all my mu scle. I couldnt even open a water bottle screw top. Many of the participants desc ribed their constant struggle to resolve dissonance they felt about the thin ideal. During her interview, Gr ace described how she dealt with media imagery that triggered her desire to be th in. By redirecting her focus to he r health, she was able to engage in a self-protective reading. Grace: The photos of Nicole [Richie] when Im in the checkout just seeing how skinny she is. Its eye-catching, and it reminds me of when I used to be scrawnier like that. D: What are some of the thoughts you have when you see someone who looks like what you used to? Grace: Uhm Theyre bittersweet. Im proud, a nd Im happy to be where I am. And I would never go back because I was not living. I was dying And it had sucked everything good out of my life when I was that size. Bu t at the same time, sometimes, its like, Eeeuwww! Wow! I really have a lot more than I used to have. And that doesnt always feel comfortable because of those images. But its not something that I really get stuck on, or triggered by. Its more act ually I remember feeling light like that, but Im strong, and Im healthy. Would I like to be thinner? Absolutely. But now, its more about just appreciating my body My size has nothing to do with my health and my happiness in life. Several women in this study were able to reduc e the inner conflict abou t the thin ideal after having what Grace referred to as fleeting moment s of weakness. For example, Grace described a strategy she used to prev ent herself from relapsing. Grace: I make the switch pretty instantly. I real ly have learned over the years to not deny that Im having the thought but to recognize, okay, Im having this thought of, Oh, shes really unhealthy, and I kind of wi sh I was still that size. But at what cost? Am I willing to? No Im not So I mean, its pretty instant that I turn around. A nd ya know what? I am healthy and Im strong, and I dont ever want to go back to that kind of life. Ever

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251 Engaging in cognitive restructuring Part of the participants recovery process involved un-internalizing the tightly wound layers of the mediated thin idea l. Until this ideal no longer was one of the most salient factors in their identity, the participants needed to engage in strategies to reduce their level of comparison with universal, particularistic targets. One of the strategies the women employed was cognitive restructuring. They consciously reconstructed th e thin ideal messages and imagery so they would not be tempted to engage in behaviors to conform to the dominant ideal female body. Even if the participants c hose not to expose themselves to the mediated idealeither because they knew it triggered them or because they now saw it as a waste of time they still retained those images in their mental archives. Many of the women discussed how engaging in mental self-talk allowed them to re-interpret the value of the thin ideal. The goal of this process was to ensure that the participants remained mindful in th eir readings of media messages. When the participants engaged in this type of active cognitive restructuring, their comments initially resembled oppositional deco ding. In reality, the women were using oppositional statements to resolve an inner conflict betw een their emotional and thought-based reactions to the thin ideal. Further analysis indicated that these participants actually were engaging in self-protective opposition. What the participants knew to be true (that being extremely thin made them miserable) contradicted their initial, more emotional react ion to media imagery (a lingering desire for the thin ideal). This logical/emotional contradicti on compelled the participants to develop new thoughts or beliefs, or to modify existing ones so they c ould reduce the dissonance (conflict) regarding the value of the thin female ideal.

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252 Prior to the onset of their eating disorder, these women tended to engage in more emotionally based interpretations with regard to the thin ideal. They would see media images of thin, attractive women, which prompted them to restrict their eating. Once in recovery, they engaged in more careful scrutiny of media messag es to determine the merit of the message. For example, Christina described a strategy she had learned. Christina: What Ive learned in therapy is I should put myself over here. Take myself out of my body and say, Look at yourself from a different position and say, What are you doing ? Question yourself. And say Stop! Just l ook at it and say like, See, no! This is wrong. Youre in your eating disorder. Get out of it. It helps just realizing that media are not what everyone looks like, not how everyone should be. Overall, the women in this st udy generally tried to engage in more cognitive processing of media messages, as opposed to a more passiv e reaction based on feelings or emotions. The participants now had a desire not to engage in thoughts about the thin ideal that could cause extreme inner conflict. More importantly, the wome n were motivated by a strong desire to avoid slipping into behavioral strate gies, such as extreme dieting, to achieve the thin ideal. Many of the participants were so used to automatically engaging in a dominant reading of thin ideal imagery that they really had to take a step back and proce ss their thoughts in a more active, cognitive way. During her interview, Isabel described a strategy she used. Isabel: Something that really helps me is writing down what Im thinking or what Im feeling if I see something in the media that triggers me. Cause sometimes Ill feel really bad and cant really figure out what is happeni ng. And just kind of analyzing it. Like, is this reasonable? If the image makes me rea lly anxious, Ill want to start planning, Okay, Im gonna lose weight like this. Thats my automatic thinking. But then Ill be like, Okay, is this helpful in the long run? What ar e the pros and cons of this? So just writing things out and taking a step back. Typically the women turned to more cognitive processing of thin ideal imagery when they realized that subscribing to the thin ideal no longer worked for them. For example, Noah said, I think Dr. Phil uses the same kind of techniques. His key line is, How is that working for you? I

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253 think its a very good question to ask yourself Cause we tend to just get in patterns, do things over and over again, and we forget to ever question that pattern. Over time, the women in this study learne d how to restructure their thoughts through intense therapy. During their recove ry process, the participants ha d become more media literate, which served as a tool for closely scrutiniz ing media messages promoting the thin ideal. Through treatment and counseling for her eating disorder, Grace had learned what she referred to as a skill set to decrease her an xiety about the size and shape of her body. During her interview, Grace described how helpful dialec tical behavioral therapy had been for her. Grace: I mean, its not fun to be stressed out and unhappy about it [my body]. And I have a choice about that. I can choose to dwell on it and focus on various body parts what size I want to be and heighten my misery. Or I can tell myself truthful, healthy things and reframe those thoughts. This section of the dissertation has discussed the various ways that the women reduced the value of appearance, which was a critical step in their recovery process. Participants who had a positive body image and no longer viewed appearance as the most salient f actor of their selfworth were the most successful in this regard. Furthermore, a diminished value of appearance allowed for a more oppositional reading of the medi ated ideal. The next section will discuss the obstacles the women in this study faced as they s ought to un-internalize the pervasive thin ideal. Obstacles to Un -Internaliz ing the Thin Ideal There were several obstacles that impeded the participants un-internalization of the thin ideal. All of the obstacles discussed in this chap ter are connected to the focus on appearance as a salient factor of self-worth. Participants who st ill perceived their appearance to be a form of currency (Bordo, 1993; Brown & Ja sper, 1993) had a much more difficult time engaging in oppositional readings of the mediated ideal.

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254 For the women in this study, comparisons to imagery of extremely thin celebrities or models resulted in conflicted readings of the me diated ideal. Furthermore, the most noticeable distinction between a protective and an opposition reading was the degree to which the participant engaged in comparisons with media imagery of celebrities or models. Accordingly, a section of this chapter is devoted to the danger of engaging in such comparisons. One of the primary obstacles the women in this study had to overcome was their fear of becoming fat, a daunting task in a society wher e fat oppression is condoned and even sanctioned. Though none of the women in this study were in danger of becoming obese, their inherent dichotomous thinking led them to believe that if they no longer were thin, they would become fat. In addition, some of the women in this study developed an intense fear of fat early on in their life, typically instilled by relatives with unr esolved issues of thei r own. For instance, Grace discussed why she used to believe that being thin would make her happy. Grace: I think some of it was in how I was brought up. I know my dad would always make statements like, Oh my God. Look at how thick her ankles are. Like random people in restaurants. Hed say, Y ou dont want to be fat like that Your butts getting big. So I think that made it very clear. And my sister was overweight. Actually morbidly obese. And I think that they were always fearful that I would become that. Researchers have contended that the thin ideal is often promul gated by the media and encouraged by family members and peers (Heinb erg, 1996). Furthermore, the social construction of thin as good and fat as bad has introduced a moral component to body size, providing additional legitimacy to myths associated with being fat (Bordo, 1993; MacInnis, 1993; Maine, 2000; Seid, 1994). During her interview Rylie described some interactions with her mother regarding weight, exercise, and clothing size that provided insigh t into her perspectiv e and degree of body dissatisfaction. For example, one year after Rylie had been in recovery from anorexia, she had

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255 gained some weight while on summer break. Ry lie had wanted to lose weight, and her mom encouraged her to do so. Rylie: My mom was like, Oh, you can lose a few pounds. She never gets it. I had just come out of anorexia, and I gained weight, which was good. And then I was saying that I was gonna to lose weight, and she was pushing me to lose weight! How retarded is that? (We laugh.) I mean really When you think about, its crazy. Its just, she doesnt get it. She doesnt grasp it. Rylie also discussed how she had gained some muscle that summer because she had been working out with a trainer at her gym. Her cl othing size had changed, and she described her mothers reaction on one shopping trip. Rylie: I remember I went to a dressing room w ith my mom. I was trying on clothes, and I couldnt fit into a size.And I was upset about it, and it was obvious that I was upset about it. And my mom goes, They almost f it you, you just have to lose a little more weight. And this is the same woman that be fore was telling me that I was too thin, and that I needed to eat more. During her interview, Rylie described how she reacted to her moms comment on that particular shopping trip. She also described how the dynamic with her mom affected her overall sense of worth. Rylie: I sat down and just was crying, and my mom was like, You said you were gonna work out every day this summe r.So my moms pretty much saying that Im worth shit and my bodys worth shit and (s ighs) to this day, Im so angry with her about that. Of course, I dont tell her that. (She laughs.) Wh en she says stuff like that, I just wanna go, Oh my God! Are you serious? (She laughs.) li ke, Whoa, back up. I should write it down or something. But Ill just take it and take it, and inside Im screaming, like Why cant you see that I look fine for once?! Her perception of me is that Im huge and that impacts the way I see myself, especially when she says things like, You need to lose 15 or 20 pounds. Its flabbergasting. And its things like that that really get to me and destroy myself. And my self-esteem. As illustrated by Grace and Rylie, some women in this study had difficulty extricating their sense of self from their appearance especially if this connection ha d been deeply instilled in their minds. As discussed previously, the toughest battle the participants faced learning to honor their body, while not allowing their appearance to define their self-worth or identity.

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256 In addition to a deep-seated fear of fat, many participants struggled with a lingering attachment to the benefits they associated with the thin ideal. The more the participants missed the identity of being thin, the greater the risk was for relapse. Conseque ntly, these participants tended to engage in negotiated or self-protective readings. For all of the participants in this stud y, numbers had been a powerful and concrete measuring stick of their self-wor th during the time when they were anorexic. The women in this study had used calorie intake and expenditure, cl othing size, and weight to measure their selfworth. Changing this type of thinking was one of the biggest obstacles for the women in recovery from anorexia. In fact the scale has such power over wo men who are in recovery from anorexia that treatment centers do not al low the patients to discuss numbers at all clothing sizes, calories, and especially weight Some of the women were able to tip the self-worth scale enough to become aware of the extent to which they had absorbed the dominant ideology, but they needed more time to cultivate their inner selves to battle the ever-present voice of their intern al anorexic mentality. All of the women in this study were at a he althy weight and had ove rcome the behavioral aspects of their eating disorder. However, a few participants still st ruggled with their body image. They had difficulty determining their self worth with personality characteristics lacking concrete numbers for measurement, such as kindness, compassion, or intelligence. These participants tended to have more self-protective o ppositional readings. Noah had earned a doctoral de gree in psychology, and at some level, she knew that her self-worth was not defined by her size. However, sh e still struggled with wanting to lose weight, at least in part to the media indicating the correct height, and wei ght, and clothing size for women. During her interview, Noah described her perception of the mediated ideal.

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257 Noah: When I see models, Im pretty sure that th eyre at least 5 9 at the shortest. And that theyre probably weighing 110 pounds. And something really ridiculous for that height. And wearing a size 2 or a size 4. Participants who viewed the at tainment of a boyfriend as a re flection of their identity and sense of self-worth tended to engage in self -objectification, which inhi bited their ability to engage in oppositional readings of the mediated ideal. This was an unexpected finding that emerged toward the later stages of the coding process. An unexpected finding that emerged was th e association between the participants perception of recovery and the nature of their reading. The wo men in this study who viewed recovery as a life-long process were less likely to engage in o ppositional readings. In contrast, the handful of participan ts who believed that it was possible to fully recover from an eating disorder and put the experience behind them were better able to resist the mediated ideal. Danger of Engaging in Comparisons This section discusses how important it wa s for the women in this study to reduce, eliminate, or alter comparisons. Those who failed to do so had dominant or negotiated readings, which tended to be damaging the womens self-esteem and body image, and in some cases, led to potentially harmful we ight loss behaviors. All of the women in this study had internalized the thin ideal at some point prior to the initiation of their recovery. Part of the participants recovery process involved unraveling the internalization of this ideal. Wo men who had un-internalized the thin ideal were able to engage in oppositional readings, allowing th em to completely reject medi a messages promoting the thin ideal. However, those who still had a significant desire for the thin ideal needed to avoid engaging in comparisons. In order to reduce the salie ncy of the thin ideal, the participants needed to engage in strategies to reduce or eliminate their expos ure to the mediated thin ideal.

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258 Until the thin ideal was no longer an important part of the participants core value system, it was dangerous for the women in this study to engage in comparisons with thin models or celebrities. In fact, this study ha s indicated that engaging in soci al comparisons of this nature proved to be one of the most important obstacles to the un-internalization of the thin ideal. What this study also has indicated is that the mo st significant difference between an oppositional reading and a self-protective oppos itional reading was the particip ants desire to engage in comparisons to the thin ideal. Women who had le ss desire to engage in such comparisons had more oppositional readings. The re sults also indicated that nearly all of the self-protective opposition strategies that the participants employe d served to reduce or eliminate comparisons. Experimental studies have i ndicated that overall, women te nd to feel worse about their body after viewing images of the thin ideal. The meta-analysis conducted by Groesz et al. (2002) indicated this as an overall effect, even with some studies having contradictory findings (Irving, 1990; Richins, 1991). Halliwell and Dittmar (2004) found that there was a distinct difference in the concepts of being aware of the thin ideal and internalizing the thin ideal. They contended that most women are awar e, but those who truly internalize the thin ideal are likely to be more dissatisfied with their body image, particularly if they engage in social comparison with media images. Social comparison theory and comparisons Social comparison theory, credited to Festinge r (1954) posits that 1) people have a drive to evaluate their opinions and abiliti es; 2) that in the absences of non-social, objective standards, people will be motivated to use social comparison; 3) and that when possible, people will compare themselves to similar others. Social comparison theory has been applied ex tensively in the literature relating to eating

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259 disorders, as the theory has evolved over time to include not only opinions and abilities, but other attributes as well, including appearance and body shape and size (Wheeler & Miyake, 1992). Taking Festingers slightly altered notion that people are driven to evaluate their attributes, it seems appropriate for social comparison theory to be so widely used by scholars examining body image and eating disorders. Comparison targets: Universalistic and particularistic. Social comparison theory has evolved to include two additional dimensions th at relate to the topic of study. One dimension involves the nature of the comparison target (par ticularistic or universalis tic). A particularistic comparison would be a woman co mparing herself with someone who is a peer, colleague, or family member, someone who she relates to in a social setting of some kind. On the other hand, a universalistic standard is one th at is more personally removed from the individual, such as a fashion model in a magazine, a character on a popular television show, or a movie celebrity. Typically, people prefer particular istic comparisons because they are more likely to be similar, however, the choice of comparison may be affect ed by a womans motiva tion: self-evaluation, self-improvement, or self-enhancement. Upward and downward comparisons. Social comparison theory posits that women typically will choose what is referred to as an upward comparison (someone who is more successful in terms of a particular attribute) if she is trying to improve or enhance herself. Sometimes this upward comparison will be a person the woman knows, but many scholars contend that because the media portray fashion mode ls and celebrities as the ideal and as having a body that is achievable, women may look to a more universalisti c comparison target (Martin & Kennedy, 1993). Typically, when a woman engages in comparison with a universalistic target, she will end up feeling worse about herself, she may become depressed, have lowered body

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260 dissatisfaction, experience shame, a nd feel anxious or guilty about failing to live up to the ideal (Wheeler & Miyake, 1992). A downward comparison would be if a woman compared herself to someone who is worse off on a particular attribute. Perhaps this person is overweight or unattractive. Many scholars have indicated that people engage in downward comparisons to feel better about themselves (Wheeler & Miyake, 1992). Women in the initial stages of reco very still compare Consistent with previous research on soci al comparison and body image, participants in this study indicated that they usually felt worse about their bodies after comparing themselves with others. Nearly all of the participants made several references to the comparison process itself. While all of the women in this study seemed to be aware that the body ideals portrayed in the media were illusory, those who were in the initial stages of r ecovery still compared themselves unfavorably to the ideal and also tend ed to engage in a dominant reading. In addition, participants who were less recovered tended to still have the thin ideal internalized. Some women in this study often used celeb rities on television as appearance-related measuring sticks. For example, while watching a movie on Lifetime Isabel wrote the following in her media journal: She has pretty hair; I n eed long hair. In anothe r journal entry, she was watching The Nanny and wrote, Fran is skinny. I need to be that skinny. Similarly, Grace was watching Friends and wrote, I wish had Rachels body. Learning the necessity of avoidance The problem with using the media as resources for social comparison or social learning is that the women represented in the media are not h ealthy comparisons for most girls. In fact, the typical fashion model would meet one of the prim ary diagnostic criteria for anorexia (being 15% below what would be considered a healt hy weight for ones age and height).

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261 Garner (1997) has suggested that women ar e increasingly becoming dissatisfied with their bodies. In general, the size of fashion models, television characters, a nd movie celebrities has declined over time, while the weight of the average American woma n has increased. Women who are inclined to compare themselves to media figures as a measure of their self-worth, or as some other measuring stick, are likely to find a discrepancy. When a discrepancy occurs, if a woman has internalized the thin ideal (Halliwell & Dittmar, 2004; Heinberg, 1996; Stice et al., 1994) and has the drive to reduce the discrepancy, sh e will turn to dieting or exercising, which is widely promoted in the media (Wiseman et al., 1992). Like several other participants, Courtney te nded to watch television when she was working out, either at a gym, or at home on a treadmill. During her interview, Courtney described what her triggers were. Comparing he rself to thin, attractive wome n on TV not only affected her thought process, but it also directly affected her behavior. Courtney: I know whenever I see these perfect-bodied women on TV or in a magazine or whatever sometimes that will make me kind of say I dont wanna eat. Or if I go work out, I watch the flat screens on the treadmill at the gym in Atlanta. And sometimes Ill see a really pretty girl sometimes I work out while Im watchin my soaps, and Im like, Shes so pretty, or Shes so skinny. Maybe Im gonna stay on here a little longer today. The women in this study had turned to dieting and exercise and took it to an extreme. Now that were in recovery, they could not afford to go back down the path of seeking the thin ideal. Thus, they needed to use protec tive strategies to prevent themse lves from engaging in weight loss behaviors. One of those strategies was avoi ding potentially damaging representations of the thin ideal. Barbara offered a strategy for dealing with the potentially dama ging representations of the thin ideal: The less you listen to the media, the better. Dont expose yourself. The participants discussed how they gra dually came to understand the importance of restricting thei r media exposure. Botta (2003) has found a link between the number of health and

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262 fitness magazines read and an increase in body im age disturbance and related behaviors such as fasting, purging, use of diet pill s and laxatives, and unreasonable desires to be thin. As the participants progressed in their recovery pr ocess, many of them ca me to understand this relationship on their own. Because it was too risky for the women in this study to dabble with the desire to be thin, some participants made a conscious decision to avoid mainstream magazines altogether. Magazines were instruction manuals for life For many of the women in this study, magazi nes had served as an instruction manual for life Like many of the participan ts, Noah used to subscribe to magazines when she was a teenager. She described how they used to influence her. Noah: When I first started reading magazines, it was like Seventeen magazine. And wed read Cosmo or Glamour too like they were your instruction manual for life. (We laugh). Wed look at the celebrities and models and be like, This is what I should be wearing. This is what I need to buy at the mall next week. These are the cu rlers I should be putting in my hair. I spent a lot of time in high school reading those magazines. Like many of the women in this study, Noah learned that reading certain magazines led her to engage in social comparisons that only made her feel worse about herself, so she made a conscious decision to avoid them: In college is when I decided I woul d stop looking at any fashion magazines. Cause I was still str uggling, and I was getting the connection between looking at fashion magazines and feeling bad about myself. Alexandra used to read fashion and health magazines on a regular basis. Over time, she realized that she was engaging in comparisons w ith the women who reflected the thin ideal, and she felt worse about herself, so she made a conscious decision to avoid magazines. Alexandra: While I struggled with my eating disord er I was somewhat addicted to reading magazines and would buy at least one new one a week. Now, I dont want to read them anymore. Reading certain magazines, w ith good-looking, skinny models is not good for me. I start having negative thoughts about myself and criticizing my body when I stare at those pictures for too long. So I avoid reading these magazines.

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263 Faith knew that it was important for her not to engage in a social comparison that might make her feel worse about her body. In order to st ay on the path of recovery, Faith had to avoid reading magazines that limit their representation of women to those who reflect the thin ideal. Faith: Its just not my thing [reading magazines like Shape ]. It would be too easy to get off on a tangent. And I couldnt. I cant say that relapse could never occur. I think Ill fully recover, but I have to keep my mind in check in order to stay that way. Faiths comments about social comparison re flect the pre-existing li terature. As Thompson et al., (1999) have contended, T he comparison process is in it self a threatening phenomenon. Faith described an example of how she had to k eep her mind in check to remain in recovery. Faith: Comparing myself to you or comparing myself to anybody in the media. We are all so different. I mean, none of us are alike. I dont even know where the idea came from, what brought it about the whole comparison thing in the first place. I have to not do that. You know, you have to make a mental choice to not do that because youve gotta reverse 10 years, well mine was 10 years, of negative thinking, that way of thinking. Thats like speaking Spanish for 10 years, and then all of the sudden havi ng to learn English or vice versa. You know, I mean, its a whole different language. Several researchers have found that compari ng ones body with other womans is related to body dissatisfaction in women (Heinberg & Th ompson, 1992a, 1992b; Strieg el-Moore et al., 1986). In fact, Heinberg and Thompson (1995) found that women who engage in such comparisons have increased body dissatisfaction, regardless of whether their comparisons were upward (with more attractive indi viduals) or downward. Consistent with previous research on social comparison and body image, the women in th is study indicated that they usually felt worse about their bodies after compari ng themselves to models or cele brities portrayed in the media. In general, the women in this study seemed to find fashion and beauty magazines to be the most powerful source of trigger material. It is possible that magazines were more powerful triggers for the women in this study because they are tangible sources that the women in this study could hold in their hands.

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264 Christina described how she recently had lear ned that magazines had been a trigger for her eating disorder behaviors. She also described so me strategies she tried to combat irrational thoughts caused by magazine exposure. Christina: Magazines are the most triggering things I would find myself looking at them and thinking things. Like, the bad thoughts. Like, Hmmmm. I wonder how she gets a stomach like that? Maybe if just like stopped eating so much at my meals. Like, just cut this food out. Now that Im healthier, my mind is kind of allowing me to think more rationally about things. And Im like, W ait a minute! Wait a minute. What am I doing? Oh my gosh. No wait. I cant do that. No! Stop, stop! Christina used to be a heavy reader of magazines such as Seventeen and Cosmopolitan but she learned during therapy that those type of magazines fueled thoughts that she needed to improve herself, and that the way to do so was to become more attractive, primarily by fitting the media-prescribed thin ideal. Over time, during Christinas recovery process, she came to realize that reading fashion magazines wa s not healthy for her because sh e would engage in unrealistic social comparisons with the models. The following excerpt illustrates Christinas reaction when I asked her to tell me abou t any magazines she read. Christina: Oh! No! No magazines. I Oh my gosh No. After therapy, no. Those things are the most triggering things I mean, I know theres like, Time magazine, but those are boring to me. I was always reading a Seventeen Cosmo Oh no, I will not look at them. I will not go near them. Those are the worst things, worse than TV. Worse than, like, the pool party out there. (She laughs.) Magazines. I think those are what threw me off. The thin ideal messages in magazines were too powerful for Christina. Eventually she realized that the best st rategy for her would be to avoid them altogether. Christina: I would say still about a year ago. It was like a big change. Everything just happened at once. I just stopped looking at them. I mean I did p eek at them a little bit. (She laughs.) Like my roommate would have them behind the couch, and Id sneak a peek. (I laugh.) Now, I dont look at them anymor e. Im just like, No! Dont even open them. Christina recognized that magazines were a trigger for her, but she also realized how challenging it was to avoid them. She described several strategies she employed.

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265 Christina: I see them in any kind of grocery store line. Fr iends houses. Its especially hard watching the girls by the pool lay out, everybody has magazines. Thats why sometimes I dont even go anymore. Yeah, and doctors offices. I usually dont try to read them. I usually like sometimes theyll have a TV. Or Ill just sit ther e. Like staring ahead and try to think about things. I try not to read them. When Ramona was really deep into her eating disorder, she watched a lot of TV. She had struggled with anorexia and bulimia, and she described how Nip/Tuck was a trigger for her binge/purge behaviors. Ramona: Nip/Tuck (says with disdain). Man, that show killed me to watch. It was just like that would send me to the grocery store for a gallon of ice cream just to watch it for a second, just cause, man, those people are so perfect. Why cant I be rich? And theyre so disordered and weird people, too. But for some reason, its just like, watching Nip and Tuck sends a very clear message of youre not good enough to me. Like Ramona, several of the participants in this study had said that MTV in particular was a trigger for them. Ramona used to watch at least four hours of MTV a day, and she described how she had to cut back: Ive consciously put a lot of effort into not putting myself in situations where Im exposed to so much TV cause it was pretty detrimental to my self view. Like watching MTV made me go, Oooh, I wanna be like that person. Veronica discussed how she used to have to avoid certain movies because she would engage in unhealthy comparisons. As she progr essed in her recovery process, she was less tempted to compare herself to unr ealistic targets and f eel worse about herself: Before, I would limit what I was watching because I just didnt want to get depressed about the way I looked compared to the people on the movies. Challenging to avoid comparisons Once in recovery, with increased media lite racy, the participants had more freedom and choice about comparison. They could choose to ignor e or discount media images they disliked or that might serve as a source for an unhealthy comparison. However, a few of the participants

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266 indicated that this was not always possible. As Enchantment said, I try to avoid looking at the models. But I try to avoid fight s with my mom too, but it doesn t always work. (She laughs.) Victorias Secret catalogs are especially challenging Many of the participants described how viewing Victorias Secret models, either in the print catalogue or in online ads, served as a trigger for their desire to attain the thin ideal. The Victorias Secret models typically appear as if they have no imperfections. In addition, the models are usually wearing very little clothi ng, exposing body parts that most women typically have insecurities about. Veronica described how she knew that images were airbrushed. Despite this knowledge, she knew that the Victorias Secret catalogue had the power to make her feel bad about herself because she still had a strong desire to look lik e the ideal, regardless of how unrealistic the imagery may have been. Veronica: Victorias Secret makes me feel the worst someti mes. I mean I dont know what theyre thinkin with these girls, but I mean, the underwears not gonna look the same on me. (She laughs.) You see it, and you like it, but then you have to realize thats not gonna look that same way on me so why should I buy it? I know its airbrushed, and its been retouched and everything. Everybody knows that But you just cant help but compare yourself to these girls. And I think that [ Victorias Secret catalogue] would be the only thing that I have to be like consciously aware of when I read it. Or look over it. Similarly, Christina desc ribed her reaction to a Victorias Secret ad online, but her response was to draw from her knowledge about ai rbrushing to negotiate the message. Her initial inclination was to compare herself to the image of the women, but then she talked herself out of comparing herself to an image th at probably was not realistic. Christina: The Victorias Secret ad just really bothered me. Cause this girl was in a swimsuit, and my first impression was like, O h my gosh! I want to look like that! But then, Im like, Okay, ya know Wait a minute. Shes probabl y airbrushed. But those things kind of get to me.

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267 Christina had knowledge about airbrushing, but she still had the thin ideal internalized. Similarly, Abigail was in the in itial stages of recovery, and she knew that she should avoid magazines: I dont read magazine s. I stay away from them. Th e people that are portrayed in there, the models and stuff. Its dangerous. Its the wrong image. Abigail described why she especially needed to avoid looking at Victorias Secret catalogues. Abigail: The Victorias Secret swimsuit magazine that I got the other day. It was women that needed some more meat on their bones for sure. I never look at the products really. I just compare myself to em [the models]. And I usually feel like crap then. (She laughs.) Because I mean, I know Im healthy and not overweight, but I dont see ri ght either. So its hard to accept that. I reme mber thinking that I was skinnier than her once. I guess it made me think of how far Id come. But yet, how far Ive got to go mentally still. Thats why I just stay away from them usually. Hard to tear away Some participants knew that media expos ure caused them to engage in unhealthy comparisons, but this did not stop them from watching potentially triggering TV shows. For example, Courtney described how watching the O.C. affected her. Courtney: Actually this is kind of crazy. (She laughs.) One of the main actresses on the O.C I just look at her and think, Oh shes got such a cute figure. Shes tall and skinny. Gosh, I wish I could look like that. And I w ould probably feel a littl e better about myself if I didnt watch that as much. (She laughs.) But Im so addicted to it. I just cant make myself not watch it. Research consistently has indicated that incr eased reading of beauty and fitness magazines is related to womens body dissa tisfaction and eating disturban ces (Harrison, 2000; Harrison & Cantor, 1997; Levine et al., 1994). Many participants had diffi culty completely steering clear of all magazines. Noah described a strategy she empl oyed to combat her init ial feelings when she saw imagery of the thin ideal in the grocery store aisle. Noah: Sometimes when Im at the grocery store, Ill end up looking at US Weekly or People as Im standing there. And even that I know is kind of bad. Cause youll see like the Paris Hilton or Nicole Rich ie. I noticed it on this trip. I was like, This is bad. (She laughs.) That you look at them, and you go, Oh, theyre so thin. And then you think, Oh

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268 thats so I dont want to be that. But it does kind of affect you. Ill think, Oh, that dress falls nicely or something. And then I have to add like another conscious cognition on top of it, rather than go with th at immediate thought or feeling. I really dont lik e that I looked at those magazines this week because I know how its gonna make me feel. Theres just so much of it Amanda no longer engaged in eating disord er behavior, yet she was not immune to comparing herself to attractive celebrities or mode ls. Despite her level of media literacy, she still felt worse about herself if she engaged in an upward, particularistic comparison. As Amanda stated, the thin ideal is everywhere, and it was ch allenging for the women in this study not to be affected, particularly if they still had the thin ideal internalized. Amanda: I guess if you just watch something on TV or whatever, and you think youre seeing the perfect person. You think theyre attractive, and it makes you feel worse about yourself. I guess its just being so exposed to it. Just all th e time seeing people that are so thin and beautiful I mean, its not real, you know. Theres just so much of it. One of the surprising findings that emerged fr om this study was the prevalence of invasive ads promoting the thin ideal online. Many of th e participants who had Yahoo or Hotmail e-mail accounts had to find ways to negotiate me ssages that popped up on their computer. Courtney had an e-mail account with Yahoo, wh ich frequently had pop-up ads for weight loss, anti-cellulite and anti-wri nkle creams. In her media journal, Courtney reacted to an online ad she saw while checking her e-mail: That models butt had to be airbrushed. Courtney saw the same ad multiple times during the week that she kept her media journal. She expressed her irritation with unsolicited online ads: Im so tired of seeing this models perfect butt every time I need to check my mail!!! Danger of Comparisons for Women with Body Dissatisfaction Richins (1991) found that women who were ove rweight and already diss atisfied with their body became even more dissatisfied after viewin g images of the body ideal. This finding provided insight into a few of the participants comments. On days when Sarah was feeling

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269 insecure about her appearance, she had to a void media sources that would intensify these feelings. She discussed how she had to monitor he r magazine reading based on her state of mind. Sarah: Fitness, Shape Self or Elle or anything like that w ith the certain images on the front of it those can be triggers. If I m not having a good day, Ill compare myself to them and feel badly. So Il l avoid them on those days. For women in this study who already were e xperiencing body dissatisfaction (even if it was completely unwarranted), it seemed especially important to avoid engaging in upward comparisons with the thin ideal. Engaging in soci al comparisons with attractive, thin women on television shows only seemed to exacerbate their level of body dissatisfaction and diminish their ability to decode messages in a way that challenged the dominant ideology. Women who admire celebrities or who try to emulate them may place more importance on reducing the discrepancy in body sh ape and size between their own body and that of a celebrity (Hofschire & Greenberg, 2002). Furthermore, a wo mans desire to imitate a media personality can affect the likelihood of he r self-esteem plummeting (Hofsc hire & Greenberg, 2002), which in the case of this study, may trigger a relaps e into anorexic thought patterns or behavior. Of all the women in this study, Rylie indicate d the most body dissatisf action: I hate my body. I hate my weight. I hate the way I look. In her media journal, Rylie wrote about her comparison to Katie Couric on the Today Show She perceived herself to be heavier than Couric, so she felt even worse about herself when Couric made references to her need to lose weight. Rylie: Thursday, July 7, 2005 @ 8:30 a.m. Today Show My dorm room Watching news, eating breakfast, getting dressed. All I can think of is how I want to lose weight. Im getting dressed and I havent looked in the mirro r in over a year. I can see that Ive gained weight. The Today Show interests me, but watching Katie Couric makes me feel even worse about myself because shes so pretty and has such a nice body. I remember this one time that she was with someone talking about food and she was saying that she needed to lose weight. That made me angry, because she has such a nice, petite body.

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270 Fear of Fat I learned that no m atter what anyone says, it really doesnt count if youre smart, kind, funny, sweet, generous, or caring, because if you also happen to be heavy, you may find yourself on the receiving end of more cruelty than you ever knew existed. (Goodman, pp. ix-x, 1995) From an early age, females receive the message that thin is good, and fat is bad. The media perpetuate the idea that being h eavy is not socially acceptable to the extent that weightism has become socially acceptable in American cult ure (Bordo, 1993; Maine, 2000). Several feminist scholars have explored the penalties associated with failure of women to achieve a body within the acceptable realm of the ideal. Research ha s indicated that women who are overweight are discriminated against socially and professionally (Bordo, 1993; MacInnis, 1993; Maine, 2000; Seid, 1994). The results of this study indica te that fear of social rejecti on or professional penalization is at the heart of the most significant challenge wo men in recovery from anorexia faceletting go of the need to adhere to the thin ideal, wh ile accepting and honoring their body at its natural shape and size. Emmas comments capture the type of thinking that hindered the participants ability to accept their bo dies and let go of their fear of b ecoming fat: I have always known that the ideal body type as portrayed in the media is not fat. Fat was the worst thing you could be, according to the media. I knew that then, and I know that now. Weight-based judgments in American culture are often based on values of restraint, selfdenial and self-control (Freedman, 1986; G oodman, 1995; Grogan, 1999; M acInnis, 1993). Thus, an overweight woman indicates her violation of such values, and she often is the victim of societal rejection (Seid, 1994). Freedman (1986) ha s attributed responsibility to the media for promoting the idea that everyone can achieve the th in ideal with enough re straint. Consequently, anyone who is overweight is lazy and unable to exercise self-restra int over her appetite

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271 (Freedman, 1986). For example, Emma described why she was afraid of gaining weight: My body would be a signal to the world that I ha d lost control and that terrifies me. Conversely, a woman with a thin, toned body se nds the message that she cares for herself and has the correct attitude re garding self-control. Because th inness is valued in society, a slender woman is the recipient of favorable judgments and is perceived to be successful, competent, and in control (Bordo, 1993). Furthermor e, several researchers have contended that thinness is associated with morality and virtue (Bordo, 1993; Franzoi & Herzog, 1987), and Joy and Venkatesh (1994) have identified a prevalent moral principle in which the person with an aesthetic outer body (with a good shape and appear ance) is the moral e quivalent of a good person (p. 349). As discussed in Chapter 2, one of the persona lity characteristics that make women more prone to developing anorexia is the need to pleas e people and make others think highly of them. Furthermore, this type of personality is extremel y concerned with not bei ng disliked or rejected (Bruch, 1973; Hall, 1993; Kolodny, 2004). Research has indicated that while women may be able to recover fully from anorexia, the personality characteristics that contributed to the development of their eating disorder are not likely to vanish (Richards et al., 2000). As di scussed previously, many of the women in this study still were working on resolving body image issu es, and several participants indicated that one of the primary obstacles they faced was the fear of becoming fat. For example, Emma described the need she had to prevent her body from becoming obtrusive. Emma: Body image is huge. I still see myself as extremely overweight. I feel too big, that I take up too much space. I feel very disconne cted with my body. I feel like a big person. I feel like my energy goes over the bou ndaries that were demarcated for me. I feel like life is this big coloring book and everything I touch goes outside the lines.

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272 Although Emma had strong oppositional opinion s informed by feminism, she still was influenced by pervasive messages about what cons titutes femininity: I think of feminine or a good woman as being sma ll and not taking up space. When someone is heavyset (in real life or in the media) typically she is punished by not being treated equally or ni cely, or by being ignored or co mpletely disregarded (Bordo, 1993; Fouts & Burggraff, 1999, 2000). Femi nist theorist have contended that the media perpetuate the prejudicial myth that fat is synonymous with lazy, stupid, and ugly (MacInnis, 1993). Many of the participants in this study ha d strongly internalized this myt h, which hindered their recovery process and impeded their ability to engage in more oppositional readings of the mediated ideal. Christinas comments illustrate how powerful the media can be in transmitting sociocultural norms. Many of the wome n in this study had difficulty not consenting to the thin ideal because they were fearful of the negative stereo types associated with the term fat. Christina discussed why overweight people were one of her triggers. Christina: Im afraid Im gonna look like them. Thats a horrible thing to say, but when I see someone whos overweight, Im like, Oh my God I dont ever want to look like that. I cant imagine if I did. Its really bad. Yeah, people who are very overweight are triggers. To me, being overweight is having no self-d iscipline, no self-control. Being sloppy and lazy. (She laughs.) Ahhhhh! I cant be lieve I said that! But thats the truth for me. If I gain weight, I totally feel like Ive been lazy, and I have no self-discipline, and thats just horrible to me. To me, its kind of like failing a test. Its like I di dnt even study. I dont care. I dont care about my body. I dont care about myself Many of the participants in th is study had strongly interna lized the socially constructed stereotypes associated with fat. As Ch ristina said, I associate ugliness with fat I think that if I was fat, I would be ugly, lazy, sloppy. Christin a described what had influenced her perceptions. Christina: The media (She says immediately and la ughs.) Cause most people are thin and beautiful on TV and in the ads when I read ma gazines. The women in them seemed to be in this place where they are just like so happy Oh, look, theyre just on display and theyre beautiful. I think Ive just been so brainwashed with it over the years.

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273 The current socio-cultural ideal reflects one of beauty, dominated by a Western value of thinness. As Brown and Jasper (1993) have argue d that Policing and c ontrolling appearance becomes an imperative for achieving both inner sa tisfaction and social su ccess (p. 19). Several of the women in this study s till had a strong connection in th eir minds between weight and success. For instance, Christina described her perception of over weight people as unsuccessful. Christina: Overweight people, I think, just sit a lot, because I guess just the weight would just be very difficult for them to move around. Im always very busy. I love to feel like Im busy. I like being productive and competent. Accomp lishing things. I feel like its like being successful. So if I was big. Like, if I wa s obese and really overweight, I would not be doing anything. Id just lay around and not get anywhere in life. Id be a total failure. Thats my biggest fear. No, my biggest fear is being overweight. But my second biggest fear is being a failure in life. Becau se I just want to be successful. Christina no longer allowed herself to r ead womens magazines because she knew that they were triggers for her. She would engage in social comparisons with the models, and inevitably, she would feel worse about her body. During her interview, Christina discussed why she admired the models in magazine ads: The women seem very confident. Very self-assured like, they know what they want. They are beautiful, and I see them as successful and sophisticated. As Malson (1994) has argued, The construction of fat-as-ugly and thin-as-beauty is so dominant and normalized that it often appears to be an unquesti onable prescription of some law of natural aesthetics; that fat is ugly and thin is beautiful. Overall, Christina had almost a textbook example of a dominant reading of the thin ideal. After years of exposure to womens magazines, she truly had absorbed the Western social construction of beauty and success as defined by the thin ideal.

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274 Similarly, Enchantment still subscribed to the notion that it was shameful to be fat. During her interview, Enchantment descri bed her perception of the mentality of someone with anorexia in recovery, They just have a different mindset, and its in there forever. Social learning theory generally has been credited to Bandura (1977), though Piaget (1954) also contributed to the development of this theo ry. This theory suggests that people learn through observation about gender roles, appearance, a nd the requirements for social acceptance and success in Western society. Severa l sub-concepts are part of this theory, including modeling (behavior viewed on television) and vicarious reinforcement or punishment. For example, we learn, either directly or indire ctly, what the social consequen ces are for certain behaviors (and appearances). Some people may learn that bei ng overweight is not accep table directly because they were overweight and were teased by their p eers. Others learn that being overweight is not socially acceptable through the pervasiveness of the thin ideal, and the lack of female images with average or overw eight bodies (Bordo, 1993). For the most part, the struggle boils down to a fear of being rejected as a person, not being loved or socially accepted. For example, Christina described why it was important to her to have an acceptable body. Christina: I was made fun of a lot when I was younge r. So Im always like trying to fit in. I want to be the most popular, the most beautif ul. Thats what I really want to be. And I know thats not good. I shouldnt do that, but still ther es a really strong part of me that wants to fit in. I want to fit in with everybody. The womens struggle with a fear of fat seems to be rooted in a desi re for social survival. Their fear was not unfounded, but rather based on a context in which they fear the social consequences of not conforming to the appearan ce standards set for women that have been ingrained in their minds for years.

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275 The participants no longer believed th at thinness would grant them happiness and popularity, but they still had a fear of becoming fa t. This cultural and media-induced notion is evident by the increasing numbers of television s hows in which people liter ally are accepted or rejected based on their weight. Barbara was from Germany, so she was fam iliar with television s hows broadcast there. During her interview, she discussed Germany s Next Topmodel (GNTM), a German reality television show with about 12 contestants who compete for the GNTM title as well as a modeling contract with the IMG talent agency in hopes of getting a start in the modeling industry. The show is based on the concept of Ty ra Banks Americas Next Top Model, and is hosted by Heidi Klum, who also serves as the executive producer and one of the judges on the show. During her interview, Barbara described the show. Barbara: Its kind of like American Idol. They compete for this title, and every time, one contestant has to go. One of them doesnt make it to the next round. They have to introduce themselves, and they ha ve to put themselves in a dr ess and in a bathing suit, and then they get measured. Barbara also discussed how some of the j udges could be really harsh on the contestants about their weight. She also shar ed Heidi Klums explanation of why the judges were so harsh, and in doing so, she explained what she perceived to be the ideal female clothing size portrayed in the media. Barbara: They told this one girl, whos like 100 something pounds, that shes too fat And shes really tall too. And sh e asked the question, Do you really think Im too fat? And the one judge said, You see that sign in the bac kground Germanys next top model? For that title, youre too fat But then, the girl who does the show [Heidi Klum], she explained later that on fashion shows, ev erything is like a certain size. And when you get there as the model, you have to fit in t hose clothes. Otherwise, you know, youre too big. So probably the size that they see as ideal probably size 2 or 4. Barbara was aware of the pressu re to attain the th in ideal, but she no longer succumbed to it. She was able to have an oppositional reading because she distinguished between what her

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276 ideal was and what the ideal was for models. Wh ile the ideal for models was extremely limited, Barbara did not care because she was not interest ing in a modeling career. She was able to see the portrayal of the ideal in the fashion industry for what it was, extremely narrow. Women in this study worked hard to resist cultural messages about womens bodies, such as messages that define what beauty is, and how women need to alter their bodies to become attractive. However, there were some participan ts who still had primarily dominant readings, and they were more sensitive to shows that lite rally rejected women based on their appearance. During her interview, Enchantment described a Ho ward Stern show that reinforced fears she already had. Enchantment: One night I came downstairs and Howard Stern was on. And his shows are kind of weird. But the day that I came down, it was really outrageous. Like they had this girl on there, and she looked okay. She was pretty, and she was thin. She was on there because she wanted to be a model for Playboy, and she was asking them what kind of plastic surgery she needed. And there was all these guys just critiquing her. And she said, I think I probably need to lik e liposuction my stomach. A nd they were like, Yeah you need a little bit of that. A nd then she says, I think I probably need a boob job. And they were like, Yeah. And then she was like, I th ink thats about it. And then one of the guys comes up, and hes like, You need liposuction in your thighs too. And shes like, What? And she looked like she was about to cry or so mething. And then he starts like pinching this like little sliver of like fat or skin like on her thigh. And shes like all upset. And I was thinking, Thats probably why pe ople get eating disorders becaus e of that. I mean like if someone did that to me, Id just be really upset. During her interview, Rylies comments appear ed to be oppositional in nature. However, her overall discourse indicated that she still subs cribed to the thin ideal. She was extremely unhappy with her weight because she felt that her body did not meet the standard of the ideal. Her desire to be thin may be better understood in the context of her pe rception of the media. Rylie: If youre not thin, youre not gonna make it in Hollywood. Theyll point you out in magazines, how ugly you look. And especially now during the summer they have you in your bathing suit. They caught you on camera, they saw your bad spots, your cellulite. Theyll sit there and take pictures of stars with like, Guess whos body this is? And then theyll circle cellulite on their legs and how theyve gotten fatter and stuff like that.

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277 Several feminist theorists have contended th at body ideals are relate d to womens social position. As Brown and Jasper have suggested, The body is an instrument of communication which mediates social life (p. 20). Some of the women in this study still had ne gative feelings and at titudes about having a larger than socially accepted body size. As Ga rrett (2004) has contende d, there is a social hierarchy of the body, a perception reflected in Western discourse and in the widely circulated media imagery. At some level, the women in this study recognized that body size affected how a person is valued and treated. In order to have more oppositional readings of the thin ideal, the women in this study had to work on reducing their fear of fat. For exampl e, Nicole said described what motivated her to stay in recovery and trust her body to be at a natural weight: I just I dont want to miss out on things anymore. I dont want to keep living in this fearful life, fearing that Im going to get fat. Still Value the Thin Ideal As discussed previously, it was extremely impor tant for the women in this study to reduce the internalization of the thin ideal. Those who di d not do so faced a significant obstacle in their recovery process. These particip ants also tended to have the most dominant or negotiated readings. For example, Jane shared her current perception of the mediated ideal: I think the medias portrayal of the ideal body image is a very thin bony woman. In the prime of my eating disorder I truly believed this looked good. Now I just envy it in some ways. Several of these women still strong desired the thin ideal, bu t did not allow themselves to engage in unhealthy weight loss behaviors to ach ieve it. For instance Rylie still wanted to look like the models in magazines: Yes, I probably w ould give a lot to look like them on most days. (She laughs.) But I dont act on it. Similarly, Ed a described how still wanted to look like models in fashion magazines, but she acknowledged that starvation was not a reasonable solution.

