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What's to blame? NDSU study finds disparity between what people with and without eating disorders think causes them

FARGO - Society largely blames eating disorders on unrealistic body images portrayed in magazines or on TV, but a North Dakota State University researcher found that media influence plays only a small role in their development.

In an open-ended survey conducted in 2010-11, a group of more than 200 individuals without eating disorders and a group of about 60 individuals with eating disorders were asked to list what they believed to be some of the reasons.

Developmental psychologist Beth Blodgett Salafia found that nearly half (47 percent) of participants without eating disorders but only about 9 percent of those with eating disorders pointed to cultural or media influence.

"Clearly, there is a stark contrast between the lived experience of those with eating disorders and the conceptualization of the problem from larger society," says Emily Haugen, an NDSU graduate student who worked with Salafia on the study.

Furthermore, those without eating disorders said they considered it to be common knowledge that media influence is the biggest contributing factor.

"The general population is not getting the right information," says Salafia, an assistant professor in human development and family science.

Instead, she says, participants with eating disorders cited reasons such as exerting control or coping with stress.

"In some cases, it's about feeling the need to be perfect or having some kind of control over an aspect of one's life, especially during childhood or adolescence, where you don't have a lot of control over things; food might be one thing that you can control," says Salafia, who became interested in eating disorder research while working on her doctorate in developmental psychology at the University of Notre Dame.

During the study, both groups were asked how they define "social and psychological problems."

When Haugen was categorizing the results, she noticed that those without eating disorders defined those issues as "low self-esteem," but those with eating disorders were more specific and listed things like depression or anxiety.

"As a society, we often blame 'low self-esteem' as the culprit for many problems; however, we don't have a good way to define or measure this concept," says the 24-year-old Fargo woman, in her third year of NDSU's couple and family therapy program.

Salafia hopes the information and perspective gained from her work will help bring awareness and understanding to the problem.

"Maybe it will lead to better education for individuals without eating disorders and better programs for individuals with eating disorders," she says.

Though each case is different, Salafia says, if those in the field have a better understanding of what causes eating disorders, maybe they can better work with them on those causes.

"Overall, I think we need to start listening to those with eating disorders and adapting the language that fits for their experience," Haugen says.

Though Salafia says media images likely reinforce the desire to be thin or worsen symptoms of pre-existing eating disorders, they may not be the primary cause.

"I think that solely targeting the media is not taking the complexity of eating disorders into account. Many individuals with eating disorders identified two or more causes of their eating disorder, suggesting that the disorders are multifaceted and quite complex," she says.

The assistant professor says focusing on the media alone is too simple and that individuals without eating disorders blame it because they know it to be a problem.

"The media should never be off the hook, however, because it likely strongly contributes to girls', women's and even young men's dissatisfaction with their bodies by promoting the thin or muscular ideals," Salafia says.

She says individuals experience body dissatisfaction when their bodies don't match the bodies portrayed in the media and that body dissatisfaction is likely a large component of eating disorder development.

"That all being said, the media also needs to be accountable for its presentation of women and men, and especially its presentation of eating disorders. Having an eating disorder is not glamorous, nor is it something that is quickly dealt with," Salafia says.