Teen Eating Disorders: The Impact of Dangerous Sites

“Eating disorders can affect every organ system in the body, and people struggling with an eating disorder need to seek professional help. The earlier a person with an eating disorder seeks treatment, the greater the likelihood of physical and emotional recovery.”

-National Eating Disorders Association, 2018

Who Is at Stake?

Virtually all Americans ages 12-17 years old have easy access to the internet (Madden, 2018). These tender years are when eating disorders tend to develop in adolescents (Keel, 2013, p. 434), with the average age of onset being 12.5 years (Mencker, 2021). The causes are complex, but one sneaky culprit consistently emerges in current cases. We find that hidden influence in their homes, bedrooms, and even in their back pockets. Via tech, the social pressure to be thin has transcended peer groups and print media, magnified by the ubiquitous images and messaging available 24/7. Early detection and mitigation give families the best chance of success in reestablishing their child’s mental and physical health.

The consequences of this exposure on the developing brain are the subject of current research, and familiarity with those findings will benefit families. During these formative years, the information the internet provides your child, true or false, accurate or skewed, can easily impact their risk for these disorders. The ways technology influences the onset and exacerbation of these illnesses are manifold. Through ads and social media, kids are bombarded with images and messages that affect their self-concept. As a parent, understanding the opponent is the first step toward prevention and remediation.

Early Exposure

Concerns about body image begin well before adolescence. The National Association of Anorexia Nervosa and Associated Disorders (ANAD, 2021) provides support and resources for those suffering from these illnesses. They share the following statistics regarding the early attitudes and habits that promote disordered eating in children and adolescents.

Statistics that promote early habits of eating disorders:

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• 42% of 1st-3rd grade girls want to be thinner.
• 81% of 10-year-old children are afraid of being fat.
• 46% of 9-11 year-olds are “sometimes” or “very often” on diets.
• 35-57% of adolescent girls engage in crash dieting, fasting, self-induced vomiting, diet pills, or laxatives.
• In a college campus survey, 91% of the women admitted controlling their weight through dieting.

(National Association of Anorexia Nervosa and Associated Disorders, 2021)

Their data also shows that BIPOC, LBGTQ+, athletes, and people with disabilities are at high risk and less likely to be diagnosed and receive treatment.

Adolescents exposed to pro-eating disorder websites have been shown to have higher levels of body dissatisfaction than adolescents not exposed to these sites, as well as decreased quality of life and longer durations of eating disorders.

– Dina Borzekowski, adjunct professor at University of Maryland College Park in health, behavior, and society.

Glamorizing a Lifestyle: Tech’s Influence on Disordered Eating

Juveniles are passive recipients of images and messages that laud extreme thinness. If you search for disordered eating, you’ll find many results—most seriously, websites that promote anorexia and bulimia as lifestyles instead of mental illnesses. Meet e-Ana and e-Mia (Borzekowski, 2010, p. 1528). This pair of young ladies represent the dysfunctional ideal of extreme thinness and are featured on pro-eating disorder pages. They advise youngsters how to get started and embrace a strict regimen of caloric deficit.

This dangerous duo also provides kids with ways to hide this behavior from parents, tricks and tips for denial, instructional guides for purging, fasting, and even recommendations for diet pills and laxatives. These sites claim an authoritative voice and coercively present their content to make their distortions appear legitimate. We see this in the following “commandments” with radicalized messaging of dangerous and distorted absolutes.

The Thin Commandments

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• If you aren’t thin, you aren’t attractive.
• Being thin is more important than being healthy.
• You must buy clothes, cut your hair, take laxatives, starve yourself, do anything to make yourself look thinner.
• Thou shall not eat without feeling guilty.
• Thou shall not eat fattening food without punishing oneself afterward.
• Thou shalt count calories and restrict intake accordingly.
• What the scale says is the most important thing.
• Losing weight is good/gaining weight is bad.
• You can never be too thin.
• Being thin and not eating are signs of true willpower and success.