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278 Eda: I will never have the body I want. The body I want is 18, 6 feet tall and willowy. And I have come to terms with the fact that I will never have an 18-year-old body. Well, also the age part. I always wanted the anorexia back but couldnt really star ve. I always want to be very thin. I just dont act on it. During her interview, Jane said that she no longer had any food issues. However, Jane still had a strong desire for the thin ideal, which negatively affected her body image. Jane: I really eat what I want and dont have scary foods. Body image is a different story. I dont act on my feelings, but I defini tely hate the way I look, and I hate my body. I dont know if this will ever change, but I gue ss if I dont act on it, it wont kill me. Despite valuing the thin ideal and having ne gative thoughts about her body, Jane no longer engaged in any weight loss behaviors. However, unlike most of the participants, Jane still subscribed to several magazines, including Fitness Allure, and Self The continuous exposure to extremely thin models seemed to be detrim ental to her body satisfaction. She described her perception of the magazines and how they made her feel. Jane: Allure and Self theyre all the same type. Theyre like Cosmo just the same type of thing. Allure is like Self Theyre all womens magazines that have all the beauty and the super thin models and all that lovely stuff. You look at it, and youre like, Okay, thanks! (sarcastic and laughing). F lip through, Oh good! Another one! Thinness is rewarded The participants discourse supported the notion that beaut y, as defined by thinness for women, is rewarded (Orbach, 1983). All of the partic ipants in this study had felt a sense of pride and accomplishment in the initial stages of their ea ting disorder, when they still felt a sense of control. For example, Noah described how she had seen her attainment of the thin ideal as an important achievement: I really was getting very very thin. I kept weighing myself, and I was very proud of how small I was getting. Western society values thinness, and there was no shortage of compliments when the participants initially started losing weight. As Jord an said, I just got all of this really positive attention. A key part of social learning theory is incentives, which refers to refer to the social

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279 rewards that people gain by learning what is socially acceptable. For example, when a woman loses weight (in real life or in the media), typically sh e is praised. Diamond described how initial compliments had affected her. Diamond: In the 7th grade, I got mono and I just loved it because I lost so much weight. (She laughs.) And everyone was like, Oh, you look so skinny! And so, I would notice that I was starving myself and also using diet pills for energy and to curb my appetite. D: What do you think ini tiated the diet pills? Diamond: Television commercials. Cause I always remember seeing Dexatrim and Acutrim, like I always saw those commercials. Some of the participants still craved the at tention and sense of being special that they associated with being thin. They had come to associate a thin body w ith being special. For instance, Isabel was in the early stages of recovery, and she still had a strong desire to be thin, though she did not engage in eating disorder behavi ors. Isabel reacted to a story she had seen on E! about Mary-Kate Olsen when she was diagnosed with anorexia: Isabel: Part of me still wants to be like that. So its like, food for the monster. The biggest thing for me is I see things like that in the media, a nd some of my automatic, immediate thoughts are, Theyre getting attention for that Theyre special. And there were a lot of needs that didnt get met while I was growing up. And still its really hard to meet those, and so its like, Yeah, if I could just be this way now, maybe someone will love me type of thing. But of course, logically I know its not gonna work. But the drive and the need for that is still strong. One evening Isabel watched a movie, The Sisterhood of the Traveling Pants and in her media journal, she wrote, I gotta be thin! Du ring her interview, Isabel explained her initial reaction to the movie. Isabel: Three of them were really small And they all seemed to be special somehow. They were young, and they were skinny, well except for one person. And they wore small jeans. They have friends. Cause I dont have any frie nds. It all gets kind of gelled into this shortened thought of, Ive gotta be thin. When really it means a whole lot more. Isabels comments in her interview combined with her media journal entries illustrate how lonely she was for attention and love. The only time Isabel had felt special was when she was

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280 anorexic, so she still had a strong, positive associa tion with thinness. This perception served as an obstacle in her recovery process, and pr ohibited her from engaging in more oppositional decoding. Missing the identity of thinness Many of the participants described how they we re attached to the identity of being a thin person, and it was challenging to let go of this self -perception. The women in this study had positive associations with being thin, and they found some value in this asp ect of their identity. For example, Grace discussed how her parent s influenced her perception of how she should look: I think they made it very clear that it was not okay for me to be fat and that I was expected to be small. Several of the participants in this study discussed how they had learned that being thin was one of their defining and valuable characteristic s. For example, Amanda described why she had been attached to a thin identity. Amanda: When I was little my, everyone would be like, Oh youre so skinny. And I just thought I would grow up and be a skinny person. I just always thought I had to be thin. And my mom liked me that way, an d I just had to be that way. Over time, Amanda had learned to disengage herself from her identity as a skinny person. For participants who still linked their identity to the size of their body however, exposure to imagery of the mediated ideal reinforced their desire to remain thin. Sense of competition and jealousy The notion of competition is infused in media, as part of a capitalist society. The participants ability to engage in oppositional re ading of the mediated thin ideal depended, to some extent, on the degree of their lingering comp etitive nature, particularly with regard to appearance and adherence to the thin ideal.

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281 One of the characteristics of women with anorexia is comp etitiveness (Burckle et al., 1999), and the participants in this study were no exception. Several researchers have found that women who compare their body to other womens ar e more likely to experience anxiety and body dissatisfaction (Heinberg & Thompson, 1992; Striegel-Moore et al., 1986). In fact, most eating treatment centers and support groups do not allow women in recovery to discuss any numbers relating to their body (such as weight or clothing size). In order to progress in their recovery process, the participants truly had to let go of their belief that less is better. Several participants discussed how seeing ce lebrities or other people in the media lose weight was a trigger for them. Fo r example, Emma said, Watching Celebrity Fit Club made me jealous, like I want to lose we ight, too! Why can they do it an d not me? Christinas comments further illustrate how seeing the societal value of weight loss reinforced in the media were a trigger for some participants. Christina: People saying that theyv e lost weight. That is a big thing. Oh my God! Theyre losing it. (deep breat h in) How DARE they! Like, I should be. Ive got to be thinner than them. I should start losing weight. I should diet. Thats a big thing too. People saying that theyre on a diet or that theyve lost such and such enough weight. Im like (big breath) No, no no! They can not be skinnier than me. They lost weight. Oh, no no no. I have to lose weight too. Cause I had this thing back when I had the anorexia that I am the ultimate weight loser. I am the best at losing we ight. I can lose it (s he snaps her fingers) just like that. In her media journal, Jane reacted to fa shion magazines she saw in the grocery store checkout line: All those actresses/ce lebrities are so rich, thin & b eautiful. Its not fair. Along the same lines, Diamond said, Sometimes I do like get really jealous of some of the women in the magazines, or even on TV, like on E! Theyre so thin. I do really get jealous when I see how pretty everyone is. Diamonds negotiated readings about dieting messages also may be attributed to her tendency to engage in upward, universalistic co mparisons. Despite her level of media literacy,

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282 she still compared herself to women on television who reflect the mediated thin ideal, and this weakened her resistance to dieting messages in magazines. In one of Diamonds journal entries, she was browsing through a magazine in her office at the campus recreational center, and she wrote: Diets to lose wei ght made me feel I need to lose. During the interview, she discussed he r reaction to the magazi ne in further detail. Diamond: It was Shape They had all these diet plans a nd stuff on what healthy foods are. And I dont eat like that, so I was like, Oh maybe I need to start eating better. I need to lose some weight. Yeah, thats why I still have problems reading magazines. (She laughs.) And E! Body dissatisfaction Women in this study who had gained what th ey perceived to be too much weight had increased body dissatisfaction and less oppositional readings. Many of the pa rticipants found that they were triggered by the way their clothing fit or made them look, not necessarily by the clothing size, which is discussed in a later section of this chapte r. For example, Sarah described one of her triggers: On certain days, my clothes might fit great, and then if they feel tight the next day, that can be a trigger whether or not my bodys actually changed. Enchantment: A lot of times, Ill just look in the mi rror and think, I look fat in this. Or Ill start picking on part of my body, Well th is makes my stomach poke out. Or This makes my legs look big. And Ill start obses sing over it, and then I have to change. Typically the women in this study were aw are of their triggers, and they had coping mechanisms in place to prevent them from e ngaging in unhealthy behaviors. As Emma said, One of my first res ponses is not to eat. I rarely fo llow through on that impulse though. Enchantment described what helped her on days when she was struggling with her body image. Enchantment: I usually just think about my health, and Ill be like, W ell I need to be healthy. Ill think of it that way. Ill try to th ink of it more as doing something good for my body rather than doing something good for my eyes, looking at my body. (We laugh.)

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283 In a Foucauldian feminist analysis, Bart ky (1988) contended that the production of feminine docile bodies requires women to pay co ercive attention to specific details of the body (p. 72). Furthermore, Bartky (1988) and Bordo (1993) have argued that when women direct their attention to the creation of a uniform feminine body shape, they become restrained under relentless surveillance. Several participants also described how focusing on fau lts with specific body parts typically served as a trigger. For example, Ver onica still had a vision of what an acceptable body should look like, and this affected her body satisfaction. Veronica: I hate my thighs a lot. I have hips, and I have thighs. And thats just the way Im built, and I cant fight nature, but I cant stand it. And Ive even had comments at work like theres gotta be black people in my fa mily because of the way Im built. And Im like, Should I take that personally? And th eyre like, No, no no. It s a good thing. And Im like, Okay. And I guess, that pa rt about me Im just not okay with. Prevalence of thin ideal Harrison and Cantor (1997) have noted tw o key points of social learning theory prevalence and incentive. Prevalence points to the pervasiveness of the thin ideal in the media. We learn from multiple sources that being thin is valuable and good, and that being heavy is bad and undesirable. This message is unavoidable. Ha rrison and Cantor (1997) have contended that repeated exposure to the thin ideal promotes notions that women come to accept as the social standards over time. Abigail described how the me dia perpetuate acceptance of the thin ideal. Abigail: I dont think my perception s changed. I think societys changed to accept what the media put out. I mean because youd see these models in these magazines, and thats all youd heard on the news and stuff Theyre too thin! Theyre too thin! And now you dont hear anything about it. Everybody just accepts it. The women all expressed how challenging it wa s to resist messages about the thin ideal that permeate our culture and are often inescapab le. As Jamie said, Too thin is what you see

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284 everywhere in commercials and womens magazine s. I circumvent most media input deliberately and conscientiously, but I still notice a nd unconsciously take in the messages. The participants were aware of the power of the media to create and reinforce the thinness ideology, and most of the women took various steps to reduce exposure to such messages in their everyday life. However, many of the women in this study discussed how it was nearly impossible to escape media imagery exemplifying the thin ideal. Noah had learned that womens magazines were a trigger for her, so in general, she chose not to read them. When I interviewed Noah, sh e was in town for a wedding, and she had been spending time with several female friends. Duri ng her interview, Noah discussed how she had been shopping with her friends, and she brow sed through a magazine in a checkout line. Noah: I definitely still think about weight, especially when I see magazines, even just in the grocery store or something. Like, I can say at an intellectual level all these nice cognitions that will help me get through it. Like, Why do people love me? Its not, whether Im thin. When I get into a wedding dress, what are they gonna be looking at? Theyre gonna be looking at my smile. Am I ha ppy? Is this the right union? That kind of thing. But I still struggle with Id like to be 10-15 pounds thinner. Noah discussed how she found it hard not to le t the images of the thin ideal bother her. Typically she avoided fashion and beauty magazine s. She did not subscribe to any, and she never purchased them, but she still found hersel f drawn to them in waiting rooms. Noah: Those messages still affect me. I mea n, I think its impossible for them not to. I think its very hard to escape it. I would have to do a much better job avoi ding television and avoiding magazines. And Ill still catch myself. I went to the doctor with my friend whos here [for the wedding] for her OBGYN vis it. Shes pregnant. And I was just in the waiting room, and what do I pick up? Ya know, all these kind of trash magazines. And I went with another friend to get her hair done. And I was in the salon, just sitting there. And I picked up InStyle. And I flipped through, a nd I remember thinking, I hate this. And you cant help but suddenly. Or I mean, I cant help, not to generalize. But its hard not to look at it or to let it go.

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285 Socialization process For several participants, it was frustrating to see how easily they c ould get sucked into caring about what they now perceived to be supe rficial concerns related to appearance. When I interviewed Noah, she had just completed her Ph.D. in Psychology, and one of the courses she taught was Psychology of Women. She considered hers elf to be a feminist, yet she realized that feminism did not innoculate her from the appear ance-focused culture in which she had grown up. Noah: I think that it was really hard when I was teaching psych of women, because I thought, here I am trying to teach women about these things, and yet, I had to forgive myself and say, Ive been socialized the same way these women have. And if I have hangups still, and if I catch myself thinking about something or caring about something superficial, I have to forgive myself and say, Ya know, just because you understand it at an intellectual level doesnt mean you werent socialized exactly the same way (said in high tone, sarcastic) to give a crap about these things. I interviewed Noah in a hotel room in States boro, Georgia. She was in town for a friends wedding, and her media exposure was a little differe nt than usual. Noah described the conflict she felt between her mental percep tion of herself as feminist and her emotional reaction to media messages about ideal female beauty. Noah: All the magazines are covered with how thin Nicole Richie is now. And so, that has been something that Ive seen. And I kind of just get mad at myself when I even care about that sort of thing. Or Entertainmen t Weekly whatever that show is. Entertainment Tonight ? Something was on the TV in the hotel room. And Im like, Lets turn this off cause you can just get captured by it. And I dont like when I do that. Like, get caught up in how Jessica Simpson looks or somethi ng. Im around women who taught psych. of women who consider themselves feminists. And ye t, its like I watch all of this and can get caught up in that. Or end up making comme nts about your thighs or whatever. Noah explained how cognitive strategies we re not sufficient enough to counter years of pervasive cultural conditioning about the female beauty ideal. Noah described the type of place she would need to be born in order to not value the thin ideal. Noah: Somewhere away from television where they id ealize something else. I guess in some other cultures, you idealize some sort of beauty, but its not always thinness. You certainly have many cultures that that seem to associate thinness with sickness cultures where sickness is a big part of their lives. Li ke, if you were thin, you gotta be poor. I know

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286 with Eskimos that was the one thing I learne d when I was a kid. I remember learning that was a sign that you werent providing enough for your wife. I she was thin it looked like you werent being a very good provider. And the plump wives were very proud. Ya know, Look at her. Ive fed her well (We laugh.) Wouldnt that be a switch. Thin indicates femininity Several feminist scholars have contended that smallness is an indicat or of femininity, and that this aesthetic value encourages women to regulate their bodies (Bordo, 1993; Malson, 1994; Wolf, 1991). Thinness signifies a delicate fragile petite femini nityThe thin woman is not only beautiful; her smallness again metaphorically signifies that she is petitedainty, fragile and delicate (p. 109). As Noah said, I think the media infiltrate this idea that to be feminine and pretty, we need to be very, very petite, very small. Many of the women in this study preferred to have a feminine appearance, and they still subscribed to the notion that a small, docile body represented femininity. For example, Eda said, I always like being a smaller size, like the pretty girls in the magazines. As Malson has suggested, the mediated ideal is firmly embedded within a romantic cultural narrative in which the beautiful women ge ts a perfect life and live s happily ever after (p. 106). Jordan described why she preferred having a small body: All my boyfriends have always been I just am drawn to the bigger guys And I remember feeling cuter being smaller, like in their arms or next to them. And I really did like it. Participants who had a desire to adhere to the conventional vision of femininity typically engaged in more self-protective opposition readings. Fo r instance, despite knowing that her focus should not be on her appearance, Grace still wanted to be small. Grace: Monday 10 a.m. Television Gilmore Girls, Full House Bedroom and Living Room with my roommates eating and talking not really paying attention Wow, I wish I was small like Rorie SIGH. Doesnt matter, Im healthy and strong.

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287 During her interview, Grace elaborated on her me dia journal entry. She said that one of her biggest challenges in recovery wa s getting used to not being so small. She also described her perceptions of her body. Grace: I tend to be more muscular built. And I would prefer to be more stringbeanish. And that just isnt how I am bu ilt. I have a strong, powerful body. And it isnt waiflike, like I want. D: What is it about being waif like thats app ealing to you? Grace: I think Id look cuter in my clothes. And Id feel more, which is probably media and how Ive been programmed, but I think Id feel, felt prettier when I was smaller. And I would dress cuter then than I will now. Wh ere its like, ehhhh (not worth it tone). I accept it, and Im very thankful that Im h ealthy and Im strong, but Im certainly not going to show it off. Hard to Avoid Diet Messages The participants discourse suggested that diet messages were virtually impossible to avoid. The women in this study discussed how diet messages permeated their everyday lives in a range of media including television, magazines, billboards, radio, and the Internet. They also saw weight loss messages in grocery stores, gas st ations, and bookstores. Their comments illustrated the inescapable nature of diet messages. The women in this study already had subscr ibed to the dominant cultural message of excessive thinness. Once in recovery, their goal was to resist messages promoting weight loss. This process was extremely difficult when me ssages about dieting and weight loss surround them on a daily basis, in the media and in their everyday personal interactions. Like many participants, Emma described how the prevalence of diet messages made her recovery process more challengi ng: Its hard to be in our cu lture where everyone talks about dieting and what not to eat. There are triggers everywhere. You turn on the television and theres a diet ad after diet ad. The women in this study needed self-protectiv e strategies to avoid engaging in weight loss behaviors. The most common strategy the particip ants used was avoiding magazines with diet

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288 ads. Nearly all of the participants avoided medi ated diet messages, but their reasons for doing so varied. The examples in this section are limited to the participants who avoided mediated diet messages as a self-protective mechanism. Several participants discussed how they chos e to avoid magazines th at might reinforce the thin ideal ideology they had been working so hard to fight agai nst. In the initial stages of recovery, the women became increasingly aware of the dangers of exposing themselves to diet messages. They had to restrict themselves from even browsing through any type of magazine that might reinforce the thin ideal that they we re fighting to un-internalize. Noah described why she avoided magazines that promoted weight loss: I can tell that I will start to care more. Ill start to think to myself, Maybe I should really start dieting more. Christina was in the early stages of rec overy, and she knew that magazines with diet messages in them could serve as a trigger for he r. She learned about di eting techniques from magazines, and because she still found the thin id eal appealing she had to force herself to abstain from any content in womens magazines: I do not go near any magazines. Magazines all have diets in them. Always. Overall, Christina tended to have a negotiated reading of media messages about the thin ideal. Her attitude about the value of thinne ss shifted between a dominant and a negotiated perspective, so to strengthen her resistance to the thin ideal, she n eeded to restrict her media diet. Nearly all of the pa rticipants discussed the unavoidab le exposure to diet messages in grocery store checkout lines. Chri stinas comments captu re the omnipresent nature of the weight loss industry, ironically enough right when people are paying for their groceries. She described how she dealt with the inescapable exposure to weight loss messages in magazines.

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289 Christina: In every single womens magazine, theres always something about losing weight or diet on the front. And I walk by th em in Wal-Mart all th e time, grocery stores. Theyre on both sides of you. Ill look at the front c overs. I wont take them out The inescapable nature of in sidious media messages promoti ng the thin ideal presented a challenge to participants who chose not to expos e themselves to diet messages. Many women in this study knew that diet messages might trigger unhealthy weight loss thoughts or behaviors, so they chose to restrict their media diet by mi nimizing exposure to weight loss messages. The Internet violated thei r restrictive diet by imposing weight loss ads on them without their permission. Several women expressed frustration or annoyance with unso licited diet ads they were exposed to when visiting Web sites or checking e-mail. Eliza consciously avoided television and ma instream womens magazines to reduce her internalization of the thin ideal. She expressed her frustration with the omni present nature of diet messages. Eliza: June 30 3:00 p.m. Im checking e-mail and notice a bunch of popup ads about diet. Online diets and weight loss miracle pills. Images and words are constantly flashing in our faces about this, like their purpose is to remind us that we arent good enough as is, and we should try this. Loose 10 pd s. [sic] in 1 week! Been there, done that. The only thing it did was make me hate myself more. Never enough. Viscous [sic] cycle. It seems the Internet is a source of in your face diet/media driven info. you cant avoid. I mean, I dont watch TV or read mags. for a reason, so why must I be bombarded online too? Eliza made an active effort to avoid intenti onally exposing herself to potentially triggering media messages. In a sense, the pop-up ads on th e Internet were an unavoidable invasion of her choice to consume a self-protective media diet. She described her preference for a recovery Web site, http://something-fishy.org/, whic h does not allow any ads on its site. Eliza: I see ads for dieting all the time. (She laughs ). All the time. In magazines or on the Internet all the time. All the time on the Internet, theyre everywhere Thats so annoying. Like youre trying to check your e-mail, a nd something pops up about the South Beach diet or whatever. I mean, its just annoying.

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290 No matter how vigilant they were in avoidi ng diet messages in the media, the women in this study still had to defend themselves from un welcome diet ads on the Internet. In her media journal, Rylie wrote about an intr usive diet ad that she was expos ed to while checking her e-mail. Her reading of the ad was dominan t with regard to her attitude, but to protect herself from the powerful temptation to engage in weight lo ss behaviors, she questioned the underlying assumption of the value of the thin ideal. Rylie: Friday, July 8, 2005 @ 8:30 a.m. Internet Checking email. [sic] There is a picture of a women, a before and after shot, showing how much weight she lost due to a diet. I always get so aggravated by these becau se all I can think is how I want to lose weight. I know diets are not th e right way to go, and yet thes e are so tempting. Also, I ask myself what was wrong with her before? Why is America so desperate to get thin? Whats wrong with a little weight on us? Research has indicated that the number of women with body image disturbances and eating disorders is on the rise. Research also has indicated that there is a normative discontent in terms of body image (Striegel-Moore et al., 1986). In other words, it is normal for a woman to express dissatisfaction with her body, and she is viewed as an a nomaly if she is happy with her body shape and size. Several research ers have referred to this as fat talk, especially common among college women (Weiner, 2003). Media messages seep into everyday lives The concept of dieting is so normative that even if the participants chose not to expose themselves to media messages about dieting, ot her people in their life were exposed, and they brought those messages into the womens lives. As Emma stated, In my everyday life, a few of my fellow classmates talk about diet ing a lot and that really bugs me. Eliza worked at a shoe store in the mall. In her media journal, she described how challenging it was for her to be around her boss, who consistently engaged in diet talk. Eliza: July 1 4:30 p.m. at work. I started work and am happy about it for the most part, but my boss, ___, is something else. She talks ab out dieting more than a lot of anorexics I

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291 used to know! I was in the back room filling out my paperwork, and she was talking to another employee about her diet and the girl, whos like 20 years old, mind you, was asking if the skirt showed her cellulite. Linda was like, yeah, so now Im just eating cereal, carrying around a container of Kashi Go Lean, asking everyone if they wanted some. Ive already lost like 30 pounds!" She wo nt shut up! Really nice lady, but for Gods sake, shes 40 yrs. old. Does anyone really care about her diet?This kind of environment is definitely the last thing I need. Healthy, balanced eating is extremely challengi ng when diet talk has become so ingrained into womens minds that they integrate it into everyday discussions. El izas comments indicate how broadly women have absorbed media perpet uated messages about the normalcy of dieting. Diets target women more than men Several researchers have found that diet ads are much more predominant in womens magazines than mens (Andersen & DiDomenico, 1992; Silverstein et al., 1986; Wiseman et al., 1992). Anderson and DiDomenico (1992) examined the ten most popular mens and womens magazines. Their findings revealed that women s magazines contained 10.5 times more dieting and weight loss ads and articles than the me ns magazines, the same sex-ratio reported by Andersen (1990) for eating disorders. Another study found the ratio of diet ads between womens and mens magazines to be 63:1 (Wiseman et al., 1992). Several participants noticed the disparity in the media messages sent to men and women. Enchantments focus on gender disparity served as a strategy for engaging in a self-protective oppositional reading. During her interview, Ench antment discussed her annoyance with diet messages of this nature targeting only women. Enchantment: I was walking out of the locker room, and there was a sign there that said Dont be a beached whale. And it was right on the edge of the womens locker room. And you know theres a scale in there and stu ff. It was kind of weird. And then I looked over like to the mens locker room where th ere would have been a poster too, and there wasnt one. I was like, Why, just women? It was annoying. Why is losing weight always targeted at girls?

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292 Christina noticed a distinct difference between the acceptable body size for men and women. She observed that men dont have same sta ndards as women to live up to, in terms of body size or overall attractiveness. As Wolf (1990) has contended, aesthetic values have regulated the female much more than the male body. The construct of femininity is regulated through standards of external phys ical perfection, equated with, and even defined by slimness. As Christina stated, When you watch these shows, it seems like the man can be this really big guy. The woman though is very thin and beautiful Weighing their Self-Worth One of the biggest obstacles women with anorexia struggle with is their weight. While many people, and perhaps women in particular, may struggle with their weight, for women with anorexia, the number on the scale becomes their so le focus, often serving as the most critical factor in their self-worth. As Ab igail said, I used to look at th e digital reading, and that number determined my mindset for the entire day. Most of the participants said that they had been obsessive about stepping on their scale when they were anorexic. For instance, Lulu de scribed how important her weight had been when she was in the midst of her eating disorder. Lulu: Every day, I got on that scale. Every da y. And when that number got lower, I had a little high. Like, todays gonna be a great day. Excellent! And if it was ever higher than the day before? It was a bad day. It was absolute insanity. As Maine (2000) has argued, To be more a female is expected to be weigh less (p. 21). These women had absorbed this no tion, and some particip ants still struggled with allowing their weight to affect their self perception. During her interview, Eliza described why she was not comfortable with her body image: The biggest problem for me is the scale and determining my worth on how much I weigh.

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293 Blind weights The women in this study indi cated that there is a need fo r increased awareness in the medical community of why some patients might pr efer not to know their weight, regardless of their body size. Nearly all of the pa rticipants in this study preferred to do what is referred to as a blind weight, in which a person turns around when being weighed at the doctors office to avoid being triggered by their weight. The participants comments point to the cha llenge women in recovery from anorexia face during any routine doctors appointm ent. Several of the participants said that they often felt embarrassed to request a blind weight because the medical practitioner inevitably would say something like, Why should you be worried? Youre so thin. A few of the participants expressed irritati on about how society reaffirms the importance of weight. Charlottes comments illustrate how employees in the medical profession inadvertently may reinforce the notion that the thin ideal is most acceptable for women. She discussed how doctors visits often were frustrating to her because they did not take her sensitivity to her weight seriously: I have to say, No. Im like, I dont want to know. Jamie told a story about one doctors visit when she requested a blind weight. When the nurse went to take her blood pressure, she asked Jamie, Are you okay with knowing this number? During her interview, Jamie explained why it was so important for her not to know how much she weighed. Jamie: I used to weight myself like 20 or 30 times a day, even when I hadnt eaten anything. Sometimes, if I drank a glass of water, and my number was over 100 or over 90 or whatever my magic target number was, Id purge the water. I know I wont do anything like that now, but I just have bad associations in my mind with the scale. And I wish that nurses and doctors would be more unders tanding not draw attention to it.

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294 Not focusing on the scale Jordan talked about how she learned not to let the scale become her main focus. She learned that a scale can serve a purpose, in term s of ensuring that she stayed within a healthy weight range, but that it was extremely important not to allow the number to provide her with a primary source of self-worth. Jordan: One good thing I do remember learning in counseling, was not to even think that, not to focus on the scale. I do have one in my bathroom. (She laughs.) But I dont obsess over the numbers, I use it just to kind of keep me in check cause if I gained twenty pounds a month, thats not healthy either. (We both laugh.) So yeah, I dont freak out like I used to when I see numbers. Jordans thoughts about the scal e while she was in recovery sta nd in stark contrast to those she had when she was severely anorexic. She ha d lost so much weight that her cognitive functioning was compromised, and she became somewhat paranoid. Jordan: I was always paranoid that I had a little bit of chub.I accused the people at the gym of having a broken scale for a week stra ight because I didnt believe the numbers when I saw it. I was like, There is no way that this is accurate. And I yelled at them and I was like, Yall need to fix this this is ridiculous! I have been coming here every single day for a week and this is so broken! And the guy trainer stepped on it, and he was like, No its not broken. Those who were most advanced in their recovery process, and who had the most oppositional readings did not weigh themselves anym ore, and they did not care what their weight was. These participants did not see their weig ht as a trigger because they no longer allowed weight to be a salient factor in their self-wor th. For example, Sunshell described how tossing her scale was an important part of her recovery proc ess because it allowed her to bid farewell to her eating disorder. In fact, part of Sunshells de finition of recovery was, Being happy with your body image. Having a well-rounded life with healt hy relationships and not measuring yourself by what you eat, the number of calories you consume, or how much you weigh.

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295 Now that the women were in recovery, they were more aware of how the media have contributed to their eating disorder. Several par ticipants noted that the media encourage women to equate their weight with their self-worth. Fo r example, Emma shared her perspective about the culturally constructed connection between weight and self-esteem. Emma: I really think that media equate th inness with goodness. Li ke you are not a good mother if you dont lose that baby weight right away. I hate it when the magazines publish the weights or dress sizes of celebrities. They also show th e incredibly thin people happy and overweight celebs as miserable. I think it all boils down to the media are just like everything else in our culture. As women, our self worth should be directly tied to how much we weight. Molly had the most outraged response with rega rd to this topic. As she said, Celebrities weights are something that stri kes a nerve with me. Molly no longer had a scale at home, and she did not have a need to do blind weights because she no longer allowed the number of her weight to define who she was as a person. Her oppositional response to the media serves as a stark contrast to the other participants previously di scussed in this section. Molly: They print these stories with the womens weight right there. Why ? I know that when I was sick, I would look through Cosmopolitan for women that I thought were thin and looked perfect. Theyd always have their we ight in there too! I didnt realize until I was better how much people let their weight defi ne their self-worth. It infuriates me that the media knowingly do this! I fell for it, and I know that people still do. Media-Influenced Meaning of Clothing Sizes In addition to their weight, the women in this study expressed how i m portant their clothing size was for them in terms of defining their self -worth and self-acceptance. This concept arose repeatedly in the interviews, to the extent that I eventually added a question to the discussion guide to get a sense of what an acceptable size was for the part icipants. What was interesting about the question was how the participants chose to answer it. I asked what clothing size would be unacceptable to them, and it was interesting to hear whether the partic ipants chose a number

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296 that was too high for them (would mean they were too heavy), one that was too low for them (would mean that they were b ecoming sick again), or both. Indicator of thin ideal For these women, clothing size was an indication of the attainment of the thin ideal. Nearly all of the participants had a clea r idea of a specific clothing size number that the media portray as ideal. Several participants disc ussed how the media encourage th e notion of social comparison by printing the weights and sizes of celebrities. The women also described how they thought that publishing celebrities sizes served as some indi cator that there is an acceptable number, or a concrete, universal measurement of what clothing size makes a woman attractive. Most participants thought the media portr aying the ideal size for women as a 00, 0 or possibly a 2 or 4. During the inte rviews, I asked the participants to describe what the media portray as the ideal body for females. However, several participants de fined the ideal body image in terms of clothing size, which reinforced the no tion that the participants perceived clothing size to be an indicator of the thin ideal. Sizes of models Several participants indicated that their per ception of the ideal clothing size was informed by the size of models. Lulu shared her perception of the medias portrayal of the ideal female body: I think they think everyone sh ould be a model, size 2 or 4. Lulu also discussed how unfortunate it is th at magazines seem to suggest that all women should strive to fit into the same clothing si ze that models wear: But thats what the media portray It seems like thats what most women are after too, which is sad in some respects. Similarly, Jordans comments suggest a view commonly held by the participants, that the media perpetuate the notion that there is an acceptabl e or ideal clothing size, one that often was extremely small.

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297 Jordan: The media portray oh God easily like 0s and 2s [as the ideal]. Like its so funny too cause theyll tell you what size th ese stars are, you know ? Totally perpetuating it. Like Eva Longoria: size 0. Y ou know, Marcia Cross, size 2 or 4 or whatever and youre like, Ug! But yeah. So I would say those ar e probably the most co mmon [sizes], anything below like a 4. Courtney defined the mediated idea l based on the sizes available in the Victorias Secret catalogues. Many of the women in this study perceive d the models in this catalog to represent the epitome of the thin ideal. Courtney: I would say like definitely no bigger than like a 3. Like I would say a lot of them are sizes 0 and 1. Yeah, because I mean, I know for one thing, like in the Victorias Secret catalogues that I get, their sizes go down to like a double extra small. (She laughs.) And they have double extra small and a size 0. D: Which ones lower? Courtney: Well extra, extra small is in their tops, and their pants they go down to a size 0. Their stuff runs a little big, so I could wear a size 0 in their stuff now. And Im just thinkin that if I can fit in a size 0 in those clothes, I dont th ink they [the models] would be over like a size 0 or a 1 or somethin. Sizes of celebrities Ramona viewed Jennifer Aniston to be a celebrity whose clothing size represented the thin ideal. Many of the participants had lingering no tions of what an acceptable size was. Ramons comments illustrate how the media informed her pe rception of a clothing size she should strive for by publishing celebrities clothing sizes. Ramona: I know that Jennifer Anistons a size 2. D: How do you know that? Ramona: I read it in a magazine once, and it was like, Ooh banana, 87 ca lories Jennifer Aniston, size 2. Ya know? (We laugh.) Its just one of those things you dont know where you read it or how it got st uck there, but its there. I remember when I was younger. I really thought that thats what a normal pers on should look like. And probably when my eating disorder started, I was like, Yeah! Thats totally what I need to look like. I remember consciously vowing to myself that I will never be above a size 3. Even in recovery, Ramona had trouble al lowing herself to accept a clothing size much higher than a 4. In contrast, Eda had an oppositio nal reading of clothing sizes the media deemed as acceptable for women. Eda described the ideal size that the media portray. Her comments

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298 suggest that the ideal size as portrayed by the media is not appropriate for a grown woman, that the number 0 indicates that there is no nu mber that fits in adult clothing sizes. Eda: 0 or 00. Look at Angelina Jolie or Paris Hilton or Nicole Ritchie or Nicole Kidman. D: I had never even heard of 00 until th ese interviews. What does that say? Eda: That you never grew up. Jordan described how media celebrities con tinued to define for her what an acceptable clothing size was, even when she was in recove ry. Because she engaged in a social comparison with television and movie celebritie s, the medias portrayal of attractive celebrities with small clothing sizes caused Jordan to experi ence conflicting thoughts and emotions. Jordan: You know, if I see someone on TV that I know used to rea lly like Graces character on Will and Grace sh e got really skinny. Julia Ro berts if you look at her old movies, she got really skinny. So Ill think, Julia Roberts used to be a size 8 like me, and then Im like, Well, she got down to a size 2, why cant I? Maybe its not so bad. Getting rid of skinny clothes Several participants described how important it was to get rid of th e skinny clothes they had worn when they were anorexic. Trashing th at clothing seemed to serve as a symbolic mechanism for bidding farewell to their anorexia and allowing themselves to live a healthy life, one that involved rejection of the dominant thin ideal. In Jordans initial stages of recovery, she hung on to clothing that she used to fit into when she was anorexic. Her discourse suggested that she still had a lingering desire for the thin ideal. However, as she progressed in her recovery process, Jordan realized that if she ever did fit into her old clothing, it would be an indicator that sh e was spiraling back into anorexia, which was not healthy. Jordan described the process she went through to accept and honor a clothing size that fit her natural body shape and size. She sh ared some challenges that she faced in her recovery process.

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299 Jordan: I got really depressed when I started going up in my jean sizes. (She laughs.) I was just so mad that I had to buy all these extr a clothes. I still held onto my old clothes for two years thinking, Well someday, maybe I can get back down to that size without starving or throwing up or overe xtending my body in exercise, and maybe I can try that in a healthy way. And then, I gave all those clothes away actually, last year with the hurricane [Katrina]. I was like, Here you go. Take these clothes. If I ever get that small again, then Ill know Ive probably gotten worse. Its not healthy. So that was really hard cause I held onto that idea for a while. I was like, Oh yeah you know, theres always later. So I finally just let go of that. Its so funny cause Im not even like a fashionista clothes really arent a big deal to me. But it was that whole visual way of seeing progress, I guess. That was hard to go up sizes with clothes. Jordans discourse regarding clothing sizes indicates that she had a negotia ted reading. She still was attached to the positive association she had with weight loss as a measure of success. Going down in clothing sizes when she was a norexic had been a tangible measure of her attainment of the thin ideal. Jordans desire to fit into small clothing sizes was tempered by the value she placed on her health. In this way, she was engaging in self-protective opposition. The participants indicated that clothing si ze was as much of an indicator of social acceptability as their weight. Emma described ho w much meaning clothing sizes had for her: My therapist told me once I could tear out the si zes and I felt like sayin g, I could tear pages out of the dictionary, too, but then it would lose all meaning. Based on recent alterations in how the clothi ng industry indicates sizes, it seems as though most women use clothing sizes as some indicator of self worththe smaller, the greater ones worth. Eliza discussed what she had learned a bout clothing sizes from her boyfriend, who was studying advertising. Eliza: A couple stores actually changed their sizing. So its like a 2 would really be a 4, or a 4 would really be a 6. So somebody that us ually wears a 10 would be an 8. And an 8 would be a 6. Just so they feel better about themselves. Not all participants found meaning in clot hing sizes. Like many participants, Sunshell learned not to place any value on the number of he r size because it varied so much, depending on

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300 the brand: I dont think much in terms of clothi ng sizes since one size is going to be a different size in a different store. The participants discourses indicated that they associated small clot hing sizes portrayed in the media with the attainment of the thin ideal. Th e extent to which the participants were able to resist the importance of a small clothing size va ried. Participants who were further along on the recovery continuum viewed extremely small clothing size as an indicatio n that they were not healthy. As Eliza stated, I mean you cant be healthy at a size 0. Theres no way. Sure theres some people with small bones, and theyre just naturally tiny, but a 0? I dont think so. Similarly, Emma described what she perceived to be an acceptable size for her, now that she was in recovery. She no longer had the desire to fit into the extremel y small sizes portrayed as ideal in the media: I would never want to be 0 again. Or size 2 for that matter. Perhaps even a size 4. It would mean that I was starving my body a nd hurting it, not letting it just naturally be. For some participants, fitting into clothing sizes above a 2 or 4 served as an indicator of their level of recovery. The partic ipants seemed to select this clothing size because thats what they saw as the ideal portrayed in the media, which they now perceived to be too thin. Clothing size and self-control The social construction of b eauty in American culture is embedded in a larger social system that values individual success and contro l, an ideology that has been extended to perceptions about weight. Womens bodies are ju dged based on their appearance and weight, and Western industrialized societies define thinne ss as the primary attribute for female beauty (Bordo, 1990). Furthermore, within the do minant cultural ideology of i ndividual success, a woman is believed to be responsible for he r weight (Bordo, 1990). In American culture, the mediated thin

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301 ideal has been associated with self-cont rol (Bordo, 1990, 1993; Chernin, 1981; Paxton & Sculthorpe, 1991). The female body is seen as something to be managed, and it is assumed that every individual has the capability of achieving the thin ideal, with enough self-control and restraint. Thus, a thin person is perceived to have made an active attempt to conform to the socially acceptable body norm. Conversely, some one who is not thin (or is fa t) is perceived to be lazy and out of control (Bordo, 1993; Ma ine, 2000). In this type of cultu re, extra weight, as indicated by an increased clothing size, is stigmatized. The women in this study recognized that the thin body connotes power, will, and mastery, which American culture values. Emmas comments illustrate how important clothi ng sizes were to the participants in this study. As Emma progressed in her recovery fr om anorexia, the clot hing size that she felt comfortable with became increasingly larger However, she had a clear limit on what she perceived as an acceptable size, one that she viewed as indicating to others that she had not completely let her body go. Emma described what clothing size would be unacceptable to her, one that she never would feel comfortable with. Emma: To be honest, if I got in to the sizes 14 and 16, I woul d feel like dying. It would mean that I had ballooned up and that is a fear of mine. I already feel like I have someone elses body. I cant imagine being heavier. My body would be a signal to the world that I had lost control and that terrifies me. D: What do you think causes your fear of ballooning up? Emma: I fear that my body, at its core, is uncon trollable. Perhaps me, at my core, is uncontrollable. If I eat, I wont st op and my body will swallow itself. Emmas discourse indicate the strongly em bedded association she had between what she perceived to be a large clothing size and her abil ity to rein her body size in, given sufficient self control. Many of the participan ts in this study expressed sim ilar notions. For example, Sarah described the associations sh e had with clothing sizes.

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302 Sarah: My mother was always concerned about her weight. I can just always remember her being on a diet. She just was constantly on a diet. Shes probably between a size 12 and a 14, and she was always constantly concerne d about her weight. And she was too heavy and this and that. Ya know, I just never Im just never gonna let myself get that big. I would never let myself get to the double dig its. Also, you never see them in the media, unless theyre on like plus-size models or something. Media define unacceptable sizes Several participants described how the media informed their concept of an acceptable clothing size. For example, Emmas perception of what constituted a size that warranted dieting was based on the television show The Facts of Life. Emma: I was driving down the road the other day and I suddenly remembered this Facts of Life memory. When I was around 8 or so, I watched a re-run of The Facts of Life The episode is when Sue Ann goes on a crash diet In the episode Mrs. Garrett talks about dieting because she is a size 14 or something. Being a size 14 or 16 whatever it was seemed like it was too big. So when I was 10 a nd had to get a size 12 or 14 bathing suit, I panicked because I was just as big as Mrs. Garrett was, and she had to go on a diet. Several participants also took issue with the medias definition of plus size. For instance, Eliza shared her perception. Eliza: I think the medias getting better about portraying women who are in clothing sizes larger than 2 or 4 because you see more plus size models. But I dont think they should refer to them as plus size becau se theyre like a 6! (sarcastic) Self-protective opposition strategies The media send powerful messages to women about failing to achieve weight loss or failing to fit into an acceptable clothing size. In the face of pervasive inescapable media messages, women in recovery from anor exia sometimes lose sight of their success in overcoming the eating disorder. They had to remain vigilant and consistently fight the omnipresent message of the value of a small body and the distorted message that b ody size is tied to self-worth. Women in this study who still strongly valued the thin ideal felt th e most conflicted about their current clothing size. They remembered the size they used to fit into when they were anorexic, and this number served as a benchmark for their self worth. Despite not taking actions

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303 to attain the thin ideal, thes e women still had an internalized concept of the size they should be, informed by their previous size, as well as the ideal size portrayed in the media. As a strategy for coping with their internal struggle, many of the par ticipants made a clear distinction between their recovered mind, and their lingering anorexic voice. Some of the women in this study even gave their anorexic voice a na me. Often the name was A na (for anorexia) or Ed (for eating disorder). In her media journal, Eliza described an intern al battle she had while at the mall. She consciously talked back to An a and reminded her that she did not have control over Elizas choices any more. Eliza: July 5 noon-12:30. Okay, this may seem really petty and stupid, which I am not, but today I went to the mall and felt myself brush wi th my former self when it came to finding sizes and trying clothes on. My former self, m eaning my anorexic self, comes out at times to make me feel shitty and inferior. Ana rears her nasty head as Im looking through the mediums on the sale rack at Gap. You should be wearing a small! she screams silently at me. I know that is totally ri diculous and Im ashamed of it, but God it was annoying. I couldnt shut it up, either. Then, Im looking at skirts and dresses thinking, damn, remember when I could fit in a size zero Aaaahhhh! Like I should be sad that I wear a six, sometimes even a fourthat voice drives me CRAZY. Theres a constant battle going on in my headmy negative mind vs. my recovered rational mind. When I do get something, I like to pull the tag off so I dont think about it. God, I fe el ridiculous even with this because it is just so silly and so pe tty, but I cant he lp it. I need to work on that. Size makes no difference and I cant base my worth on it. Dominant interpretation Not all women in this study had the arsenal to combat the negative thoughts they had about their bodies when they were exposed to medi a imagery. For example, Jane described some thoughts she had recently when perusing a fashion magazine. She still engaged in social comparisons, not only with the models, but with her former size when she was anorexic. Jane described how she felt about her body. Jane: I look back and remember when size 0 wa s too big, and I thought I was fat then. I must be gigantic now. Ive tried working on body imag e paperwork with my nutritionist and therapist over the years, but its always been too uncom fortable. I dont think I can even imagine being happy with myself and the way I look, especially when you see thin women all over the media. And they publish their sizes! How can I not compare?

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304 Focus on health permits resistant reading Not all the participants felt the need to stay within a certain size limitation. Several participants discussed how thei r health was their primary c oncern, and they only would be concerned about fitting into a spec ific size if that size also meant that they had health problems. Molly shared her perspective on clothing sizes. Molly: My health is the key fact or to me maintaining my health and respecting my body. So I dont really care what clothing size I would wear, as long as my body was still healthy. Now, if I was I dont know w earing a size 12 and my blood pressure was getting high, and my cholesterol was creepi ng up, then I would stop things where they were at. But it wouldnt be about the si ze or number, more about my health. Lulus comments illustrate how she came to accep t the clothing size that is right for her. She discussed how her perception of an ideal clothing size no l onger matched the size typically portrayed in the media. Lulu: My clothes fit. I like the size Im at. Sure, youve got size 0 and 2s out there in magazines all over the place. But you know what? Im not ever gonna be that. I dont want to be that. Thats too thin, and its not h ealthy. And thats not me So Im happy at a I guess Im an 8. I like clothes a little baggy. I dont like anything tight anyway. So 8 to 10 is perfect. And those are the clothes Ive worn since I can remember. Ya know, since the hospital. Desire for a Boyfriend One of the most interesting findings from this study was that the desire for a boyfriend seemed to impede the womens ability to un-internalize the thin ideal. For some women in this study, having a boyfriend was a top pr iority because they wanted to have an intimate relationship with someone. In addition, a couple women perceived a boyfriend to be an achievement of sorts, an indicator of their attractiveness and self-w orth. The women in this study who placed the attainment of a boyfriend as one of the top pr iorities in their lives tended to have more negotiated readings of the thin ideal, which t ypically caused a sense of internal conflict.

