Pretty Thin?

Last Editorial Review: 1/30/2005

Researches delve into beauty's role in eating disorders.

By Tula Karras
WebMD Feature

Feb. 21, 2000 (San Francisco) -- Thirty-one-year-old Michelle Gil, of San Antonio, Texas, is an actress and former beauty pageant participant. Her Sophia Loren lips, mocha-colored skin, and to-die-for cheekbones turn heads, as does her lithe 5-foot-6, 130-pound frame. Gil works hard at keeping trim by running every day and eating well-balanced meals. But her healthy habits have not come easily -- they are the result of years of therapy, medication, and daily mental adjustments. Gil is a recovering bulemic.

"I began to deprive myself of food when I was 16," Gil says. "And I was purging daily by the time I was 19." Luckily, Gil?s family discovered her dangerous illness when she was nearly 20 and family intervened, placing her in a hospital treatment program for two months -- a decision she says saved her life.

Looking at Gil, you?d never peg her as someone who harbors insecurities about her body. But a new study from York University in Toronto, Canada, suggests that it is precisely the women who meet our society?s standards of beauty who are the most likely to express body dissatisfaction, a precursor to developing an eating disorder.

The High Cost of Beauty

The study, published in the January 2000 issue of the International Journal of Eating Disorders, looked at 203 women with an average age of 21. Researchers found that those rated as having the most attractive faces (on a 10-point scale specifically ignoring body weight or shape) had the greatest dissatisfaction with their bodies. The women did not know they were being rated for attractiveness.

Why would physical attractiveness play such an important role in the development of eating disorders? Caroline Davis, Ph.D., the study?s lead author and professor of psychology at York University in Toronto, has a simple theory. "How you feel is often how other people see you," she says. "People who are blessed by having an attractive face learn to value themselves more in that regard from a young age." Davis has since replicated her results in a more rigorous, follow-up study in which eight different raters were used. The study has just been accepted for publication in the Journal of Social and Clinical Psychology.

Beauty Isn?t Everything

No one suggests that Davis has found the sole, or even the main, reason for eating disorders. "There are many causes for the problem, including genetics, temperament, and biological factors such as brain chemistry," says Seth Ammerman, M.D., Assistant Clinical Professor of Adolescent Medicine at Stanford University in Palo Alto, Calif. "But this study is important because it gives us one more thing to look for so we can intervene early."

Davis herself says that the results of her study will not influence the way eating disorders are diagnosed or treated. "Getting sufferers to stop viewing themselves solely as physical objects is already part of the treatment for eating disorders." But she does think the findings underscore how important a role environment plays in the development of the disorder -- and that parents have a particular responsibility to prevent a child from becoming preoccupied with looks.

"We should be giving all children the message that social relationships, academic achievements, and sports skills are desirable goals, but it?s even more important to do this for attractive children," she believes.

Ammerman and other experts agree. "It all goes back to having high self-esteem, which is based on internal attributes," he says. "Once those are in place, a person can better resist the external attributes that the media promotes."

A woman who is worried about her body shape and weight needs to focuson nonphysical qualities, says Leslie Bonci, R.D., M.P.H., a Pittsburgh-based spokeswoman for the American Dietetic Association and an eating disorders counselor. "Ask yourself which internal traits -- humor, generosity, intelligence -- set you apart from others, besides the physical," she says. "Appreciating one of these will counterbalance an emphasis on the physical."

Bonci is careful to point out, however, that wanting to look your best and take care of yourself is very different from vanity. "You can?t tell a person that they shouldn?t care at all about the way they look," she says, "but if your entire self-worth is based on your mirror image, having one bad hair day will leave you feeling completely empty."

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