(Borzekowski, 2010, p. 1530)

Their grotesque gospel promotes the belief that thinness equals success and encourages devotees to punish themselves for eating. For the adolescent brain, the design and content of these sites look legitimate, and devotion to the disorder is the next logical step. Of concern, these websites have begun to proselytize via social media and are therefore even more accessible to young people (Borzekowski, 2010, p. 1526).

These platforms can fuel potentially disordered thinking and even spark interest in the casual reader. Hoping that children will recognize these accolades as dysfunctional is not realistic as even adults struggle to distinguish between healthy and unhealthy diet plans (Čevelíček, et al., 2018, p. 128). There is evidence that young people exposed to pro-eating disorder websites have higher levels of body dissatisfaction, lower quality of life, and a longer duration of eating disorders (Borzekowski, 2010, p.1526). Although these children may not place physical appearance above health, they are at risk of doing so.

Warning Signs

Early detection and mitigation give families the best chance of success in reestablishing their child’s mental and physical health. Given the prevalence of disordered eating, from emergence to active symptoms, resources are available to parents and children. NEDA provides an online screening tool (NEDA, 2021, Screening Tool) that is easy to use and instantly available. It surveys attitudes towards food, eating, thought processes, and self-concept.

This screening tool provides a risk assessment to these questions:

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• How much more or less do you worry about your weight and body shape than other people your age?
• How afraid are you of gaining three pounds?
• When was the last time you went on a diet?
• Compared to other things in your life. How important is your weight to you?
• Do you ever feel fat?
• How often do you restrict your food intake to less than 1200 calories per day?

(National Association of Anorexia Nervosa and Associated Disorders, 2021)

Based on responses, the tool then provides a risk assessment and resources. If parents or children have any concerns about a potential illness, they should consult a primary care physician, as they are best equipped to make diagnoses and recommendations.

Combat With Media Literacy: Teaching Kids to Question the Message

Each day young people digest an immense amount of images, videos, and text. Encouraging youth to become competent media viewers is the first line of defense to prevent these disorders. This type of critical thinking is referred to as “media literacy” and includes the skills needed to understand the intent behind what they view. When children become savvy at deciphering images, they will be better able to judge the content as harmful or helpful.

Regarding media associated with eating disorders, questioning the intent will allow them to challenge unhealthy messages (NEDA, 2018, Prevention). Encouraging young consumers to speak out against untruths surrounding body image and healthy lifestyles will help them question content and images when they conflict with healthy attitudes. Asking questions about ads is an easy way to build this competency at home. Here is a list of questions to help start the conversation:

Questioning the media you see:

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• Who made this? How can you tell?
• Why did they make it? Why do you think that?
• What is the creator’s point of view? How do you know?
• How do I know if this is true? Why do you think that?
• Who might benefit from this message? Who might be harmed by this message?

(National Association of Anorexia Nervosa and Associated Disorders, 2021)

Empowering young people with the necessary tools to interpret the content they view is critical towards educating them about and protecting them from eating disorders. The skills of critical thinking, identifying intent, and questioning messages will set children up for success in this area and in any situation in which they encounter a new idea.

Moving Forward

Here are some tools to help you begin these necessary conversations about healthy attitudes surrounding body image, weight, eating, and exercise. Equipping yourself with these strategies will enable your children to be savvy consumers of online images and messages.

Key Take Aways

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Have a conversation where you model questioning content viewed via technology. This ad for Pretzel Crisps (which was pulled after it sparked outrage) is a great place to start. You’ll have the opportunity for a great chat as you discuss the truthfulness of the message:

• Who made this? How can you tell?
• Why did they make it? Why do you think that?
• What is the creator’s point of view? How do you know?
• How do I know if this is true? Why do you think that?
• Who might benefit from this message? Who might be harmed by this message?

Resources

• Utilize this screening tool if you are concerned your child is at risk or has developed an eating disorder.
• Consult your family physician and schedule a check-up. Ask your doctor to review healthy attitudes towards food and exercise.