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305 Cash, Ancis, and Strachan (1997) found that women who endorsed more traditional gender roles in relationships were likely to internaliz e societal standards and also tended to focus on their physical appearance. According to Mals on (1998), One dominant meaning of feminine beauty/thinness is being heterosexually attrac tive, the object of a ma le desire (p. 106). Participants who were not curren tly in a relationship and who strongly desired a boyfriend were the most likely to engage in dominant or negotiated readings of media messages about appearance and the thin ideal. Christina provided a good example of a partic ipant in this study who had more traditional notions of gender roles, that a woman should be desired by a man. Christ inas comments during her interview reflect her consen t to this dominant ideology, whic h had a strong influence on how she decoded media messages about the female ideal She described what motivated her to remain in recovery. Christina: I want to have a life. I want to be su ccessful. I want to be normal. I want to have a boyfriend. Its hard for me to have a boyfriend, cause I have an eating disorder. Guys, a lot of guys I know, they dont lik e that. I feel like I need to be accepted with guys. I feel like give me some ki nd of attention that I cannot get anywhere else. Cause to me, its like intimate attention. I feel like Im de sirable when they pay attention to me or like me. I guess I want to be desired. Engaging in self-objectification Thomsen et al. (2002) have suggested that th e most important long-term effect of reading beauty and fashion magazines may be the internalization of traditional gender-role beliefs, particularly with regard to the perception that attr activeness, which is required to please a man, is defined by thinness. Christinas comments suggest that she subscribes to the traditional ge nder-role ideology. During our interview, she also described how much negative impact beauty and fashion

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306 magazines had on her in terms of contributing to the development and sustenance of her eating disorder. She engaged in self-protective oppos ition via avoidance of womens magazines. Christina: Those are the worst things, worse than TV. You know what?? In every single womens magazine, theres always something about losing weight. All these magazines. These gorgeous women. Great stomachs. I mean, gr eat chests. Its just the most triggering thing for me. I just, I do not go near any magazines. Christina may have avoided magazines while in recovery, but she st ill watched television and movies. One of her journal entr ies indicated that she still enga ged in social comparisons with Hollywood actresses. Christina was watching Waterworld one Friday evening, and the reaction she wrote was: This is a good movie. I havent s een it in awhile. The woman in it has a nice body. I wish I looked like that. Christina used television and movies as a resource for what males found attractive. During her interview, Christina discussed why she wanted to look like the actress in Waterworld. Christina: There was a woman, and she was wearing th is it was supposed to take place way in the future, and everything was covered in water. So she was just wearing this little brown dress. It showed her whole stomach. A nd it was kind of like a bikini top, with this stripe across her chest. And th en she had this little skirt. A nd she had a really nice figure. And the guy in it he liked her. And I just thought that she was very attrac tive. And I was like, Wow! She looks really nice I wish I looked like that. Throughout her interview, Chri stina indicated that she used media sources to determine what physical characteristics would make a guy like her. In doing so, she was essentially allowing males to determine whether or not her appearance was acceptable to them, rather than asking herself about the qualities she was seeking in a relationship. Several researchers have contended that the objectification that wo men encounter in both the media and in everyday life is a contributing factor to body image and eating disturbance (Hall 1984; Swim, Hyers, Cohen, & Ferguson, 2001). Furthermore, Fredrickson and Roberts (1997) have suggested that women respond to objec tification by engaging in self-objectification

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307 adopting an observers perspective of their ow n bodies and tying their self-worth to their physical appearance. When a womans self-worth relies on appearance, she comes to view her body as an object to be evaluate d (Fredrickson & Roberts, 1997). Christinas comments during her interview illu strate how she learned to engage in selfobjectification. Her desire to find a boyfriend was inextricably linked to her appearance, and she watched several programs on MTV to learn how he r body could become more attractive to guys. During her interview, she discussed how she enjoyed Room Raiders because it allowed her to learn what guys think is pretty. She also described how she enjoyed watching Maxims Hot 100 on VH1 to learn what society views as beautiful. Overall, Christina had a dominant readi ng of programs on MTV and VH1. Her comments indicated that her desire to at tract a boyfriend was more powerful than her ability to engage in self-protective opposition. In addition, Christina s had a minimal level of media literacy. Her knowledge of media influence seemed to be lim ited to what she learned about magazines from her therapist during her se nior year of college. Being concerned about mens expectations The literature has shown that there is a link between a womans perception of what males find attractive and her body image. Thompsen ( 2002) found that beauty and fashion magazine reading was linked to body shape concerns, but only indirectly via womens belief that men expect or prefer women to be thin. Other rese archers have found that a womans belief about mens expectations and preferences for thinness was the strongest predictor of concerns about body shape (Stice, Ziemba, Margol is, & Flick, 1996). In addition, research has suggested that internalization of media and cu ltural ideals is a criti cal mediating link between media exposure and eating disorder pathology (Cusumano & Th ompson, 1997; Stice, Nemeroff, & Shaw, 1996).

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308 Not only did the women in this study think the media reinforce the ideal body to women, but some participants also thought that the media taught men what to expect. As Harrison and Cantor (1997) have contended, Not only do the media reinforce ideals to women, but they can teach men what to expect. In her media journal, Christina discussed an e-mail pop-up ad that disturbed her. She did not seem to be comparing herself to the women in the ad as much as she was expressing concern that males might see it. She wrote about how she thought males might compare the models bodies to hers, which might make her feel inadequa te: Those Victorias Secret models are really thin. I wonder if guys can see it. Christina knew that the imagery was an unrea listic standard for her to try to achieve, but this did not prevent her from engaging in a compar ison to models that made her feel worse about her body. Her belief that men come to expect wo men to look like the medi ated ideal fueled her insecurity and caused her to feel like she would never measure up. Subscribing to codes of femininity for attracting (and keeping) males McRobbie (1978) has suggested that there ar e codes of femininity that shape the consent of the readers to a set of particular valu es (p. 2). One of these codes is the importance of a romantic, heterosexual relationship. Furthermore, according to Evans et al. (1991), Articles and advertisements mutually reinforced an unde rlying value that the ro ad to happiness is attracting males for a successful heterosexual life by way of physical beautification (p. 110). One of the codes of femininity that the wo men in this study had absorbed was that being thin would not only attract a male, but it woul d prevent them from st raying. For example, Charlotte discussed how she got a serious boy friend her freshman year of college. She described how having a boyfriend in her life influenced her weight.

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309 Charlotte: Whenever I had a boyfriend, that was when I would lose weight and be obsessed with everything. But if I didnt ha ve a boyfriend, then it wasnt like that. I thought about it a lot. I think that I always wa s afraid that they w ould I dont know. In the beginning I guess I was afraid th at he would leave me or cheat on me or something. But like if I was like skinny enough or pre tty enough either he wouldnt do it. Several of the participants discussed how the media portrayed one ideal for models and another for television and movies. Ramona commen ts illustrate why it was important for some of the women in this study to remain small or petite. Ramona: TV and movies portray a diffe rent physique than models Its more a tiny, petite, big busted, little waist. And I think that a lot of that is due to well just from what Ive learned that men well, a lot of male actors are fairly short. (She laughs.) So that to make it good on TV, you have to be shorter than the male counterpart that youre playing with. (She laughs.) Like Jennife r Anistons super tiny. So for actors and actresses, usually tiny is better. And I always wanted to be so tiny. Tiny is like I don t know. I always want someone to just take care of me and be my he ro and just love me and do all the nice things. I dont really know any girl thats like, Yeah!!! I want to be bigger than my MAN!!! (She does in deep dark voice, and we both laugh.) Its like a sense of pretty for some reason. Cause the media portray it that way. Rylie served as another ex ample of a particip ant whose desire to have a boyfriend influenced how she interpreted media messages of the thin ideal. On one level, Rylie criticized the media propagation of the thin ideal; yet, Rylie had a conflicting desire to be thin because she saw slenderness as the key to getting a boyfrie nd, which was extremely important to her. Rylie: Monday, July 11, 2005 @ 7:30 a.m. Sa ved By the Bell Waking up and eating breakfast. All these girls are so thin. It angers me to think that I could never look like them. I want to look like them. This episode is about Screech and a girl. The girl is not pretty, but shes thin. And I know this is just television, bu t it still makes me f eel like no one will ever like me because of my weight. Experiencing conflict with a negotiated reading In a negotiated reading, the reader understands the dominant position, but she also applies a more negotiated position arising out of comp eting frames of reference, motivation, and experience that counter this hegemonic position (Hall, 1980). Rylie engaged in what Hall (1980) would call a negotiated reading, wh erein particular elements of resistance to the dominant

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310 ideology pertaining to the thin ideal are based on perceived conflic ts between the construction of the dominant ideology and the womens own personal and social experience. Rylies comments illustrated how a negotiate d reading can leave someone feeling uneasy and conflicted about their self-conc ept and their perceived need to subscribe to cultural ideals. Rylie was aware of medias perpetuation of the thin ideal, and she also was aware of how damage dieting could be, for her and for others. However, she had internalized the thin ideal, and she had trouble unraveling its grip because of her internal conflict about the importance of attractiveness as defined by sle nderness. During her recovery pr ocess from anorexia, Rylie had gained weight to the point that she was dissatisfi ed with her appearance, and she believed that weight loss was a requirement for her to earn a boyfriend. Rylies dualistic inte rpretation of media messages about th e thin ideal makes sense in light of the priority she placed on having a boyfrie nd in her life. Although she had some level of opposition to the media messages about weight loss, she still subscribed to dominant media messages targeted to young women that their existe nce is defined by their ability to attract and maintain the attention of men. Many of the entrie s that Rylie wrote in her media journal and the comments that she made during her interview re flected the notion that she thought she never would get a boyfriend unless she was thin. Despite Rylies knowledge about the unrealistic imagery in the media, she still was affected by the messages, and her self-esteem and body satisfaction plummeted after brief exposure to one magazine, a concept consiste nt with the literature (Englen-Maddox, 2005; Halliwell & Dittmar, 2004; Lin & Kulik, 2002). As St einem (1992) has stated, Self-esteem isnt everything; its just th eres nothing without it (p 26). Rylies media journal entry describes her conflicted frustration with medi a portrayals of thin women.

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311 Rylie: Thursday, July 7, 2005 @ 7:30 a.m. Shape magazine My dorm room Writing a paper. I need to write a paper on a magazines audience. I bought Shape and decided to write about it. The girl on the cover ha s the most amazing body. Its magazines like Shape that make me not want to eat for the next ye ar and a half. These girls are unrealistic and probably spend most of their time working out Of course, that doesnt stop me from wanting to have their body If I did have their body, maybe I could get the guy I like and be more confident with myself. I hate magazi nes. They exploit images that no girl can achieve and make us feel bad if we dont. Peterson, Grippo, & Tantleff-Dunn (2008) found th at the more powerless individuals felt, the more likely they were to pa ssively internalize societal st andards of beauty and have body image and eating disturbance. During her intervie w, Rylie made several comments related to her dissatisfaction with her body. She also shared ho w she engaged in binge eating behavior, though she did not fit the criteria for an o fficial eating disorder diagnosis. According to Chapkis and Buurman (1986), when a woman says that she feels fat it is an indicator that she feels powerless. As Simone de Beauvoir (1952) stated, To lose confidence in ones body is to lose confidence in ones self (p. 310). Rylies comments during her interview reflect the powerless she felt because of her negative body image. Rylie: Im uncomfortable with myself, so Im unc omfortable with other people. I hide behind this big shield because of it. And its very true. I mean I hate my weight. D: What do you think would make you feel more comfortable with your body? Rylie: Getting a guy to ask me out. (She laughs.) Its frustrating cause I feel like Ill never be good enough. No matter what I do, I will ne ver get a guy because of my body. I mean, Ive never had a boyfriend. Ive never. I dont th ink a guys ever asked me out except that one guy who said I looked better when I was thinner. (She laughs.) Yeah so, I mean, I feel like Ive never really been loved or even liked by a guy. Contrasting views of the value of a b oyfriend: negotiated and oppositional Rylies comments are best understood when c ontrasted with another participant, who did not define her sense of self by having a boyfrien d. During her interview, Molly described one of the qualities that she admired about the character Miranda on Sex and the City : She can enjoy having a guy in her life but she doesnt need to have one to fit her personal definition of success. Mollys perspective about the importan ce of a boyfriend definitely influenced her

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312 reading of media messages. She had a complete ly oppositional reading of the mediated thin ideal. In addition, she said, I will not change who I am for someone else. Several other participants expressed how they admired Miranda on Sex and the City. Amanda described how she related to Miranda. Amanda: Miranda, on Sex in the City I definitely can be very cynical like she is. And theres one episode that my roommate and I joke d its like us because she walks into the little restaurant they sit in, she plops down at the table, a nd shes so mad because theyre all talking about boys. And shes like, We are four intelligen t women, and all we can talk about is men. And she gets up and like stor ms off. Thats something I would do. (She laughs.) Cause like, last night, I went out w ith my roommate and her friends. And I mean its just, thats all we talk about, I feel like thats all we talk about sometimes. And I kind of had night like that last ni ght where I was like, I just wa nna go hang out with them and not worry about guys. In early adolescence, girls become increasi ngly dissatisfied with their bodies and overall physical appearance (Feingold & Mazzella, 1998). Th is discrepancy may be explained in part by two gender role socialization processes that occur during adolescence. First, girls are taught the importance of attracting a dating partner and gaining popularity as a measure of their self-worth. They are also socialized to take responsibility for the establishment of relationships and to sacrifice their own needs in order to mainta in their social connections (Miller, 1993). Participants who had learned to honor and accept their body resist ed this dominant ideology. For instance, Jordan described how sh e no longer allowed other people in her life to influence her body image: Im definitely drawn to relationships or boyfri ends that are going to love me for me, and theyre gonna see the beauty in any shape or form, and if they dont, then theyre not any guy that I need to be with. Perception of Recovery The women in this study had different pers pectives about the levels of recovery and whether full recovery was possibl e. Participants who had less optimistic outlooks on recovery

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313 tended to have more negotiated or self-protec tive opposition readings. For instance, Eliza did not see an end to her recovery proces s, and this perception affected her view of the mediated ideal. Eliza: I dont really think that anyone can fully r ecover. I hate to say that. I wish it was true, but, I dont think th at its possible. Cause I think that itll always be something that I struggle with, unfortunately. Bu t I dont know. I think you can maintain it. And I wanna say that you can fully recover, but I honestly think its always gonna rear its head at some time, so. Like what I wrote in my media journa l. I like to refer to my eating disorder as Ana or Ed. Ed likes to come up every now a nd then and say some nasty things, but its your job being in recovery to shut him up. But I think hes always gonna be somewhere hangin out in your brain. Like, Hi! (We laugh.) Research has indicated that women who only stop the physical symptoms of an eating disorder, but do not make strides toward improvi ng their body image and self-esteem are likely to relapse (Kordy et al., 2002; Rastam et al., 2003). Several of the women expressed concern about ensuring that their recovery was long-term. Some participants feared that they might relapse, so they avoided any exposure to triggering media messages. The more the participants were aware of the potential for relapse, the more they seemed to avoid potential triggers, particularly if the women still internalized the thin ideal. For instance Faith had to avoid reading Shape because she knew that she might engage in comparisons with images of the thin ideal. E ngaging in such a comparison would only decrease her body satisfaction, and she did no t want to risk the temptation to engage in weight loss behaviors. Faith: I think that my chances are good that Im in the percentage of people that totally recover. I think there were like three different percentages. Th eres a percentage of people that fully recover. Theres a percent of people that manage it. And then theres a percentage of people that never recover. So I th ink that Im in the per centage of being fully recovered, but like I said, I really have to keep my mind in check.

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314 Some participants knew that they only were in the initial stages of recovery, and that they still battled with an obsession with food and numbers. In her interview, Abigail discussed her goal and hope of becoming healthy and freeing he rself from her eating disorder entirely. Abigail: Healthy to me would be freedom from compulsion and the obsession of food and numbers and weight and size a nd comparing. I mean, Im nowhere close to actually being there, but Im on the right track. Some days Im on a slippery slope. To me healthy is just having the freedom to eat what you want, when you want, without the mind games. And if Ill ever get there, I dont know. I honestly dont know. Ive heard th at theres freedom. Complete freedom. And then Ive hear d that you never totally recover. In contrast to Faith, Abigai ls comments indicated her ambiva lence about the belief that she truly could recover. She had heard stories of women fully recovering, but she had also heard about women who struggle with some aspect of their eating disorder for their entire lives. Because she was in her initial stages of rec overy, she was not yet convinced that complete recovery would be possible, so she completely avoided any potential triggers. Participants who considered themselves to be fully recovered tended to have the most oppositional readings, and they were not at all te mpted by media images of the thin ideal. For instance, Barbara no longer was concerned that any media imagery of the thin ideal would interfere with her recovery. In fact, she considered herself to be fully recovered because she knew she never would become anorexic again: I dont see those images as a challenge because I know that I wont go back. Perception Shift: No Longer Value the Thin Ideal Women learn how to view their bodies from me dia sources, and this affects how they treat their bodies and live their lives (Sparkes, 1997). When the women in this study were younger, media imagery was a powerful source of informa tion for them. The participants had used images of celebrities and models as an interpretive frame for learning about their bodies and what it means to be a woman. They also tended to of ten accept the media imagery at face value.

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315 Through media imagery, these participants ha d learned to desire what they formerly perceived to be a normal, healthy, and realistic image of a perfect female. As Jane said, I think the medias portrayal of the idea l body image is a very thin b ony woman. In the prime of my eating disorder I truly believed this looked good. When they were anorexic, the women in th is study found thin bodies to be attractive, regardless of whether the person lo oked healthy or not. The partic ipants discussed how the sick thin ideal had been appealing to them. However, as the participants got treatment for their depression and other underlying causes of their eating disorder, thei r desire to live a healthy and meaningful life became a huge motivator for recover y, which altered their pe rspective of the thin ideal. As Grace said, When youre in recovery you focus on living and being healthy, not dying and weight loss. Perception of Ideal Changes: You Can be Too Rich or Too Thin The participants perception of the sick thin ideal also altered becau se they no longer were malnourished, so they had a less distorted view w ith regard to the type of images that truly were healthy. As Nicole said, I had to slowly start to be able to differentiate what normal or healthy looks like versus be ing really thin. When the participants had been sick, they perceived all thin bodies to be desirable. In fact, several participants described their mentality at that time as the thinner, the better. In recovery, however, they tempered thei r perception of the ideal with the knowledge that you can have too much of a good thing. Similarly, Enchantment was reading Stick Figure a book in which the author recounts her experience with an eating disord er. The book is by Lori Gottlieb, who wrote the story to convey the perspective of an 11-year-old girl with anorexia. Enchantment read the book when she was in

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316 recovery. While reading the book, she came across th e line, You can never be too rich or too thin, and the thought she wrote in her media journal was Maybe you can be. In recovery, Enchantment still desired the thin ideal, more so than most of the participants, but she also knew about the he alth consequences of being too thin. When she was anorexic, Enchantment had several health issues, includi ng losing her hair and de veloping heart problems. I Dont Want to Be Seen As Sick Overall, the participants perception of the th in ideal altered, and th ey now viewed health as more salient than the thin id eal. They also no longer found the sic k ideal to be attractive. For example, Michelle described how her percep tion of thin ideal transformed over time. Michelle: When I was anorexic an d looking at women in mag azines, I wanted to be thinner than them. (She laughs.) I think with some of my distorted thoughts I think I liked that look. The sort of sick, thin look, whic h I know you shouldnt like, but it just, to me seemed to me seemed very, sort of clean a nd pure. Like you dont have any theres no room for imperfections. I dont want to look that way anymore. And I think its something that I dont want to put my ener gy into anymore. It just takes a lot of energy and effort for nothing. And I dont want to be s een as sick. I want to be se en as healthy and capable. Once in recovery, the participants found di fferent characteristics more appealing. For example, Michelle discussed how the Nike ads offered a healthier role model for women: They portray a woman whos more st rong and sturdy and capable, as opposed to thin and weak. With an increased sense of self-worth that was less based on app earance and the approval of others, the women in this study were able to channel their focus to their health, which allowed them to minimize the value of attaining the th in ideal, an image they now perceived to be unhealthy. As Faith stated, When you get that thin, that just does not look healthy to me. The participants were able to resist media imagery if they no longer found the mediated ideal to be attractive. For example, Faith descri bed how her perception had changed. Faith: The only reason I would have ever thought that [the thin ideal] looked good is because the media that showed that that looks good. Runways. Fashion shows. Celebrities. Now, I just think its really sad that I spent so much time trying to look like that.

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317 Questioning the Term Ideal Several participants questioned the very nature of the term ideal because they perceived the term to indicate a positive, healthy exampl e or standard to which people should aspire. Because the women in this study now valued their health, and they recognized that most models appeared to be unhealthy, many pa rticipants distinguished between the medias ideal and their own. In fact, several participants had to ask for clarification du ring their interview when I asked them to describe the ideal female body image that the media portray. For example, Rylies initial response to this question was, My ideal? Or the medias? Sim ilarly, Barbara said, The media do not portray an ideal. Oh! In thei r opinion, or in my perception? Several participants even made comments that pointed to the absurdity of the concept of a mediated ideal. For example, Metkit discusse d how she found the phrase ideal female body image to be somewhat comical. When I asked Me tkit to describe the ideal female body image that the media portray, she replie d: Im sorry? Thats kind of an oxymoron isn t it? (sarcastic) They dont portray the ideal body image. (She la ughs.) Isnt oxymoron the right word there? What they should portray? Or what they do? Suspecting Thin Media Figures of Unhealthy Weight Loss Behaviors Now that the participants knew the reality of wh at it takes to be extremely thin, they tended to suspect that some models and celebrities mu st be engaging in unhealth y behaviors. They knew from personal experience how challenging it was to attain and maintain th e thin ideal, and this colored their current perspective. Amanda was working out at the gym one day, watching a music video. In her media journal, she wrote: Christina A gulara [sic] is so skinny I reme mber seeing an interview with

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318 her where she said she eats anything she wants I wonder if that is true. During her interview, Amanda explained her reaction. Amanda: I remember seeing something with her sa ying that she eats pizza before every show like she doesnt worry about what she ea ts at all. But I alwa ys think that its not true when people say things like that. I mean it could be true, but the chances are small. Im sure thats true for some people. Its pr obably true for five of the 100 people that say that. (She laughs.) I guess more and more, you hear about people that havelike stars and celebrities, have eating disorders. And you hear about some of the thi ngs that they do, and just the strict diets that theyre on and stuff. And it just seems like, Im sure that there are a few that can eat whatever they want, and maybe shes one of them. But I dont know. I dont think so. The participants also tended to have the same type of reaction when an actress lost a visible amount of weight. As Jane said, It always cat ches my eye when heal thy-looking actresses end up losing weight. Courtney was watching her favorite soap opera, and she noticed that one of the actresses had lost a lot of weight. The thought she recorded in her media journal was, I bet she hardly eats. During her interview, Christina discussed how this was a typical reaction: I really pick up on stuff like that. I was like, I wonder whats been goin on with her. And the first thing that comes to my mind is, I bet she hasnt ea ten that much. The women in this study had achieved the thin ideal, but to do so, they had engaged in unhealthy weight loss behaviors that ultimately le d to the development of an eating disorder. Unlike their earlier perceptions, the participan ts now believed that most people could not maintain the thin ideal naturally. The women l earned to alter their pe rspective so they now viewed the mediated ideal as typically achievable only through unhealthy or harmful behaviors, which they did not admire. Shifting the Nature of the Comparison as a Self-Protective Opposition Strategy In fact, attributing a media figures thinness to an eating disorder seemed to be an effective strategy self-protective strategy for many partic ipants. For example, Christina was browsing a Victorias Secret catalog. In her media journal, she shar ed her reaction to an extremely thin

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319 swimsuit model: It might not be a real picture of her. And if it is maybe she has eating problems. In some ways, the se lf-suggestion that a model had an eating disorder transformed the nature of the comparison from upward to downward, making downward comparisons in which they rated themselves better than the target, and therefore felt better about themselves and less inclined to engage in pot entially unhealthy comparisons or weight loss behaviors. Rather than serving as a thinspirations to lo se weight, some celebriti es now served as an incentive for the participants to eat because they had no desire to return to a body size that had made them miserable. For example, Grace (whose pseudonym was religiously based, not because of the character in the show) was watching Will & Grace one evening. She had always perceived the character Grace to be extremely thi n, and she wrote in her media journal: She has to be anorexic. Glad Im not there. I like to eat. Think Ill eat a snack. Graces media journal entries as well as th e comments she made in her interview suggest that she needed to find a strategy to prevent her from engaging in upward comparisons. Like many of the participants in this study, Grace found that it was helpful to believe that a celebrity who was extremely skinny was probably engagi ng in unhealthy weight loss behaviors. The participants had come to associate bei ng extremely thin with the misery and suffering they had experienced. Several of the participants learned how to transfer this association to imagery of the thin ideal. In doing so, they tr ansformed the nature of the comparison from upward to downward, making the thin ideal much less appealing, thereby re ducing their desire to look like models or celebrities. Eating Disorders and Dichotomous Thinking People with eating disorders, depression and perfectionism tend to have a rigid, black and white cognitive thinking style al so referred to as dichotomous thinking (Fairburn et al., 2003; Garner & Bemis, 1982). Dichotomous thinking is a form of cognitive rigidity that results in a

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320 polarized, either-or persp ective on reality as opposed to a con tinuum of possibilities. An example of dichotomous thinking is: If Im not completely successful, then I am a total failure. (Linehan, 1993). In a recent study, Byrne (2008) found that di chotomous thinking was strongly correlated with eating disorder symptoms (especially those with anorexia ner vosa), depression, and perfectionism. Research has indicated that dic hotomous thinking is a cognitive rigidity that serves as a key factor in main taining eating disorders (Fairburn et al., 2003; Garner & Bemis, 1982). As part of their recovery pr ocess, the women in this study fi rst needed to recognize their natural inclination toward dichotomous thinking, which many of them did. For example, Emma shared the mantra that was ingrained in her mind for years: I am nothing if not all-or-nothing. Similarly, Kerry said, I feel lik e I have a tendency to just be extreme in my thoughts. Rigid dietary rules A dichotomous thinking style contributes to the development of rigid dietary rules (Egan, Piek, Dyck, & Rees, 2007), which all of the women in this study had. As Kerry said, I definitely had very rigid eating routines. Like many of the participants, Ch ristina said that it took a long time for her to develop flexible eating behaviors, and it was something she was still working on: Im trying not to be so rigid with my eating. Ive gotten away from m easuring. That took a long time. I think its taken a year to get away from that. According to Egan et al. (2007), dichotomous thinking also can increase the likelihood of binge eating following any transgression from these dietary rules. As Jamie said, If I ate a bite more than my allotted calories, I had to binge and then purge. Other participants discusse d extreme eating behaviors. As Grace said, There was no happy medium. Similarly, Jordan said, I would go through weeks at a time where I could not

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321 be hungry. I wouldnt eat anything. And then Id ha ve one cheat day a week where I would just eat whatever the hell I wanted. Extreme fear of fat Nearly all of the participants had a fear of becoming fat. In their minds, if they were not thin, then they would become fat, or worse, obese. The distress some participants expressed about their fear of becoming fat re lates to the potential for a self-perceived failu re to fit into an expected female norm of slimness. Fear of beco ming fat has created a cultural environment that not only does not foster health, bu t also may directly undermine it. The participants in this study had become so fearful of becoming fat that they eventually became afraid to eat any food, and one participant described how she had become afraid that ice cubes might have calories. While most of the participants thoughts were not that severe, all of them had developed an extreme fear of food, informed by media messages. The participants intense fear of fat led them to fear any foods that contained fat. As Christina said, I was so afraid of fat that I thought that eating fa t would make me fat. Christina also described how the media have influenced her fears. Christina: It just seemed like everything had to be fat free. Magazines were always saying low fat. And to me a low fat diet was fat free I went three years without eating fat. Like literally, I would not eat fat.Nothing. No butter. Because of her previous dichotomous thinking that all fat was bad for her, Christina had a difficult time introducing fats into her diet. As she said, I still have a big problem with that. Christina: Im trying to work on getting my eati ng Trying to eat normally. Eat, normally eating what I want to eat, without fear. Like, I eat waffles now. Ice cream. I dont do. Desserts are hard. Like, chocolate s hard. So Im just trying to eat the things that Im afraid of very small quantities of them. Ive become more flexible with my eating. To overcome their fear of eating certain foods, the participants had to slowly introduce foods they feared and devel op the confidence that they w ould not become obese. Nicole described what gave her the courage to take this step.

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322 Nicole: I didnt want to keep living in this fearful life fearing that Im going to get fat And thats the only thing I care about. And now, I know that I can maintain a healthy weight, whereas before it was like an all or nothing. Like, Im either going to be really thin and unhappy, or Im gonna be really fat and happy for the rest of my life. So Ive realized that its not a black or white s ituation, like I onc e thought it was. Several women in this study described how they had internalized the media-perpetuated notion that eating certain foods might instantly make them obese. For example, Molly described an experience she had at the Cent er for Change, an eating disorder treatment center: I remember the first time we had cheesecake. I really believed that I was not gonna get out of bed the next daythat they were going to have to roll me dow n the hall cause Id be so fat. Similarly, Jordan said, I remember at pizza parties Id be like, Im not touching that with a 10-foot pole because I will put on three pounds if I even look at that pizza. Good and bad foods The participants perspectiv e about foods was influenced by the m edias tendency to associate morality with different types of foods. In fact, nearly all of the women discussed how they had fear foods, which they had considered to be bad and off limits. Isabel: At the start, it was obvious that th ere were good, pure foods and bad, junky foods. Heavy guilt was associated with eating the bad foods.I thi nk these early ideals helped warm the seat for anorexia, in which I also had a clear idea of whic h foods were good those with very few calories -and bad all other foods. This moral association was powerful, and the pa rticipants had to learn not to subscribe to the medias black and white misrepresentations. As Lindsay said, I kind of put certain foods off limits, so Im just tryin to eat more normal things in moderation. Many of the participants described how they e ither felt like they were eating perfectly or being totally out of control. Perfect eating wa s associated with extremely restrictive eating behaviors, and bulimic behaviors were consider ed out of control. In addition, several women used the term clean to refer to their restrictive eating, which they used to perceive as healthy. For example, Michelle described how perception of the sick thin ideal portrayed in magazines,

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323 which she used to strive for: I t just to me seemed to me seem ed very sort of clean and pure. Like you dont have any there s no room for imperfections. Diamond also used the term clean to refer to her former perception of what constituted healthy eating. She described what initiated her clean eating. Diamond: I didnt like my butt. I felt like I was gett ing fat. I really got into dieting. Thats when I got into these magazines and I was eati ng, I would eat broccoli for a snack or a-a meal. And I just, I ate really cleanly. I was like, If I ate clean ly, I would like Ill lose the booty. Ill lose my love handles I would be a lot leaner. D: What do you mean by clean? Diamond: Um, its just no butter or light margarin e like fat free dressing, I mean I went through the fat free fad. Everything was fat free. I didnt eat cheese on pizza; I didnt meat, didnt eat buttered popcorn, didn t drink pop, didnt eat candy ba rs, didnt eat junk food, didnt eat French fries, I mean just restricted all junk food. The participants had to work extremely hard to expand their list of acceptable foods. For example, Grace said that she had to avoided ma gazines that suggested certain foods were not acceptable. As she said, I dont lik e to classify food as good or bad. It just is. And its meant to nourish me. And I can enjoy it. Similarly, Emma sai d, There is no food that is off-limits for me now and that took a long time to get to. Im very proud of that accomplishment. During her recovery process, Molly learned how the media had contributed to her rigid thinking about food. Molly admired Oprah, and she knew that she has a broad audience, but as Molly said, She slips up once in a while and will make some stupid weight or diet comment. And I think shes a bit on the rigid side with food thats when I e-mail her! Rigid exercise routines A dichotomous thinking style also contributes to th e development of rigid exercise routines (Yates, 1991). As Kerry said, I definitely had very rigid exercise. Defi nitely scared everyone else around. (She laughs) I had to go running before I could do anything else. When they were anorexic, many of the women in this study had relied on fitness and health magazines to help them lose more weight. Howe ver, many of the women in this study tried to

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324 avoid these types of magazines because they tend ed to equate fitness with weight loss. In addition, the women thought that the media placed too much focus on intensity. As Jamie said, The medias always like, Push! Go! Faster! Hard er! Do this now! (She laughs.) Its like, they expect you to always be really intense and just focused on burning off calories. Similarly, Kerry said, The hardest part was knowing how much exercise was really good for me. I was just trying to be healthy. Amandas comments provide some insight as to why it may be difficult for young women to discern what truly is a hea lthy amount of exercise. She discussed how magazines need to be more responsible about providing information prom oting a healthy balance of diet and exercise. Amanda: One day I was working out, and I was reading a magazine. It was one of those when they have nutritionists write in. Somebody else left it in the gym, and I was looking at it. There was an article a bout this lady who was a nutritioni st, and she said she ate very healthy but very few calories. She was like, Occasionally I let myself have a snack. I cant remember what it was. And I run fi ve miles every day. And this is from a nutritionist. First of all its not practical for a lot of people and second of all I mean she ate very few calories and ran five miles a day, so I mean, I just didnt think that was great advice from the nutritionist. Dichotomous thinkers avoided media exposure and exercise There were several participants who knew that th ey still ha d an all-or-nothing perspective about exercise. To avoid the temp tation to over-exercise, these women did not exercise at all. They also tried to avoid any potentially triggering media sources, especially fitness magazines. For example, Abigail knew that she still had a dichotomous mentality. She did not trust herself to engage in a healthy amount of exerci se. She described why she avoided exercise and magazines in general. Abigail: I was exercising all the time. I did basket ball, soccer and soft ball. As far as my eating disorder, it wasnt bulimia as far as throwing up. But exercise definitely. When I was at my worst, I was doing 5,000 sit-ups a day in my bedroom. I mean, it started out, lets do 500. And then it was just like. (She laughs.) And I would keep track. Each tally

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325 was 100. I mean it consumed me. Its all I di d. I wouldnt sleep at night. Now, I do not work out at all. I dont r ead any fitness magazines ei ther. Its too dangerous. As a teenager, Christina looked to magazines for advice, and she absorbed all of the diet and exercise information. She described why she no longer allowed herself to read magazines. Christina: I think magazines are what got me. Cau se when I was younger, I used to read them. And I used to be like, Oh, did you eat a cookie today? Well, you need to run an extra mile to burn it off. Did you eat those fries? That wasnt good (in a condescending motherly tone). Ya know, like you should eat more healthy. I just do not go near any magazines. Like many participants, Christin a did not exercise because she knew that she was not able to do so in moderation. In addition, she avoided all magazines because they were triggers for her: If I look at any of those magazines, Im like, O h, I need my thighs to be thinner, so I should exercise. Conflictedfighting lingering tendencies for comparison Nicole challenged the notion that wom en should be flawless and defined primarily by their appearance, but her cognitive abilities for resi stance were not powerful enough to overcome the years of conditioning that shaped her notions of beauty. As Rubin et al. (2004) have suggested, it may be that young feminists have perceived and are struggling with a normalized view of the good feministthe fictional woman who refuses to discipline her body to meet mainstream beauty standards, and has learned to unconditi onally feel good about herself (p. 34). Consistent with previous research on soci al comparison and body image, participants in this study indicated that they usually felt worse about their bodies after comparing themselves with others. Some women in this study knew that they should not use certain media images as a basis for social comparison. They knew that th e imagery was unrealistic, yet because of the pervasiveness of media message s relating to the ideal body, it was difficult for the women to avoid some social comparisons with media images which nearly always made them feel like

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326 they fell short of the ideal. For instance, in her media journal, Ni cole wrote about a billboard for a fitness center that had a woma ns stomach as the focal point. Nicole: Monday 5/1 5:30 large poster to ad vertise a fitness center: NO EXCUSES written over a bare womans belly the shoppi ng center next to my apartment complex walking home. Irritated. Sad at the unrealistic image being promoted. Also looked to see if I am as thin as she is. When Nicole was active in her eating disorder, she was obsessed with exercising. During her interview, she discussed how she had eased up on her compul sive exercise behavior in recovery. Nicole: I am the most lax about exercise as I ha ve been in years alt hough I still exercise regularly. Im not obsessive abou t it. Like if Im on vacation, I can handle skipping a week of exercise. Whereas before, Ill get out and ta ke a walk around to a disgusting city block because I have to move because I have to burn calories or Ill go crazy. When Nicole was about 9 years old, she used to subscribe to Teen and Seventeen. However, a couple years later, right around pube rty, she became more interested in fitness magazines: I would say when I starte d down my eating disorder path, I got Shape and Self. Those are the ones that come to mind. And Fitness that was another one I read regularly. I didnt subscribe to them, but I bought them regularly. In general, Nicole now tried to avoid any mainstream magazines. Even when she was in doctors offices or at a friends house, she intentionally did not look at them because she knew they were triggers for feeling badly about her bod y. She still valued the thin ideal, but she was no longer engaging in weight loss behaviors to attain it. Nicole: Im always caught up in the grocery store by the magazines like Self and Shape The celebrity magazines don't catch my eye as mu ch as like the fitness ones because I used to read the fitness ones when I was in high school. I guess I have a special attachment to them or something. (She laughs.) Its just the unrealistic images that bother me. Or I catch myself getting caught up and reading them And then I feel bad about myself.

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327 Media encourage fear-based exercise, not exercise for health According to W olf (1991), a dvertising and the media indoctr inate the consumer in these ideals to the detriment of most wo men. Diet products, fitness, and the fear of fat are encouraged and promoted to the extent of marketing unhealth y addictions (Anders on & DiDomenico, 1992; Kilbourne, 1994; 2003; Striegel-Moore, 1993; Wolf, 1991). Several participants discussed how the media had been extremely effective in instilling the notion that if they did not exerci se, they would become fat. In he r media journal, Eliza described how this fear affected her. Eliza: I always feel like I have some inte rnal argument about exercise. Im easily influenced into the belief that not exercisi ng makes you fat. I miss when I would want to exercise on my own all the time, and cant figure out where the motivation has gone. I wonder why it is that absolutely everything with me is either t oo much or not enough. It goes for eating and exercising too. Right now, Im at the not enough stage. Noah also recognized that she had tended to engage in fear-based, extreme exercise with her eating disorder, primarily because of fitness and health magazines. Now she typically avoided them because she knew the messages were not healthy for her. She described how she had to learn to disassociate exercise from weight loss. Noah: I had this girlfriend when I first moved to Nashville. And she would always talk about her supposed fat thighs when we were at the gym. She would tell me things her husband said, like, If you ever get fat, Im divorcing you. So I thought This is a woman whos gonna suffer her whole life and be worri ed about her body. I felt bad. She read all these fitness magazines and stuff in the gym, which just confirmed what her husband said. And I told her, Im really trying to make exercise something thats for my spirit and makes me feel good and thats about cam araderie. And if you keep making it about weight, I cant work out with you. I just said, This is not helpful. Ive struggled for however many years with an eating disorder. You can not make my workout every day be about losing weight and your fa t thighs. And we just stopped being friends. But I think there are so many people out ther e that live like that. That dont question the messages they get. And they might have husbands that say incredibly hurtful things.

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328 Noahs friend truly had internalized a fear-b ased need to exercise instilled by the media. She described her concern for people who might be driven to exercise com pulsively because they are afraid to get fat. Noah: For some people, it really is about f ear-based exercise. They read stuff in magazines, about, Oh, youll get fat. And so, th ats the motivation to get to the gym. So when theyre at the gym, they just keep worki ng harder and harder just to keep their body thin. Its sad when exercise can be so fun, especially with friends. In general, the participants who had engaged in compulsive over-exercising as part of their eating disorder had extreme difficulty reduc ing their dichotomous thinking. They had to continuously engage in self-prot ective opposition strategies to combat the desire to exercises in an obsessive way. It was more challenging for the women to re duce their dichotomous thinking with regard to exercise, if they were exposed to imagery of the thin ideal. Like many of the women, Grace exercised at a gym. One day, she saw a television show that was triggering and the reaction she wrote in her media journal was: Im tired toda y. Not much of a workout. Its okay. I dont need to lose weight. Im doing this for fitness. My body is telling me what it needs NOT THE MEDIA! A gentle workout. Let it go Grace. Overall, participants who were able to reduce their dichotomous thinking had more oppositional readings. Emmas definition of reco very captured what the ultimate goal of the participants: Recovery is shattering this rigid black and white, perfectionist mindset I have and just embracing my heart, my head and my body as one complete lovable and loving unique human being. Awareness of the Limited Portrayal One of the key factors in un-internalizing the thin ideal was for participants to recognize how limited the media were in their representation of women. The media provide structure for a

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329 great deal, perhaps even most of our social a nd personal lives, particul arly with regard to conformity to an ideal bodily appearance. According to Heyes ( 2007), the structure itself is not inherently negative; rather, a prob lem arises with the single, rigid goal of conformity to a thin body ideal that is not attainable by most women. As Amanda sa id, People are shown in the media as unrealistically thin. I mean, there are people that are that thin, but the majority of the population just isnt. Christina contrasted women in her personal lif e with those portrayed in television. In doing so, she recognized how narrow and restrictiv e televisions portrayal of women is. Christina: I think on TV everyones beautiful it seems to me. You dont see ugly people. You dont see normal people on TV, that much. Roseanne was one that was different. But most of them the women are definitely like on Friends, the girls are all very thin. They seem very thin to me. Not normal Like, my mother doesnt look like that. She doesnt try to look like that. (I laugh). Other women dont look like that. I dont see women like that. All of the participants wanted to see more normal and diverse representations of women in the media, women that they could identify with a nd who reflected the diversity they saw in their everyday lives. For example, Courtney describe d the media representati ons she would like to see: I kind of wish they would just show more of what you would see in normal life rather than the picture perfect people in magazines and TV. Ramona knew that the images she saw in ma gazines were not realistic, yet they still affected her. As she said, I get frustr ated that I start th inking that I should be like the people in those magazines. Young women internalize narrowly defined cu ltural norms of beauty. As they do, they become more concerned with how their body looks in relation to the culturally generated images portrayed as normal (Wolf, 1991).

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330 Like most of the participants, Molly define d the mediated ideal as someone with fairly large breasts, no fat anywhere to be seen, flat stomach, no hips, very thin legs and arms. I guess basically Barbie! Many participants described an extremely narrow range of acceptability for the female body. Sarahs perception of the mediated idea l reflects the description of many of the participants in the study: Thin. Big boobs. But not too big. Ya know, you cant be huge. They want your body small, but not too small. Its al ways a narrow standard to live up to. Similarly, Faith shared her description. Faith: The media portray the ideal as tall a nd slender with sizeable breasts. And its like, I guess, a perfect behind, too because its either too small or too big. Theres evidently this ideal of a perfect behind. I dont know what it is, but evidently everyone else is either too small or too big. (sarcastic) Overall, the participants indicated that the media representations of women create a dichotomy that contributes to th e fear many of the women in this study had, if they do not fit the thin ideal, then they will be fat and ugly. One dominant wa y in which the idealization of thinness and the negativity of fatness is produced in the media as well as in the wider social sphere is through the construction of fat as ugl y and thin as beautiful (Malson, 1995; Malson & Ussher, 1996). As Malson (1998) ha s contended, The fat body is despised as unattractive, and conversely the thin body idealized as perfecti on and beauty (p. 105). One of Graces journal entries illustrates how effective the media have been in disseminating the thin equals pretty conflation. Grace: Wednesday 10 a.m. Television flipping channels living room talking with roommates and flipping through magazines not watching at all. Models suck they are so skinny & pretty. Why cant I be pretty if I cant be thin ? I am acutely aware of how disgustingly fat I am. Why does society do that to us?! Pisses me offf*ck society. I am more than a number, and Im done thinking about this.

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331 Many participants discussed how the media tend to portray the extremes, in terms of appearance and body size. As a result, the majority of women are not able to see their body type represented. For example, Lulu shared her perception of the medias portrayal of women: It seems like all the magazines covers theyre ei ther showing obese or fat people. Or theyre showing the really thin, beautiful people. So either way. Its all or none. Along the same lines, Diamond described the dichotomous representations of women in music videos: Theyre all either very voluptuous, very cur vy, curvaceous or model skinny. Several of the participants i ndicated that the modeling industry has contributed to this type of portrayal by creating a division between regular models and plus-sized models. For the most part, the participants thought that the media seemed to be portraying larger women, but only if they belonged to a specific category, one that the women in this st udy did not fit into. For instance, Eliza discussed he r thoughts about Emme Aronson. Eliza: Shes a plus-size model (uses quote mark fingers). And shes pretty big. But, shes just cool. I read an article about her somewhere in a doctors office. Shes huge Shes so tall. Well, all models are tall, but sh es actually like I dont know, 190 pounds or something? Shes big. But shes really happy with it, and thats great. So I think that the medias getting better about that. But theyre like a group of people they re plus-sized models. And theyre big boned. Some people ar e just built that way. Ive never been big boned. Several participants discussed how it was important represent normal, average, healthy women, not the extremes. As Metkit said, We shoul d represent everyone, well, everyone thats healthy. We have a serious obesity problem here. So Im not suggesting we should portray obese sizes. Similarly, Eliza said, I think it should just be normal looking people, modeling clothes. Not super thin and not really bi g because neither is healthy. The representation of women in the media is so narrow that several studies have had difficulty even finding an average woman for a c ontrol image, and one study had to use images

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332 from a magazine that was supposed to target overweight women. Other researchers have had to create their own images because there is a scarcity of normal weight women in magazines (Groesz et al., 1999). As this section shows, the women in this study discussed how they would like to see imagery of women that reflects th e reality of the diverse body shap es and sizes that they see in their everyday lives. Emmas comments demonstrat e another one of the participants concerns. Emma: Its not so much that I rea lly want to be thin again. Its more like (pauses to think) I dont fit into a category that th e media present as acceptable. I feel like the media just tell women what they cant look like, but theres limited options for what you can. Feminism celebrates bodily diversity. However mainstream media images limit the portrayal of what constitutes womens beauty and appearance by pr ivileging one aesthetic idealyoung, extremely thin, and perfectly manicured women, over all other potential representations (Sypeck, Gray, & Ahrens, 2004). According to feminist theory, the medias proclivity for portraying a rest ricted representation of fema le body types ignores the genuine diversity in womens physical appearance and creates unrealis tic standards of beauty. Many of the participants noted that there was a single acceptable representation of women, one that fits the ideal. For instance, Faith cri ticized media messages that suggested there was some perfect, one-size-and-shape-fits-all mold that every woman should look like. In her media journal, she wrote her reaction to a couple television ads that struck a nerve with her. Faith: The media give women the idea that everyone is supposed to look a certain way: This Barbie Doll image that society has cr eated. Everyone was born with a different body type and with different features. We are not supposed to all look alike. Several participants indicate d that the media have their own view of what constitutes an attractive appearance, which no longer aligned with the participants. This perspective allowed the women in this study to resist media imagery of the thin ideal. For example, Isabel discussed

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333 how the mediated ideal is an unrealistic image so ld to American women as something to strive for. She completed rejected the medias visi on of the ideal female body on principle. Isabel: I hardly think about it [the ideal]. I dont think about it as in, this is the ideal, so this is what I want to be. Its more like this is their ideal. And thats really ridiculous. Its like, the average American woman is not gonna be that. Im critical of any ideal. Its kind of the same thing as trying to sell you somethi ng. I cant stand that stuff. Like, this is the ideal, you have to be this way. No. Several participants had oppositional readings of media messages criticizing women who did not adhere to the thin ideal. They expressed anger about media messages perpetuating societal weight preoccupa tion and weight prejudice. Diamonds comments reflect the concept that womens social power is inextricably linked to their appearance. In our culture, attractiven ess and success is equate d with a thin body, and that the body is a commodity in this case, an image, literally to be sold. Diamonds anger reflects her frustration with her struggle to maintain a positive body image while being bombarded with media messages judging women who do not conform to the thin ideal. Diamond: Theres still an emphasis on thinness. I mean I saw it in American Idol when a lot of the singers I mean there were some that were very curvy and some of them were very full figured. And the judges, Paula Abdul and others they would come out and tell them, Youre a little thick. Youre a lit tle too big. Your bodys not gonna sell. You are not small enough. One of the girls on there is singing, and shes modeling. Shes full figured, and shes doing well. They said stuff to her too like, Your image is just not thin enough. Youre not gonna portray what we thinks gonna be successful. It makes me angry. The participants also expressed frustration w ith the medias portrayal of women who are at a healthy or average weight as being overweight. Whether it wa s a comment in a movie or a photo caption in a magazine, the participants e xpressed anger about the expectation that women attain or maintain a specific body weight in orde r to avoid disparaging remarks. Rylie wrote in her media journal about a movie shed recently seen in which a character was the brunt of jokes about her body, even though she was a healthy weight.

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334 Rylie: Friday, July 8, 2005 @ 9:00 p.m. Legally Blonde on TBS Getting my hair done. Im watching a movie as I sit, getting my hair done. I dont like the pa rt in the movie when the nail-woman makes comments about how she ha s a fat ass and big th ighs. The part is played by Jennifer Coolidge, who is not fat, she s average. It gets me so angry that they portray someone is just av erage as being overweight. Rylies oppositional journal, combined with her comments in her interview, illustrate how disparaging remarks targeted at women who do not adhere to the thin ideal can cause an inhibitory effect. Social cognitive theory (Ba ndura, 1971, 1994) posits that people can learn from observing others being rewarded or punished for certain behavior. An inhibitory effect occurs when a viewer sees an individual in the me dia punished for a certain behavior, and that observation decreases the likelihood th at the viewer will engage in that behavior. In this case, Rylie saw an average woman deni grated, and despite her angry re sponse, the movie seemed to reinforce her body dissatisfaction as well as her fear of being judged as fat now that she perceived herself to have a normal body. Molly was the only participant who opposed the medias perpetuation of weight bias without accompanying body dissatisfaction. She e xpressed outrage at me dia messages defining an acceptable body: How dare they (the media, advertisers, society) dictate what a person should look like! A person should look like WHO THEY WERE MADE TO BE! And to think that there are millions of not only women, but men who buy into this crap! It should be illegal! Molly sincerely believed that there was no such thing as an ideal body, and during her interview she said, I dont really have any body image issues. For Molly, seeing weight discrimination did not have an inhibitory effect because she no longer feared being fat. In fact, she discussed how part of her recovery process involved feeling the fear, but breaking free from it. Her conc ern was more for others who might accept media messages at face value as she once had.

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335 Need Normal Represented Several participants in this study were critic al of the media for not portraying more normal women, those who represented a diverse selection of women. For example, Metkit shared what she thought would be helpful in terms of prev enting the number of eati ng disorders that are developing in women: Portraying normal people in the media! The participants strongly believed that the women represented in the media do not, but should reflect reality. As Faith stated, I think th at different forms of media should show more and more realistic people in their me ssages. Give the world the truth. Many of the participants said that the media need to provide health ier representations of models and celebrities for young women. Metkit sa id that she thought th e media portrayed the size of the normal, average woman as a 2 to 6. She also discussed how a different size range should be portrayed. Metkit: Often times, I feel like they portray something thats too thin as the ideal. What they should portray is not what they do. It should be a 6 to 12. Normal women. The average normal weight is what they should portray. But then, there should be some of everybody cause thats the way the real world is if I rea lly think about it. Some Strides are Being Made, but Not Enough In general, the participants indicated that the media seemed to be shifting away from the stick thin ideal to a healthier body. Metkits comments captured how the participants felt in general about the nature of the media portrayals: The media are getting better about showing more realistic women, but theres not nearly enough. The portrayal of normal, average women was so rare that the wo men applauded and took notice of incremental changes in media represen tations. For example, in her media journal, Jordan wrote a brief statement about Kristin Davis from HBOs popul ar television show Sex and the City Charlotte has a real body yay!

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336 Several participants noticed that womens magazines occasionally acknowledged that there should be a more balanced representation of women. For example, Amanda noted what Marie Claire had done. Amanda: I know in the past theyve done some i ssues of body image. Like they had one magazine where they put normal-sized peopl e in it and that was all. I think its good because they, you know, are recognizing that this is an issue, a problem. But at the same time, you see that article and then there s an ad next to it, and the persons tiny. But at least theyre trying (She laughs.) You know, like theyr e moving forward versus some of them that arent at all. In her media journal, Faith reacted to a te levision ad for a plus size fashion model show. Her perception may have been influenced by the f act that she usually wore a size 14 herself, which she shared with me during the interview. Faith: Tuesday 2-2:30 p.m. TV, Plus size mode l fashion show advertisement my family room watching TV. Awesome! Plus size women are beautiful too! There is more than one body type out there. Media consider the size 14 plus size. Marilyn Monroe was a size 14 + she was a beautiful model. Some participants were extremely media savvy and were able to dete ct the dual nature of the positive portrayal of wome n in the media who are a normal weight. Emma commented on how refreshing it was to see an admirabl e character, one who was Latina and was not extremely thin, portrayed positivel y on the television show Ugly Betty Emma: I love that the main character is Latina and a normal weight and she likes herself for who she is. She has such self-confidence.T he only downside is that they play up the ugly card too much at award shows. I forget which show this was probably Golden Globes and the actress who play s Betty won an award and the audience gave her a standing ovation. It was so self-serving, lik e, See, Hollywood isn t all about looks. We can have one show in 100 with a Latina heroin e who isnt a size 2. See? Arent we great? It also bothers me that a lot of publicity stuff about Ugly Betty is about how they uglify America Ferrera so that she can play the part. Its like, No one could possibly look this ugly so we have to add hair and make-up. Its pretty insulting. The show itself however is great. The thin body ideal is not forced upon people. However, even those participants who elected to minimize or eliminate exposure to popular magazines and television shows, were

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337 unable to avoid exposure altogether. In one resp ect, this phenomenon can be attributed to the lack of sufficient alternatives, though some participants did choose to consume less mainstream media. More importantly, the ubiquitous nature of the cultural values and ideas related to diet and thinness led them to some level of frustra tion with what the media promote as requirements for fitting into society. Informed by Normal, Average Models and Celebrities Once the participants were in recovery, they tended to ad mire celebrities who had a body shape and size that did not fit the thin ideal. In a sense, viewing diverse representations of women in the media provided the participants with additional permission to challenge the dominant encoding of messages that primarily promote the dominant thin ideal. While the traditional ideal body standard represented in the media still may be pred ominantly thin (Bissell & Zhou, 2004), recently there have been some celebri ties who challenge the thin ideal, providing an alternative example for women about the type of body that might be perceived as beautiful and attractive. Seeing celebrities with curves Many participants indicated that they were st arting to see examples of diverse body images in the media, which they saw as refr eshing. Lindsay described her perception. Lindsay: I do think that in the more recent times, th ey [the media] have embraced a fuller figure, that they used to kind of look dow n on. You know, girls with hips or whatever. There just seems to be more people speaking out about it. For many women in this study, seeing repres entations of diverse body types in the media provided them with hope that a new era may be emergingone that do es not restrict the representation of beauty to the thin ideal. For ex ample, Michelle said sh e did not think that all of the main figures in Hollywood had bad body types.

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338 Michelle: Now I like when they embrace characters that are more healthy and not so thin like, when the media show people like Queen Latifah, who are more full figured. And so, I think Im more aware now of when they have people who are good media body images, I think. People who dont fit th e standard of the norm. What seemed to help several participants to un-internalize the thin ideal was seeing representations of women in the media who had diverse shapes and sizes, particularly celebrities who flaunted their hips and curvy bodies, such as J. Lo and Beyonce. The women in this study discussed the increasing repres entation of curvy bodies in th e media. Jordan shared her perception of a few celebrities that the media now portray as sexy. Jordan: I love the way that they give Jennifer Lop ez and Beyonc attention and talk about how they have hot bodies cause those women have got hips. Like even Shakira, I mean hello shes got, you know. (She laughs .) Like they have really curvy bodies. And for me as a woman who has a curvy body, that makes me feel better. I personally love that they get a lot of attention. And theyre healthy. You can tell they take care of themselves. At one point, many of the women in this study strived to fit the thin ideal, which often meant defying their natural body type. Now that the women were in recovery and saw more curvaceous body types positively represented in the media, they felt more comfortable embracing their natural body shape and size. Jordans comments illustrate how celebrities with diverse body types can contribute to a more expansive view of female attractiveness. She described how her perception of the ideal female body image and of her own body changed over time. Jordan: I like having curves. Ive embraced that side of my genetic build, and actually I feel more sultry now than I did. Im like, Wow, I got a l ittle bit of T and a little bit of A. Its kind of nice. (She laughs.) You know, it s funny. I never would have imagined that I would have more confidence now than when I was a size zero And I have so much more confidence now than I did back then. Many participants expressed admiration for celebrities who challenged the traditional Hollywood standards. The celebrity that the participants menti oned most often was Tyra Banks, possibly because at the time, she was receiving a great deal of publicity.

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339 Faith: I like the whole thing with Tyra Banks and how shes handling the media. When she was a model, she was actually one of the heavier models one of the curvier models.Now, shes like, Look, Im not on a runway. I dont have to meet those standards. Im healthy. Im happy.She wants girls to know that being anything other than extremely thin is ok, as long as youre healthy. What a great ro le model for girls and women! In addition to Tyra, several participants di scussed other celebrities that challenged the portrayal of the dominant thin ideal. For exam ple, Lindsay discussed how she admired Kate Winslet for directly challenging th e medias use of airbrushing Lindsay: Kate Winslet always says that shes proud of being kind of fuller, even though I think she still has a really great body. I just remember the one time I dont know if it was a photo shoot or somethin that she got a pi cture taken, and they re shaped her legs to make them look much smaller than they actually were. And she made a big deal about that those werent her legs, that they sent th e wrong message out to young girls and stuff. Hopefully maybe more people will do stuff like her just so its not such a norm to think that you have to be tall and skinny. Overall, the women in this study tended to admire celebrities who respected their natural bodies and provided the public with a positive, healthy representation. Th e participants also indicated respect for women who were more rea listic looking and did not starve themselves for a movie role. Along the same lines, several participants admi red celebrities who did not try to alter their body with surgical procedures. Molly described how she admired a celebrity who refused to have breast augmentation. Molly: I read an interview with Debra Me ssing that said that the producers of Will and Grace wanted her to have breast implants put in and she refused! She said that she was the way she was, and they could use it as material for the show, but she was not going to have surgery! Dove Campaign for Real Beauty Many of the women expressed support for th e Dove Campaign for Real Beauty, known for its diverse representation of female beauty. The campaign Web site explains the goal of the

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340 Campaign for Real Beauty, offering hope for a tr ansformation in the lim ited portrayal of the ideal female body image. For too long, beauty has been defined by narrow, stifling stereotypes. Women have told us its time to change all that. Dove agrees. We believe real beauty comes in many shapes, sizes and ages. That is why Dove is launching the Campaign for Real Beauty. Doves global Campaign for Real Beauty aims to change the status quo and offer in its place a broader, healthier, more democratic vi ew of beauty. A view of beauty that all women can own and enjoy everyday. (h ttp://www.campaignforrealbeauty.com/) Several participants said they respected th e Dove ads because they showed real women, not just stick thin models. In addition, th e participants like th at the Dove models had flaws and were not representations of perfection. Jordan discussed how the Dove campaign wa s celebrating diverse body shapes and sizes. She also had noticed that differe nt hair styles and other physical characteristics were now starting to be represented. Jordan: In my opinion, Im seeing more of a healthier representation, like the Dove commercials that theyve started doin g, the real women Dove commercials. I love those. Just gotten into so many more, you know average women, plus size women, skinny women, I mean any kind of representation. Freckles, no freckles, curly hair, straight hair, just all the way around. And they re, theyre making that their thing. I dont know what the word is, not their motto, but theyre making th at their image now, which I think is cool. The participants interpretation of the Dove campaign and the extent to which it provided hope for a transformation in body ideal seems to have been tempered by their personal life experiences. For example, in her media journal, Rylie indicated that she liked the portrayal of women with normal bodies in mainstream advert ising, but she did not ha ve hope that the thin ideal would change. Rylie: Thursday, July 14, 2005 @ 8:15 a.m. Today Show Getting ready for class, breakfast. On the Today Show are these women who did an ad campaign for Dove. They are in just bras and underwear. These wome n are normal women. Katie Couric keeps mentioning how its a good thing and that she hopes it spread. I agre e. These women are a

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341 more normal body weight then your average campaign ad women. I dont think this will catch on, but its nice to see one compa ny using women who are not supermodels. Media Ideals Fluctuate Attractiveness has not always been equated with thi nness, as body standards and perceptions have changed over time (Bor do, 1993; Seid, 1989). The media-propagated construction of thin as attractive and fat as ugly is so prevalen t and normalized that it often appears to be an unquestionable prescription of some law of natural aesthetics; that fat is ugly and thin is beautiful (Malson, 1998, p. 106). However, the notion of what constitutes a beautiful female body is an historical and cultural construction that has transformed over time since the Rubenesque era (Bordo, 1993; Malson, 1992; Orbach, 1986; Seid, 1994). While the participants did not discuss body ideals dating back to the Rube nesque era, they did talk about the Twiggy ideal, which started around the 1960s. Historical context Women in this study who were able to place the current ideal body image into an historical context were more likely to resist the dominant body ideal perpetuated in the media. They understood how the culturally-cons tructed notion of what constitu tes an attractive woman, has changed over time. Jordan discussed her hope for a transition to a healthier, naturally curvy woman shape as the ideal body image. She noted historical trends of the 1960s, 1990s and current times. Jordan: I think the medias gotten better. Toda y, they seem to embrace the curvy body types of Jennifer Lopez and Beyonce more. But back in I mean I can remember when I was a teenager like in the 90s it really was people like Fiona Apple and Kate Moss, really were the, I guess they really were kind of like the equivalent to what Twiggy was, when my parents were growing up. You know, it really was cooler to have like the waif, dark circles under your eyes kind of a look a nd Im seeing, in my opinion Im seeing more of like a healthier representati on, like the Dove commercials.

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342 Several participants discussed Marilyn Monroe as an example of how beauty standards have changed over time. Knowledge of Marilyns size allowed Eliza to challenge the dominant notion that a woman needs to be thin to be sexy. Eliza: I like Marilyn Monroe. She s this really great figure for women. And shes a size 14. I love that! I think thats great. Shes kind of a sex symb ol. And I like th e fact that shes a size 14 and a sex symbol. Like, you can be both. (sarcasm) Many of the participants discussed how they had seen a shift from the sick thin look of Kate Moss in the early 1990s to a healthier-l ooking skinny. For instance, Sunshell described the transformation. Sunshell: As a teenager I grew up in the Calvin Klein heroin chic era. Scary skinny seemed to be portrayed everywhere. I think nowadays a healthy thin is more the ideal. Although the little sick, scary sk inny socialites such as L ohan, Richie, and Olsen, are portrayed everywhere, th e media coverage has been somewhat negative. Most of the participants had a clear distincti on in their minds between thin and sick thin. For example, Sunshell described the distinction in her mind: I would say sick thin or scary skinny is below a normal BMI. Normal ski nny would be having a healthy BMI. Like, I consider myself normal skinny. Im thin, but I have a normal BMI. Athletic and toned ideal The participants also discussed another relatively recent shift in the ideal female body image, a woman who was not overly muscular, but toned, someone who works out. For example, Kerry described her pe rception of the current ideal. Kerry: The medias portraying more women who ar e in shape and not necessarily just thin I dont know exactly when it changed. But I think that the media now place more of an emphasis of having toned, athletic bodies Whereas previously, women were just supposed to look skinny. Many of the women in this study were able to oppose the dominant readings of thinness in media and possibly create a divergent view. However, they still were enticed by the

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343 athletic/toned ideal, a relatively new media portrayal. For instance, Enchantments perception of the ideal seems to have shifte d along with the ideal itself. Enchantment: Before anorexia, my ideal image wa s more curvy. It was like Britney Spears. Cause I mean shes not too thin, but then shes curvy. A nd I dont know thats probably what I thought. I alwa ys wanted to look like her and stuff. Then during the anorexia, I guess it started out with just looking like a supermodel or something, and then it was just like where I just want ed to be stick thin, like a litt le girl or something. More like I guess Mary-Kate and Ashley. Like then, I didnt even wanna have boobs or anything. And now, its probably like the images you see on like Shape magazines. Like I wanna be thin, but I wanna be in shape and toned. In contrast to Enchantment, many partic ipants engaged in se lf-protective oppositional readings of the athletic/toned ideal. Several women discussed how they would counteract media messages by telling themselves that this type of look only could be achieved if someone devoted their entire life to working out. As Jamie said, They only look like that b ecause theyre paid to look good. They can spend their days in the gym working on their abs. Nearly all of the particip ants discussed how they felt insecure about their stomach, especially when they saw images of women with clothing that flaunted their strong abdominal muscles. With some rare genetic exceptions, to achieve this type of sculptured look, a woman would have to devote several hours a day to creating and ma intaining that type of body. Many participants were able to oppose the thin ideal, but they still felt the need to look really fit and have well-defined muscle defin ition or abs. To resist feeling badly about her body, when she saw images of extremely fit woman, Christina engaged a self -protective strategy. During her interview, Christina questioned the effectiv eness of a product f eatured in an ad. Christina : The commercial had an image of this woman, and she had abs and she was all muscular and toned, and I was just like, W hoah! But then I was like, (she laughs) you cant. The diet pills dont really make her look like that. But it got to me though. There were several participants who percei ved the thin and athlet ic/toned ideal to be unrealistic, impractical, or outri ght absurd. This perception allo wed them to engage in more

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344 oppositional readings. For instance, Noah described her perception of the athletic component of the current ideal female body image. Noah: Its [the ideal] also, athletic. So not onl y do you have to be really thin, but you have to be muscular as well. And have big boobs, so. Yeah, it really pisses me off. Its not like they stopped the incredibly thin person. Now theyve got th e very toned, athletic look, which is also difficult to get to. And it takes up a lot of time. And it makes me really mad. To think, that would be fine if it was my full-time job. But its not. I mean, you just think, on top of having my Ph.D., Im supposed to sudd enly think that I need to have the body of a fitness trainer Other participants did not find the athletic l ook to be attractive or appealing. For example, Eliza described why she was able to resist messa ges promoting a more athletic-looking ideal. Eliza: I think that theres a lot of hype about ex ercise and being really fit. The media are kind of obsessed with being fit. But Ive ne ver found that rock hard stomach appealing. I dont think thats attractive. And I wouldnt ever strive to have that kind of look. Media Awareness and Critical Media Literacy In their initial stages of recovery, the participants merely had awareness of media techniques. With this newly found media awareness, the women r ealized that they needed to avoid unhealthy media messages and, if they were unavoidable, not to take the media messages at face value. As the women progressed in their recovery pr ocess, they did not fi nd the need to place media imagery off limits because they had de veloped a strong enough sens e of media literacy to know that the thin ideal wa s not healthy, and they were ab le to engage in oppositional decoding. Like many of the participants, Lulu became literate through her battle with and recovery from an eating disorder. Lulu : I think Im more aware of the media having lived through my eating disorder. I mean, I never paid attention to the media a nd how it portrayed womens bodies. Then, after living with an eating disorder, I pay much more attention now cause I see it and its like, Gosh, its terrible that theyre portraying women this way. That theyre encouraging them to starve themselves to be a certain way.

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345 The women who were most advanced in thei r recovery transformed their awareness into anger as they realized just how powerful the medi a are as an institution in American society. The more the participants felt that the media were wielding their power to victimize an unwitting audience, the more irate they became. This was particularly true when the participants recognized significant contradict ions in media messages. For Molly, evidence of rampant contradictions in magazine messages allowed her to discredit the entire source as credible or sincere. Molly: It makes me really mad when magazines will have some really stupid diet that youd have to starve yourself to follow, and then right after that, they tell you how to accept yourself or boost your self-esteem. When they pull that kind of crap, it just all seems so artificial. Definition of Hegemony This dissertation draws on Foucaults (1973, 1979, 1980) concept of the exercise of power and Gramscis (1971) concept of hegemony to examine how women used the knowledge they gained in recovery from anorex ia to exercise power and free choice over their bodies and lives. Foucault (1979, 1980) has ar gued that the conceptualization of power is incomplete, and that a more comprehensive approach to understanding power would be to move beyond the focus on who has power to how power functions and the consequences of its management. Gramsci saw the mass media as tools the ruling class used in this process of ideological hegemony to perpetuate their power, wealth and status (Barr, 2000, p. 17). The participants cultivated an effective resistance against the hegemonic constructions of the ideal female body, which attempt to fix ideas about what constitutes a socially acceptable physical appearance. Hegemony is the idea that a capitalist cultures most powerful economic groups obtain consent for their leadership through the use of ideological and social norms

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346 (Altheide, 1984; Condit, 1994; Croteau & Hoyne s, 2000; Gramsci, 1971; Hall, 2001; Holtzman, 2000). In Western culture, women are socialized to believe that femininity affords women acceptability and respect (Bordo, 1993). The privileg ed, or hegemonic, form of femininity is constructed within a White, he terosexual, and class-based st ructure, and it has strong associations with heterose xual attraction (Ussher, 1997). Wo men who meet the social expectation to adhere to hegemonic femininity are afforded privilege and concomitant power in social realms and within the workplace. Convers ely, there are social retributions for women who do not, suggesting that if a woman wants to garner social acceptan ce, then the only choice is conformity with the idea l (Bordo, 1993; Butler, 1990). As a powerful industry, the media are the driv ing force behind the collective societal understanding of what constitutes female beaut y. By limiting the representation of the female body to the thin ideal, the medi a privilege a single body type, wh ile affording differential value to alternative bodies in comparison to th e dominant mediated ideal (Bordo, 1993, Goodman, 1995; Maine, 2000). The standard and value of the thin ideal is built into the foundation of our societal structure, which serves to aids the pow erful (i.e., diet, fashion and beauty industries), while placing others (females seeking social acceptance) at a disadvantage. Hegemony is a commonsense understanding of the world, established through a set of meanings and values (Williams, 2001, p. 157) Through mass media channels, hegemonic notions are instilled in the public by repeated exposure to ideas. Mainstream media are powerful institutions, which have the ability to instill hegemonic ideas by exposing individuals to values and beliefs presented as unquestionable, univers al norms (Croteau & Hoynes, 2000). Magazines in particular are a powerful ideological for ce in society (McRobbie, 2000, p. 69), especially for

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347 young girls who are seeking information about what they need to do and look like in order to be liked and accepted by their peers. Because of the subtle nature of media, the general public does not necessarily see the hegemonic power of the mass media. As Lull (2 000) has contended, The victims of hegemony dont realize they are being repressed through ideology (p. 73). Several researchers have contended that mass media are in strumental to culturally-constru cted hegemony, particularly in the United States (Croteau & Hoynes, 2000; Herman & Chomsky, 1988; Holtzman, 2000). By internalizing the thin ideal, these women had beco me victims of a false consciousness to adhere to the hegemonic construction of attr activeness and social acceptability. Media No Longer Trusted Friends The participants used to consider the media to be trusted friends. They also used to view media sources as experts, with valuable informa tion about topics of inte rest to them. Alexandra described her perception of beauty an d fashion magazines when she was 15. Alexandra: I actually looked at some of those ma gazines as my bible. I know that sounds extremely stupid now. But I believed ever ything I read. And well, if it was in one of those magazines it had to be true! I got a lot of tips from the magazines when it came to dieting, exercising, and what creams work and so on. Once the participants were in recovery, not only were they less interested in primarily appearance-related content, but they also no lo nger granted the media the authority they once had. The women had learned that mediated message s, particularly those in beauty and fashion magazines, were fueled by capitalism and offered a skewed view of realit y, pushing an ideal that was not achievable. As Michelle sa id, I think its sad that people feel the need to look that way or want to look that way. Choate (2007) has argued that adolescent gi rls need strong internal resources (such as gender role satisfaction, strong physical self-concept, and coping skills) as well as external

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348 support from family members and peers to develop what she refers to as body image resilience (p. 317). Furthermore, research has indicated th at teenage girls who place too much importance on physical appearance may neglect to devel op critical, healthy coping mechanisms and supportive, nurturing relationships to navigate the challenges of adolescence (Striegel-Moore & Cachelin, 1999). While the participants previously had fallen victim to the insidious mediated ideal, increased media literacy gained during their recovery process allowed them to become active consumers, rather than passive casualties of potentially-damaging media influence. For example, Alexandra no longer read magazines, but as a te enager, she loved them because they were about everything fashion, beauty, love, men just about everything women are interested in. Critical Media Literacy The participants discourse indicated that media literacy was a key component to an oppositional reading of the mediated thin ideal. This finding reflects what some of the preexisting research has indicated that critical thinking about the media can produce behavior change (Irving, 2000, p. 86) and affect ones thought processes. Furthermore, Irving and Berel (2001) have found that increased media literacy can result in increased skeptic ism about media images, reduced beliefs that models are realistic and reduced desire to be as thin as models. Broad definition Media literacy will be broadly defined as th e ability to access, understand, analyze, and evaluate various media messages. In addition, media literacy is the ability to use critical thinking skills to transform media consumption from a passi ve to an active process. According to Potter (2001), media literacy is a pers pective that we actively use when exposing ourselves to the media in order to interpret the meani ng of messages we encounter (p. 4).

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349 By becoming more media literate, people ga in greater awareness of the potential for misrepresentation, manipulation and bias in the me dia. Media literacy is about learning to ask important questions about imagery and messages that are there, and noticing whats not. Its also about gaining the instinct to question the motives for a media message and how those motives influence the content. As such, part of medi a literacy involves analyzing the production and consumption of media products as ideo logical texts (Sholle & Denski, 1995). Specific definition More specifically, media literacy will be define d as the ability to be a critical consumer of appearance-related media. Participants in this study who have a high degree of media literacy have the tools to critically evaluate and dec onstruct media images of women, becoming critical consumers of appearance-related media. These partic ipants also have visual literacy, which will be defined as an understanding of the various ways that visual media can misinform, distort, and manipulate (Messaris, 1994, p. 2) as well as the powerful eff ect of cumulative exposure to such media. Research on the effectiveness of media lite racy in the prevention of eating disorders and internalization of the thin ideal is still in the preliminary st ages of investigation. However, several researchers have found that comprehensi on of socio-cultural messages regarding weight and shape provides some buffer from potentially negative effects (Hen derson-King et al., 2001). Furthermore, awareness of such pressures must be combined with critical thinking skills that allow women to deconstruct social influences th at define and promote the thin ideal (StriegelMoore & Cachelin, 1999). Research also has sugg ested that women who ha ve critical awareness are less likely to try to conform to narrow defi nitions of beauty as defined by the thin ideal (Cooley & Toray, 2001; Guinn, Semper, & Jorgensen, 1997).

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350 According to Celio, Zabinski, and Wilfley (2002), all women can and should adopt broad, flexible definitions of beauty that any individu al could attain. As Pete rson (2000) has contended women who are capable of identifying culturallyconstructed gender roles and who are able to use their own voice to define themselves are more resilient to social pressures. Furthermore, McKinley (2002) has contended th at many women are not able to separate their own needs and desires from those espoused by the media, thei r family, and their peers because they have internalized socio-cultural pressures. Some rese archers have developed su ccessful media literacy programs (Irving, 1999; Levine & Piran, 2001) to t each young women how to identify and resist harmful socio-cultural pressures by cr itically evaluate media messages. To resist socio-cultural pressures, the women needed to develop tools that enabled them to challenge dominant pervasive media messages prom oting the thin ideal. While this dissertation does not make concrete claims about cause and e ffect relationships, th e results of this study suggest that media literacy may be an eff ective preliminary strategy for reducing the internalization of the mediated thin ideal. Fo r example, Nicole discussed how her overall perception of the mediated ideal transformed as she progressed in her recovery process. The more recovered she was, the more critical and oppositional her perspective. Nicole: My perception of the medias portrayal of the ideal body has changed over time in the sense that Ive become more critical of it. More so in the last couple of years, Im much more critical of the way that the media portray people. Overall, these women suggested that they b ecame increasingly resistant to the mediated thin ideal as they developed a sense of media literacy. Participants who maintained consistent oppositional readings also tended to be the most critical of the media and advertising industries as a whole.

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351 No Interest in Mainstream Media Many of the participants rejected m ost mainstream media, not as a self-protective strategy, but rather because they found th e messages worthless. As Kristin said, I do really avoid the media. But its not necessarily like Oh God, media! I cant do it! Its just not a part of my life. Mollys comments illustrate the type of internal perspective that enabled her to resist the mediated ideal more than most women in this study, and she stood firm in her position. Molly described her perception of the ideal body image over time: I th ink that I saw the ideal the same. What changed was how important it was in my life, how important it was to me, and deciding for myself what Im willi ng and not willing to buy into. Media Promoting the Thin Ideal are Worthless As the participants progressed in their recove ry process and un-internalized the thin ideal, media messages promoting the thin ideal became in creasingly less likely to tug at their emotions. Diamond described how her reaction to fashion and beauty magazines changed over time. Diamond: I definitely boycotted Cosmo and Elle because of really skinny runway models and killing animals for fur. I boycotted a lot of those magazines for a while. I was really extreme, but I mellowed out. So now, its not like, Ugh! Theyre awful! I mean, it just, it doesnt affect me the way it used to. The participants also considered media sources promoting the thin ideal to be a waste of time. For instance, Barbara had no interest in magazines. The only time she saw them was at the hospital where she worked. She described their mag azine selections as the typical hospital-type subscriptions like People and Vogue and Newsweek When she did pick up a magazine, she was interested in reading an articl e, not looking at the ads. She de scribed one time when she picked up a Vogue magazine at work during her night shift. Barbara: I was really bored. Nothing to do. So I picked up Vogue cause it was that bad. (We laugh.) And I thought Id find some material to read. But I was all ticked off because its all advertisements. Its all girls with weird makeup. Like extreme And then you have like 1,000 pages, and theres maybe one interesting article.

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352 D: Ive never looked through one. Barbara: Dont bother. (We laugh.) Several participants found little value in womens magazines because they offered the same material month after month. As Jamie sa id, I stopped buying magazines a long time ago. I remember one year when I was looking at an old, leftover pile I had, and I realized that I could just change the date on the issues, and Id get the same information as buying new ones! Participants who were furt her along in their recovery pr ocess, and who had progressed further in terms of un-internaliz ing the thin ideal, avoided mediat ed diet messages, but not as a self-protective mechanism. Rather, these partic ipants had more of an oppositional reading based on the notion that the media no long er were trusted friends that pr ovided reliable information to them. They had come to view mediated diet s as ridiculous and not worth their time. When I interviewed Nicole, she had just completed her B.S. in nutrition. She opposed diets suggested in mainstream health and fitness publication because she knew that the information was totally wrong. Grace was completely committed to her recovery process, and she never wanted to return to her eating disorder. This commitment allowed her to resist messages about dieting. Grace: I am stronger. I know who I am. I dont want to throw up. I don t want to diet. I dont read like Cosmopolitan or Glamour or Bazaar I might look at the pictures in there? Like the fashion things? Or the makeup? But I will not read the articles because theyre so body, diet focused. And I dont have any interest in that. Many women in this study discussed how they saw magazines as a waste of money. Some participants truly saw the magazines themselves as useless, while others gained some enjoyment from magazines, but just did not want to spend m oney on them. Participants in the latter category tended to decode messages about the thin ideal in a self-protective oppositional manner. For

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353 example, Ramona said that she did not subscrib e to magazines anymore, but that she enjoyed reading them while she was in checkout lines. Ramona: Im fairly cheap. So I usually I try to go to like a long line so I can actually read through the majority of a magazine, or at least flip through it. (We laugh.) Ya know how most people go to the short lines? Well, sometimes I go to the long line just so I can read the magazine for free. (We laugh.) Many participants expressed regret about the amount of time and money they had spent supporting their eating disorder. As Alexandra said, I wasted so much money on magazines while I had my eating disorder. I also wa sted so much money on things promoted in the magazines, like diet pills, diuretics, laxativ es and binge food, gym memberships, slimming cream. You name it, I bought it. Once Alexandra was in recovery, she no longer read magazines unless she was in a waiting room for a hair appointment or in a doctors office. Alexandra described why she no longer purchased magazines: Magazines are too expensive, first of all. I mean they are not worth the price. You are kind of paying money to look at ads. As the participants progressed in their r ecovery process, their overall media usage declined. Participants who were furthest along on the recovery continuu m tended to find TV to be a waste of time. For example, Barbara had b een recovered for severa l years, and during her interview, she described how she considered he rself to be recovered, not in recovery: I know that I wont go back. Barbara ha d a television at home, but she did not have cable: I dont miss it. I dont care for TV. She described her media diet as limited primarily to online news sites and movies. Most of the participants used to watch a lot of adolescent type televi sion shows, such as 90210 and shows on the WB, like Dawsons Creek and Felicity However, for the most part, they no longer watched much TV, if any. For example, Nicole had not had a television since she

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354 moved out of her parents house, about six years prior to her interview: I think its a time suckage. And it also just makes me feel yucky. Its more than just the images. It just makes me feel, I dont know, like Im wasting my time. Selective Exposure to Mainstream Med ia: A Self-Protective Perspective To minimize exposure to extremely thin m odels and celebrities, several women in this study preferred media sources with imagery of h ealthy women. While the participants with more oppositional readings of the thin ideal avoided ma instream media altogeth er, the women who had more self-protective oppositional readings tended to substitute media options that were still mainstream, but were slightly less conventional in the portrayal of ex tremely thin bodies. For example, Grace described two ma gazines she enjoyed reading. Grace: I like Self and Runners World because theyre more realistic than the fashion magazines that are showing these anorexic models. Like Bazaar and Glamour ya know, the advertising with these anorexic models. And some of them are definitely thin in these [ Self and Runners World ], but generally, theyre just healthy fit women. And I like seeing real women and not anorexic standards to live up to. Enchantment had just started subscribed to Fitness and Prevention when I interviewed her. She explained why she preferred those two magazines over others, such as Cosmopolitan Glamour and Cosmo Girl : I like them because they have a lot of health tips and lot of tips on working out and how to get in shap e, but I feel like they have less pressure to be super small. While most participants avoided all reality shows, a few women in this study said they enjoyed reality programs that did not focus prim arily on the thin ideal. For example, Alexandra enjoyed watching What Not to Wear because she thought the show promoted the idea that all body types can look attractive with the right clothing. Alexandra: I find this show very inspiring. The people on the show have all kinds of body types. They celebrate your body no matter how it looks like and make it look pretty. You see people who dont look like models and have normal or overweight bodies getting a makeover.

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355 The participants also tended to watch tele vision shows that did not focus primarily on appearance. For example, Lindsay described why she liked ER: I like a show that is not all about vanity and looking good, but about people with real problems and how to get through them. The relationships remind me of the impact people have on one another and how important close relationships are. Ideal is Not Natural It seemed to be extremely important to the women I interviewed not to view an unrealistic comparison target as achievable, or they were li kely to unravel the progress they had made in their recovery. What allowed wome n to resist the mediated thin ideal was an understanding that perfection was not possible. The participan ts thought process with regard to the reality of achieving a perfect body transformed over time. Several participants described how they used to think that they should be able to look like the representati ons of the models and celebrities in the media when they were in the midst of their eating disorder. During th eir recovery process, however, they had a more realistic and less distorted view of what their bodys natural shape and size was, and whether striving to attain a perfect body truly was reasonable, or possible. Not Everyone Can Look Like a Model These women used to conform to the domina nt ideology suggesting th e egalitarian nature of thinness, that all women are capable of beauty because the sole requirement is thinness. The media promote the false notion th at body shape and size are comp letely under a persons own control (Seid, 1989). Furthermore, research has indicated that people who subscribe to this notion and are unable to reduce the gap between exp ectations and reality are likely to experience psychological and physical consequences such as shame, failure, nutritional deprivation, and long-term yo-yo dieting (M ishkind et al., 1986).

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356 Several participants debunked the media-pr omoted myth that everyone can achieve the ideal body because the only requirement is weight loss. Courtneys comments illustrate how she truly had believed that she could look just like a model. However, in recovery, her interpretation of media messages transformed. Courtney: I guess my perception has changed a little bit. Whenever I first started with my eating disorder, I would always look at, like females and stuff in the media, and I would say, Shes got the perfect body. She looks great And before, I would tell myself, Okay I should look like that. I should be able to look like that too. I s hould be able to work out and eat healthy and stuff and be able to look just like that. And now, I mean I still look at people or women in the media, and Im like, Oh wow she looks great! But I dont have that distorted thought of, Well I can look exactly like that. Cause now I know I cant. My body type is a certain way. I can eat hea lthy and work out a regular amount. But I can only look just to what my body will allow me. And so, thats definitely a major change. Social comparison theory has evolved over time, and one of the f actors that has been incorporated into the theory was who the woman compares herself to, or the target comparison. The target might be particularistic (a peer or family member) or universalistic (fashion model or celebrity). The results of this study indicate that univ ersalistic comparisons no longer held meaning for many of the participants because they now perceived fashion models and celebrities as belonging to a completely different category. Often, the participants discussed how they had learned that modeli ng was a profession, and that models had a certain body type, not one that everyone should strive for. Many participants learned to distinguish between the criteria for themselves and the criteria for supermodels or celebrities. Amanda: I can separate things in my mind. Li ke, media images are how we get our perception of whats attractive. I mean I thi nk thats obviously a c ontributing factor. And I even though I think being thin is attractive, now I think I definitely can say, Theyre famous. They have personal trainers, and their job is to look this way. Shes a supermodel. Shes the skinniest person in the world, and th ats why she has this job. I can separate that. Like, I dont see a celebrity and think, Oh my gosh, I want to be thin. I think, They work out six hours a day or whatever. It doesnt bother me as much that way. But Im sure that standard is where Ive gotten my definition of what it is [the ideal].

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357 Understanding of Image Manipulation Women, especially those who are in recovery from anorexia, need to learn that media messages cant be taken at face value, that most women on television and in magazines do not reflect what can be achieved naturally, wit hout airbrushing or other image manipulation techniques. Comparison against such imagery is likely to make women to feel inadequate, particularly if they lack know ledge about computer-enhanced imagery. Courtney described a helpful strategy she used to avoid feeling worse about herself, the women needed to reduce their level of comparison with celebrities and models. Courtney: In most ads in magazines, I tell myself, Well this has gotta be airbrushed. Oh, she doesnt really look all that great. She s just in this perfect setting. They can do so many things with the camera these days. And I used to be like, Gosh, shes so skinny! Why cant I be like that? But now its not as distorted th at I can look like that. An understanding of airbrushing was not onl y useful for magazine images. Ramona described how her knowledge of digital manipul ation prevented her from engaging in an unrealistic comparison. Ramona: I was shopping at the mall with my sister And they were probably like, 10 foot tall, like five of em in a row. It was a Victorias Secret ad. She didnt have anything on. It was just a naked woman, with her hand over the front of her. Then, right next to it was one with she had lacy underwear on. But theyre so perfectly manicured. And thats not what a human looks like! Not what a real woman looks like. And I consciously have to tell myself, No. That person is not healthy. The ad is computer generated Little nips and tucks, and its only showing one little tiny part of her body. She probably has like fat toes or something for all I know. Charlotte described how she felt better knowing that images were manipulated, but the nature of her thought process and comparison to m odels was different. She still subscribed to the dominant ideology of the thin id eal and flat abs, but she used her knowledge of airbrushing and lighting techniques to rea lize that she might be capable of lo oking like the images if she had all the image manipulation tips a nd tricks at her disposal.

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358 Charlotte: Ill be like, Oh, at that angle, it doesnt look that flat! (She laughs.) Or Im like, Well, its just airbrushed. Or If I was wearing that and had that light or reflection on me that way or this or that, then Id look like that too. Theres always something they do to the image. Kerry was able to oppose the medias portrayal of the ideal body image by realizing that the women shown in ads were not real people, but images. This allowed her to avoid engaging in potentially harmful comparisons. Kerry: I realized when I did this journal that I used to look at all these ads and just compare myself. I used to just, that was the fi rst thing I did when I looked at them. Id be like, What does their body look like? What does how does my leg look like, compared to them? But those thoughts are completely absent now. And I think that there was a period of time when I was consciously saying to myself, Thats a person too. Its a person, and she does real things and she has a real life. But now, its like, Its just a picture So theres no point in comparing yourself to something that doesnt exist. Doing this media journal, I realized that I didnt do that anymore thi nk that shes a real person. One of most effective ways for the women to understand what airbrushing truly could do to a photograph was to actually see the alte ration done in a program like Adobe Photoshop. Having the opportunity to see the before and after imagery allowe d the participants to have a concrete vision of the extent to which an image can be altered. Alexandra: I did not really believe it at first. It is hard to imag ine that what we are looking at is not real Its hard to imagine because I did not have a before picture to compare it too, I only saw the after picture. I also really underestimated those prof essional retouchers. In the beginning for the firs t couple of years I did not know that there is so much they can do. I thought they do some minor changes. Now I am finding out more and more about this [airbrushing] that they make breasts way bigger and hips way smaller and that they can change your hair color and so on. I had no idea about all that. My husband is a pro when it comes to playing around in Photoshop and he showed me what is possible. As the women in the study progressed in thei r recovery, much of their knowledge of image manipulation became more oppositional, rejecti ng the whole concept of digital manipulation. Typically these participants expr essed outrage at the unrealistic nature of the images, or they viewed the whole modeling industry as absurd. Faith expressed her frustration with an ideal that she felt was forced upon people, de spite its unrealistic nature.

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359 Faith: I think that society pushes what women should look like. How long have we been aware that those pictures [referring to a cover of Shape] are not what that camera took? I mean, even that one. Something is fixed on there. Theres ju st no way. Its just not real. Theyre all airbrushed. All of them. In general, the participants perceived the ideal female body to be unrealistic, at least without surgical interv ention or digital manipulation. As Ed a said, Right now, the ideal is skinny with big boobs, which rarely happens naturally. During her interview, Courtney said that sh e was constantly comparing herself to other women, in real life and in the media. She desc ribed her thoughts about An gelina Jolie, whom she perceived to be drop dead gorgeous. Courtney: If I had to choose a womans body, it would definitely be Angelina Jolies. And every time I see her on TV, Im just like, God, shes got the perfect body Just shes not too skinny, shes not big. I remember that one day I saw her on an interview, and she was wearin something, and her waist was super tiny, and then she had on I dont know if it was the top she had on or what but her boobs looked humongous (She laughs.) And I was like, How can somebody be that little ha ve such big boobs? Cause thats just not normal Little people have little boobs (We laugh.) Courtney knew that it was important not to feel badly about her own body. She discussed a strategy that was helpful for her. Courtney: And so, I was thinking, Hmm, I wonder if she got plastic su rgery. Stuff like that always goes through my mind. When I s ee people like that on television, Im like, They probably just got plastic surgery. (She laughs.) You know, or a boob job or whatever. I would actually feel better if I did know. I wish I could. You know how you can see ads in magazines sometimes? Or with the whole Britney Spear s thing. Everyone said she got a boob job and stuff like that. It does makes me feel better when I see stuff like that because Im like, Oh okay, theyre not just naturally perfect. Cause Im constantly telling myself, No ones perfect. And so when I see somebody who I think is drop dead gorgeous, and I consider them to have the pe rfect body or whatever, Im just like, Gosh, you know, thats unnatural (We laugh.) So it does It makes me feel better. Media Imagery Does Not Reflect Mature Womens Bodies One of the most visible changes for an a dolescent girl is her body. During adolescence, females are supposed to develop wi der hips, and develop fat in their breasts, thighs and buttocks (Dubas & Peterson, 1993). However, such weight gains are inconsistent with the thin beauty

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360 ideal espoused in Western cultures (Levine & Smolak, 2002). Changes at this time cause young women to become increasingly aware of and c oncerned about their physical bodies (Pipher, 1994). Unfortunately, right when young women are experiencing these bodily changes, they get bombarded with powerful cultural messages that a thin and fat-free body is beautiful, even imperative (Pipher, 1994). Christina discussed how she in itially developed her eating diso rder shortly after she started her period at age 13: Thats when you start deve loping, and I was just de veloping getting hips and breasts. And I thought that was fat and my clothes were getti ng tighter. I would have felt better if there werent all those stick thin models Christinas comments illustrate the need for the media to portray more accurate representati ons of young women, ones that reflect the natural body transformations that young teenagers experience. Christina: I have to say to myself, This is me becoming a woman. I have to become a woman. I have to have hips. And buttocks. Even though I hate it. I hate it so much. I dont want to even walk. I feel like Im bouncing all over. I have a butt now. And its hard for me. Along with the physical changes of adoles cence, girls also experience psychological changes as they seek to understand who they are and how they fit into society (Dubas & Peterson, 1993; Erikson, 1968). Adol escence is a time for integrati ng childhood identity with the development of ones adult self Adolescents seek to find thei r true identity by trying out different roles they learn from their peers a nd from the media (Erikson,1968; Miller, 1993). Many of these women described the tremendous pressure they felt to be accepted and wellliked by their peers, and part of being accepted wa s conforming to the right look. As Eda said, When I was a teen, women were supposed to look like boys. At some level, they had known that women should be more developed than young girls, but this was not the message they saw represen ted in the media images. For instance, Nicole

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361 discussed how she felt pressure as a teenager to look like the young models, who had not yet developed characteristics of a womans body. Nicole: When I was 11, I felt good about my body, and I was one of the first girls to develop. And then I remember there was a sh ift, and my confidence just went down the tube, cause I was just was growing as an adolescent. And I didn t see those types of images around. Once the participants were in recovery, they recognized how celebriti es and models tended to be extremely thin, and that this body type usually was only natural for young girls, not young adults or women. For example, Kerry described how it wasnt until recently that she realized how young the models actually are. Kerry: Lately, like even doing this media journal, Ive noticed that they [fashion models] were very skinny just really young-looking models Maybe its just because Im getting older that I notice how theyre actually really young. Many participants were able to resist ideal media imagery because they learned that the media misrepresent the ideal with extrem ely young or young-looking models who have not developed (or who have inhibited) natural characteristics of a womans body. Alexandra discussed her frustration with female mode ls that looked more like boys than women. Alexandra: All the models dont have hips, but real women do, and so I would like to see curves. Women should not have to hate their hi ps. I hated my hips for years and wanted to look like a boy in a way. Women are trying so hard to escape thei r bodies and look like guys. Women have to realize that they are wo men and that is why they have curves. The participants indicated th at the media need to be more responsible about showing ageappropriate models, ones that reflect the natural developmen t of womens bodies. Charlotte expressed frustration with the fact that th e media use young women to advertise womens products. Charlotte: I think a lot of the models or ads they always have these young people.Theyre teenagers, 13/14 years old.I mean hell when I was 14, I was skinny and in shape, and nothing was sagging.It just keeps getting younger and younger. Im like When youre 17, are you rea lly gonna look like th at?...Arent they still growing?...

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362 Your whole bodys changing. I dont understand why they have these 15-year-old girls as models advertising womens products. Media promote products and procedures to eliminate all cellulite When the women had been anorexic, they were terrified of fat, equating any cellulite on their body with being fat. As Featherstone (1991) has cont ended, Advertising thus helped create a world in which individuals are made to feel emotionally vulnerable, constantly monitoring themselves for bodily imperfections which coul d no longer be regarded as natural (p. 175). Diamond discussed how she thought that her butt was different than everyone elses, in her personal life as well as the representations she saw in the media. Because most of the media figures were too thin to have a butt, she thought hers was wrong because it was round and had cellulite. During their recovery process, the participants learned that cellulite was a natural part of being a woman. Charlotte expressed her frustra tion with media messages suggesting that women should eliminate all cellulite with produc ts or procedures. Charlotte: This whole thing with the liposuctio n, or the cellulite, stuff. Im like everybodys got it like even Cindy Crawford said she has cellulite. I mean even the skinniest people have this cause thats how youre scientifically, th ats how youre built womens skin fibers grow like that. Fibers attach like that womens criss-cross, and thats why you get cellulite. So if ev erybody has it, or its normal, then why do we all need to have creams? Like why ? I dont understand. Charlotte discussed how was thankful that sh e had reached an age where these types of ads no longer affected her. However, she expressed concern for young girls toda y: It definitely is worse now. It just makes me concerned for the young kids. Im like, Gos h these poor girls, like they have so much more to worry about now. These women no longer engaged in dieting behaviors, but a few of them expressed interest in cellulite treatments. Based on Courtneys comm ents, it appears as if Charlottes concerns may be warranted. For example, Courtney wrote about endermologie in her media journal.

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363 Courtney: 6/10/05 Friday 10:30 a.m. Atlanta Journal Constitution Living Room Talking with sister. Read an article & became interested in endermologie a new cellulite procedure. I started thinking I coul d do that when I get older. During her interview, Courtney discussed how she was influenced, not only by ads, but also by media content. I asked her about her media journal entr y, and she clarified her thoughts about treatments for cellulite. Courtney: Yeah, I did write about it in my journa l. I was interested well, I mean not really seriously because its not like I went and looked up prices or anything on it. (She laughs.) But I was just thinkin in the back of my head, Oh well if I have a problem with that later on, maybe I mi ght consider that. Reinterpreting Fashion Messages Understanding the participants interpretation of fashion when they were in recovery sheds some light on how they consumed the same media imagery in a new way. A common theme in this study was the participants former belief in the importance of being extremely thin in order to fit into society. As they progressed in their r ecovery, most of the participants still subscribed to the dominant ideology that appearance is important, but they no longer had a primary focus on altering their natural body shap e and size in an unhealthy way. These participants found strategies that allowed them to engage in self -protective oppositional readings. Other participants found little value in fashion, and these women te nded to engage in more oppositional readings. One of the surprising findings of this resear ch was that many of the participants in this study said that they used magazines as a source of information about fashion trends. Despite the fact that all the participants st eered clear of magazines with diet -related content, and very few participants looked to magazines for exercise tips, many of the women still maintained an interest in fashion. Several of the participants di scussed how they were interest ed in fashion so they would know what was in style, and they would not v iolate fashion rules. For example, Ramona

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364 stated, I try not to spend too much time reading magazines. I like to glance through em fast, just so people dont look at me and be like, Did she realize th at the 1970s are over? Similarly, Charlotte said, I dont wanna be out of style or totally nerdy. In gene ral, the participants discussed how their in terest in fashion now was channeled specifically to the clothing itself rather than the body of the fashion model. Self-Protective Opposition Readings: In formed by Social Comparison Theory Social comparison theory (Festinger, 1957) may provide some insight into a common theme that emerged from this study, that fash ion seemed to be something the participants remained interested in, despite their avoidance in general of mainstream fashion and beauty magazines. Researchers have used social comp arison theory to explai n why women might feel badly about themselves when they do not compare favorably with thin models. Social comparison theory posits that in orde r to enhance their motivation to improve on a particular dimension (in this case, appearance), people may compare themselves with others who are slightly better on that dimension, an upwar d comparison. The difference may be related to which type of comparison a pe rson engages in, self-evaluative or self-improvement. Selfevaluative comparisons focus on direct compar isons of specific attributes, traits, or characteristics and are more li kely to produce negative effects on self-esteem and physical selfconcept (Martin & Gentry, 1997; Wood, 1989). Self-improvement comparisons are more general and are often used to inspire or motivate (Wood, 1989). It may be possible that health and fitness magazine reading tends to be associated with self-evaluative comparisons, particularly by wi th those who place a high personal relevance on specific physical attributes being compared. However, following fashion may cause more general self-improvement comparisons based on st andards of attractiveness solely based on the clothing itself. Most of the partic ipants looked at fashion magazine s only to get creative ideas,

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365 which may have helped them to feel more positively about their ap pearance. Many of the participants still had a focus on appearance, but it was not rela ted to trying to alter their body in an unnatural, unhealthy way. According to Martin and Gentry (1997) th e motive behind the comparison may mediate the level of appearance-related di ssatisfaction. For example, if a woman compares herself to idealized media images of other women with the in tent of self-evaluation, she is more likely to feel dissatisfied with her app earance. Jane was watching a fash ion show on TV one morning, and in her media journal, she wrote: I could never wear those outfits those models are wearing. Im toooooooo fat. Jane was not inspired by fashion magazines; ra ther, she tended to f eel much more negative about her own appearance after viewing fashion shows on television or looking at images in magazines. This seems to be because she was engaging in self-evaluative comparisons. Jane: I definitely take in all the images in mag azines. Just any ads. Pretty much anything with a body. Im just always assessing [myself] when theyr e advertising new clothes. Ive been watching CBS in the morning, and they have something on a shoestring. They have models come out and different magazines will talk about it or have something that costs like $1,300, and then something th ats like $300. And the hosts of the show have to guess which is the bargain and which one is the steal, or, whatever. Which one is the steal vs. the splurge I guess, it is. So I look at these clothes, and I would never wear anything like that because I just wouldnt feel comfortable. So I mean, Im always comparing. And I guess thats the same thing in magazi nes. Ill see outfits, and Im like well, Ill just stick to my whatever I have. My T-shirts and things because I just never would feel comfortable wearing something like that a straple ss little top or something like that. According to Martin and Gentry (1997), if a woman engages in the same type of social comparison, but with the intent of self-imp rovement or self-enhancement, she may not experience the same level of dissatisfaction w ith her appearance. Many of the participants discussed how they still enjoyed fashion, but th at their focus on fashion was more for self-

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366 improvement purposes. Ramona actually referred to herself as a self-improver, and unlike Jane, fashion magazines seemed to inspire her. Ramona: I like to read fashion magazines because when I read them, well. Im always kind of a self improver. (She laughs.) So I thi nk that I just really wanna be cool. I wanna know what hairstyles are new. And what styles of jeans or shoes, or dresses or whatever is the coolest, newest thing. And if I read this magazine, Ill be able to get an idea. Changing Their Focus The participants discourse indicated that what they focus on when they see media images affects their interpreta tion. Botta (2003) has found that young women who focused on models bodies had significantly increased bo dy image dissatisfaction, even if the observer was critical of the biased representation of women. Jane tended to feel worse about herself after looking at fashion imagery. A portion from her media journal serves as a good illustration of the difference betw een participants who focused on models bodies and those who focused on the clothing itself. Jane was looking at a clothing catalog one Sunday afterno on in Florida when she was at a friends pool. In her media journal, she wrote: Id never look good in any of these out fits. These women are so beautiful. Several participants were able to engage in self-protective oppositional readings because their focus was on the clothing itself, and they did not engage in social comparison with the models bodies. Altering their focus to the clothing seemed to prevent the women from feeling worse about their own bodies when they looked at fashion images. Kerry: I think that having an interest in fashion is also pretty helpful. Cause it takes me focused off of those bodies. But its weird. Okay, heres so mething that I almost made a note of. I feel like I still sort of look at media with kind of an obsessive eye But just not about the body. Like, Ill still like read mag azines and Ill be like, Oh, I wish I had more money. (She laughs.) Cause then I could buy those clothes, ya know? And so its different from when I used to think, I wish I was thinner like her. No w, its more like, I wish I could dress like her. It seems less harmful.

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367 As a strategy to protect herself from engaging in unhealthy comparisons, Jamie also reminded herself that the women in fashion magazi nes were just models. During her interview, she shared a scene from a movie that was helpful. Jamie: One thing I think of is that movie 13 Going on 30 Its a lighthearted film, not too deep or anything. Anyway, I love the part where the daughter is upset about how she looks, and she thinks she needs to be prettier to be popular. Her mom says something like, Honey, youre beautiful in your own way. And the daughters looking at a magazine or something, and shes like, But mom, I dont want to be beautiful. I want to look like these people. And her moms like, Oh honey, those aren t real people. Theyre models. I just love that scene. Its so funny and true in a way, and the mom just says that so matter of factly. Several of the participants now viewed fashion magazine s as playful, artistic, and expressive. As Noah progressed in her recovery process, she redefine d her perception of the magazines. They no longer provided her with thi ngs she must have, but rather with creative, fun inspirations. Noah: Now I dont worry about that stuff, but I still think I kind of have fun playing. I think part of it is just the artistic expression. I still think of it as sort of a game. Like, its still fun when I bring home, like a curling iron. And its like play It feels very different than anything else I do in my life. And s o, I try not to put so much, place so much importance on it. But I can still have fun with it. Ramona described how her use of magazi nes transformed over time. When she was anorexic, she used to read magazines to try to achieve a perfect body. At that time, she was comparing herself to the models, and she did not feel like she measured up. However, in recovery, she learned to view adve rtising in general and fashion ads in particular from an artistic perspective. Ramona viewed the portrayal of the women in the Victorias Secret catalog as an art form to be admired. D: What were your thoughts when you were looking through the Victorias Secret catalog? [She had perused through a friends catalog on the way to my hotel.] Ramona: Its kind of weird. Its almost I dont really know. The human body? Like, just in general. Just like animals. Is so beautiful. And so interesting. I love looking at other womens bodies. Not in a sexual way. Like, an artists perspective. I love looking at like

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368 art of, like about women. I just, I love looking at art. When I was looking at the Victorias Secret catalogue, I was just looking at it like art. Eda watched fashion shows on television, and sh e subscribed to several fashion catalogs. Her interest in fashion now was more for the creative outlet; she no longe r compared herself to the extremely thin models. Eda : I am pretty vain and like to look good, but it is for myself. I like the Style network, and sometimes watch it before I go to sleep. I read fashion catalogues a lot. I really like the creative aspect of it. I like to wear different clothes. I also sell clot hes online so I need to know what is in style. I have always liked fashion, even as a child. Resisting the Fashion Industry In contrast to the self-protective strategies the participants engaged in to reinterpret fashion imagery, there were several participants who had completely oppositional readings. These women tended to reject the fashion industry as a whole or merely ha d a casual interest in fashion. In addition, one woman described how she came to find the fashion industry a bit absurd. Kristin provided some insight into the fashi on industry itself because she had participated in a fashion designer drawing workshop through the National Art Honors Society Conference. During the workshop, Kristin learned about the disconnection in the fashion industry between designers and models. The workshop solidified what she was learning as part of her recovery process, that models should not serve as a realistic source of comparison: When I was younger, I would flip through dance catal ogs and only see the bodies.A nd my perception has kind of changed from, Im not good enough to a little bit more, Why are they doing this? Kristin explained how the workshop altered he r perception of the enti re fashion industry. She now viewed it as absurd, a perspective that allowed her to have an oppositional reading of fashion imagery. Kristin: The teacher kept emphasizing, Dont think of this as a person. Shes an alien its an alien. Dont think that youre drawi ng a human because otherwise youd look at it and be like These proportions arent right. Even the teacher of the class, she was like,

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369 Its kind of ridiculous that we do it this way because it causes problems since its not humanly proportional. Like its not at al l proportional, and it causes problems when designers try to go see fabric makers and the ac tual producers of the outfit. A lot of times, theres problems in translation because its not proportional in terms of the production of the outfit because it has to be translated from this alien figure to a human being. And its so stupid that they do it that way. A few of the participants had no interest in the fashion industry. Mollys perception of the fashion industry as placing too much focus on appearance informed her opposition reading of fashion-related media messages. Molly: Mon. 7/18 @ 4:00 PM Oprah My living room Getting my Oprah fix. OK, I love Oprah, but today she has these 2 [sic] British chicks on who I guess are the fashion police. Shes dedicated an entire hour to How to dress for your body type. Ill admit that the women theyve made over do look awesome, but what if they were comfortable with the way they looked before? What right does anyone have to brazenly come up to you and tell you that you are dressing wrong? I dont have time to learn all these fashion rules. Truly, I could care less which type of sandal I need to wear if I wear a skirt that hits mid calf! Besides, my wardrobe consists mainly of jeans and shirts or sweaters! Comfort is my #1 priority when it comes to clothes and dressing! Coverage of Celebrity Lives Research has indicated that womens interper sonal attraction and comparison to thin media celebrities is mediated by how important they considered celebri ties to be. Harrison and Cantor (1997) have found that women who were attracted to thin/provoca tive media persona lities had an increase in their eating disorder symptomol ogy, including a drive for thinness, anorexia, and perfectionism. The findings in this study reflect those of the lite rature. More interestingly, the results from this study also indicate that the inverse to be true The less the participants cared about celebrities, the more likely they were to have an oppositional readin g of the mediated thin ideal. This study also indicates that social comparison medi ated the effect on womens body image. The less women engaged in upward social comparisons to celebrities, the more satisfied they were with their body image.

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370 What this study illuminates is the power the media may have to tempt young women into thinking that they can attain an appearance similar to a celebrity. Television programs and magazines that promote and depict thinness have been found to have a strongest influence on young women in terms of perpetuating unrealistic be liefs about the importan ce of the thin ideal (Harrison & Cantor, 1997; Stice et al., 1994; Silverstein et al., 1986). Wanting to Look Like Thin Celebrities Many of the participants had used imagery of thin celebrities as a source for comparison. Alexandra used to purchase magazines that focu sed specifically on celebrity diets and fitness programs. In addition, several of her comments describe how attached she was to the celebrities. In her mind, the celebrities were not universal istic targets of compar ison, but rather were somewhat particularistic in nature. This percep tion appears to have cont ributed to her belief, when she had an eating disorder, that the repr esentation of the celebrities in the magazine reflected reality, and that it was reasonable to think that she could attain her goal of looking like them, if she just followed the diet and ex ercise plans suggested in the magazines. Alexandra: There was one British magazine I just ab solutely loved. It came out four times a year, and it was only available in places wher e they sold foreign magazines. I bought this magazine also in Austria. It was called Celebrity Diet, and I read it like a bible. During the midst of her eating disorder, when Alexandras primary focus was losing weight and maintaining a thin body, she truly had immersed herself in th e lives of celebrities. Not only did she read magazines about their diet and fitness programs, but she also watched celebrity news programs, such as The Insider. As she progressed through her recovery and realized how unhealthy it was for her to follow celebrity lives so closely, she eliminated celebrity news from her media diet. Alexandra described her attachment to the celebrities via media channels to the extent that she now sees it as a former obsession.

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371 Alexandra: I used to watch celebrity ne ws and all that. But I dont anymore. It was hard in the beginning because I felt so attached to th e celebrities, like I knew so much about them. Well, this is how it felt to me anyways. And to give that up was hard. Now, I have reached a point where I dont care anymore. And I actua lly do stay away from certain shows like celebrity news just in case my old obsession is coming back. Limiting Media Exposure Alexandra made concerted efforts to curb any behaviors that might trigger her former obsession with celebrities. The process Alexandr a went through to stop following the lives of celebrities was similar to recovery from her eating disorder. She gradually found that other things in life were more important, and she no lo nger had a desire to follow celebrities lives. D: Do you still get cravings for magazines? Alexandra: No, I dont actually. In the beginning it was hard since I think I was addicted to them. Well, yes I was And I had some setbacks like I would not buy one for a couple of weeks and then something caught my attention, and I had to buy it. Now, I dont anymore. I personally dont care anymore. The only reason why I know certain things about celebrities is because I ha ve to wait in line at the store. Other than that, I would not know anything about them. The self-described nature of Alexandras obsessive tendencies to follow the lives of celebrities in magazines and on television programs speaks volumes about the power of the influence the mediated thin ideal had on her. What this study has revealed is the challenge that women in recovery from anorexia have in overcoming their fascination a nd perceived connection with the li ves of celebrities. I chose to share Alexandras story because it was the most vividly described, but many of the participants described similar scenarios. With todays new coverage, even if people do not watch celebrity news, they are still likely to be exposed to news about celebrities, even on networks such as CNN. However, some participants viewed celebrity c overage as light entertainment, rather than a resource for comparison. For instance, Eda no longer was trigge red by imagery of the thin ideal, she came to find humor in the salaciousness of celebrity coverage.

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372 Eda: I read it maybe every two weeks or when I get my nails done. It is really trashy and voyeuristic. I like read ing about the rich and famous and sh allow. Its funny. I am able to see most of it for what it is mostly. It doesnt really have much emotional charge anymore. Being Critical of Unwarranted Celebrity Coverage Many of the participants had completely oppositional readings of media coverage of celebrities. For example, Nicole said, The celebrity stuff is crap, so I stay away from that. Several other participants expressed their annoyance with media c overage of celebrities that seemed to lack merit or substance. For these participants, universalistic comparisons were pointless because they did not per ceive the celebrities to have a ny redeeming characteristics. For instance, Jamie indicated that she was aggravat ed with the medias presumption that people would be interested in such coverage. Jamie: Why do they plaster these stick thin celebr ities all over the magazines? Theyre just abusing their bodies, and thats not what should be celebrated. Plus, most of them probably couldnt carry on an intelligent conversation wi thout their PR consultant or whatever feeding them lines. Why are they famous in the first place? As Harrison (1997) has contended, repeated expo sure to images of celebrities probably has little effect other than annoyan ce on media consumers who find such media figures repellent to begin with. Kerrys comments illust rate this type of annoyance. Kerry: Like, interviews with celebrities, Im not that interested in because I dont really care. Im not that very interested in their pers onal lives. Mostly, Im not interested in any of them. It kind of annoys me that the magazine assumes that everyone is so interested in celebrities. That they want to he ar about their lives or whatever. Noahs negotiated reading contrasts with Ke rrys more oppositional interpretation of the media coverage of celebrities. During her interv iew, Noah discussed how she wished she could be completely disinterested in celebrity lives. Noah: I noticed when I got here for the wedding, and I was with my girlfriends. We were at Walgreens, and I picked up this magazine about Angelina Jolies adopted child. I read the whole thing about her and Zahara and all that. And I noticed that was capturing my attention a lot. I kind of just get mad at myself when I even care about that sort of thing and what she looks like too.

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373 Jordan had conflicted feelings about follo wing media coverage of celebrities lives: Theres something about those stup id tabloids that Ive gotten suck ed into, and I hate it. Jordan was against Hollywood in principle, yet she was dr awn into the celebrity na rratives just as much as others who keep newsstand magazines in business. In general, the American public is fascinated by the lives of people elevated to celebrity status, and the media feed their addiction. Despite the comfort Jordan found in the humanness of celebrities, she also realized at some level that following such media coverage some times served as a tri gger for negative thoughts about her body. She described how she sometimes comp ared herself to celebrities in the media. Jordan: Its so sick and demented and catty and sh allow, but when I see really thin people, in real life or in those magazines, Ill catch myself thinking, Im a little too average now. I need to step it up a little, or Ive gotten a little lazy. Like Ill catch myself having these thoughts. Im like, God, Im 25, Im supposed to be in my prime. (She laughs.) Like Heidi Klum was back on the runway three days after her baby was bor n and Im like, How in the hell do you people do this? Contrast Illustrates Benefits of No Interpersonal Attraction to Celebrities Harrison (1997) found that young womens diso rdered eating attitudes and behaviors are related not only to the types of media they expose themselves to, but also to the way they perceive and respond to specific mass media char acters. Harrison (1997) also found that a media consumers perceptions of these models in rela tion to herself were an especially important moderating variable, increasing th e likelihood of potentially damagi ng attitudes or behaviors. As Harrison (1997) has cont ended, women who perceive media personalities to be interpersonally attractive are at greatest risk for enabling medi a exposure to do its damage more efficiently (p. 484). Unlike, Jordan and Noah (discussed above), partic ipants who sincerely faulted the media for its abhorrent, unwarranted cel ebrity coverage, avoided this danger and were able to have more oppositional readin gs of the mediated thin ideal.

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374 Understanding of Diet Industry It began as an innocent diet. I just wanted to lose a little weight, be more healthy. I mean it wasnt like a big de al or anything huge. Rylie made these comments, but nearly all of the participants descri bed the same type of scenario. Across the board, the participants disc ussed how they had dieted prior to developing anorexia. Diets do not cause eating disorders. If they did, ea ting disorders would be much higher than their already chilling proportions, given that approximately 95% of women dieting at some point in their lives (Gaesser, 2002; Ogden, 1992). Eating Disorders Start with Diets Research has indicated that dieting is a high risk factor for the development of eating disorders (Neumark-Sztainer et al., 2006; Patton et al.,1999), particularly with certain biological and environmental factors (Groesz et al., 2001; St ice, 1994). The findings of this study indicate that the normative nature of dieting combined with the media-perpetua ted value of extreme thinness can be a dangerous combination. Many pa rticipants said the sense of accomplishment and control they experienced upon their initial wei ght loss encouraged them to lose more weight. As Bordo (1995) has noted: Usually, the anorexic syndrome emerges, not as a conscious decision to get as thin as possible, but as the result of her having begun a diet fairly casually, often at the suggestion of a parent, having succeeded splendidly in taking off five or ten pounds, and then having gotten hooked on the intoxicat ing feeling of accomplishment and control. (p. 149) For all of the participants, the transition onl y was visible in hindsight. None of the women indicated that there was any clea r turning point when they switched from dieting to diagnosable anorexia. As Eda said, I dont remember exactly when that line was crossed. Its a thin one. Unfortunately, the transition was just very, very subtle, said Jordan.

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375 During their recovery process, the women gained an understanding of the connection between dieting and the development of their eating disorder. As Britta said, I think it started as a diet. Thats what everybody says. It started like a diet. I started losing weight, and I did that for a long time until my mother thought, Hmmm. I dont think its a diet anymore. Nearly all of the participants had believed they were ju st dieting, and they continued to lose weight until the disease took over. In fact Rylie thought she was just following what the media portray as a healthy lifesty le: I thought it was just a mixed up diet. Just a diet gone too far. Similarly, Kerry said, It took me a really long to understand that I had a problem. I thought I was just doing what I was supposed to do. I just had very rigid exercise and eating routines. For all of the participants, it was extremel y important not to engage in weight loss behaviors because dieting had served as a gateway for them to the developm ent of anorexia. This knowledge, combined with their desire to maintain their recovery, allowed the participants to become more resistant to medi a messages promoting diets. The women who had more opposi tional readings did not allow the inescapable nature of diet messages to serve as an obstacle in th eir recovery. Armed with knowledge from their personal experience, these women tended to be ex tremely resistant to the overwhelming number of diet messages they were exposed to on a regu lar basis, regardless of the choices they had made to disregard most mainstream media. Diets Gone Wild: Media Messages Promot ing Weight Loss are Too Prevalent Overall, the research has indicated that women have been presented with increasing numbers of messages to diet. Any woman who s hops in a grocery store, casually picks up a magazine while in a doctors waiting room, or f lips on a television will be blasted with media messages about weight loss. For example, Rylie discussed how the media encourage people in our society to focus on weight loss.

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376 Rylie: If you pick up any f itness magazine like Shape, and even on the cover of Womens Digests So and so lost 25 pounds by walking! I mean, its just all over. And its like, you know people are buying this crap. And its frustrating cause its if th ey subscribe to it, what are they gonna do? Lose weight all the time? You know, go join a gym for $40 a month? As Maine (2000) has stated, The diet industr y is a capitalist dream come true, with its self-generating market, widespread target audi ence, and high failure rate. Check the bestseller list to see the latest fad diet books. Entire sec tions of bookstores and even greeting cards are dedicated to weight loss (p. 44). Molly seemed to be particular ly attuned to the widespread so cietal focus on weight loss. In her media journal, she noted the prevalence of di et messages on television, on the Internet, in gas stations, and in bookstores. Molly: Sun. 7/17 @ 4:00 PM Diet/Exercise/S elf-help books Barnes and Noble Bookstore Looking for a good book to read and enjoying the atmosphere. There are more books on diet, exercise, and weight loss than th ere are classic novels a nd books of poetry!!! And when did psychology become solely about weight?!! Where are the books on the theories and practices of psychology? Not to mention educational books on depression/anxiety/PTSD/trauma, etc.? There are even books on how to use God to help you lose weight! This is out of control! I need to get out of here before I start screaming and throw a huge temper tantrum!!! Similarly, Eliza wrote an entr y in her media journal critic izing the diet industry. Her comments reflected an understand ing of how broadly diets are promoted in American society. Eliza: June 29 at the grocery store. I am look ing at foods in the organic section and come across a lot of diet foods like cookies. How can it be theres such a thing as diet cookies? Cookies with very thin people on the package eati ng them. Then I notice as Im picking out the rest of my groceries that every food has a diet counterpart. But the calories and fat dont change that much. Only flavor I noticed while I was overseas that this doesnt exist. People just eat what they want cake, cookies, etc. and as much as they like and never gain an ounce from it because theyr e not so obsessed with the idea of losing. Molly wrote in her media journal about a weight loss ad she saw on television. She criticized the commercial for making an absurd claim, one that ofte n goes unnoticed by the general public.

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377 Molly: Mon. 7/18 @ midnight LipoDisolve Ce nter commercial My living room Picking up before I go to bed. They cant be serious! If I wasnt about to climb into bed, I would have to call them up and ask them exactly how they dissolve fat away?! And their slogan is, It doesnt suck! What is happening to our society? Not Everyone Needs to Diet Dieting has become so prevalent in some c ountries that it is rarely questioned. Orbach (1993) described the normative nature of dieting. No one is much disturbed by statistics that show that 80 % of women in countries like the USA, the UK, New Zealand and Australia are dieting at any given moment. The anguish and distress behind these figures are concealed behind an attitude that accepts this as the norm and sees the need for no further questi ons. Women like to diet. Women expect to diet. Women are accustomed to diet. Women have a tendency to fat. Women are vain. Women are always so self-involved. (p. xxiii) A portion of Americans are overweight to a de gree that will impact their health, but many more people diet than need to do so, and most diet for aesthet ic reasons as opposed to those relating to health (Gr ogan, 1999). A few participants expresse d anger about the implication of a preponderance of weight loss messages. As Am anda stated, I dont think its good that the health magazines are trying to get people to follo w those diets. I mean it is good to eat healthy, but at the same time, not everyone needs to diet. The participants indicated that they thought diets were too normalized, to the point where people dont even question if they need to diet. During her interview, Eliza challenged the w hole concept of dieting, noting that diets are a relatively recent concept: There is such a th ing as, ya know, eating normally. I mean, if you think about it, like 100 years ago they didnt have any diets, but people lived normally, and were normal weight. And so, I kind of want to get back to that. Molly had an oppositional reading of a diet ad. She deconstructed the underlying message of the ad and expressed ange r at the advertising industry. Molly: Last night I saw this commercial for some stupid diet pill. There are a million out there so I couldnt figure out w hy this one bothered me so much. It said that stress causes cortisol to rise in your blood, which increases your body fat. But then they said, You Need

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378 Relacore! And I realiz ed that it was that phrase that one sentence that sent me over the edge. They dont know who is seeing this comme rcial yet they can declare that apparently everyone needs to lose weight! For an advertisement to say that I NEED that product advertising drives me crazy! Diets Are Perceived to be A Rite of Passage The media may be not only the most influen tial communicator of the thin-ideal, but also one of the most effective due to it s pervasiveness (T hompson et al., 2004). A few participants described how they saw dieting as a rite of passage of sorts, a wa y to feel a sense of belonging in a diet-obsessed culture. Like ma ny participants, Rylies eating diso rder started with a diet. She started dieting at age 15 as a wa y to cope with her stepfathers recent death, and within a year, she was diagnosed with anorexia. She describe d the initial stages of her development of anorexia: I started a diet that summer of 2002 and well, I kind of like you know, you see stuff on TV and in magazines, and I was like, oh its cool to lose weight. And so I did. Similarly, Emma described how she came to believe that di eting was the mature and grown-up thing to do. Emma: I learned some from media, some from everyday life. I saw women characters on television and in books dieting and dieting was the message of every womans magazine. In real life, all the older girls seem to watch th eir weight. It seemed like a rite of passage to me, that it was inevitable that you grow up, you diet. Christina described why she used to like wome ns magazines. She used to see diets as the key to self-improvement. Christina: Oh, I would love to hear, what was the new di et. Like, What should I do? This diet that they claimed on the front would make you lose weight or how you should eat. I was always trying to find things Oh, how can I make myself better? Thats why I would read [magazines]how can I make myself better? Media Promote False Association Between Dieting and Health The participants had learned from magazines that dieting wa s the key to self improvement and a healthy lifestyle, an association that many Americans have absorbed with incessant exposure to media messages tou ting the health benefits of di ets and weight loss. The multi-

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379 billion dollar diet industry ha s flourished and continues to grow (Bordo, 1993; Gaesser, 2002; Schroader, 1991; Seid, 1994). As Ralph Waldo Emerson once said, The first wealth is health, and the diet industry has gained a significant am ount of wealth from the blanket association of dieting with health. In fact, the participants indicated that the concepts of health and healing seem to have become enmeshed with dieting. Several participan ts discussed how the diet industry continually introduces weight loss fads that perpetuated this connection. Even while driving, women are subjected to diet ads suggesting health benefits. A few participan ts discussed how the alcoholic beverage industry had jumped on the low carbohydrate craze. For ex ample, Christina discussed a Bacardi billboard she had seen. Christina: It said zero carbs. It was supposed to be that shes thin and beautiful because she drank Bacardi, which had zero carbs. (She laughs.) It was really misleading cause you know it has all those ca lories. (sarcastic) She also expressed her frustration with the inextricable link between health and weight loss: Magazines that supposedly focus on h ealth, natural healing, and even yoga still always have several articles about losing weight and diet plans, so I dont buy magazines anymore! Similarly, Sarah described how she saw the promotion of dieting to be a false panacea for what people really should be concerned about, their health. Sarah: I would rather not see weight loss, but see healthy weight advertised as a health benefit. There are such a variety of health pr oblems like diabetes, heart disease, and some cancers that come as a result of people being overweight or obese. They should focus on a healthy body weight as treatment, preventi on, and relief from these issues. That would be a more accurate portrayal. Even those who do not have a weight problem still may suffer from some of these issues, so a focus on a healthy body vs. a thin and sexy body would prevent a lot of pressure on women. By reframing their focus to health, the particip ants were able to alter their perception of the thin ideal from an image that was appealing to something they rejecte d. Once in recovery, the

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380 participants overall health was much more impor tant than the potential results of any diet promoted in the media. These women came to reali ze that our society produces and cultivates the normalcy of dieting and that this notion is not on ly faulty, but also ofte n unnecessary and unsafe. During her interview, Amanda discussed how she used to believe that magazines offered healthy solutions for weight loss. Amanda: Wed get Health magazine, Self magazine, all those wo rkout magazines. And you know how they have the diets in em and stuff like that. Theyre ridiculous. I mean theyre like 1,300 calories a day, eating somethi ng like that. And so we would like try to eat like that and everything. A nd we thought they were just li ke the greatest things. We thought it was healthy they were promoting healthy things. Amanda had followed the diets in health and exercise magazines, and she lost a pound a day for a few months. After fainting one da y, she went to a doctor on campus, and she was surprised by her diagnosis. Amanda: They took my BMI or whatever, and they were like, you have anorexia because your BMIs so low. And I was just like what?! I just thought, Theres no way. How can that be? Like I thought I might have some sort of eating problem, but I did not know they would diagnose it as anorexia cau se when you think about it, what I was eating is like what they might recommend in one of those magazines. It was not extreme. Amanda had believed everything she read in ma gazines because she used to view them as a trusted resource: My roommate and I just thought fitness ma gazines were like the greatest things. Self and Fitness We bought every single one. I read them all the time. We thought they were healthy. Now that Amanda was in recovery, she was mu ch more critical of any diets promoted in womens health magazines: Aft er my eating disorder, I would never read those magazines and think, This is what I should eat. Never. I would not buy one. Amanda also expressed concern for young girls who might follow the advice in magazines without question, as she once had. Amanda: But now I never would follow what they sugge st. Its just so easy to keep following them and keep losing weight. Like I lost a pound a day, and I kept losing. And

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381 thats not healthy. I hate thi nking that other girls might do th e same thing. Like, I didnt know any better back then. I never even thought I had anorexia because I was eating what those magazines recommended and doing the workouts. Many of the participants us ed the terms unrealistic and unhealthy together when describing their perception of diets promoted in womens magazines. These participants applied the knowledge they had gained th rough their personal experience to challenge mediated diet messages. For instance, when she was anorexic, En chantments ultimate goal was to be as thin as possible. In recovery her primary focus was on her health, a lens through which she interpreted diet messages. Enchantment: Sometimes it helps to read magazines like Fitness and Health and stuff because its usually like about being healthy. But I mean sometimes it does talk about like diets, and itll say you know, eat like less than like 1,200 calories a day. And so its like you know theyre not really talking about being healthy When the participants were anorexic, many of them did damage their body, and in some cases, the damage was irre versible. For example, some participants suffered with osteoporosis or long-term heart issues. In addition, the participants discussed how the effects of their eating disorder had been painful for their families and friends. As Molly stated, Now my perception of the medias ideal is that it is unrealistic and harmfu l. I do not want to diet to look that way to fit the ideal because not only is it dangerous for myself, it hurts others as well. Media Prey on Desperation to Lose Weight The participants in this study followed the medias most common prescription for achieving happiness, success, and popularityweight loss. Yet, they learned through their battle with an eating disorder, and usually hitting roc k bottom, that the media-promoted notion that being thin makes you happy, successful, and popular wa s false. This realization made them more attune to media messages touting the infallible benefits of dieting. Th ese women now realized

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382 how harmful it could be to take diet messages at face value, and they were concerned for others who might do so. The participants saw the media as a colle ctive opportunist industry, willing to take advantage of the culturally-constructed desire to attain the thin ideal. Sarah said she now perceived magazines to be callous, showing no regard for the potentially unwitting audience. Sarah: Who knows what someones goin through what theyre battling in their mind on the inside. And then they just pick it up. Cause its to sell a magazine. Ya know, theyre not necessarily concerne d about the potential person out there. My heart just sinks for the potential person out there. It drops because the torment in their minds. You know what it feels like.And its like hearing myself and seeing myself all over again. When I think about all the people that c ould be affected by those messages, it just breaks my heart. It really breaks my heart. According to MacInnis (1993), many people are willing to place their health in harms way to avoid being ostracized because they are at a we ight that does not conform to the thin ideal. In her media journal, Molly reacted to a commer cial for LipoDisolve Center on television: I know if my best friend saw this she would do it in a heartbeat! Despite the dangers including death! During her interview, Molly discussed he r concerns about weight loss ads in general, especially those that promoted diet pills. Molly: Last night I saw this commercial for so me stupid diet pill. It made me angry because there are a lot of peopl e out there who will believe them and they will get this diet drug that could be harmful and take it out of desperation. Who knows wh ats in those diet pills! They could give someone a heart attack! The sad thing is that most people are willing to take that risk because they are so desperate to lose weight and be accepted! Mollys opposition to diet messages was info rmed by her personal experience. Once in recovery, she could clearly see that the media do not convey res ponsible messages to consumers. During her recovery process, Molly had gained an understanding of marketing techniques, but she was concerned about others who did not ha ve the same level of knowledge: It makes me

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383 livid that there are people who pr ey on peoples desperation and so cietys insane attitude about size! They should be ashamed of themselves!!!! Feminism Informs Critical Media Literacy Prior to the development of their anorexia, th e participants subscribed to the notion that thinness was attractive, and that an attractive appearance was of primary importance for females. While the women were in the midst of their eatin g disorder and in the initial stages of their recovery, many of the participants described the ubiquitous, inescapable nature of media messages propagating the importance of appearance. This tended to leave th em with a feeling of helplessness, of being a victim of cultural domination by a global media machine impervious to resistance. For many of the participants in this study, feminism provided a filtering lens through which cultural messages about women could be interpreted. A feminist perspective allowed several women in this study to reject the noti on that women should be de fined primarily by their appearance. As Faith said, Ive learned that, unfor tunately the hard way, th at your worth is more than your appearance. Your worth isnt or shouldnt be based on your appearance. Feminism Learned in Wom ens Studies Courses Several women had learned about feminism through womens studies courses in college. These courses seemed to be a gateway to an understanding and adoption of feminist ideology, which in turn allowed the participants to learn tools for resisting the im portance of appearance for women. As Emma stated, Ive become a lot more articulate about my dissatisfaction and anger over the years, thanks to wome ns studies and sociology courses. Similarly, Diamond had taken several women s studies courses, which allowed her to become more critical in her re adings of media messages. She described how her perception of

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384 mediated messages about gender roles changed over time: I see media differently now. Im very aware of body image and appearances and the role that they cast women in. Diamond described how women s studies courses informed her decision to stop reading health and beauty magazines: I was like, Im not paying for this. Im not learning from this. Im not gonna look at these magazines b ecause it will put a kink in my mind. Many participants made comments indicating that they found the progress of feminism to be incongruous with the consistent media me ssage that a womans worth is defined by her appearance. As Jamie said, In a world where wo men are in high positions of power now We might even have a female president in the futu re. It is absurd that theres so many media messages telling women to judge our worth by our looks. Objectification Theory Several researchers have contended that in a cultural climate in which a womans physical appearance is constantly a primarily source of evaluation, she will increa singly feel objectified, shameful, and anxious (Fredrickson & Roberts, 1997; Fredrickson, Roberts, Noll, Quinn, & Twenge, 1998; Hyde & McKinley; Noll & Fredrickson, 1998). Furthe rmore, appearance-related dissatisfaction also has been linked to decreased social self-esteem and increased social anxiety (Cash & Fleming, 2002). Objectification theory (Fredrickson & Robert s, 1997) posits that ob jectification of the female body in Western culture produces a multitude of negative consequences for women. Primary among these consequences is the internalization of a viewers perspective as a primary view of their physical selves (p. 173), a tendency called self-objectification. According to objectificati on theory (Fredrickson & Robe rts, 1997), women react to societal objectification by taking on an observers perspec tive of their own bodies (selfobjectification) and tyin g their self-worth to their physical appearance. Womens self-worth

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385 becomes dependent on their evaluation of their a ppearance, and they begi n to view their bodies as objects to be evaluated (Fredrickson & Roberts, 1997). A primary way that an objectifying culture is propagated is through the media, and Fredrickson and Roberts (1997) have argued that the objectifying gaze infuses American culture (p. 176). However, Myers and Crowther (2007) have suggested that women with higher levels of feminist beliefs may have a more balanced view of themselves, which enables them to look more critically at appearance-related evaluations, thus reduc ing self-objectificati on and body dissatisfaction. Portrayal of Perfection Renders Women as Ob jects to Be Admired Females learn that appearance is more valu able for women than it is for men (Bordo, 1993, 2000; Bruch, 1973; Brumberg, 1997; Kilbourne, 1994, 2000; Pipher, 1994; Steiner-Adair, 1994; Wolf, 1991). As Frost (1999) has suggested, Wo men are the most clearly trapped in the narcissistic, self-surveillance worl d of images (Featherstone, 1991, p. 179). Men act and women appear. Men look at women. Women watch themselves being looked at. This determines not only most relations between men and women but also the relation of women to themselves....Thus she turns herself into an objectand most particularly an object of vision: as si ght. (Berger, 1972, p. 47) During her interview, Faith shared an exam ple of a television ad that put a womans body on a pedestal quite literally. She described an ad Nutrisystem that ha d caught her attention. Faith: This woman said, I havent had this smoking hot body since college. And she said that her husband jokingly calls her his trophy wife. I think of a trophy as a reward of something that youve accomplished. But I think when you refer to a person as a trophy, what else can you be referring to besides the way they look? Who you are its just more than appearance, and for someone to say th at youre a trophy I mean thats kind of insulting, I think. One relationship I was in, I felt like I was his trophy. If I was starving myself or eating basically nothing, what some women consider normal eating, (sarcastic) then I was considered a polis hed trophy one that was intended to be showed off. When women are not presented as whole, they are reduced to parts, not people. Furthermore, the portrayal of women as mere body parts renders women as sexual objects. As Fredrickson and Roberts (1997) have contended, sexual objectif ication is when a womans

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386 body, body parts, or sexual functions are separated out from her person, reduced to the status of a mere instrument, or regarded as if they were capable of representing her (p. 175). The virtually unavoidable exposure to sexuali zed depictions of female bodies and body parts in the media are a major contributor to self-objectification. Self -objectifying individuals view themselves as objects or sights to be appreciated by others, and they tend to define the self in terms of how it appears to others, rather than what it can do or how it feels (Fredrickson & Roberts, 1997). Research also has indicated that reading contemporary womans magazines for appearance-related and gender role advice was positively related to obj ectifying ones own body and accepting the content of the messages (Kim & Ward, 2004). Several participants expressed their discontent with the mainstream medias reinforcement of womens bodies as just a sum of their parts, instead of a whole person. This concept has been explored in award-winning films about gender representation in advertising (Kil bourne & Jhally, 2000; Kilbourne & Lazarus, 1987; Kilbourne & W underlich, 1979). In addition, research has indicated that magazine advertisements tend to portray womens bodies or body parts, rather than their faces, sometimes eliminating their heads altogether (Rudman & Verdi, 1993; Sullivan & OConner, 1988; Unger & Crawford, 1996). Self-objectification is exactly what women in recovery from eating disorders are working on reversing. These women had focused on their ex ternal appearance primarily through weight loss, and they had ignored their internal self and their feelings. As part of their recovery process, they tended to reject media messages that portrayed women as a nything less than a whole person. Emma: Girls look to who to emulate and its ju st body parts. Its lik e this whole bump watch which I hate. I know the impetus behind all of this stalking is scoop, which equals prestige and money for the magazines, but it turns women into these maps to be deciphered. Female celebrities are dissected into parts he r bump, her fat legs, her tooskinny arms. In the media, females dont get to be whole. Theyzre constantly reduced to parts.

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387 Veronica had taken several womens studies courses, and she learned about the feminist perspective of the widespread por trayal of women as body parts. This knowledge allowed her to reframe her perception of media imagery of the ideal female and avoid comparison to specific body parts. Veronica described how her perception of the medias portrayal of the ideal female body image changed over time. Veronica: Before, I would look at this detail or that detail. I would look at how large the womans chest was, or just look at her thighs. I used to look at womens thighs, like ads in magazines or something, and wonder why mine arent shaped like that. Cause I wasnt looking at the whole person. I was just looking at the thighs. Whereas now, I can just look at it as just the whole person. Most of the participants in this study resi sted imagery of women that served merely as decoration. They rejected the por trayal of women who were redu ced to being body parts rather than whole people with intelligence, personal ity, and feelings. As Brumberg (1997) has contended, the medias elaboration of ideal beauty (p. 108) has increased the anxiety that young girls feel about their body overall, as well as their specific body parts. Concept of Ideal Woman is Absurd Media m essages suggest that women can and should have it all, promoting the superwoman myth (Steiner-Ada ir, 1986). As Wolf (1991) has contended, todays women work three shifts: working, taking care of their home and family, and trying to meet our cultures standards for beauty. Women who internalize these pressures and believe they are required to meet such standards tend to experience body diss atisfaction, and they are more vulnerable to eating disorders. Emma pointed to the absurdity of the concept of the ideal woman. Her comments reflect the pressure on women, not only to adhere to an acceptable ideal body image, but also to serve in multiple roles while holding everything together : I guess the closest thing to an ideal body

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388 image is for a woman to be everything to give birth in the morning and then do her own action stunts in the afternoon and be home in time to cook dinner in heels. Emmas sarcasm indicates her understanding of the unrealistic expect ations places on women not only to fulfill the traditional female gender roles as mom and wife, but also to pursue an independent, successful car eer. This widely accepted message that women can have it all often leads to a feelings of in adequacy, confusion, and frustra tion for young women resulting in the manifestation of body image dissa tisfaction (Thompson et al., 1999). Smolak and Murnen (2001) have suggested that thinness is valued in most of the roles to which young women are encouraged to aspire, in the domestic and career realms. Furthermore, research has indicated that women who strive to be superwomen typically find they need to sacrifice relationships, which may leave them fe eling disconnected from social networks. To gain a sense of control and manage their feelings of c onfusion, many young women learn to define themselves solely in terms of their appearance and channel their energy toward the attainment of a perfect body (Friedman, 1999; Hensley, 2003). Critical of Media Emphasis on Appearance Media messages encourage women to seek positive attention from others for their appearance, rather than fostering self-esteem and confidence. Despite the medias repetitive messages about the value of appearance, primarily defined by the thin ideal, the participants in this study learned to question the importance that the media place on appearance for women. For example, Emma described her frustration with the media coverage of Britney Spears performance for the video music awards. Emma: What bothered me so much about her performance was that she was just going through the motions. She looked empty. That's wh at people should be outraged about. That should have been the headlines, no t comments that she was a cow.

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389 Nearly all of the particip ants chose not to watch real ity shows that judged women primarily on their appearance or weight. However, there was a distinct difference in the reasons why the participants did not watch these types of shows. In order to strengthen their resistance to the ideology of the thin ideal, participants who we re in the early stages of their recovery needed to avoid programs like American Idol and Americas Next Top Model, which they perceived to involve judgment or rejection based on appear ance and weight. For example, Grace described why she did not watch Americas Next Top Model. Grace: Its looking at skinny, pretty people, and then I go look in the mirror, and Im like, Damn! I got screwed over! So I just dont go there. And then I can celebrate what is good and unique about me. And just focus my attention on that. While the participants in the beginning stages of recovery tended to avoid media that might cause them to engage in unhealthy comparisons those who were further along on the recovery continuum and who had adopted a feminist ideo logy had more resistant readings to programs that encourage women to place appearance as the mo st salient factor in th eir self worth. Many of the participants in this study avoided programs th at focused primarily on cel ebrities (which they perceived to have an inherent focus on app earance). As Emma stated, I dont watch many reality shows because theyre contrived and ri diculous and further the cult of celebrity. A feminist perspective allowed the women to reframe their focus on media messages that place womens appearance as a primary concern. The participants who had more oppositional reading of reality shows tended to refuse to watch the programs, as opposed to avoiding them so they would not feel worse about themselves. Many of the participants refused to watch reality shows because they perceived them to be a waste of time. As Sunshell sai d, I think theyre just poor tasteless concepts.I guess they ar e all just tasteless and shallow.

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390 Many of the participants de scribed reality shows as repul sive. For instance, as Molly progressed in her recovery process, she became in creasingly critical of media that perpetuated the notion of judgment based on appearance. Molly: American Idol and now the shows that have spun from that I refuse to watch them. I dont find them that interesting in the first place. Plus, I dont like it when people are being judged! Who is anyone to say that there can be only one person in all the hundreds that season that is good enough. It makes me kind of angry! I also refuse to watch beauty pageants! They make me sick and I dont know if I can control my anger over them! The Biggest Loser and Americas Next Top Model come to mind as shows that I do not watch ever! All reality shows. Pretty much for the same reasons. The literature has indicated that the more women subscribe to feminist attitudes the less they evaluate themselves solely on physic al appearance (Affleck, 1999; Dionne et al., 1995; Doninger, Enders, & Burnett, 2003; Martz, Ha ndley, & Eisler, 1995; Tiggemann & Stevens, 1999). Some participants resistance to The Swan was informed by feminist ideology, which emphasizes that womens self-worth should not be determined by their physical appearance (Orbach, 1978; Wolf, 1991). For instance, Jord an rejected the notion that women should constantly be focused on attending to thei r bodies. She also dec onstructed the underlying ideology of most makeover television shows, that appearance is a measure of a persons worth. Jordan: This one show Ive seen Swan. The transformations that people undergo I guess plastic surgery. I think I saw a couple epis odes of that. First, they do a nutrition and fitness routine. Usually its someone that wa nts to lose weight. And then on top of that, they want, you know, their boobs bigger and th eir nose smaller or whatever the case is. They give them a doctor, a psychologist, a nd a couple other counsel ors and trainers, and then they go through this whole process. I think they just work on building their selfesteem. And then they give them a new out fit, and they give em surgery. You know, someone does their make-up and hair. And then they come out and shock their family and friends, and talk about how they feel like they can be better people in society now that they have more confidence and a smaller butt. (sarcastic and laughing) It s like, Oh come on, did you really have to do all that to be a better person? Adopting alternative media Exposure to feminism seemed to encourage se veral participants to seek alternatives to mainstream womens magazines, which tend to focus primarily on appearance and attaining the

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391 thin ideal. For example, Nicole discussed how di d not enjoy the traditional womens magazines, ones that were solely focused on fashion, beaut y, or fitness. Instead, she preferred to read magazines that informed her about her career field, or her interests in womens studies and environmental issues. Nicole: Right now I subscribe to things like Ms and things that are a little more political, Id say. Like, Utne And I know the midwifery magazines th at I read that Im into are all full figured. (She laughs.) Pr egnant women and stuff. A couple of the participants enjoyed reading Bust an alternative feminist magazine. Eliza described how she found the lack of focus on app earance and less mainstream perspective to be refreshing. Eliza: Its kind of a feminist magazine, but its really geared mostly towards people in their 20s or 30s. And it always features a celebrity that is inspirational in some way that has nothing to do with the way they look A lot of times they have actresses that are kind of undergroundactresses that nobody knows about. And they just have a lot of funky stuff in there. I just love the articles that they have. Theres always something really interesting for a smart reader. Its not like they dont talk about makeup or anything thats really surface stuff. They have really great interviews with inspirational women. Eliza also discussed how she preferred Bust over other womens magazines because the models were not extremely skinny. As she said, All the models in this magazine are just normal people. And some of them are even like big bone d. Theyre curvy. So thats nice, thats kind of refreshing. Kerry read Bust magazine, as well as Teen Voices an alternative to the typical magazines for teens. I visited the Web site for Teen Voices The mission of the publication reflects feminist ideologythat traditional teen magazines are too focused on appearance, and they lack information that would fuel girls abilities to be productive and contribut ing members to society in ways that are more intellectually-based. Teen Voices is written by and for teenage girls, and the goal of the online publication is to encourage teen girls around the world to use their skills

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392 to speak out on issues, create positive and pow erful media, and lead change in their communities ( http://www.teenvoices.com/AboutTV/abouttv.shtml, 2005). Overall, the participants expressed that they wanted more substance in their life in their interactions with people, as we ll as in their media consumption. In general, the participants avoided magazines and television sh ows that they felt were too superficial. They wanted to be exposed to things that were mo re inspirational in nature. Reading books for self-growth Som e participants had reached their satura tion point with magazines solely focused on more surface-oriented, appearan ce-related issues. Several wome n in this study described how they replaced their mainstream ma gazine reading, which was primarily appearance focused, with sources that fueled their inner self. Diamond described how she preferred reading books that allowed for personal growth, which in turn allowe d her to progress in her recovery process. Diamond: Im so fascinated by, you know, reading books about the Dali Lama, and going through excavations and reading journals a bout women. And just focusing more on my inner being than my outer being. Definitely more focus on that. D: Can you explain what you mean by excavating? Diamond: Yeah. Excavating, discovering like my auth entic self. So it was a term that was used in one of the journals that I was r eading on a daily basis. They just used like excavating, like learning what makes you r eally happy and knowing who you are. Like, What do you enjoy? What do you like? Who are you? Many of the participants expressed how they preferred movies with some depth to them, and several participants tended to watch mostly independent films or older, classic movies. In general, they were looking for something me aningful, not superficia l, appearance-oriented films. As Kristin stated, I generally like movies that have a strong message or meaning, or are artistically done.

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393 Other participants enjoyed films that did not limit wome ns body representations to the thin ideal. Eliza described why she preferred classi c black and white films: I find that the older films, people are just healthier looking than with the newer movies. Several other participants mentioned that they enjoyed Little Miss Sunshine because they thought the film portrayed the absurdity of our cu ltures obsession with beau ty and the thin ideal. One participant even recalled a sp ecific line in the movie that she particularly enjoyed: You know what? Fuck beauty contests. Life is one fucking beauty contest after another. School, then college, then work. Fuck that. Discount Sexist Media Messages According to LaTour and Henthorne (2003), Feminist consciousness-raising is easily facilitated by exposure to the issues. In a sense, women with a raised consciousness see the same things, but see them differently (p. 102). Fe minism may help women to develop a critical perspective, which allows for resistance to the normative representations of women. The concept of attaining the ideal body and We stern concept of beauty seems to be closely tied with the goal of attracting a man (Harris, 199 0). For instance, Jordan described how valuable magazines were to her when she was a teenager. Jordan: When I was in junior high and high scho ol, it [a magazine] had to have stuff about boys. (She laughs.) And it had to ha ve advice, whether its girly advice on you know, what feminine hygiene products youre us ing, or what makeup youre using, or where to get your prom dress, it had, it was just a lot of social frou-frou stuff that you go through when youre a teenager. Many of these women learned to resist pa triarchal constructions of femininity as represented in mass media. The participants saw the media as sources for transmitting the message that something was wrong with them, that they needed to fix something about themselves to attract a man. Michelle discussed why she chose not to read womens fashion and beauty magazines.

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394 Michelle: I dont tend to like as much of the magazines like Marie Claire or Cosmopolitan or whatever. Because theyre just I dont real ly think that theres really good images in there of women. And I think its all about how to please men. (She laughs.) And some of them just annoy me. I dont really think they really empower women. I think its more about, Oh how can you get rid of your fat thighs? And How can you please your man? Just these things that as opposed to just really being em powering articles about anything, its, How can you look good at any size? Research has indicated that females who r ead womens magazines for beauty advice were likely to identify with a more traditional fema le rolevaluing passivi ty, acquiescence, and harmony as essential qualities for maintaining successful sexual relationships (Kim & Ward, 2004). Mainstream womens magazines tend to en courage women to conform to stereotypical requirements for an attractive appearance, while isolating and denigr ating those who do not. Women who adopted a more fe minist ideology had a better understanding of how media messages reflect and shape what constitutes femininity. As Nicole progress in her recovery process, she became increasingly aware of how womens magazines had informed her of the cultural expectations for women. She challenged the dominant social norms underlying beauty messages in womens magazines. Nicole: In guys magazines, there arent those same things, about how to please women. And I think I would feel differen tly if there were. And the fact that girls a dolescent girls are brought up learning that role to please men, whereas guys are brought up learning that theyre deserving of that treatment. That really bothers me. Media Need to Make Image Unattainable Many participants realized that the media enga ge in relentless efforts to encourage women to believe that they are never good enough. One of the keys to minimizing the medias contribution to low self-esteem, which fuels eati ng disorders, is in the decoding process. If people are taught at a young age (mi ddle school perhaps) that the goal of advertising is to sell a product, then they might be less likely buy into the ideal body image portrayed in advertising.

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395 The imagery presented in magazines is intended to be unattainable. If the ideal body image was easily attainable, then there would be no need for people to consume products to fix all of their faults. Noah: The magazine industry is built around trying to make people get to something better And if you make it so difficult to attain that, then theyve got a mass readership that will continue to buy something that says you can get there. You know, if it [the goal for the ideal woman] was the 135 pounds, and we ll-educated, then who would buy their magazine on how to get perfect abs? So I mean, I know thats what theyve gotta do is continue to make it more more hard to get to. More hard. (She laughs at herself.) All of the women used to look to the media for ways to improve themselves. During their recovery process, they learned th at no matter how much they work ed toward trying to attain the medias portrayal of the ideal woma n, it was always beyond their reach. Nicole: The messages that are sent, esp ecially to adolescent girls, really gets on my nerves. Where it didnt before. Where I sucked those messages in and inte rnalized them before as more normal. My sisters are 16 and 20, a nd my youngest one is especially just completely caught up in all of that, and its just. Its sad to see that. When you internalize so many messages that youre not good enough and that you need to do this, this, and this to make yourself better or to match some unrealistic conc ept of perfection, your confidence is awful. And when you enter your adult life with th at, to me, youre just not starting on the right foot. Its just sad. It really breaks my heart. Like Nicole, nearly all of the participants discussed how they had internalized media messages that they were not good enough. During her interview, Isabel described herself as a young woman who lacked an identity or sense of se lf. She also discussed her low self-esteem, a characteristic that made her even more suscep tible to media messages suggesting that she was not good enough, and that she need to improve hersel f. The following material is an excerpt from a research paper she had shared with me. I was the dumpsterMaybe I was born with a sign on my forehead: Im where you put the garbage. Starving yourself is an excelle nt way to follow the rules. You are truly, unequivocally obese do someth ing about it, because obesity represents and shows all of your evil. The only thing you can do right now to fix everything is to lose a ll the weight you have.

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396 Look, youre one of a mob a litter a nd youre important when you conform, a nuisance when you dont. Youre a worthless piece of crap you should starve yourself, because the only way youll ever be able to come anywhere near be ing as special, important, or unique as other people is to be skin and bones, a nd even then, youll never compare. Isabels writings clearly indi cate just how damaged her conf idence already was, primarily from her family life, as well as physical and sexual abuse she had suffered as a young girl. As she indicated in her writing, she was looking for instructions on how to become a better person. She had internalized the blame for the abuse she had endured, wh ich made her feel like she was an inherently bad person, deserv ing of starvation. As Isabel ha s indicated, the void she felt from her nearly negligible self-esteem became the perfect breeding ground for anorexia. Furthermore, on the Internet, she found all the tools necessary to provide her with the confidence she so desperately needed. Isabel discussed how when she was in the mids t of her anorexia, the In ternet had served as a source of support: It didnt cause my eating disorder. However it really helped sustain it, and keep it going. And fed it. The pro-ana sites she visited pr ovided just the confirmation that she needed that it was good to be extremely thin. Isabel: When I discovered pro-anorexic Internet sites, I thought I had found support. If anything in society exacerbated my eating disorder, it was th e Web. I thought, Im fat, Im gross, Im disgusting, and the Internet said, Dont eat. If you want to eat food, look in the mirror at your thighs. If it tastes good, its trying to kill you. Happy or sad, rich or poor, its better being thin. Thin is a skill. Nothi ng tastes as good as thin feels. Calories cant make you happy. Craving is only a feeli ng. These were things I read on BlueDragonfly.org. And with those lines running through my head, I felt power, confidence, and determination. What is also noteworthy about Isabels comments is that one of the phrases that Isabel remembers from the pro-ana sites is the same thin spiration that Kristin adopted as her mantra after visiting a pro-ana site while she was anorexic: Nothing tastes as good as thin feels. It was not until Kristin recovered that she developed a strong opposition to pro-ana sites, which take the

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397 support of the dominant ideology of th e thin ideal to an extreme. As discussed in several sections of this dissertation, the message that being thin will make you feel good is one that the participants most strongly resi st, and one that is nearly un avoidable in American society. Media Demand Elusive Perfection Several participants noted how powe rful the media are in terms of conveying an elusive ideal. For instance, Nicole shared her perception of the medias contribution to womens desire for perfection. Nicole: I think the media just crea te these expectations that womens bodies should look a certain way just by always showing them as perfect. I mean, the models and celebrities always look thin and perfect, well not perfect to me But perfect from the medias perspective, which kind of drives what most people think is perfect. As the participants comments have indicated, recognition of the unrea listic nature of the thin ideal allowed for a more oppositional reading. Faith challenged the nature of the term ideal. Faith: I still think that the medias pushing an unrealistic body type or body ideal or typical or normal. You know they use all these words that whats normal anyway? I think that the body images I think that they portray more of th e unrealistic, unhealthy pictures of perfection. Ya know, where there is airbrushing and stuff like that going on on top of already going to major extremes plas tic surgery, diets, starvation. I think its negative because its false its pushing something thats not even attainable. The participants indicated that women receive the message that they should aim for perfection, yet the media present this concept as elusive. Emma noted that there is no individual woman who represents the ideal. Though we have had beauty icons in the past, Emma was unable to recall someone who se rves in that role today. Emma: There isnt the iconic woman anymore. And that was problematic, dont get me wrong. There are problems with idolizing Marily n Monroe or Twiggy of course. Its not like those times were better. But there is no longer some shared concept of beauty. I mean, its bad to be fat, its bad to be short but media arent espousing some perfect measurements. Every female body has some flaw, which magazines always point out. Soand-so is worst dressed. Heres Julia Roberts without make-up. Nicole Richie is too thin. No matter what women look like, it isnt enough. There is this weird catch-22 in media. The ideal is to be Super Woman, to have an infallible body, but the minute the tabloids pick an It girl, they tear her to shreds. The media like wo men to be inhuman, and flaws

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398 show their humanness. So the audience feels better because Cameron Diaz is having a bad hair day, while at the same time, the underlyi ng message seems to be: What a failure. She cant keep it all together either. One of the strategies that women in this st udy used to un-internalize the thin ideal was to see the absurdity of the media me ssages. Emmas comments reflect the idea that the media spew out multiple criticisms for what is not acceptable, but lacks a realistic representation of what is: The media just tell you what you should not look like. They always find some flaw even with women who seem to look like the ideal. Contradictory Messages in Magazines Several participants in this study found all media sources to be fraught with ideological contradictions, sending confusing messages to young women about th e thin ideal. According to Gauntlett (2002), popular culture and its transmissi on via media present inescapable levels of contradiction (p. 255). In some cases, the co ntradictions are what enabled some of the participants in this study to navigate through the ubiquitous medi a messages promoting the thin ideal. As Enchantment wrote in her media jour nal, This magazine tells you to stop worrying about your body when they put anorexic models all in it! How can they tell girls to love their body, when theres nothing but skinny models? Several women in this study discussed how womens magazines in particular were extremely contradictory, offering inconsistent and conflicting messages about the value of appearance and the thin ideal with a discrepancy between the textual and visual media messages. In particular, they noticed that advertisements tended to consistently portray extremely skinny women, despite occasional articles challenging this ideal. This dichotomy provided evidence for some participants to question the sincerity of media messages. Jamies comments illustrate what many of the participants note d, that magazines do a disservice to women when they pretend to care.

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399 Jamie: Theres so many contradictory messages. Its hard to believe anything in magazines. They dont genuinely want you to fe el better about yourself or accept yourself the way you are. If they did, why would they plaster an entire mag azine with all these sickly-thin models, and incl ude one little article about how you should feel good about your body. How do they expect women to feel good, or especially young girls, if all they really see are super skinny models. According to Kotsopoulous (2001), several fe minist scholars have contended that exposure to ideological contradict ion results in an oppositional, fe minist stance (p. 44). Molly used these contradictions to deconstruct and opp ose magazine messages promoting the thin ideal. As she said, theyll print up some stupid starvation dietand then three pages later is an article on how to accept yourselfI just think its a lot of superficial crap! As Hensley (2003) has suggested, women are be tter able to resist media messages if they recognize and acknowledge contradictory cultural e xpectations, and, rather than internalizing their feelings, articulate these conflicts directly. These women also are better able to interpret contradictory cultural messages and define for themselves what it means to live an authentic life as a woman who is comfortable with her gender role and with her body (p. 325). Media Promote Diets as a Mechanism for Control Preoccupation with fat, diet, and slenderness are not abnorm a l. Indeed, such preoccupation may function as one of the most powerful normalizing mechanisms of our century, insuring the production of self-monitoring and self -disciplining docile bodies sensitive to any departure from social norms and habituated to self-improvement and selftransformation in the service of those norms (Bordo, 1993, p. 186). Garner and Garfinkel (1982) have contended that media and the die ting industry capitalize on the desire for the thin ideal, which has become associated with self co ntrol and success (p. 106). Dieting is valued in our society, and peopl e tend to perceive women who lose weight as successful and in control (Bordo, 1993). Metkit described how she thought dieting woul d allow her to regain control over her body, and thus, her life. He r initial diet led her to deve lop both anorexia and bulimia.

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400 Metkit: I didnt really gain that much weight. Bu t I got to the highest weight Ive ever been in my life. I remember that spring when I was 15 just feeling really out of control and just feeling like, God, I need to lose this weight. What is wrong with me? Im fat and Im out of control. I was reading Cosmo and th at kind of stuff, even though my mom thought it was trash. (She laughs.) And I just thought I was really fat. So I kind of went on this kick. I think my dad was doing weight watchers at that time. My dad has always struggled with his weight. And I remember picking up that book and tracking my points with food. That turned into calorie counting. A nd I lost like 30 pounds in four months. Initially, the participants perceived dieting to be a weight control mechanism, but at some point, the diet took over, and even tually the obsession w ith being thin controlled the person. This transfer of control was expresse d by all of the particip ants, and they all di scussed how a turning point for them, in terms of sincerely wanting to recover, was when they truly realized they no longer could manage their eati ng disorder or their life. These women initially had felt like starvi ng their body was an accomplishment. They had defied the nutritional needs of their body for some time, but eventually the eating disorder mentality and behaviors that enabled them to ma intain an extremely thin body became miserable and oppressive. As the women were drawn more deeply into attain ing the ideal body via anorexia, they became increasingly self-loathing, fearful of deviating from their achievement of thinness, and increasingly obj ectified themselves, losing sight of any sense of self worth. Femininity is associated w ith a perfect diet Diet ads promote the freedom of weight loss, but constraints about calorie intake are inherent in the diet process, cr eating a focus on internal constrai nts and restriction, not freedom. As Brown and Jasper (1993) have suggested, we live in a patriarc hal culture that promotes a focus on weight control through rigid, restrictive, calorie counting. These women described how they felt enslav ed by anorexia. They became relentless in their pursuit of perpetual we ight loss with an infinite series of calorie and weight charts. Many of

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401 the participants knew exactly how much they ate each day, and they often kept records of their progress. The participants indicated that womens magazines perpetuate the idea that there are perfect measurements for different parts of wome ns bodies, promoting the idea that women are quantifiable commodities, with a narrow range of acceptability. Several participants discussed how they had turned to mainstr eam womens magazines when they were anorexic to learn about diets and calories. During her interview, Isabel discussed how she used to think that magazines offered a prescription for attaining the thin ideal. Figure 4-2. During her interview, Isabel shared an index card with me that she had kept when she was anorexic to record measurements of her body. The participants discussed how calorie counti ng forces people to aim for perfection, as if there was a perfect number of cal ories to consume. Women who were able to deconstruct media messages that promote an unrealistic image of pe rfect eating had more oppositional readings of diet and weight loss messages. Emma discusse d her frustration with health magazines. Emma: Health magazines are not about health. Theyre about pe rfection. They never say, Hey do the best you can do, and having a cheese burger wont kill you. Theyre like, Eat five almonds but for the love of God dont eat more than five because if you do youll become obese and youll turn into an almond and all youll think about are almonds and if you eat too many almonds you wont be well-nourished, which means by tomorrow, you will be dead and it will be ALL YOUR FAULT.

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402 Recovery is freedom from ob sessiv e, restrictive thoughts Peterson et al. (2008) found that empowerment is an important protective factor in reducing self-objectification and body image and eating disturbance. Knowledge of feminist ideology empowered many of the participants in th is study. With an increased sense of critical media literacy, the participants became more resistant to media messages, particularly those placing appearance as the most salie nt factor for a womans self worth. Several participants also described how they saw their recovery process as empowering, at least in part because they no longer felt victimized by the media-suggested need to engage in the relent less pursuit of the thin ideal. Several women described a profound sense of freedom and empowerment they had felt in their recovery process. This feeling emerged as they shed their obsession with weight loss. Kristin: Recovery from an eating disorder m eans no longer having an obsession. Being free from that obsession so other things can take up the major ity of your time, rather than spending time and energy thinking about what youve consumed that day or anything tied to that. Once women in this study had tasted the freed om of recovery, their resolve to remain in recovery was strengthened. Molly described what recovery meant to her. Molly: A freedom like youve never known! Its hard to describe, especially to a person who hasnt dealt with an eating disorder Its like 10,000 pounds being lifted off your shoulder. Being able to take a deep breath and feel the air fill your lungs. I dont know its just a freedom like youve never known! Over time, the participants who embraced feminist ideology resisted magazines messages that they now perceived to foster insecurities about womens bodies and their overall appearance (Gough-Yates, 2003; Korinek, 2000, p. 10). The participants came to believe that femininity through beautification was not a choi ce, but a patriarchal construction imposed on them, but for the benefit and sa tisfaction of a male gaze.

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403 Media Promote False Associat ion s with the Thin Ideal The mass media exert extraordinary infl uence through cultural hegemony, which Lull (2000) has summarized as the power or domin ance that one social gr oup holds over others gained through a tacit willingne ss by people to be governed by pr inciples, rules and laws which they believe operate in their best interests, even though in actual practice they may not (p. 51). During adolescence, girls struggle with the development of their own, unique identity. In American society, girls are socialized from birt h to place the primary source of their personal value and identity on their appearance. As they reach adolescence, they increasingly tend to evaluate their appearance in re lationship to otherstheir peers and celebrities that they view as role models. As Amanda discussed, media sources set the standard for whats attractive. Amanda: Media images are definitely how we ge t our perception of wh ats attractive. I guess its just being so exposed to it just seeing the people th at are so thin and everything. I mean theres just so much of it. They obvi ously contribute to peopl e thinking that being thin is attractive. Through the powerful force of the media, wome n repeatedly receive the message that the ideal is the only acceptable body shape and size (Fallon et al., 1994). Furthermore, many women have internali zed the importance of achieving thinness, a goal associated with reaping significant personal and prof essional rewards (Bordo, 1993; Butler, 1990; Malson, 1994). Rather than representing a diversity of female body types, the media consistently limit their portrayal to the thin ideal, which has comes to symbolize (or represent) a collective unified understanding of what is attr active. The participants conf irmed the seemingly universal acceptance of this ideal when they we re praised for their weight loss. In fact, nearly all of the participants de scribed how their initial weight loss led to compliments, which fed their self-esteem and enc ouraged them to continue losing weight even when they progressed beyond a healthy amount of weight loss. As Jordan said, I just got all this

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404 really positive attention. To this day, she still remembers when she became one of the beautiful people. The media cultivate unrealistic standards of beauty that can be detrimental to ones body image and may contribute to the development of eating disorders (G uillen & Barr, 1994; Hamilton & Waller, 1993; Levine & Smolak, 1996; Levine et al., 1994; Pinhas et al., 1999; Shaw, 1995; Stice et al., 1994). Teenagers use wome ns beauty and fashion magazines for selfevaluation and self-improvement, and as severa l researchers have contended, these types of magazines emphasize physical beautification, whic h reinforces the socio-cultural preference for thinness (Festinger, 1954; Martin & Gentry, 1997; Shaw & Waller, 1995; Thomsen et al., 2001). Furthermore, several researchers have found that womens maga zines propagate the perception that happiness, popularity, and success are linked to attractiveness, as defined by extreme thinness. Female happiness and success ar e tied to physical appearance, with ultrathinness being the preferred state of health and beauty as well as the most important form of selfimprovement (Evans et al., 1991; Guillen & Barr, 1994; Silverstein, Peterson, & Kelly, 1986). Thinness Will Not Make You Happy Many of the women had used media imager y to inspire them to lose weight. Grace discussed why she used to cut out thi nspirations from womens magazines. Grace: Looking around at the images in mag azines, I felt such a void. And so unacceptable that, everybody likes the pretty people. Theyre putting them on these magazines, and they look so happy, and if I could just look like that, then it would hide all of my inadequacies and all my faults. And Id be happy. I remember thinking, I just have to lose weight to feel okay. Through her battle against anorexia, Grace had learned that being thin did not provide her with health or happiness, but she still was temp ted by imagery of the thin ideal. She was in the early stages of her recovery process, and she shared a strategy that was helpful to her:

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405 Remembering where I was helps me to stay on track because my life was not anything worth living for. And I dont want it back. As the participants progressed in their reco very process, they realized they had been looking for happiness in the wrong placethat the me dia-promoted idea that weight loss was the key to happiness was false. Emma described a st rategy she now used to resist diet messages. Emma: What keeps me motivated is that any despair I feel now does not compare to the despair I felt then. I have moments of p eace and happiness now, where my heart feels warm and full, and while my ea ting disorder promised me that it never gave that to me. And now I finally know that dieting and anorexia is not the way to get it. The participants discussed how they felt betrayed by the media messages perpetuated in the mediathat losing weight would make th em happy. They also expressed concern that so many people still were being exposed to the same message s that had served as such a negative influence on them. Noah: Theres that part of me th at thinks, Oh pretty, cause youre socialized the same way. But theres that other pa rt of me that says, its sad because this is so fleeting Weve been sent a false message. And its upsetting to see so many people told that somethings gonna bring them happiness. And theyre gonna grow up one day and go ya know, I believed it. And I wasted all this time and ener gy, and I couldve been into things that really, truly would bring me happiness. And instead Ive created this person thats gonna constantly be worried about her weight And thats the only thing Ive built up that I think I have any value for. Weight Loss Does Not Solve Problems For these women, it was not until they were in recovery and gained some media literacy that they were able to look back and realize that they had fallen for the media implication that being thin would solve all of their problems. Lulu described how wome n might be tempted to focus their energy on weight loss. Lulu: We all want to be beautiful on the outside especially if you don t feel so beautiful on the inside. I think thats probably why ea ting disorders happen. Y oure either not happy with how your life is or the choices you ve made. Youre not happy about what has happened to you whether thats abuse or whatever. So you dont feel so great about yourself. And you dont know how to fix that. So dammit Im going to fix whats on the

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406 outside! And if that means controlling what I eat, controlling how I look, controlling what I weigh everything on the outsides going to be perfect cause the insides not so good. I know thats kind of how I felt when I was si ck. I couldnt control anything, as far as medical school was goin. My grades werent the straight As that Id been used to having all my life. I was away from family and home, and it was like, Okay, well let me start controlling something else the n. (She laughs.) And the media kind of send the message that being thin is all that. Before I knew it, thats all my life was. Eating. Getting rid of it. Trying to lose weight, and it was ridiculous. Armed with an increased sense of media lite racy, several women in this study criticized any media messages overtly or indirectly promo ting the thin ideal. These participants also learned to question the underlying hegemonic noti on that the thin ideal is the only means for gaining social appr oval and success. Metkit : What I find very irr itating about things, like Glamour and Cosmopolitan all that crap is that magazines sugge st that being thin, or eating certain food, or appearance, or anything superficial so to speak will provide you with the ultimate happiness. Attaining the Thin Ideal Does Not Make You Popular As agents of socialization, media influence young wome n (Ferguson, 1983) by teaching them about norms and social expectations (B andura, 1977). The media provide illustrations of the social rewards that females can gain from being thin, such as love, happiness, acceptance, and success (Bordo, 1995; Seid, 1989). The women in this study were attuned to such media implications, and nearly all of the them had started a diet because they viewed the attainment of the thin ideal as a mechanism for gaining social rewards of happiness and acceptabili ty. For example, Barbara described what set the stage for her eventual development of anorexia. Barbara: It started like a diet. I was chubby as kid, but back when it started, I dont think I was fat. But I thought, Im not popular because Im not skinny. So if I get skinny, maybe I can be popular. So I started losing weight. Barbara continued to lose weight, and eventu ally her obsession with continual weight loss precluded her ability to maintain friendships: And I stopped havi ng friends. I lost contact with

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407 everybody. I didnt go out with my friends anymor e. I didnt hang out with anybody anymore. I always went home and did my own stuff. As an eating disorder progresses, so does the isolation that tends to accompany it. The participants all described being l onely and miserable when they were in the midst of their eating disorder. Christina described how specific media messages she internalized had conflicted with maintaining a healthy social lif e: I would only eat fat free things. I think its because I was trying to fit in more, and magazines always ga ve off this image that everybody should eat fat free, and everyone likes the thin, beautiful people. Over time, Christina deve loped an intense fear of any food with fat in it. She described how her restrictive eating be haviors influenced her life. Christina: I would avoid all social situations. Like, I woul dnt eat pizza. I wouldnt go anywhere to eat with friends, which kept me r eally isolated. I really lost a lot of friends because of what I was doing. Eventually, I had no friends. Especially when I started with the exercise from magazines. I would ju st exercise all day long. I would avoid everything Focus on Appearance Diverts from Other Activities When women spend their time continually tr ying to attain the id ealized version of femininity, they do not have time to devote to other, more mean ingful activities. According to Buetow and Jutel (2007), Appear ance is a powerful tool in social control Seeing, being seen, or simply being at risk of being seen creates an internalized form of constraint that makes people adhere to social rules (p. 426). This concept is based on Foucaults (1977) theory of control through a Panopticon, an 18th-century prison design designed to allow concealed guards to view inmates at any time. The potential of being seen at any time constrains ones behavior and serves to moderate how one would like to look and be perceived. From a young age, females are sent powerf ul media messages that their bodies are commodities. Women also learn that attractiveness is a primary form of currency (Fredrickson

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408 & Roberts, 1997, p. 178), which encourages a preoccupation with physical appearance. From a feminist perspective, when females focus ex cessively on appearance-related issues, their cognitive and monetary resour ces are diverted away from more empowering activities (Kilbourne, 1994). Todays perfection-driven, appearance-focused society has produced a rise in eating disorders and a generation of women who waste hours obsessing about their body image. Several researchers have contended that too much focus on body image can adversely affect a womans quality of life because the tim e, money and energy she spends on her appearance impedes opportunities to focus on other aspects of her se lf (Strachan & Cash, 2002; Striegel-Moore & Franko, 2002; Wolf, 1991). As Noah said, If we waste so much energy thinking about the size of our bodies and our clothing, how are we ever going to excel in other things in life? Product Associations are Profit Driven Advertisem ents typically associ ate the products theyre trying to sell with the ability to transform our life style, appearance and achieveme nt of personal and professional goals (Jhally, 1987; Kellner, 1990; Leiss, Kline & Jhally, 1986 ; Williamson, 1978). Many of the women used to believe that purchasing certain products would allow them to be more attractive and popular. For example, Ramona shared how TV commercials used to affect her. Ramona: Watching commercials always made me feel like I needed something. Whatever they were advertising. Like watching a face cream commercial. Id see the commercial, and I think, Wow, she s got perfect, skin. I need that. Ill be be tter liked, better appreciated. Everything I need will come to me as long as I have skin like that. Once in recovery, most of the women no longer subscribed to this notion. They had placed their trust in media messages, yet as the partic ipants learned that media messages are heavily influenced by the motivation for profit, they re alized the extent to which attractive women are used to sell products. For example, Amanda shared what she had learned in recovery.

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409 Amanda: Its like, If you use this youll look like this. They re not even exactly saying that, its just implied. I mean, the images of the people arent always real. But were exposed to thin, attractive women so much. So if you see that image and you think theyre attractive, you just feel worse about yourse lf. And basically they use these attractive people, who arent even always real to try to get you to buy their products. As consumers of mediated messages, we are taught to view our bodies as matter that we can shape and change at will. According to Fr eedman (1986), female beauty in the media is packaged and peddled as an illusion that anyone can cultivate (p. 5). During her interview, Amanda described how the media promote the idea that perfection is attainable: I used to really think, when I was in high school and college, th at you could look just like the women in the magazines if you did the things they sai d, or bought whatever. (She laughs.) And now I know thats definitely not true. Belief in Attainability The participants in this st udy had thought they could achieve the ideal represented in the media. Mainstream, popular womens health and b eauty magazines are saturated with images of the ideal female body, often accompanied with advice on how viewers can achieve a body that resembles the imagery of models. Alexandra s comments indicate how easily a woman seeking to be thin might believe that the magazines might offer a simple solution. Alexandra: I used to read Shape and other fitness magazines on a regular basis. I liked having a look at their suggested exercise programs. And then they had skinny models doing those exercises. And when I was younger well, while I had my eating disorder I thought, So this is what I have to do to look like that. Magazines were not the only s ource of comparison for these women. As teenagers, several participants used to admire characters on TV s hows. For example, Nicole described why said that she liked shows such as 90210, Dawsons Creek and Felicity : It was just kind of a nice fantasy world to be in, just a nice, perfect world that I wish my world was like.

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410 Several participants said that they used to enjoy watching 90210 when they were in high school and college. Charlotte described why sh e no longer thought highly of the show: Ive watched it a few times since then, and its definite ly a show that bugs me cause theres all these young, pretty, thin girls, and I know I used to think that I could l ook just like them. According to Milkie (1999), social comparison theory allows for the notion that people can choose to avoid or discount media images that they know are not an accurate basis for social comparison. For these participants, the pervasiven ess of media imagery a bout the thin ideal and more importantly their lack of knowledge about the unrealistic nature had not allowed them the freedom to select an accurate, realistic source for comparison prior to onset of and during their eating disorder. They had lacked sufficient media literacy and knowledge about the unattainable nature of the representations of women in the media. Celebrities are happy and perfec t. Celebrities are thin. Wei ght loss is key to happiness and perfection. When presented with an ideal body image, re peatedly illustrated in the media, women who are prone to perfectionism are more likely to internalize this ideal and strive to achieve it, especially given the media messages that suggest th ere is a formula. Some of the most pervasive advertising messages are portrayal s of the ideal female body, with detailed how to guides of how to achieve perfection in terms of appearance. Many of the participants discussed how they felt the need to be pe rfect when they were children to keep the peace at home. For example, Molly said that her parents divorced when she was 5, and she discussed how this contri buted to her desire to be perfect. Molly: My mother has several mental problems and was truly unable to take care of two children. She wasnt shy about her feelings she let us know that she wished we were never born. So I started believing that I could make things better one of two ways I could disappear or I could be perfect and never cause any problems. Di sappearing didnt work quite well, so I became perfect. And one of th e ways I tried to be perfect was with my

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411 appearance. Id occasionally buy a Cosmo or Seventeen when I had my eating disorder. I thought the celebrities were perf ect, so I would follow their diet s to try to lose weight. Sarah described how she used to think that she could achieve the perfect life if she became thin. She attributed the perceived perfecti on of the celebrities to the thin ideal. Sarah: The media, I wouldnt say is the cause of the drive to diet, but it certainly doesnt help. Ya know because you do see those images of like a model or a movie star or whatever. And you see the perfect life or whatever that they seem to have. And you strive to achieve something like that. Perfection is Not Possib le Once the women were in recovery, many of them worked to reduce their level of comparison, some with more success than others Regardless, nearly all the participants expressed concern for others w ho might engage in unrealistic co mparisons and head down a path similar to the one that had led these women to anorexia. Participants who tended to engage in more oppositional decoding targeted their anger at the media as vehicles for dispersing negative, in accurate messages to people who were unaware of the potential damage of embracing the ideal body. Now Charlotte saw th e mediated ideal as unattainable, but she expressed concern for young people who might lack the knowledge that she had gained in her recovery process. Charlotte: It kills me that one of the characterist ics [of the ideal] is the perfection. When they talk about, Oh celebrities have perfect bodies. And Im like, Its not perfect. Its just a show It just bugs me when I see little girls, little girls, younger girls or teenagers, who are like that thinking celebrities have pe rfect bodies, and they could look like that. These women used to believe that a perfect body was easily attainable, but now they knew this was not the case. Through their personal expe rience, they knew that they had the will power to achieve the thin ideal, but in doing so, they ha d sacrificed their health and well-being. They also knew that maintaining the perfect body took a grea t deal of effort and sacrifice, often inhibiting their ability to function in any other re alm of their life.

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412 This knowledge allowed the women to questi on the underlying messages of media images. For example, Jane was watching Will & Grace one evening, and she noted how thin and attractive all the characters in the show were. In her media journal, she wrote, I wonder if theyre happy. Similarly, Courtney was in line at Wal-Mart one day, and a picture on the cover of In Touch caught her eye. The thought she recorded in her media journal was Jessica Simpson has the perfect body; I wonder how hard it is to keep it like that. These types of interpretations indicate that the participants now saw the media implications of appearance-related perfection as a faade because they knew that achieving that type of look was all-consuming. The participan ts also had learned that the consequences of focusing their energy in this way outweighed any potential benefits. An important part of recovery for these wo men involved a journey of self-discovery that involved learning to value who they were on the insi de, so they did not have as much of a need to focus on fixing their outsides. Lulu shared the following thoughts du ring our interview. Her comments reflect the realization that she had been working toward an unrealistic goal of attaining elusive perfection portrayed in the media. Lulu: I realized that Im not perfect at all And thats okay (high pitched)! Once I started seeing that Im not perfect, and neither is anyone else, and st arted watching how the media portray perfection, and how they portray this un attainable perfection re ally, then I wasnt so interested in focusing on my outside so much anymore. (She laughs.) Overall, relinquishing the desi re to be perfect also seemed to be a key component for resisting the dominant mediated ideal. Several participants desc ribed how letting go of perfection was an integral part of their recovery process. For example, Jamie said jokingly, Sometimes I feel like Im doing a 12-step pr ogram for perfectionism! Emma discussed what she thought would be helpful in terms of preventing the prevalence of eating disorders today.

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413 Emma: In general, the media not equating body image with adulthood. And raising girls self-esteem. Stop shoving perfectionism down thei r throats. It seems lik e girls need to be good at everything school, friends, sports the right body. They just need to be themselves Stop focusing on a perfect outco me, especially for their body. Media Promote a Dangerously Unhealthy Ideal Across the board, the participants indicated th at the ideal female body as portrayed in the media is unhealthy for women to emulate. All of the women said that the mediated ideal female body was not only thin, but too thin. Many of the participants discussed how they now perceived models and celebrities who fit the medias ideal to be unhealthy, sickly, and malnourished, which was cont radictory to what they perceived that the term ideal should si gnify. Barbara worked in a hospital, and her comments during her interview illustrate this perspective. Barbara: The media do not portray an ideal, in my opinion. Medically, they dont show healthy people. They show many people who lo ok like they are ill. If somebody like that came into the hospital as a patient, and lets say they werent rich or anything. They would probably send them up for a social worker. They would help them get food stamps and things like that. Media Equate Thinness with Health The thinequals-beauty discourse is the mo st flagrant example of the contemporary medias conflation of appearance with health. As the participants progres sed in their recovery, they learned to reconstruct the concept of health y, and they deconstructed media messages that equated health with the thin ideal. Many participants now had adverse reactions to overly thin women on magazine covers. For instance, Amanda described why she disliked magazines such as Cosmopolitan or Vogue : The thing about magazines that is frustrating to me is that they try to portray this unrealistic, unhealthy thinness as healthy.

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414 Laden with sponsors from the diet industry, the fitn ess industry has shifted its focus to weight loss, rather than fitness for health. According to Jordan ( 1995), more than 80% of sensational headlines on the c over of fitness magazines equated fitness with thinness. Charlotte used to read fitness magazines wh en she was anorexic. However, she discussed why she no longer read them. Charlotte: It just bugs me that they have those f itness magazines. And then they have this anorexic girl on the front. Like, shes supposed to be in shape cause you can see her abs. But you can also see like all he r hips bones and I mean ever y other bone in her body. And youre like, Thats not f itness. You know, Thats not healthy. Thats not healthy fitness. Media Have a Responsibility to Portray a Healthier Ideal The more media literate the participants had become, the more they realized how much the media contribute to a dangerously unhealthy th in ideal. Furthermore, the women believed the media have a responsibility to present a health ier representation, especi ally to young girls who are more susceptible to media messages and are likely to take them at face value. Molly: I thought that what actresses looked lik e was what the normal person looked like. In high school I started to notice a difference between my body and the medias image. Although I was still thin I did not see that because my perception changed a bit. I think thats when I also decided that I had to be ve ry tiny in order to be acceptable. And I fell head first into the eating disorder. This c ontinued throughout college and while I continued to struggle to reach recovery. Towards the end of my battle I was so low, I think I could have given up the desire to fit the ideal, but I was in too deep. Now, that ideal just seems really unrealistic, and I think its harm ful for young girls to see all the time. Female adolescents tend to consume media as resources for learning how to become a woman, especially at an age where they are tryi ng to develop some level of independence from their parents. Studies have indica ted that adolescent females turn to television and magazines as sources for information on what is socially acceptable. Research also has shown that young females often read magazines and compare themselv es to the images of fashion models they see (Bordo, 1993; Harrison, 1997, 2000, 2001; Harrison & Cantor, 1997; Martin & Gentry, 1997;

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415 Martin & Kennedy, 1993; Nichter & Nichter, 1991). This is especially true if the girls do not have other sources for this information. Alexandra had regularly purchased fitness magazines from the age of 15. She truly had thought that magazines portrayed reality and if she followed th eir suggestions, she could look just like the models. Alexandra: I loved the ads they were my insp iration. I loved how the women looked and how they were dressed and their make up. They always looked so pretty! And I wanted to look like them, just like them. My room was actually full of ads from the magazines on my walls. That was my wallpaper. It looked kind of cool actually but it was unhealthy for my body image. Righteous anger seems to have fueled oppositional readings for several participants. Mollys oppositional interpretation of shows on te levision now. Her media journal entry suggests that she perceives the media to be guilty of some injustice for planting unrealistic ideas in young womens minds. Molly: Sat. 7/16 @ 10:30 PM CSI re-runsMy living room Hanging out getting ready for bed. I love CSI! I feel good that no one on the show is extremely thin, but they are still thinner than the average person. Thats what sucks about TV and movies! When I was little, I literally be lieved that what the actre sses looked like was normal and that is what I should look like! It makes me livid when I th ink about what this might be doing to our children now! As Amanda progressed in her recovery, sh e became more critical of media messages promoting the thin ideal. In her media journal, she expressed concern for people who could be negatively affected by watching Americas Next Top Model : I HATE this showit is damaging the self-esteem of women everywhere! Amanda had believed that the thin ideal was healthy when she was young. Once in recovery, she expressed concern for young people who might lack the knowledge that she had gained in her recovery process.

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416 Amanda: I just dont think its good for people to watch it especially younger people that dont realize that its not good to watch it. Cause they dont know that this is not healthy. I mean theres probably teenager s sitting at home watching it thinking, Im gonna be one of these people or something. Li ke I could have been watching that my freshman year of college and, it wasnt on then. But I proba bly would have watched it and though, Oh! you know, I wanna look like that. Many participants realized that celebrities and models also are victims of the thin ideal and have unhealthy standards imposed on them. As Molly said, It makes me sad that they are hurting their bodies and cant have much confidence or assertiv eness to stand up against the industry of films and models, things like that. Models Meet Diagnostic Criterion for Anorexia Due to increasing concerns about eating disorders, there has been global interest in developing weight requirements for models, a nd several European countries already have instituted requirements or are considering doing so. Several of the women supported the requirements that countries like Spain and Germany already have established. For example, Kristin said, In Spain, runway models have to be a certain requirement. I think thats good, and we should do it here. Faith expressed similar sen timents in one of her media journal entries. Faith: Friday 4 p.m. Internet AOL Pop up My family room looking at AOL stuff It is sad that there are so many people in the media with eating disorders. These women are so thin. It is sad that the media pushes that ideal. I am glad that Spain has started to regulate their requirements. They have banned overly skinny models from the catwalks. Italian fashion houses have signe d a pact not to use under-16-y ear-olds or stick-thin adult models. I hope that the rest of this industry follows in their footsteps. The participants felt strongly that the fashion industry should require models to be healthy so people would not strive to look like an image that qualifies for anorexia. As Metkit said, The models look like death warmed over to me.I mean you often see rail thin models. Several researchers have found that the typi cal fashion model actually would meet one of the primary diagnostic criteria for anorexiab eing 15% below what would be considered a healthy weight for ones age and height (C usumano & Thompson, 1997; Groesz et al., 1999;

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417 Wiles, Wiles, & Tjernkund, 1996). Kristin had done research papers on medi a representations of women. She expressed her concern that most Amer ican models met the criteria for anorexia. Kristin: Society idolizes thinness and displays beauty as the models on television and in magazines. And many of these models even m eet the criteria for anorexia. From what Ive read, female models in magazines read by adolescents are under average recommended weight. I also remember some thing like that over half Playboy cover models are below their recommended body mass number. During their interviews, the participants we re asked to describe the ideal female body image that the media portray. Several of the women described an image that might fit a description of a woman with anorexia. Abigail noted that the women needed more meat on their bones. Part of Enchantments description was shes so skinny that you can almost see her ribs. Grace described the ideal as Tall and very, very skinny. Really skinny. Ribs showing. Hip bones poking out. Not really a lot of anything. Similarly, Sarah said, Hipbones sticking out a little bit. You always see that. Because they always wear those little cut bath ing suits or jeans or whatever. And maybe the ribs pok ing through just a little bit. Extremely Thin Models Suggest There s No Such Thing As Thin Enough Some researchers have found that social comparisons with fashion models are most dangerous for women who already have developed eat ing disorder symptoms, particularly if they are competitive in nature (Burkle et al., 1999;). According to Thomsen et al. (2000) magazines served to reinforce the cultural thin ideal, even when the women were at an unhealthy weight and were urged by family, friends and physicians to gain weight. For the women with anorexia, magazines helped to rectify cognitive dissonance they experienced, confirming that being extremely thin was a positive achievement. As Lager and McGee (2003) have argued: One of the most frustrating and contradictory messages the woman learns from popular magazines and from articles about anorexia is that the low weight of models in the media are the normal and natural state of the female body. It simply shows that even the women our society idealizes as icons of feminine beauty have internalized the lesson that there is no such thing as thin enough. (p. 283)

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418 Not only were these participants trying to ach ieve the size portrayed in the magazines, but as their disease progressed, they tried to become even thinner than the models, not perceiving them to be too thin or unhealthy. Michelle disc ussed how she used the extremely thin models to justify, to herself and others, that there was nothing wrong with her. Michelle: When I was anorexic, I just compared my self to those women that were smaller. It probably just reinforced the idea that Oh, Im not too thin. Im still okay. Im still healthy. And, when you can look in a magazi ne and see all these people who look the same, then, you can rationalize whatever you want (She laughs.) I dont think that now. Once in recovery, Michelle expressed con cern for young girls who might engage in the type of comparisons she had: I dont like all the ads. Or all th e fashion models that are stick thin. I do think thats bad, especially if they re role models for younger people. Attribute Responsibility to Individ ual Celebrities Through their recovery process, all of the participants came to believe that the media collectively have played a signi ficant role in our cultures body-image obsession. The women also learned to attribute some responsibility to individual celeb rities for cont ributing to the perpetuation of an unhealthy, unrealistic thin idea l. As Rylie said, It s exploiting that whole image of what beautiful is supposed to be. Many of the participants discussed how some celebrities had looked bett er prior to recent weight loss. Lindsay Lohan was the celebrity most commonly discussed in this regard. For instance, Rylie shared her perspective in her me dia journal about the media coverage of Lindsay. Rylie: Saturday, July 9, 2005 @ 3:00 p.m. Magazin e: US Weekly Waiting to get waxed. Im flipping through a recent copy of US Weekly. This article is about Lindsay Lohan. She used to be so gorgeous. When she had her fu ll figure and red hair, I thought she was the prettiest girl. I wanted to look like her. In the video Over, she was thin and so beautiful. Now, shes hideous.

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419 During her interview, Rylie elaborated on her thoughts: She looks horrible I didnt want to even see Herbie Fully Loaded cause she looks so horrible. She looks really bad, like this skinny little image. Rylie actually had colored her hair red because she admired how it looked on Lindsay Lohan: I loved her body when she was at her norm al weight with the red hair. I actually had red hair up until a couple months ago. Not anymore. Rylie changed her own hair back to her natural color when she lost respect for Lindsay because of her extreme weight loss. Rylie had looked to celebrities as role models in her life, so she expressed concern for young girls who might do the same. Rylie: I liked Lindsay before she lost the weig ht and dyed her hair blonde. I always found her to be beautiful. I used to think, She s so pretty. She has the best body. In Over, I was just sitting there like, Wow that is gorgeous. I saw Mean Girls and Freaky Friday, and I always thought she was so pretty. With her hair and everything, she was so naturally pretty. It was very weird in Hollywood, because red hair is not the typical blonde, and she was not the typical skinny, I mean she was th in, she had a very nice body, but she wasnt extremely thin. I used to be like, Wow, thats a good role model for a young girl. Not anymore. It really bugs me. Several participants also di scussed how Christina Ricci ha d lost too much weight. For example, Kerry thought that Christina Ricci was healthier-lo oking in the movie Pumpkin before her extreme weight loss: I like Christina Ricci s body in this movie when she was still curvy. Ironically enough, my interview with Kerry wa s about one month afte r Christina Ricci was featured in the May 2005 issue of Jane magazine, in which she discussed her battle with anorexia and bulimia. This article is discu ssed in further detail in the next section Media promote Misconceptions about Anorexia In recovery, the participants tended to be much more criti cal of people who were extremely thin, especially those who were in the public eye. Many of the participants were critical of Nicole

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420 Richies stick thin appearance. For example, Molly reacted to online media coverage in her media journal. Molly: Fri. 7/14 @ 11:00 People magazine on line My bedroom. Checking my email and starting homework Pictures of Lindsey Lohan and Nicole Richie. They look disgustingly thin!!! Dont they realize how many young people they are affecting negatively? With wealth and fame comes power. The participants were most concerned with the power todays celebrities wield over young people, particularly with regard to body image. Rylie: Its funny cause well be all like, Theyre super stars, and they have their own lives, blah, blah, blah. But at the same time th eyre getting paid to be almost role models for us, and its like I understa nd that its human. (She laughs.) They make mistakes just like I made a mistake and everyone makes mistakes. But thats just not right. Most of the participants believed that with the inherent power of celebrity status comes responsibility and the obligation to be healthy role models for young women, and they disdained celebrities who were irresponsible about serving as a respectable role mode ls. The participants criticized celebrities who took drastic weight loss measures with the same fervor that they applauded celebrities who challenged the mediated thin ideal. For example, Jordan described why the portrayals of Nicole Richie made her concerned for young women. Jordan: Nicole Richie drives me insane cause I just think shes way too skinny and it just irritates th e crap out of me to see her like waif thin walking around. I cannot stand I know and I understand that she wanted to lose a litt le bit of weight to be healthier, but shes just gotten to this far extreme And I just I cant stand anyone who is in the public eye that much. Not that Nicole Richies gonna be necessarily a role model, but it just drives me crazy seeing her. Even like Mary-Kate and Ashley Olsen like they had such a great following. And Im kind of like the Reese Witherspoon. I guess if I was a Hollywood personality, I think that s what I would be like ju st because I feel like these people have a social responsibility -especially with young girls to just show them that they dont need to be that small like I just dont think its healthy. The participants used to view thin celebrities as sources of inspiration. Once in recovery, they tended to be disappoint ed in celebrities who were too thin. For instance, Enchantment described how her perception of Jess ica Simpson changed over time.

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421 Enchantment: I saw her in concert for my 15th birthday. I used to like her a lot, and I used to watch her show Newlyweds. Now it seems like I guess just recently when she started filming her movie Daisy Duke (actual name of movie is The Dukes of Hazard) I was kind of disappointed cause she was doing all this hard core diet and working out stuff. When these women had been in the midst of their eating disorder, they admired celebrities who were extremely thin. Once in recovery, however the participants were more interested in seeing healthy women who resp ected their natural body type. During the time that I was conducting the interviews for this study, Jessica Simpson had lost a significant amount of weight, which caught the participants attent ion. Faith described her perspective. Faith: Jessica Simpson had a normal, healt hy, proportioned body. And then, she went on this crash course diet, or whatever she di d to become stick thin and make her body look like the way it wasnt built to look. I cant say that it looked bad. Its not like she looked like she was going to fall over, but you could tell it wasnt healthy. And it wasnt normal for her body type. It was something that she had to make happen. It wasnt natural. So that really bothered me. The participants indicated that celebrities who defied their natural body weight set unhealthy examples for young women who look to young celebrities as role models. Some of the participants indicated that they were more for giving of celebrities who seemed to be naturally thin, even if they lost an unhealthy amount of weight. Rylies conflicting perspectives about two cel ebrities who had received media coverage for their extremely thin appearance may be helpful in this regard. As discussed above, Rylie had been critical of Lindsays extreme weight loss, a reaction that serv es as a stark contrast to her perception of Mary-Kate Olsen, who still triggered her desire to be thin. Rylie: Thursday, July 7, 2005 @ 12:00 p.m. Full House My dorm room Eating lunch. As I sit here, eating, all I can think about is how I should not eat so much. Also, watching Full House reminds me of how pretty Mary Kate a nd Ashley Olsen are. Mary Kate is so pretty, and now shes amazingly thin. It reminds me of how bad I want to be thin again.

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422 The Olsen twins had been role models for Ry lie, and she seemed to identify with them. Of all the participants, Rylie had followed the Olse ns lives most closely, prior to and during the time when Mary-Kate was di agnosed with anorexia. Rylie: In the Full House I didnt think she looked bad. (S he laughs.) I just thought she was gorgeous. I thought she was gorgeous wh en she weighed 90. She was never normal weight though. She was always a very thin girl whos never been heavy. When she did So Little Time I followed those. I mean, (laughing) I was always in love with them. They were always my role models. So when they went to NYU then I was like, I love NYU anyways. I want to go to NYU and meet them! They were just great role models for me. Rylies comments also indicate that she perc eived Mary-Kates weight loss to be much less drastic than Lindsays, which pa rtly may explain why she was le ss critical of Mary-Kate. As Rylie said, She was always tiny though. It wa snt extreme. By the time there was extensive media covera ge of Mary-Kates eating disorder, Rylie had returned to what she perceived to be a normal weight. She was in her initial stages of recovery, and she missed the identity she used to have as a thin person. Rylies mother had forced her to gain weight, but Rylie had not yet committed to the process of recovery: I had just started really putting back the weight, and it [t he coverage about Mary-Kate] caught my attention. I was like, Man, she looks good even now, thin. And it almost hurt to see her cause I had wanted to be that way. Media Promote Misconceptions about Eating Disorders I was always so hungry. I was always dizzy. I couldnt concentrate. I had horrible headaches. I had the w orst insomnia. My hair was falling out. I fell down. I passed out. I started losing my eyesight. I was constantly throwing up blood. I was cold all the time. I started getting facial hair. My skin had turned gray. I hated myself. I was having heart problems. I had palp itations. My heart was ready to stop. I had a heart attack. I started vomiting. My throat was raw and burning. My teeth were destroyed. I started taking la xatives. I had to wit hdraw from college. I lost my job. I was miserable. I lost all my friends. It tore my family apart. I wanted to die. I couldnt afford treatment. I wanted to stop. I couldnt stop.

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423 These statements are from the women in this study. Through pers onal experience, they truly understood the horrifying reality of what it is like to live with an ea ting disorder, a reality that they strongly believed the media did not portray accurately. Across the board, the participants in this study had oppositional readings of the medi a coverage of celebrities with eating disorders. The participants discussed how media message s leave the public with the impression that anorexia is equivalent to an extreme diet, and th at it is a lifestyle ch oice that easily can be jumped into and out of, which is not the case. As Molly said, Theres just so much misconception out there. And the media make it s eem like, Oh, I wish I could be anorexic for five days. If they had any idea what living like that is like. According to OHara and Smith (2007), pr int news articles simplify and sensationalize eating disorders, as opposed to presenting th em as complex medical phenomena. The news media both reflect and perpetuate public beliefs about EDs that can impede diagnosis and treatment of these conditions (p. 49). Media Focus on Appearance and Weight, Not Underlying Issues By focusing solely on a womans appearance, the medias coverage of celebrities with anorexia ignores a tremendously important compone nt of anorexia, the underlying issues. During her interview, Charlotte discussed how she trul y had believed that anorexia was all about body image and just wanting to be thin. She describe d how she had to learn to work on her underlying issues to progress in her recovery process. Charlotte: They [therapists at her treatment center] would say, Theres always something, its not about food. Its about your f eelings. And I was like, Whatever. No its not. Up my butt! Its about me being sk inny, or how I see myself like my body or whatever. But it really does have a lot to do with underlying issues, and its not all about how you look, like the media make you think it is.

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424 Noah also discussed how it took her some time to realize that her ea ting disorder was not all about vanity: Ive only recently realized th at this is a coping mechanism. I didnt really understand. For the longest time, I just thought it had to do with weight and body image. Many of the participants in this study were frustrated with the medias limited focus on the appearance of anorexia. Mollys media journal entrie s strongly expressing her level of anger with bolded capital letters and exclamation marks. In her interview, she was equally as animated, as she expressed her frustration with the medias portrayal of celebrities. Molly: Celebrities weights are something that st rikes a nerve with me. Even if a magazine article is saying that they are too thin, the media are still focusing on peoples weight and size, which should not matter at all They are glorifying a si ckness and the cycle just continues! If they want to write an article about these shrinking star s then they should find explore their emotional and mental state and not solely focus on their weight! The participants discussed how the medias lim ited portrayal to the visual emaciation of women with anorexia contributed to misconcepti ons about the nature of recovery. By focusing solely on the celebrities weight, the participants indicated that the implied message was that the solution to anorexia was simply to eat. As Ja mie said, They make it seem like you can get over anorexia if you just eat a cheeseburger! Many of the participants discussed how anorex ia is portrayed in the media as an extreme diet with vain motives. This type of depiction su ggests that recovery from an eating disorder is simple, which all of the participants now knew was not true. Amanda was doing work on the Internet one afternoon, and she described a segm ent of a movie that caught her attention. Amanda: I heard a man in the movie yell, W hy dont you just go eat something!?He was making fun of his anorexic supermodel girl friend.They were in a fight, and he told her to go eat. And my roommate was just li ke, Oh thats funny. And I was like, No. I dont really think thats funny. Its not that easy.

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425 Publishing Celebrities Weights The participants indicated that many magazi nes publish celebrities weights. For people who use the media as an informational source of comparison, knowing the weight of a celebrity could be problematic. As Rodin et al. (1985) have contended, For many women, weight is a quick and concrete barometer by which to m easure oneself and ones worthhow well one is doing as a woman (p. 290). By publishing the we ight of a woman with anorexia, the media reinforce a patriarchal focus on weight as a measure of self-worth. More importantly, this study has suggested that these numbers may serve as an indicator for some women of how successful they are (or were) at being anorexic. For instan ce, Rylie described her re action to knowing MaryKate Olsens weight: I was neve r their weight. I was never 97 pounds. So I guess thats part of why I felt like I was never anorexic enough. They were lower than I was. Rylies comments illustrated the potential for th e media to define what weight qualifies someone to be anorexic. During her interview, Rylie said that she had seen Mary-Kate and Ashley Olsens weights publishe d in magazines a few times. Her recollection of the twins weights may explain why many of th e participants seemed to believe that weighing less than 100 pounds was one of the qualifications for anorex ia: I think it was like oh 100, maybe like 105. Actually I think Mary-Kate went down to 80s. Thats what I thi nk it was like high 80s and her sister like 100. Ashley was always thin. The 100-pound mark held significant meaning as a measure of being a successful anorexic for the participants. For some women, not achieving the 100-pound mark served as evidence that they were not anorexic. For example, Molly described her reaction when her high school guidance counselor first confronted her: I was extremely defensive. Even then I questioned it because I felt that I wasnt thin enough to have anorexia. I truly believed I didnt have anorexia.

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426 And I confirmed that belief with my weight. Molly continued to lose wei ght, and it wasnt until she became extremely physical sick and afraid to eat an ice cube that she realized she needed to get help. When the media print the weight of a woman wi th anorexia, they contribute to the publics perception of the criteria, and th ere is not a specific weight that defines anorexia. Rather, one of the criteria is being 85% less than an expected we ight for an individuals age and height. Thus, it is possible for a woman to be more than 100 pounds and still meet all four of the criteria for anorexia, only one of which is related to the number of an individuals weight. Celebrity Coverage Cont ributes to Fine Line Rylies comments point to another critical issue that the participants discussed. She described her perception of the media covera ge of Mary-Kate when she had anorexia. Rylie: Its kind of funny because it was all so comical. Like, Look how small MaryKates ankles are. And then you look at As hleys, and theyre not that much bigger. Theyre like, maybe a tiny bit. So it was funny. Well, not really funny. You could see she was anorexic, anyone could. But at the same time, she was always thin, so it wasnt such a dramatic change. The participants indicated that the media present contradictory representations of emaciated female body types, blurring the dis tinction among conspicuously thin celebrities, bone-thin models, and images of women with anor exia. The issue is further obscured by the fact that the average model is now more than 20% underweight, which meets one of the diagnostic criteria for anorexia (Tiggemann & McGill, 2004). Mollys comments illustrate how fine that line really is. In her media journal, she expressed outrage at the medias portr ayal of actresses with anorexia. Molly: Tues. 7/19 @2:00 PM AOL top news st ories -My bedroom Procrastinating doing my homework. Finally, theres an article about how much thinner the actresses have gotten over the years. OK, There are 6 actresse s profiled with current photos and photos from a few years ago and the difference is frightening!! However, the before photos are

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427 just as sickening!!! As for the after photos, they all need to be checked into a hospital ASAP!!! During her interview, Molly elaborated on the thoughts in her media journal. She described why the People magazine article was a huge thing for her: Of course, they are too thin they were too thin before and they are disgustingly thin now! Celebrity Denials Blur the Line The participants indicated that when emaciat ed celebrities deny that they have an eating disorder, they further blur the distinction be tween acceptable skinniness and anorexia. For instance, Sarah discussed an article about Li nsday Lohan that had caught her attention. Sarah: They were accusing her of having an eati ng disorder cause shes dropped tons of weight. And Lindsay was saying that she didn t have one. She had some quotes saying something about shes been on a strict diet, and shes lost her baby fat, or whatever. When celebrities attribute an emaciated body to losing baby fat, they further confuse young women, especially in a culture with an inflated value of the thin ideal. In her media journal, Molly expressed her indignati on with celebrities who deny that they have a problem. Molly: Fri. 7/14 @ 11:00 People magazine on line My bedroom. Checking my e-mail and starting homework Pictures of Lindsay Lohan and Nicole Richie. They look disgustingly thin!!! How can they say they ha ve gained weight a nd dont have an eating disorder when they look exactly the same and can not be healthy! Be Skinny, Get Famous The issue is compounded when celebrities ga in media attention and publicity for weight loss. For these women, media imagery promoting th e thin ideal had served as a set of cultural codes or rules, which set the stage for their ini tial desire to lose weight and their eventual development of anorexia. Like many of the part icipants, Jane expressed her concern about the effect of the thin ideal on young women. Jane: Unfortunately, more and more of the young actresses are really losing weight and looking extremely thin nowadays which does no t set a good standard for young girl, or any

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428 female for that matter.People get too much pub licity when they lose weight and are thin, so the media just adds to the glamour of it. Many of the participants ha d oppositional readings of the extensive media coverage of celebrity weight loss. The most commonly menti oned celebrities were Nico le Richie and Lindsay Lohan, who even made headline news on TV stati ons such as CNN. As Eliza said, Theres something wrong with that picture. (She laughs.) Faith was online one evening on ncnlocal.com, and she saw something that caught her eye. She recorded it in her media journal, and she brought a copy of the bl og to her interview. Nicole Richie and Lindsay Lohan used to be co nsidered trashy famous-for-nothings. Now that each has turned up her nose at the healthy body image and embraced the wasteaway silhouette, the pairs fame has skyrocketed. The smaller a stars dress size, the more attention she receives. What kind of message are we sending to girls? Be skinny, get famous? Drawing Visual Attention to the Issue Sends Contradictory Messages Nearly all of the participants discussed the da nger of the duality of the medias portrayal of thin celebrities. Eliza had a self-protective opposi tional reading of th e medias seemingly positive portrayal of celebrities with anorexia. Sh e was in her therapists office and she had seen five pages of Hollywood Diets with before and after shots of dram atic weight loss. Eliza: The article says nothing about being unhealt hy or sick, but rather glorifies the feat these celebs. [sic] have achieved. Included ar e snapshots of the ga unt-looking Mary-Kate Olsen, the diminishing body of Lindsay Lohan, a nd a sickly thin Jessica Simpson next to an old photo of her former curvaceous body. Th e pics of Mary-Kate are disturbing. Shes standing on the red carpet looking like d eath but somehow happy and surrounded by fans, beaming. Her supposed bout with anorexia appears to be unnoticed.As Im flipping the page, Anorexia rears her nasty head and sa ys, Wow, she looks great! Damn, I miss being so thin. While my recovered self says, How screwed up is that? I know the truth behind the pictures, but I cant help but be affected. I dont care the least bit a bout these popular celebs, but somehow their image speaks loudly, even to me. All the participants expressed opposition to th e medias portrayal of celebrities with eating disorders because the nature of the portrayal did not serve as a disincentive for them when they

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429 were young women. As Jane said, Now I think that so many celebrities really look sickly. But when I was anorexic, I truly believed this looked good. Faith discussed how she used to view the me dia coverage of celebrities extreme weight loss. She had brought several media examples w ith her to the interview, one of which was a Life & Style magazine with coverage of increasingly thin celebrities, such as Lindsay Lohan and Nicole Richie. Faith: A magazine with Skinny 911 I would have bought four years ago and been like, Oh MAN, what can I do to look like that? And Nicole Richie is like skin and bones on the front of the magazine. And its just a diffe rent mentality now. Now, if I buy a magazine like that, its to get Hollywoods side of the story. To figure out what images they are trying to promote. The participants were concerned about the me dia portrayals of celebr ities with anorexia because there was no indication that anorexia is a serious disorder with life-threatening consequences. Rather, the participants perceive d the media to contribute to rampant social anorexia by providing imagery that idealizes em aciated-looking bodies. As Elizas journal entry indicates, she was able to disengage from her desire for the thin id eal by reasoning with her lingering Ana voice. But like al l the participants, Eliza knew how long it had taken her to develop skills to negotiate such imagery, and she was concerned for young girls. During her interview, Sarah described why she was concerned for others: Ive been there, and you dont want anyone else go ing through that. Just because pe rsonally I know what its like, and I wouldnt ever wish that on anybody. I hate to see that people are going through it. Many participants discussed how media covera ge of celebrities who are too thin could be problematic. Rylie shared her th oughts in a media journal entry. Rylie: Monday, July 11, 2005 @ 4:00 p.m. TV: VH1 s How Thin is Too Thin Working out As I do my cardio in the gym, they have th e show How Thin is too thin? on VH1. I didnt listen to it, but I could see it. Ive seen this show before. The ironic part about this show is it is supposed to be showing how unh ealthy it is to be thin and how Hollywood

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430 pushes thinness to an extreme, and yet they are at the same time, inevitably, pushing that image on people. VH1 shows Britney Spears and Lindsay Lohan all the time, then they go around saying they are too thin. The truth is as someone watches that show, they are going to want to be thin, because thin is in. Its horrible that they do this, they make a program to show the unhealthy side of Hollywood and yet they have the opposite effect on many different people. During her interview, Rylie elaborated on he r journal entry. Her comments reflect what many of the participants in this study had indicated. Rylie: In some part of my mind its like, with media, exposi ng it as a bad thing, and yet what it teaches girls is shes gorgeous even th in and, and look how much attention she gets because of it. So its kind of a double-edged sword almost. Like we can expose it as a bad thing, but it doesnt mean thats the way people are gonna take it. Several participants also were frustrated th at the media, primaril y magazines in grocery store aisles, will print headlines indicating that extreme weight loss is negative, yet photographs of sickly thin celebrities are plastered all ov er publications. In gene ral, the participants perception was that the media did draw attention to the issue of eating disorders, but not in a manner that was helpful. For instance, Eliza disc ussed her perception of the media coverage of Mary-Kate Olsen and Lindsay Lohan. Eliza: Kind of does more damage, I think, than it helps. It was just before and after dramatic weight loss. And it seemed like they were glorifying it. I mean, like they did make statements like, Lindsay Lohans fadi ng away. (sarcastic) A nd it was all dramatic. But it was more like it was glorifying it, be cause it had all these photographs. So that kind of bothered me. It just talked about how women are bombarded with this stuff, but yet they were showing it. Overall, the participants were opposed to the focus on the photographs themselves. Across the board, they thought that the media drew too much visual attention to the issue. Molly: Pretty much any pictures of Lindsey Lohan or Nico le Richie just send chills up my spine and makes me want to scream! They [the media] write these st ories and think they are educating the public, but in reality theyre giving attention to something that already has too much attention. It made me angry because they glorify these actresses weight while putting these images out there for everyone to see.

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431 Even if the media have only one photograph of a celebrity, its likely that the same image will be plastered all over severa l publications. Images tend to s tick in peoples minds, and the participants described the imagery of anorexic celebrities as inescapable, much like the diet messages they could never completely avoid. Most of the participants noted that magazines are placed in prominent locations where the audience is somewhat captive. Courtney talked about the media coverage of Lindsay Lohans weight lo ss that caught her atten tion in a grocery store checkout line. Courtney: Nearly all the magazines were covering it, and there was this one picture, the same picture of her, in this silver dress or something, and she looked super, super skinny, And gosh, I think I saw that pict ure maybe two or three times. The participants expressed anger about media messages implying that a celebrity looks good, even with an eating disorder. For example, Charlo tte described a magazine article she had seen about Nicole Richie. Charlotte: Shes got a real bad eating disorder, shes real small. I mean they were even talking about it in the magazi ne. You know, there was like an article about like, Does she have an eating disorder? blah, blah, blah, blah But then every other page is her at this premiere here, and her there and Look how great she looks. Look how pretty she is. And Im like, Well, thats not right. One of Rylies friends was anorexic, and th e two of them were ta lking about magazine photographs they had seen of Lohan: My frie nd was like, Have you seen Lindsay? She looks so good! Shes lost all this weight. Shes anorexic blah, blah blah. During her interview, Rylie discussed her anger about magazine coverage of Lohan: They were saying that she never looked better. Its no secret that she has an eating disorder, so by saying that it is setting young girls up to say that they too want to be thin. Soft News Coverage of Celebrities wi th Anor exia is Not Taken Seriously Research has indicated that the high representation of celebri ties with eating disorders in magazines actually encourages eating disorder be havior (Levitt, 1997). OHara and Smith (2007)

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432 have found a connection between eating disorders and the entertainment industry, with nearly half the stories that mentioned eating disord ers placed in entertainment-related newspaper sections. Entertainment stories are generally seen as soft news: personality-driven and lightweight (Patterson, 2000) As OHara and Smith (2007) have contended: The pattern of ED article placem ent thus raises the possibility that newspaper writers are more attuned to EDs as a source of titillation a soft topic that belongs on the gossip page along with celebrity divorces and other scandals than as an issue that deserves serious consideration and possibly societal response. The placement of many articles discussing anorexia and bulimia in the entertainment pa ges suggests that EDs are only newsworthy in the context of famous people who suffer from them. (p. 48) When the media publish a story about a li fe-threatening illness in the context of entertainment, it suggests that a norexia does not warrant serious c oncern. As Rylie said, Its sad because I know the media just publishes these stories about celebrities with anorexia to sell magazines. They dont take the issue seriously. Some participants were outraged at the medias lack of concern or compassion for young girls who are more vulnerable to media messages. Molly shared her thoughts. Molly: The People magazine article about wh ether certain actors are getting too thin made me angry because they print these stories wi thout thinking about how they are affecting others young girls, people struggling with eating disorder s, even people who struggle with their weight! I mean, do they realize how theyre affecting young girls? Do they know that some of these girls post their pictures in their closets, lockers and even in their bathrooms? Whats worse is that this is one story in one magazine and tomorrow it will be forgotten! These insane ideals will continue. Celebrities do a disservice to women when the manner in which the nature of the representation of their battle with anorexia appeal s to the inherent fascination that people have with unusual human behavior. As Emma said, I think magazines glamorize eating disorders not necessarily because the person is thin, but because it exemplifie s their inhumanness her ability to push past normal limits and we as a culture are fascinated by that.

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433 The participants thought the media portrayed ce lebrities with anorexia in almost a positive light, portraying extreme weight loss and even anorexia as something to strive for, a feat to be accomplished. For some women, particularly those who tend to be competitive, this type of portrayal may serve as an incentive to challenge their body with extreme dieting or starvation. Barbara: You read all these stories about these gi rls who get put in ho spitals and who get sick, cause theyre not eating anymore. And there was this certain kind of sick glamour attached to it. And then, there was this in sane thing that you ask yourself, I wonder if I be like this? And then it turns out that you can be like that. I dont know if its like selfimposed, because you ask yourself, if you could do it. But then it just happens and it takes it own course from then. And you cant think straight anymore. So I probably realized what was going on when I couldnt stop it anymore. For Abigail, informational Web sites about anorexia just served to enco urage her to test the limits of her body. She discussed how the sites pr ovided her with benchmarks she would try to meet to become anorexic. Abigail: I remember there were site s that had the criteria for anorexia. When I was down to 105 pounds, I was like, I wonder if I could get below 100. It s eemed like the sites focused on being under 100. But it became a numbers gave for me. And then, I was way below the 100 pound level. And then I was like, I wonder how far I can go before somebody says something. The Web just it fed into the whole disease. It was like putting fuel on the fire. Lifetime Movies Served as a Learning Resource or Trig ger Many of the participants discussed how they had perceived women with anorexia as being special. This perception was in part due to Lifetime movies they had seen when they were younger. For women who have low self-esteem and ar e seeking love and attention, these types of portrayals may make anorexia look enticing. Isabel: Just in general they glamorize them. I mean, from my perspective. For someone who hasnt had an eating disorder, it mi ght be different. But from my perspective, they do. Like, I can remember being 10, and watching some movie about anor exia. Like, Tracey Gold having anorexia or whatever. She was in the movie. And I remember thinking, shes so special. This is so cool. Stuff like that.

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434 Several women discussed how Lifetime movies actually served as resources for learning tips about eating disorder behavi ors. Diamond said she learned to use laxatives from watching a Lifetime movie starring Tracey Gold. Diamond: I was always fascinated by the Lifetime movies about, you know, like Tracey Gold or just different females that I knew had eating disorders. I was kind of like Oh wow! Like Howd they hide it? you know, Whatd they do? (laughing) What were their tricks? Other participants adopted new ea ting disorder behaviors after seeing Lifetime movies. Isabel shared her reaction to a Lifetime movie she had seen in the in itial stages of her recovery process, when she was not yet committed to getting better. Isabel: When the movie came on, I was all into it. It was about a girl who had bulimia. And then after I watched it, I purged. It was kind of weird. D: Can you remember your thought process at all? Isabel: Oh, yeah. I mean, every now and the n, Id get into this thing where I decided that I was going to be anorexic again. It lasted like a day. (She laughs.) I was like, Im going to do that. So at that point, I was in that mindset, and that movie happened to come on, and I was like, Oh great! I can throw up everything I ea t. And Ill only eat a l ittle bit at the same time. It was like, Great! A new tool! Sarah was the only participant who remembered the specific names of some of the movies: One was For the Love of Nancy Shes a recovering anorexic, and it takes you into her mind. Her family tries to get a court order to put her in treatment. And then there was Dying to be Perfect Once Sarah was completely committed to her recovery process, she had to force herself to avoid movies of this nature. Sarah: Sometimes when I still had my eating di sorder, I would watch them anyway, just because they were triggers. Watching those movies it reinforces the beha vior I think. Or even put within me a greater desire to ev en be smaller. Cause I felt like watching them at times, I felt like I wasnt doing enough. I wa snt starving myself enough, or I wasnt exercising enough. Or whatever. Overall, the participants indicated that the Lifetime movies focused too much on the behaviors of an eating disorder, which in their minds, created more of a fascination with eating

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435 disorders. Even purging behaviors became intrig uing because there was no indication of longterm health consequences such as heart attacks or irreversible tooth damage that many of these women had suffered. Jamie: Those Lifetime movies where they just show a ll the really unhealthy behaviors those kind of movies just send a bad message, wh en it would be better to tell people how to stay healthy. Not focus on the sickness and show all that stuff. I know that Tracey Gold had an eating disorder too, a nd I think its good to create aw areness, but it seems like it cant really help for people to see all the behaviors. Some of my friends from treatment even said they learned new behaviors from that movie. Many of the participants now had oppositional readings of Lifetime movies, especially in recovery, when they could see the potentially damaging effects. During her interview, Faith discussed her perception of Lifetime movies. Faith: For the Love of Nancy with Traci Gold. Moment of Truth, a secret between friends, really gets me because it shows a girl teachi ng a girl how to be bulimic, which is disgusting to me. But its still interesting to me to watch because I could never. I would never go out and teach someone how to do that. I mean, thats just crazy. Why would you do that? Why would you ever want anyone el se to go through something like that? Faiths comments point to one of the issu es that emerged from this study. Several participants discussed how they ha d learned eating disorder behavior either from a friend or from the media. As Jamie said, When a movie shows a friend teaching a girl to throw up, that kind of says, its okay. Theres nothing bad about this. Isabel shared her thoughts about how Lifetime movies might serve as a more preventive measure for eating disorders as opposed to a l earning tool or trigger: People are always interested in the extreme and the unu sual. If they focused more on the devastation of it, the reality of it. Like, no one does that with cancer. Ya know? But with eating disorders its okay. Even some celebrities have said that they learned new eating diso rder techniques from Lifetime movies. For example, in the May 2005 issue of Jane magazine, Christina Ricci shared

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436 how media played a factor in the development of her eating di sorder. Her comments illustrate how the nature of the portrayal appeals to human fascination with unusual behavior. Filming the movie with Gaby was the best tim e but also the worst time, because thats when I became anorexic for a year. What triggered it? I dont know, she answers laughing, but I did get all my tips from a Tracey Gold Lifetime movie on anorexia. It taught me what to do. There was also one on HBO, starring Calista Flockhart when she was really young. She was bulimic and anorexic Shed vomit into Tupperware containers and keep them in her closet. It was so crazy to me that for some reason it was appealing... But I didnt keep my own vomit. (p. 138) Tracey Gold suffered from an eating disorder he rself, and it is likely that the intention of the Lifetime movies was to create awareness about eating disorders and prevent young women from engaging in such behavior. But the wome n in this study described how they had the opposite effect. As the participants have indicat ed, the message they d ecoded at the time was not that eating disorders were something to take stee r clear of, like alcoholism, or something to take preventative measures against, like cancer. Rather they viewed eating disorders as something to experiment with, and they learned new techniqu es for becoming a better anorexic or bulimic. The participants discussed how it was impor tant that the public understand that eating disorders are not about the behaviors, that symptoms and behaviors are just that, symptoms of a bigger problem. These women suggested that if media portrayals of eating disorders focused on the depression and worthlessness that underlie most eating disord ers, women who be less likely to view media portrayals of anorexia as an incentive to experiment with eating disorder symptoms. Pro-Ana Sites For these participants, the hegemonic construc tion of the thin ideal had provided fertile soil for the development of anorexia. They had cons ented to the culturally constructed value of thinness, and as they embarked on their quest for the mediated ideal, they learned to ignore their

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437 natural body signals and embrace mantras reinfo rcing the ultimate superiority of a thin body. Many of these mantras can be learned on proana sites, which reinforce this idea. Research has suggested that approximately two-thirds of adolescent girls seek health information online (Rideout, 2002). Furthermore, R oberts, Foehr, Rideout, & Brodie (1999) have found that nearly half of young girls looking for health information online are searching for weight loss techniques, and almo st 25% are seeking information about eating disorders. Some Web sites are merely informational in nature, but others are pro-anor exia sites, offering communities of individuals who engage in and promote the benefits of disordered eating practices. Most of these sites include images of anorexic women, as well as tips and techniques for avoiding detection by health care providers, friends, and fam ily members (Chesley, Alberts, Klein, & Kreipe, 2003) The Internet has emerged as a powerful sour ce of imagery, and according to Bardone-Cone & Cass (2007), the increasing prev alence of pro-anorexia Web site s has the potential to have profoundly detrimental effects on womens body image and eating attitudes/behaviors (p. 537). Estimates have indicated th at there are about 500 operating pro-anorex ia sites (Bennett & Catan, 2007; Byrne, 2007), which are viewed most frequently by young females between the ages of 13 and 25 (Fox, Ward, & ORourke, 2005; Udovitch, 2002). During her interview, Enchantment said that sh e used to visit pro-an a sites every day when she was anorexic. She described what she had liked about them. Enchantment: I felt like I was in some club or some thing, and I had this secret, and I was special, and everybody else wasnt And it gave me advice and ju st encouraged what I was doing and said it was good and it was okay. And so I was happy about it. It just made me feel like I had a secret that no one was part of. According to Bardone-Cone and Cass (2007), Pr o-anorexia sites offer a controversial yet flourishing, underground community of individuals who advocate anorexia as a life style choice,

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438 rather than a psychological disorder (p. 537). Several of the pa rticipants discussed how the media portrayal of eating disorders as a life styl e choice, rather than a diagnosable disorder, makes light of the serious nature of anorexia. Kristin: When I was still anorexic. My motto was, nothing tastes as good as being thin feels. And I wrote it down. I put it on my mirror. When I wa s still struggling because I wanted to lose weight. It ruled my existence, from the time I woke up until I went to bed, and even into my few dreams. Kristins reading of pro-ana sites during her anorexia and while in recovery truly reflect her transformation from thinspir ation to opposition. She now str ongly opposes pro-ana sites and thinks of them as a contributing factor to th e prevalence of eating diso rders today. Kristin had done a research project on pro-ana sites, and she shared a port ion of it with me. Kristin: A big problem is pro-ana websites. With these sites promoting anorexia as a way of life rather than a disease, its no surprise that eating disorder cases have over doubled since 1970. These sites also offer a place wher e anorexics can share tips, thinspiration pictures, talk in chat rooms, give encouragement to one another, and condemn each other for being weak. I cant believe theyre allowe d to exist. The media definitely promotes eating disorders through magazines, television, and now the Internet. Several participants discussed how they ha d learned about pro-ana sites from the news. They also indicated that rather than discouraging them from visiting the si tes, the nature of the coverage merely incited their curiosity. As Suns hell said, I did go a few times simply because it was all over the news and I was curious and wa nted to see what the hoopla was all about. Many of the participants had visited pro-ana sites for the first time after they were in recovery, and all of them who did so said that they were thankful that such sites did not exist when they were anorexic. The participants indicated that pro-ana sites just would have reinforced their dangerously unhealthy perceptions about the value of starvation. As Sunshell said, Its sad that they are presented in a way that attracts wanaabees.Im glad they [pro-ana sites] werent around in my day.

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439 The participants said that pr o-ana sites would have been app ealing to them in their initial stages of recovery, either to pr ovide them with tips about how to continue to lose weight, or to reinforce that anorexia was not such a horrible di sease. Jordan learned about pro-ana sites when she was anorexic, and she described her reaction. Jordan: You know its funny, I heard that those sites existed on a news show or something, and I would frantically try to find them. (She laughs.) Cause I was like Oh how cool! I can get support on th is, and I can learn new tricks of the trade like tricking my body into thinking that Im not hungry at one oclock in the morning when I want a box of raisins. I could never find them, and it pi ssed me off cause I wanted to find them so badly, and I never did. (She laughs.) Lulu had not ever visited a pro-ana site, but she had heard of them. During our interview she expressed her concern about Web s ites promoting a dangerous disease. Lulu: They shouldnt do that. They should be ille gal. Kind of like the Web sites with child pornography. Thats illegal. They should not be able to do that. I mean, were a free country, and we have freedoms, but thats ju st not right. To promote disease like that. Cause if little girls read it. Thats the thing; young gi rls can go on these sites. Coverage of Extremes Can Prevent Detection One of the significant themes that emerged from this study is that the media portray women with anorexia as bone thi n. This portrayal is problematic because if a woman does not loss enough weight to meet her media-induced pers pective of the requirement to look skeletal, she may not even realize that sh e has developed anorexia. Not one woman in this study ever felt like she was anorexic enough. The participants had seen images of what anorexia looked like in the media, but the examples portrayed were extreme, usually show ing womens bones and ribs sticking out. So even when the participants developed anorexia a nd fit the criteria as defined by the DSM-IV TR, they didnt think they qualified because they did not measure up to the visuals they had seen in the media. As Sarah said, Magazine covers with pictures of celebrities on them they just reinforced that I wasnt anorexic en ough. The pictures on the front of em.

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440 Like all of the participants, Faith never fe lt like she had achieved the type of body that she had associated with anorexia During her interview, she descri bed what her perception was of someone who truly looks like an anorexic. Faith: In my mind, I was not the typical anorexic because I never made it to actually looking like a skeleton. I mean because some anorexics take it so far that they literally look like theyve almost decayed, like theres nothing left but bones. But my body was never capable of appearin g that way, even when it was that way. Because my frame is just Im not petite at all. So I was like, I dont get it. This sucks! (She laughs.) Faith discussed how the media provided her with a vision of a t ypical anorexic body. She also described her personal battle with anorexia had altered her perception. Faith: I really think media play into all of that. Cause where else would those ideas come from? Like, what I need to look li ke to be considered anorexic. I now know that there is no such thing as a typical anorexic. You dont ha ve to look like a skel eton for it to kill you. And theres no exact size that will determin e when it will take that toll on a person. Similarly, Molly discussed how the imagery sh e had seen in the media prevented her from believing that she was anorexic. As she said, I think the medias definition of anorexia and the extreme images they showed defined a thin enou gh for me. I had to look skeletal, which I never thought I did, especially compared to those images. Abigail did a Google search for anorexia when she was in the midst of her eating disorder. During the interview, she explained how the imag es of the women and the information provided on the pro-ana sites caused her to think that she was not anorexic enough. Abigail: I just did a search for a norexia on Google, and it pulled up a bunch of sites. You could go to them and pull up all these pictures. And I was comparing myself. I was like, Oh mi gosh, you have a long ways to go, ya know, I mean to get to where they were. I was like, My collarbones dont stick out like that Or poke out like that. My ribs You can pinch my sides and not get my ribs I mean, the Internet is huge I can still see these pictures of these women, and Im just like, I was never like that. Women who visited sites on th e Internet not only were expos ed to extremely emaciated imagery, but they also learned about behaviors that women who had acute cases of anorexia

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441 engaged in. For example, Rylie had visited a pr o-ana site, and she described her reaction: I never did what these girls did.I just didnt see myself as the typical anorexic. Amanda had thought that women with anorexia did not eat at all. During her interview, she explained how this misconception prevented he r from realizing that she was anorexic. Amanda: Until the end, when I passed out and wa s diagnosed, I never actually thought it was anorexia. I mean I never thought it was anor exia because I ate. I ate three meals a day. I never skipped a meal the whole ti me. When you hear about anorexia in the media, its people that dont eat, right? Li ke, they starve themselves. The participants now knew that limiting the po rtrayal of anorexia to severe cases could have a dangerous effect. As Molly said, Now I dont think there is a thin enough to have anorexia. Ive known people who were starving them selves, but didnt look skeletal, and they died from heart attacks! Bulimia More Recognizable Than Anorexia Because of the media-induced fine line between the acceptable thin ideal and sickly thin, the women in this st udy often did not recognize when they had developed anorexia. However, binging and purging seemed to be concrete actions that they knew indicated that they had a serious problem. Molly: There were moments at night when I wa s painfully hungry that I would think, Maybe somethings wrong with me maybe I need some help. And of course, I knew the desire to vomit and taking laxa tives was not normal behavior. Alexandra described how her mom only becam e aware of Alexandras eating disorder because of her binging. Like many of the partic ipants, Alexandra initially developed anorexia, and her eating disorder transformed into bulimia. Alexandra: My mom did not know in the beginning. She found out about three years later when I was about 19 and had bulimia. She noticed that I binged. But she did not notice when I starved because I was never extrem ely skinny. I was thin, but not sick thin.

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442 Metkit was 39 when I interviewed her, and she had developed anorexia in 1984, when she was 16. She said there was not much coverage about eating disorders at the time: It was so new. Or at least the publicity or awar eness of it was so new. When she was anorexic, she knew that she had some sort of problem because her clothi ng size had decreased to a size 0, but she did not acknowledge that she had an eati ng disorder until she develope d bulimia, six years later. Metkit: I knew I needed help cause I was eating and throwing up. Thats not normal. I would spend all the extra money I had on f ood, and I would go to lots of different restaurants and eat lots of different things until I could literally hold no more and throw it up. It wasnt really the anorexia that got me to seek treatment. It was the bulimia. Metkits comments illustrate how normalized excessive thinness is American culture. Metkit engaged in self-starvation for six years, yet she did not perceive that to be a problem because she viewed dieting and th e attainment of the thin ideal as an achievement. However, when her body had been deprived of essential nutr ients for six years, and she turned to binging and purging behavior, it was more evident to her th at she had an eating disorder and needed help. Metkit realized that she was thin because she fit into size 0 pants, but as she said, I didnt see that I had a problem until I bottomed out, which for her, involved engaging in socially unacceptable binge/purge behaviors. Isab el said, For me, the bulimia was a lot more of an issue than anorexia. Treatment is Not Accurately Portrayed Research has indicated that found that peopl e tend to overestimate the ease of curing eating disorders (Crisp, Gelder, Rix, Meltzer, & Rowlands, 2000) a nd that news stories present oversimplified solutions to eating disorders, indi cating that individuals ca n merely snap out of their eating disorder in to long-term recovery (OHara & Smith, 2007). The findings from this study suggest that the medias port rayal in the media of women w ith eating disorders contributes

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443 to this dangerously false presumption. As Ramo na said, I remember thinking, I always thought I could stop whenever I wanted to. Here I am, years later! Like many of the participants, Emmas commen ts indicate her frustr ation with the nature of the media coverage about eating disorders. During her interview, she described a magazine cover that caught her eye. Emma: This week has Angelina looki ng healthier and holding her daughter with the headlines saying something like How Zaharas Operation Save d Angelina. And it really pissed me off. I feel like that is an idea that the media perpetuate. You just need to find the right guy or have children or go on a retreat and youll just snap out of it. The participants expressed how the media s inaccurate portrayal of eating disorders minimized their experience. In a survey of public opinion about eating disorders, Crisp (2005) has found that the public often feel s that eating disorder patients are to blame for their disease should just pull themselves together (p. 147). However, all of these women described how the recovery process was extremely challenging and di d not happen overnight. As Kristin said, I dont think I even knew when I stopped because it s too fuzzy. Its not ju st like, Okay, great! The road to recovery was gradual. There was ne ver a single moment when things began to be different. Along the same lines, Emma describe d her frustration with the media coverage. Emma: They make eating disorders into this conscious lifestyle choice where you can wake up one day and say, I dont think Ill be anorexic anymore because so-and-so needs me. It trivializes our experiences and it make s us appear selfish. Oh, if you really loved your family, you would choose to be better, stuff like that. Many of the participants were outraged at the complete absence of coverage regarding treatment for eating disorders, especially when they perceived the media to suggest that celebrities can be anorexic one week but not another. For instance, Jamie commented on the media coverage of Mary-Kates treatment: It was like, she went to treatment for a week or

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444 whatever amount of time, and she came b ack all magically healed! I dont know anyone who recovers that easily. But the me dia make it seem like you can. Research has indicated that treatment for eat ing disorders is expens ive, complex, and often involves inpatient hospitalization, intensive ther apy, and psychotropic medications. Furthermore, long-term recovery studies with the most pos itive outlook indicate that only about 50% of anorexia patients recover full y, 30% recover partially, and 20% struggle with a chronic eating disorder, managing to avoid becoming a statistic of the disorder with the highest premature mortality rate (Staresinic, 2004) ranging from 5.1% to 19% (C risp et al., 1992; Herzog, 2004; Sullivan et al., 1998). All of the participants in this study discussed how challengi ng recovery is. As Jordan said, Recovery is a bitch. Other participants said that its an exhausting process, or its a continuous journey. With one of the highest fatal ity rates (Herzog, 2004; Sullivan et al., 1998), anorexia is also one of the most challenging diso rders to treat (Maj, 2003). Nearly all of the participants suffered for years before they sought help, and many participants had to go to several inpatient treatment centers, spending thousands and thousands of dolla rs before they even started their road to recovery. For example, Grace desc ribed her recovery process. Grace: Recovery is slow and hard! It was over a lot of years. It took a lot of time. It wasnt like an instant, Oh, Im not afraid of food. Oh, I can handle this weight gain. Oh, by the way, I was assaulted. Ill just get over it. All of those painful wounds. I had to walk through all the underlying stuff that created my eating disorder in the first place, like my assault. All of that. And with that, comes ups and downs. Some days, the best I could be was maybe to throw up five times, but, I didnt throw up the other five times that I wanted to. I mean it was two steps forward, one step back. And the last two times at treatment programs, I was pretty desperate.I t finally stuck the last time. Despite medical studies that have shown ther e are serious health consequences from eating disorders, including heart failure, decreased bon e density, kidney failure and dental erosion

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445 (Walsh & Klein, 2003) as well as high premat ure mortality (Staresinicm 2004), only 3% of respondents perceived anorexia and bulimia to ha ve physical consequences (Murray et al., 1990). In a more recent study, OHara and Smith (2007) found that most of the news coverage they analyzed did not communicate the message that ea ting disorders can have severe physical effects and typically require professional treatment. When the media portray a serious disease so lightly, it trivializes the experience of someone who has suffered, or is suffering with an eating disorder For example, Courtney shared an experience she had while on a trip with her family to San Diego Courtney: I went on a trip with my parents to San Diego me and my twin sister and my parents. We were out one night, and I had le ts see a skirt on and a top. And it made me look really small. I mean, there were some out fits that I could have hidden it better, you know, me bein so skinny. But I looked really skinny in the ou tfit. Anyway, we went to a piano bar. And the people at this piano bar were very, really outspoken. They would pick people out of the audience and crack on em or wh atever. So we were in that piano bar, and they were just pickin, people out of the audience and just jokin on em or whatever. And so they noticed me and my sister, I guess becau se were twins or whatever and they told us to stand up. And they were like, Hey. You two right there, yall stand up. And this bar was crowded. It was packed to the max with people. And the guy said, Are yall twins? And were like, Yeah. And he was like, O h okay. Hey! We got some twins in here. Yeah, as a matter of fact, they look a little bit like the Olsen twins, dont they? This was when all the stuff was going around about the on e Olsen twin with the eating disorder. He was like, Yeah they do, they do. Yeah, uh, eat something. And just like really, really loud. And I was like, Oh god. And everybody was just laughin and stuff. And he was like, Okay yall can sit down now, or whatever. And so, my parents knew then that I wanted to leave. So I went back to the hotel room, and I just cried. The horror and humiliation that Courtney felt may be better u nderstood if one of the Olsen twins had been battling with terminal cancer. The participants indicated that the media need to portray eating disorders as serious illnesses w ith specific diagnostic criteria, not merely as temporary lifestyle choice s to be joked about. Many of the participants discussed how th e media portrayals of celebrities with eating disorders do a disservice to those who have suffe red from eating disorder s and to the public in

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446 general. The public is unaware of what it really means to have an eating disorder because the reality of what its like to have an eating diso rder is absent from the media coverage. Emma: I read the headlines in th e checkout line in the grocer y store. Ive been following the whole thing with Angelina. I saw her on Jon Stewart several months ago and she looked really unhealthily skinny then. So Ive been reading that shes been struggling with an eating disorder and Brad is at his wits end, st uff like that. This is so bad of me to say but I thought, I hope she really does have an eating disorder because then shell give attention to this cause. Isnt that terrible? But I re ally wish there were celebrities out there advocating for eating disorder su rvivors and research and treatment and telling it like it is. Anorexia a very serious and often deadly dis ease, yet it has become wrongfully trivialized and synonymous with skinny. By making light of such a devastating illness, the media demonstrate their ignorance and perpetuate dama ging misconceptions about anorexia. In order prevent increasing numbers of young women de veloping anorexia, the media must stop trivializing and mocking anorexia and begin to approach it with the same sensitivity that would be granted to other life threatening illne sses. Perhaps if young women knew about the reality of the inner turmoil of anorexia, th ere would be more of a deterrent and less of an appeal for young women to flirt with extreme dieting, which led the women in this study to develop anorexia. Resisting the Dominant Ideology As Foucault (1990) has suggested, power and meaning are con tinually shifting in discourse, and where there is power, there is re sistance (p. 94). Notions of health are routinely challenged, resisted, and negotiate d by women, in light of social and cultural values, time, and individual circumstances (Bunton, 1997; Cr awford, 1980). Armed with the undeniable knowledge of the health risks of extreme thinness, these women no longer were willing to voluntarily discipline themselves in the interest of attaining a thin ideal that they now perceived to be flagrantly conflated with health. As the participants became more media literate, their awareness transformed into anger directed at toward the source of the media messages. Molly described how passionate she was about actively resisting potentially damaging media messages.

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447 Molly: Many people are unaware of how they are contributing to our societys unrealistic viewsthat we can be, or shoul d try to be perfect. But when approached in the right way, they are actually open and can see ho w damaging most of our culture is. Empowerment Fuels Anger Channeled at the Media The extent to which the participants held the media accountable for creating and perpetuating the thin body ideal mediated their degree of opposition. The more the participants held the media accountable, the more oppositional their readings were. Molly consistently had oppositional readings informed by outrage that th e media could promote such insidious ideals. As she said, It pisses me off so much! Empowerment, an important aspect of femini sm, may prove to be a key ingredient for reducing societal and self-objectif ication. For many of the participants, critical media literacy fueled their desire to take act ion to affect social change. E ngaging in activism was empowering for these women because it brought their person al experience into the public realm. Through their battle with a norexia, these women learned on a personal level not to subscribe or aspire to the unreal istic ideal body image that the media prescribe. Over time, many of the women developed a strong enough sense of self to reject the medias more destructive messages. They also learned that others woul d benefit from the knowle dge they gained when they suffered with anorexia and from their recovery process. An important part of the recovery process is finding a healthy avenue that allows ones voice to be heard. This section of the disserta tion illustrates how the women in this study used their personal battle against anorexia to fight the dominant ideol ogy that had provided fertile soil for their development of anorexia. Three Stages for Challenging Body Wars Maine (2000) has contended th at there are three stages that can serve as strategies for challenging and changing the current Body Wars These stages can serve as a useful

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448 framework through which to understand the participants responses, their level of oppositional decoding, and the likelihood that they may one day engage in radical actions to transform society notions of the importance of appearance in general and thinness in particular. First Stage: Individual Level According to Maine (2000), the first level of change is at the individual level. Each individual needs to first learn how much she has personally abso rbed the dominant ideology and begin to challenge her thoughts and behaviors to spend more time cultivating her inner self and less time submitting to the pressure to meet the consistently altering, arbitrary, and unrealistic beauty standards. All of the participants had reached at least this in itial level of change, examining how they had been personally affect ed by the pervasive noti on of appearance being the most salient representation of self. Second Stage: Cultivate Personal Value System The participants were at various levels in terms of challenging the dominant ideology and learning to develop a sense of their true self, valuing some sense of an identity defined beyond their eating disorder, and mainta ining an extremely thin body. According to Maine (2000), the second step toward effecting change is to cultiv ate a personal value syst em that does not place appearance as the most salient factor in determ ining self worth and value. This stage also involves honoring ones body as a precious vessel that enables us to live each day to our fullest potential, not as an object that represents who we are. Women who were able to shed their identity as a woman with an eati ng disorder and adopt a new identi ty as a woman in recovery (or recovered) from an eating disorder had more opp ositional readings. Part of what allowed these women to shed their eating disorder identity was to engage in activist effo rts that involved being more public about their eating disorder history. Kristins perspec tive illustrates this point.

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449 Kristin: I wouldnt say Im on the path of recovery. I would say that I am recovered. I would say definitely establishing L.U.L.A. has really helped. Like I cant start an organization combating eating disorders and have one. (She laughs.) So through activism Ive become more recovered. For these women, the other key component of cultivating a personal value system was establishing a sense of self beyond ones appearance. Noahs comments illustrate the process these women had to go through to let go of their primary focus on appearance. Noah: I was so focused on my appearance and my weight. And I really believed that was the only thing I had built up that I had any value for. I think that at some level, I thought everythings going to be lost if I dont stay this thin pers on. And, what I found is that, you almost had to live it to really at your core believe that youre loved for not for these superficial things that you think youre loved for. Third Stage: Activism Several of the women in this st udy had achieved enough self-awareness and comprehension of the larger socio-cultural system to take the third step toward social change by engaging in varying degrees of activist strategies The participants drew from their struggle with anorexia and their recovery process, using the kn owledge they gained from their experience as a tool for effecting change at some level beyond the personal. They expressed not only a desire, but also a need to effect societal change Once the women understood ho w the media try to target them, they were more able to carefully deciphe r the messages they saw and take a stand against the negative effects that the media may have on their body image. Engaging in resistant action was part of the process of recovery and un-in ternalizing the media-perpetuated thin ideal. From Private to Public: Leve ls of Participant Activism The women in recovery recognized the potential for activism in several capacities intrapersonal, small group, and public settings. In addition, some women took part in activities through a pre-existing non-prof it organization, and one woman started her own prevention organization in her high school.

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450 Some women even discussed how they saw participating in my dissertation as a mechanism for helping others. For example, Suns hell said, One reason I wanted to do this interview because when I was recovering, I had no role models who were recovered. I swore that when I recovered, I wouldnt just disappear. Several women discussed how they wanted to sh are their stories so th at others might learn from their experience. As Faith sa id, I feel blessed to have opportunities like this interview. Im so thankful that my str uggle was not in vain. Using Their Voice It seemed to be important to these wome n to have their voice heard because as they became more fully entrenched in their anorexia, the disease itself served as their voice and part of their recovery process invol ved recovering (or finding) thei r voice and learning to express their thoughts and feelin g in a healthy way. The participants need to sp eak out appears to stem from a desire to contribute their perspective so the dominant ideology would not s ubjugate others. The participants in this study expressed the need to help di spel the myths about eating diso rders, including the notion that anorexia is merely a diet or a short-term we ight-loss technique. Given the horror of Mollys battle with anorexia, she had a need to inform people about the reality of eating disorders. Molly: I dont go out and broadcast that I had anorexia. Its no t something Im proud of. If you had any idea what living that is like. Thats something that I would love to be able to do educate people like that a nd give them hope too. I want people to know this is what I overcame. This is how horrible it was. Historically, the work of Carol Gilligan (1982, 1991) and others point s to the crucial role of womens relationships with ot her women in their constructions of social reality. These women found strength in connecting with others, and they were eager to use thei r personal experience to educate others and contribute to prevention effort s. They also felt an obligation to share with

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451 others what they had learned through from their battle against anorexia. In doing so, they empowered others with valuable knowledge that these women wish they had earlier in life. Supporting Others and Creating Awareness Many participants spoke about how it would be more helpful if they had support groups similar to those that are available for alcohol icsgroups that are easily accessible in various locations and during convenient times. Toward the end of the interview, I asked Michelle what she thought would be helpful to prevent eating disorders. Michelle: Let it be something thats talked about. And not somethings thats so much a hush, hush kind of a thing. I do think there should be more support groups besides. I know theres ANAD, but I dont know of a lot of ANAD meetings. Whereas, alcoholics, they have A.A., and they can go any time, any day. Or, they can find friends that struggle with the same thing. I havent found that with th e eating disorder community. I think it would help if there were more support groups. These women did not allow lack of support groups to prevent them from gaining support and providing hope to others. Part of the reason I had difficulty recruiting pa rticipants at first was because it is extremely challenging to find women who have recovered from anorexia. As previously discussed in this dissertation, anor exia has a high mortality rates, and those who survive often deal with varying degrees of relapse. Many of the people in these womens lives completely had given up hope on them. These women are survivors in many senses of the word, a nd their stories truly are inspirational. What is most amazing is their desire to help others. Fo r example, after an ini tial e-mail contact with Molly, we set up a time to talk on the phone so that I could describe the st udy in further detail to her, and this was her response: I look forward to speaking with you and would love to use my experiences to help in any way!

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452 Providing Support Online While there is no 24-hour support group such as A.A., there are several online support sites for women who are committed to recovery from an eating disorder. Several of the women discussed that this type of interaction had been helpful to them, and interacting with others served to strengthen their commitment to recovery. Molly described what had been helpful to her in her initial stages of recove ry: Hearing others recovery stor ies. Meeting people that have achieved complete recovery. It would be like an injection of energy propelling me towards my goal knowing it is possible. One of the Web sites that came up often in the interviews was Something Fishy. After several participants had made reference to that site, I incorporated a question specifically asking the participants if they had ever visited So mething Fishy. Sunshell used Something Fishy to provide support to others through their online bulletin boards. Sunshell: Yeah, I think Something Fishy is a great site. Its huge. Its recovery oriented. It has tons of new research on it, and is just very thorough. I dont really post about myself, but I pop in to give support and hope to others. Sunshell provided an example of someone w ho offered help to others on Something Fishy. Other participants described how they had used the site for support. Michelle described why she found the site helpful: Peoples individual storie s helped. There were a couple of really sick people who had gotten better, and it just gave me some hope. Eliza also said the site was extremely helpfu l to her in her recovery process. What she found most helpful about th e site was that it was available 24 hours a day, so she was able to use the people who visited the Web site, rather than waking up a friend to support her in the middle of the night. Eliza: I love that Web site. When I first started recovering, I used that all the time. It was great because it was a way to meet people, and get support, even though I wasnt actually physically meeting them. The bulletin board that they have you can go literally any time.

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453 It could be 2:30 in the morning, and you just feel crappy, and you want to write something, and youre always gonna get a respon se, like within an hour, usually. For most of the women, another way to effect positive change was to help others in some way. Eda had recovered from anorexia, alcoholis m, and drug addiction, and she credited her recovery to both Alcoholics A nonymous and Overeaters Anonym ous. She remained active in both organizations as a co mmitment to her recovery, and she often served as a sponsor for those who were struggling with food, alcohol, or drug addictions. Grace became very open about her recovery pr ocess, and during the interview, she said that serving as a role model for others in recove ry really helped her to stay on track with her own recovery. She offered help to others in several ways. She started a support group in her church, and the Sunday after our interview, she actually was directing a play about recovery from eating disorders. Grace also had formed a support group online through e-mail. Every morning, she would send the members some inspiration quotatio ns as well as her thoughts for the day. Grace also was a Resident Assistant in her dormitory, and because she was open about her recovery, she had some residents who would come and talk to her abou t their struggles with eating disorders. Helping others served to keep Grace on track in her recovery because she felt a commitment to serve as a positive role model to others. Grace: Saturday 10:45 p.m. DVD Friends Bedroom Talking on my blog I want to lose 20 pounds. But too many people count on me. I cant go back. Ate too many cookies at Diannas. During her interview, Grace elaborated on he r journal entry. Making her eating disorder and recovery process public kept her accountable. Grace: I think because its out there, and there ar e other people suffering in ways I used to there are other women looking at me saying, If you can do it, I can do it. And, I feel like that keeps me motivated. On days like Thursday. Where I wanted to binge and purge so bad, I cried. But I knew there are people counting on me. My life isnt just mine Its other

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454 peoples. I share it, and were in community. And, to do that to me is hurting other people. And that really keeps me motivate d knowing that people are depending on me. When I visited Grace in Illinois, I took my camera with me to document my traveling experience. I also used the camera to capture anything that I thought might relate to the dissertation. Figure 4-4 is a photograph of a bulletin board that Grace had put together in the dormitory laundry facility about eating disorders. Unfortunately, the photograph did not come out as clearly as I would have liked it to, but the basic message is captured. One of the most interesting portions on the bulletin board was the section labeled Its Not Your Fault. Grace had included brochures abou t the various causes of eating disorders, including the media and the power it wields in terms of promoting die ting and the thin ideal. Figure 4-3. I traveled to seve ral locations around the country to interview women for this study.This photograph shows some of the efforts these women engaged in to contribute to the prevention of eating disord ers. Grace was a Resident Assistant at a Midwestern university. She posted this bu lletin board in the laundry facility on campus. By speaking to others about their recovery pr ocess, either privately or in a more public setting, the participants were able to shed their identity as someone with an eating disorder and to solidify their identity as a rec overed person. The women found a new ways to see themselves, not as a person defined by their eating disorder, but as someone who had overcome a horrible disorder. Sharing their experience with others strengthened their own recovery because it served

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455 as a reminder of how awful it is to live with an eating disorder, which prevented them from relapse. For the most part, these women felt that the challenge presented in overcoming their battle with anorexia had allowed them to build thei r character and become a stronger person. Emma described how she was working on utilizing what she learned from her eating disorder, Now I am at the point where I am trying to completely le t go of my eating disorder identity yet integrate the experiences I had and lessons I learned into my current life a healthy productive way. Faith used the knowledge she gained in her battle with eating disorders to support others. Faith: I wouldnt trade everything that Ive learned and everything that Ive gained from well, Id trade the weight, but (laughing) I wouldnt trade everything that Ive learned And the parts of my personality and character and the ability to reach others and share with others and comfort others and encourage ot hers. You know its re ally important. And, its something that I really wish that I would have had a long time ago that I didnt have. The women in this study had learned the power of to resist the dominant media messages about the thin ideal, and they had a need to be nefit others by sharing their knowledge. They had suffered from a horrible disorder, and they expre ssed that they would not wish their experience on anyone. Once the participants recovered, they had a need to talk to others who were struggling and let them know that they are not al one and that recovery is possible. Several participants used preexisting websites, but Alexandra actually built her own Web site. Alexandra: I wanted to reach out and educate othe r people. I have experienced so much pain and I know what other sufferers are goi ng through. I want to give them hope, let them know that they are not alone, th at they can get through this. I want to let them know that recovery is possible. I want to share my stories and em power and inspire people to continue fighting. Maine (2000) has contended that women need to overcome their socialization of silence and become radical and vocalize their concerns. Anger, correctly and co nsistently channeled,

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456 can lead to constructiv e cultural change. Share your outrage, your worries your concerns with others. Challenge your friends or family member s if they say or do things that promote Body Wars (p. 13). Some of the participants challenged statemen ts made by friends or family members in an effort to hinder the propagation of the thin ideal. They had reached a point in their life where they felt empowered to make oppositional statements to others, and they could not allow others to perpetuate the dominant norms without at l east verbally challengi ng the underlying ideology. For the participants in this study, part of the recovery process was being open and honest about their eating disorder and thei r recovery process. They wanted to share their experience in a helpful, responsible way, usually starting with a place that felt safe. For some women, that meant sharing their story with their family or a frie nd. Others took more gra dual steps in recovering their voice. Writing to Educate Others and Create Awareness Isabel had been in therapy for several years, and she had been a member of a few support groups on campus. After learning that she truly wa s not alone in her experience with anorexia, she chose to use her voice in an independent study research paper for one of her college courses. Through her research paper, Isabel wa s able to educate a so cial psychology professor about the reality of eating disorder s, which he would not have lear ned from the literature or from the mainstream media. In her paper, Isabel described the underlyi ng causes of her anorexia in detail, what her feelings and emotions were, as opposed to focusing on her ph ysical starvation. Like many of the participants expressed, Isabel f ound that it is these underlying issu es that the media leave absent in their portrayal of anorexia. By writing her pape r, she hoped to dispel the myth that the simple solution to treating someone with anorexia is to feed them, to just force them to eat.

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457 Isabels approach in her research paper st raddled the line between a personal and public form of activism because she shared the reality of eating disorders, the horror and devastation of being anorexic. Her paper serves as a strong contrast to the ma nner in which the media portray women with anorexia. She did focus on her persona l experience, but in writing with the audience of a social psychology professor, her goal was to shed some light on an eating disorder that is misconceived by many, at least in part due to the medias coverage of women with eating disorders. By sharing her paper with me and encour aging me to use excerpts from it, Isabel also sought to reach a larger audience, one that might benefit from her portrayal of the reality of anorexia. As she said at the end of her paper: Anorexia is not just about food. It is about a desperate attempt to tell someone that something is dreadfully wrong. I am so thankful that I have been able to air my dirty laundry, and by doing so, perhaps shed so me light on a devastating disorder. Writing to Effect Social Change Over time, some of the participants realized that mass media are an institution with some degree of social power, and that they might be capable of us ing their experience and knowledge to challenge media messages about the value of the thin ideal and to prevent others from succumbing to the oppression of extreme dieting a nd weight loss. They found that their recovery process itself was empowering, and they became mobilized them to take social action. Some women in this study engage in a level of activism that could affect social change at a societal level. As Kelln er (1995) has suggested: When individuals learn to perc eive how media culture transm its oppressive representations of class, race, gender, sexuality, and so on th at influence thought a nd behavior, they are able to develop critical distance from the wo rks of media culture a nd thus gain power over their culture. Such empowerment can help promote a more general questioning of the organization of society and can help induce indi viduals to join and participate in radical political movements struggling for social transformation. (pp. 60-61)

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458 Some women engaged in activism through writing, with the goal of educating others about the reality of eating disorders. The type of writing they did varied. The participants wrote informative articles for their student newspa per, admission essays about how they overcame anorexia, and protest letters to individuals or organizations th at perpetuate unhealthy notions about the thin ideal. Many of the participants e xpressed extreme frustration with the medias unrealistic portrayal of eating disorders. They felt like they needed to let others kno w that there is nothing glamorous or desirable about developing the diseas e. This frustration was a driving force behind their need to engage in activist endeavors. Jordan published an article about her battle w ith an eating disorder to inform others about the potential dangers of dieting in college and the more long-term consequences of eating disorders, something that the media rarely cover. Her article was the lead story on the front page of the student newspaper, and it covered nearly two pages, including im agery that celebrated women of varying sizes and some staggering statistics, specifically relating to college students. The articles lead might incite the interest of any female college student because it described an experience common to many young female college students, gaining the freshman 15. It began as a seemingly innocent diet. [university] senior, Cara Pers leo (name has been changed) had gained a few extras pounds from her beer and pizza over the past few mont hs and wanted to fit into her new swimsuit by Spring Break. As Cara lost the weight, how ever, she became increasingly obsessed with losing more. Soon, Cara was obsesse d with diet and exercise. In the article, Jordan attributed some of the blame for eating disorders on the media and the diet industry. Her comments re flect an oppositional reading informed by concern for others. In a society centered on waif-thin models and TV stars like Kate Moss and Ally McBeal [sic], it is easy for young women to be influe nced into thinking skeletons are more attractive than curves. Add to Western culture the millions of dollars spent and made on

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459 fad diets and gadgets promising the ability to eat what you want a nd not exercise and you have yet more negative messages being sent to impressionable women about their bodies. In the article, Jordan described Caras transformation from a simple diet to the development of anorexia with purging tendencies, primarily through exercise. Jordan also noted how 20% of the 2,000 students seen at the [unive rsitys] counseling center were suffering from eating disorders. She did not glamorize the di sorder; rather, she spent time describing how miserable the experience is, how easy it is to slip into anorexia, and how challenging it is to recover. She also touched upon various potentially contributing causes, as well as tips on how to be helpful to a friend who might be suffering from an eating disorder. For Jordan, writing the article and having it published allowed her to use her voice to portray the reality of eating disorders in the hopes of preventing ot hers from developing anorexia or bulimia. During her interview, Jordan described her need to take some action after she began to recover. Jordan: I wasnt ready to tell the world that it was me who had had anorexia. In fact, many of my friends, or at leas t acquaintances, never really knew what I had gone through. But I had this need to let others know what a miserable experience it was for me. And, I wanted to use my experience in a beneficial way. When these women recovered, many of them need ed to turn their negative experience with an eating disorder into something useful for othe rs. Like Jordan, Grace also wrote an article for her student newspaper during Nation al Eating Disorders Week to illuminate the reality of eating disorders for others. The headline of her article, The horrors of having an eating disorder, served as an effort to dispel the myth of any glamour associated with eating disorders. As she wrote in part of her article, It was out of control for many years before I acknowledged it, and many more years after which I had to battle to recover. Graces goal was to reach out to others who may be

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460 suffering from an eating disorder, educate them, and let them know that recovery is possible and worthwhile. Now that Im in recovery, I look forward to it [National Eating Disorders Week] each year. February is no longer a time for me to fear being found out, instead its a time for me to celebrate how far I have come.I suffered with my eating disorder for more than 20 years but am now happily in recovery. It was the hard est thing I have ever done but also the most worthwhile.I share my store for one reason : To bring hope to those who suffer. Being free from the obsessive thoughts and co mpulsive behaviors is possible. In sharing her story, Graces goal was to prevent others from falling for the empty promises of the thin ideal promot ed in the media. She also wanted to educate people about the underlying issues that might make someone pron e to developing an eating disorder, such as control issues and a la ck of sense of self. I know that Im eating to fill a void food will neve r fill and that thinness wont either .If I cant control anything, at leas t I can control what goes in my mouth. I feel worthless, unlovable, stressed, ugly, insignifi cant.and for me, all of those feelings equal FAT! I just want to lose weight. Graces intent was to illustrate how negative emotions usually cause her to feel fat, but as any woman in recovery from an eating disorder can tell you, fat is not a feeling. An important part of the recovery process is to learn to identify ones feelings so that the real issue can be resolved, as opposed to using eating disorder symptoms to numb oneself from feeling painful emotions. Part of Graces ar ticle points to this issue. I claim its all about my size and weight as much as I try. Its not.The truth is, in addition to hating my body, I am afraid.[sic] I m afraid of the future, my feelings and failure. Its too hard to face those things, so I focus on my body. If a woman stays caught up in feeling fat, and does not identify underlying emotions that contribute to her overall negative affect, then she w ill continue to turn to her eating disorder as a coping mechanism. The media promotion of dieti ng and weight loss as the key to happiness and success remains a tempting offer, until she realizes that no matter how much weight she loses,

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461 her eating disorder will not resolve her internal issues. Part of Graces article addresses this issue: The challenge losing weight presents is that I eagerly aw ait one day when I reach my low weight, but that day and that weight never come. Throughout the article, Grace descri bes in vivid detail the horribl e reality of living with an eating disorder. Her goal in doing so is to disp el the media-promoted myth that an eating disorder is in any way glamorous, or merely about vanity. I want to share with you the hell that an eat ing disorder inevitably brings by sharing with you a day in the life of someone with an eati ng disorder.Its not rea lly a way to live, but it is a way to die and I am well on my way. If I dont die physically Im dying in every other way. I am throwing my life away, down the toilet.I dont want to do it, but I just cant stop myself. I HATE IT!...I hate myself. Li fe with anorexia and bulimia is not life its hell. Grace also illustrates how challenging it is to dig out of an eating disorder. As this study has illustrated, none of these women recognized they had a problem until their eating disorder had taken over their life, and they no longer had control. As Grace said, I guess I realized it when I wanted to stop, and I couldnt stop. In part of her article, Grace illustrates how challenging it is to escape the powerful grip of an eating disorder. For all of these women, what started as a diet to control their weight tu rned into a disease that controlled them. Every night I tell myself tomorrow is a new day and that I will do bett er. After every binge and every purge, I promise myself and my body its the last time, that Ill do better and try harder. I have almost died from my eating disorders too many times to count I wish I could view food and my body in a healthy way. I wish I could eat and enjoy it without obsessing Despite the suffering that Grace endured, she wanted to share with the readings that she had been able to free herself from her eating diso rder, and that recovery was possible. She also wanted to convey that she was on the road to recovery and was hopeful about her future. That is where I used to live. That was the battle raging within every minute of every day. Today, my life is completely different. I no long er fear the future or my feelings. I am not

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462 consumed every minute with thoughts of food or my body. I eat and I dont vomit. My life is far from perfect but it is so much better than it ever was. If I can do it, anyone can. Speaking Publicly to Educate Others Some participants gave public talks about their ex perience in an effort to educate others about the medias association of certain foods with instant obesity and morality. As discussed in Eating Disorders and Dichotomous Thinking, several women in this study described how they had internalized the media-perp etuated notion that ea ting certain foods mi ght instantly make them obese. For example, Molly described the first time she had cheesecake when she was in recovery: I really believed th at I was not gonna get out of be d the next daythat they were going to have to roll me down th e hall cause Id be so fat. In the midst of her eating disorder, Molly had internalized the me dia-perpetuated notion that eating certain foods, such as desserts, woul d make a person bad or sinful. With increased media literacy and self-confidence, Molly learne d to decode media messages in increasingly oppositional ways. She became more confident, and she started to speak publicly about eating disorders. She educated others about how eating disorders are not just about being skinny, but instead, about underlying issues, a concept rarely di scussed in the media. She also tried to dispel the media-perpetuated notion that a persons self -worth should be measured by the type of food they consume or by their weight. Initially, Mo lly only shared her opini ons with family and friends, but over time, she began to express herself to pe ople in more public realms. Molly: Ive spoken publicly at a soror ity at the University of Ka nsas. I spoke mostly about the signs of eating disorders, how the symptoms /behaviors are just th at symptoms of a bigger problem. And I talked about how best to approach a friend or loved one who might have a problem. Other than that its just personal lectures Someone at work might say, I was bad this weekend because I went to a bi rthday party and had pizza and cake! Well, then I would have to spend the next 20 minutes lectur ing them on how food is not good or bad. It is an inanimate object. It can not make a person good or bad! I used to draw blood at our local blood center, and we always had to ask the donor for their weight. Most of them would respond with the same Im bad because I weigh blah, blah blah. The more I

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463 learned about the media messages, and the more I realized how much people let a weight or a piece of food determine th eir self-worth, the more I felt compelled to redirect them. Contacting the Media Directly Several scholars have suggested the importance of young women becoming actively resistant to the media. For example, Choate (2007) has argued that writing letters to protest advertisements or other media messages that cont ribute to the perpetuati on of the thin ideal can empower young women to believe that he r voice can be heard, that she can make a difference in altering socio-cultural norms. Women can engage in media activism to challenge the socio-cultural status quo and contribute to shaping healthier cultural norms. According to Levi ne and Piran (2001), females can feel empowered if they recognize and harnes s their ability to activel y protest harmful media messages. There are several activ ist strategies women in this study incorporated into their everyday lives. Orenstein (1994) has suggested that young women s hould target the overarching institutions, policies and cultural at titudes (p. xviii) rather than feeling like a victim of media messages intended to make women feel like they are never good enough. As many of the participants b ecame more media literate, their awareness transformed into anger directed at toward the source of the medi a messages. Molly described how passionate she was about actively resisting poten tially damaging media messages. Molly: I think part of it for me is realizing how ignorant a nd uneducated people are. Many people are unaware of how they are contributin g to our societys unrealistic viewsthat we can be, or should try to be perfect. But when approached in the right way, they are actually open and can see how dama ging most of our culture is. For Molly, voicing her opinions on e-mail allo wed her to channel he r energy in a healthy and productive way. As she stated in her interview, I think its probably one of the healthiest ways I deal with anger and my feelings. Molly used e-mail as a resource for directly challenging the source of potentially damaging messages.

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464 Molly: I really only tend to read the stories that pop up online. Most of the time about 85 % I try to ignore them, but once in a while I cant resist the urge! Its mainly the stories about weight or suggestions that someone might have an eating disorder or drug addiction that I end up reading. They al ways infuriate me and I know that going into them, but my curiosity about how stupid the media and journalists can be gets the best of me. Then I get all worked up and end up sending nasty e-mails to them. Molly discussed the types of actions she took when media sources contributed to the misconceptions about eating disorders. As Piphe r (1994) has suggested, Once girls understand the effects of the culture on their lives, they can fight back. They learn that they have conscious choices to make and ultimate responsibility for t hose choices. Intelligent resistance keeps the true self alive (p. 44). Molly: My biggest example is probably over the sitcom that was out last year called Starved It was a sitcom that was on FX about four people who had eating disorders and belonged to a very dysfunctional support group. I tried to watch it once, but only made it through about 10 minutes. I wrote e-mails to the sponsors of the show Toyota and a couple other companies. I also wrote e-mails to the producers and write rs of the show. The sponsors actually responded to me, but I never heard from the network. The show is off the air now, so Im happy! Molly described how she wanted to make certain that everyone was held accountable to the same standardsnot perpetuating the dominant ideology of the thin ideal. As she became stronger in her oppositional beli efs, Molly wrote several prot est letters to media figures, including Oprah: If Oprah makes a comment about weight or dieting that I think is inappropriate, out goes an e-mail! And I love Oprah! Forming Preventive Programs Choate (2007) has contended that because body image dissatisfaction is such a pervasive problem in adolescent girls, there should be eff ective prevention programs in place. Prevention programs can serve as one of several protec tive factors that cont ribute to young womens abilities to resist socio-cultura l pressures regarding thinness.

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465 Margaret Mead once said, Never underestimat e the ability of a small, dedicated group of people to change the world; ind eed its the only thing that ev er has changed the world (Mead, 1992, p. iv). Kristin started a prevention program on a small scale at her high school. The organization, L.U.L.A. (Love Ur Life Always), grew to be a model program for other high schools in the area. In addition, Kristin is now usi ng some of the concepts from her original high school program to form a new program that is de dicated to the prevention of eating disorders at her college. During her interview, she described her desire to harness what she learned from her experience with a life-threatening disease to educate people and help to prevent other young women from slipping into the de structive path of anorexia. Kristin: When I had my anorexia, I was isolated and depressed. But when I was in recovery, I slowly started to change my t houghts and appreciate my life a little more. I started to have more of a connection with others and it gave me more confidence in myself in my ability to face challenges without my anorexia. And, then, the more I faced challenges, the more I felt, and saw, a better way to live. As horrible as my eating disorder was, it helped me to shape who I am today, and all the activities Im involved with. My eating disorder helped me to f eel empowered to take action. Kristin also discussed an inci dent that contributed to her ne ed to take some action. She was talking to a 9-year-old girl, who confided in her that she didnt like wearing her bathing suit because of her shape: It crushed me. I couldnt stand to think about her facing the hell I had gone through, especially so young. I guess having had my eating disorder made me realize that I had to do something to help girls like her. About a month after this c onversation, one of Kristins te achers announced that the Eating Disorders Information Network (EDIN) was l ooking for someone to spearhead an outreach program. As Kristin said, It was exactly what I was looking for. Kristin shared her story with her teacher, and she began to at tend EDINs regional meetings.

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466 As part of Kristins involvement with L.U.L. A., she also took part in several media-related activities. She was filmed in an EDIN docum entary about eating disorders, and she was interviewed on television (Fox news) and Star 94, one of the largest radio st ations in Atlanta. Through EDIN, Kristin was able to start an organization that not only helped to prevent eating disorders, but also was pe rsonally rewarding to her. In addition to helping her stay committed to her recovery, being involved with L.U.L.A. provided Kristin with an outlet to combat some of the harmful messages that th e media disseminate to young people about their body image. In fact, one of the fi rst activities that Kristin orga nized was a day when L.U.L.A. members passed out positive body affirmations to the entire student body. Kristin: It kind of made me feel good, especially when the eating disorder had made me feel so bad. And when I met that little girl, I just knew I had to do something to help in some way I didnt want others to go th rough the hell I went th rough. My life was just fear and depression, and I wouldnt want anyone to go through all the awful stuff I did. Nearly all of the pa rticipants in this st udy talked about the disproportional importance the scale weighed in their lives. As Jamie said, I was a prisoner to the scale. Kristin initiated a scale-smashing event at her school to bring attention to the pote ntially damaging affects of our cultures obsessive focus on weight. Organized through L.U.L.A., th e event was part of EDINs Love Your Body Week, and it was a success, with high school males and females participating. Kristin also helped to write the L.U. L.A. Handbook, a regional publication with contributions from several national scholars, prof essionals, and organizations. On page 29 of the handbook is a letter from Kristin. In the letter, she shared sugg estions from her leadership experience, both in the school and in the community. Before L.U.L.A., Kristins school did not have a forum for discussing eating disorders and body image issues. Kristin discusse d the positive impact that L.U.L.A. had in just one year.

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467 Figure 4-4. Photo of Kristin at the February 200 8 L.U.L.A. scale smashing event, organized to protest the excessive value placed on women s weight. Kristin is wearing a L.U.L.A. bracelet to increase awareness about eating disorders. Kristin: The most important thing is that no one every talked a bout eating disorders at our school before, even though they were really pr evalent. And now, L.U.L.A. has created an awareness and what I call posit ive peer pressure (she puts her fingers in quotes) that is making a difference. And, its spreading to other schools its growing. Its kind of like something really powerful has been created a nd theres more awareness that hopefully will stop some people from developing these life-t hreatening diseases before they start. Empowerment through Counter-Hegemonic Activity This section has detailed some activist strategies the partic ipants used to move beyond the hegemonic obsession with control over their body to achieve an unnatural and unrealistic body type. By sharing the potential dangers of the thin ideal and the reality of life with an eating disorder, the participants challenged the dominant discourse and introduced an alternative, more accurate framework. The participants used activism to cement their own recovery, and to contribute to the prevention of eating disorders. In a very real se nse, these women also were engaging in counterhegemonic activity, using the medi a as tools to resist the type s of messages that once had consented to. As Watkins and Emerson (2000) have suggested, feminist perspectives on media reception have revealed the ways in which wome n appropriate the media [sic] as a site of

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468 meaning construction, actively engaging and, occas ionally, contesting images and themes of gender domination (p. 157). Hegemony is not fixed, but rather can be ch allenged by alternative or oppositional forces (Condit, 1994; Lewis, 1992; Williams, 2001). As th e women in this study have illustrated, mass media, particularly college campus newspape rs and the Internet, offer fertile ground for contesting the dominant ideology (Condit, 1994; Hargreaves, 1994; Kellner, 1990). Gramsci (1971) has argued that hegemony is ex ercised in multiple domains, and that it is fluid and mutable as conditions change. In a he gemonic system, the interests of one group exert power and control over ot hers through a system of consent and coercion. As obsequious adolescents with little self-e steem or sense of self these women fully had consented to the media-perpetuated formula fo r social acceptability. Furthermore, with the socially-constructed fear of fat ingrained in the partic ipants young minds, media messages touting the value of the thin id eal appeared more coercive than suggestive, leading them to believe that the attainment of the thin ideal was imperative. As a fundamental aspect of hegemony, consent typically is gained by providing sufficient rewards to individuals who adhere to the domin ant ideology so that the benefits outweigh potential consequences of coercion. These women had consented to the dominant ideology of the thin ideal, and after the initial compliments faded, they gradually continued to lose weight until they lost the cognitive ability to see that they had taken their initial diet too far. This chapter has presented the main categories that emerged during the analysis phase of the grounded theory process. As Chapter 4 has dem onstrated, the women in this study engaged in readings of the thin ideal that were diverse, complex, and sometimes contradictory. In order to

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469 illuminate the most the most significant and meaningful aspects of the data, I developed a theoretically grounded typology that will be discussed in detail in Chapter 5. Figure 4-5. The L.U.L.A. (Love Ur Life Always) Handbook

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470 Figure 4-6. A letter that was included in EDINs L.U.L.A. Handbook which is distributed to several Atlanta high schools. Kr istin wrote this letter her se nior year, right before she left for college.

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471 CHAPTER 5 DISCUSSION This chapter discusses the implications of th e findings in Chapter 4. It also addresses the limitations of this dissertation and su ggests areas for future research. This study is the first to e xplore how women who are in r ecovery (or recovered) from anorexia navigate the media lands cape, one that is saturated w ith dominant ideologies defining cultural ideals of female beaut y. In investigating th is research question, I used socio-cultural theory and feminist ideology as th e supporting theoretical frameworks. The essence of socio-cultural theory is that there are a number of social, cultural, political, and economical factors that in fluence a womans body image and the likelihood that she may develop an eating disorder. While the media do not act in isolation, they do serve as a powerful socio-cultural force because of their omnipresent nature. As the findings have illustrated, it is difficult to escape media messages pervasively transmitting the importance of appearance and adherence to the thin ideal. Women in recovery from anorex ia may not be able to complete ly avoid imagery of the thin ideal, but through their recovery process, they gained various tools to resist media messages. One of those tools was the adoption of a feminist ideology, which primarily afforded the women in this study with some resiliency and resistance to media messages that contribute to womens subordination through a primary focus on appearance. Five Types of Readings The study revealed five types of readings, three of which al ready have been proposed in the literature: dominant/hegemonic, negotiated, and opposition al. The other two categories emerged as part of the grounded theory approach employed in this dissertation, and they are

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472 subsets of oppositional readings : self-protective opposition and opposition informed by concern for others. Known for developing reception st udies, Hall (1980) proposed that there is an encoding and decoding process with media messages. While the media disseminate a dominant ideology constituting the preferred reading encoded in a message, Hall argued that readers do not automatically adopt this dominant perspectiv e. Rather, they may produce negotiated or oppositional readings. A viewer adopting th e negotiated position approaches a message recognizing the encoded ideology, but decides to pa rtially accept it with some alterations. The third position of Halls m odel is the oppositional perspective, in which the viewer recognizes the encoded dominant ideology, but decodes the message with a fr amework directly opposite of what the message sender, thereby rejecting the pr eferred reading. Participants Previously Had Dominant Readings of the Thin Ideal The media collectively serve as a dominant institution, which portrays and perpetuates a powerful cultural message that women should st rive to attain the thin ideal. Many young women have dominant readings of the media, agreeing with and accepting ideo logy of the messages and the subjectivity that th ey produce. The women in this study were no exception. Previously, the women in this study had subscribed to that ideal, viewing me dia, particularly magazines, as a reliable resource for information about relationships, beauty, and fa shion advice. In fact, many of the participants described how they used to vi ew magazines as a bible, a how-to guide, or even an instruction manual for life. The women in this study had worked so hard to attain mediated ideals of femininity that they sacrificed their physical, mental, and emotional health. Once these women were in recovery, the nature of their media interp retations altered. As they came to understand how the media were

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473 implicated in their obsession with the attainment of the thin ideal, and to the widespread body dissatisfaction in women, they no longer engaged in dominant readings of the mediated ideal. This dissertation is based on the premise that individuals are able to negotiate meaning from media messages. Negotiation is a term generally associated with reception studies and Stuart Halls article Encoding/Decoding (1980) in which he has cont ended that all readings are negotiated to some degree as opposed to passive acceptance of the preferred meaning. The women in this study no longer pa ssively accepted the mediated ideal, but they had varying degrees of resistance informed by their personal life experience. Predominant Participant Readings: Self -Protective and Concern for Others The most predominant forms of opposition in this study were the two categories that emerged in this dissertation: self-protectiv e opposition and opposition informed by concern for others. Nearly all of the part icipants engaged in self-pro tective opposition. They had a desire to decode the mediated ideal in an oppositional way, but their own internal conflicts prohibited them from doing so without significa nt self-talk, a negotiation within themselves Selfprotective readings init ially appeared to be oppositional in nature, but closer examination revealed that the participants were using statements of opposition as a tactic or strategy to protect themselves from accepting the dominant code, which might lead to unhealthy thoughts or behaviors. In addition, nearly all of the women in th is study had oppositional readings informed by concern for young girls, regardless of how capab le they were of resisting such messages themselves. These women knew how easy it was to fall victim to insidious media messages offering valuable solutions to issues of concer n to female adolescents. Once the women were in recovery, they realized how harm ful it could be to take media messages at face value, and they

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474 expressed concerned for others who might do so. Their concern for others was informed by the knowledge they had of what they us ed to take from media messages. Typology Provides Abstract Conceptual Understanding To date, no studies have explored how wo men in recovery from anorexia develop oppositional readings to the mediated ideal. Cons equently, the findings presented in Chapter 4 provided a broad overview of the main categories that emerged from the data. This chapter will discuss the typology I developed to clarify central relationshi ps among the various types of participant readings. In a qualitative study, there ar e many different ways to find, depict, and present the results. Further analysis of the findings allowed me to develop a typology (or matrix) that provided a more abstract conceptual understanding of the range and divers ity of the various participant readings. Constructing this typolog y facilitated a higher level of an alysis and enabled me to have novel insights about the various ways that women in recovery from anorexia negotiate