Monday, 14 July 2014

B-EAT - RESEARCH NOTES

The below notes have been taken from research packages put together for students and press by B-EAT. The essays have been read and notes have been typed up accordingly with additional comments and guidance for myself.

The individual essays can be found via the link below.

http://www.b-eat.co.uk/about-beat/media-centre/

Facts and Figures

Hard to judge accurately due to a lack of data regarding how many people in the UK suffer from an eating disorder. The Dept of Health provides NHS in-patient statistics only, leaving out a majority of people in the facts an figures. Numbers exclude:
- not come forward
- private treatment
- undiagnosed
- outpatient treatment
- treated in the community

The National Institute of Health and Clinical Excellence provides the most accurate figures we are aware of - 1.6m in the UK are affected by an eating disorder. 11% of which are male.

NHS information centre provided information stating 6.4% of adults in the UK showed signs of an eating disorder (Adult Psychiatric Morbidity Survey, 2007). Also showed that a quarter of which are male - more than previously expected.

Breakdown:

10% Anorexic
40% Bulimic
50% EDNOS, inc binge eating disorder and being overweight (Eating Disorders Not Otherwise Specified).

Many eating disorders develop through adolescence however cases reported vary from 6 to 70+ years old.

Those outside of the stereotypical age bracket are less likely to be appropriately diagnosed due to a lack of understanding and awareness of eating disorders in these age groups. (Not as commonly seen, witnessed, talked about or viewed - i.e. media, advertising, fashion all fall under stereotypical age bracket for anorexia and bulimia).

Duration: Research carried out in Australia suggests the average duration of anorexia is 8 years, whilst bulimia is 5 years. In some cases however it can last a 'short' life-time and lead to death, or even reoccur over time (relapse).

Recovery: Reviews of the research into the recovery of Anorexics suggest that:

45% of anorexia patients fully improving
33% improving
25% remaining chronically ill
(Steinhausen, 2002).

Bulimia:

45% make a full recovery
27% improve considerably
23% suffer chronically
(Steinhausen & Weber, 2009)

Anorexia has the highest mortality rate of any psychiatric disorder, from medical complications associated with the illness to suicide. 

Research suggests 20% of Anorexia suffers will die prematurely from their illness. 

Bulimia is associated with severe medical complications, and binge eating disorder sufferers often experience the medical complications associated with obesity.

In every case, eating disorders severely affect the quality of life of the sufferer and those that care for them.

Genetics: Multiple factors contribute to the development of an eating disorder, but research suggests that genetics DO play a role in this, however currently unsure of how much so.

Some research has found that female relatives of anorexia sufferers were 11.4 times more likely to suffer from anorexia compared to relatives of unaffected participants. For female relatives of those with bulimia, the likelihood of developing bulimia was 3.7 times that of those with unaffected relatives. 

Screening:

Unable to tell if someone has an eating disorder from looking at them, however some case studies argue otherwise.

SCOFF screening tool, developed by Prof. John Morgan at Leeds Partnership NHS Foundation Trust, can indicate a possible eating disorder. A score of 2+ positive answers, scores positive for an eating disorders. A disorder can only be officially diagnosed by a clinician. 

1. Do you ever make your self SICK because you feel uncomfortably full?
2. Do you worry you have lost CONTROL over how much you eat?
3. Have you recently lost more than ONE stone in a three month period?
4. Do you believe yourself to be FAT when others say you are too thin?
5. Would you say that FOOD dominates your life?

A healthy weight depends on height and age. 

The diagnostic criteria for anorexia nervosa include the refusal to maintain, or reach, 85% of the expected body weight for someone of that age and height. Determined by BMI - Body Mass Index.

BMI below 17.5 is seen as indicative of anorexia.
BMI above 25 is over weight.
BMI between 18.5 and 24.9 is ideal.

Further links:

National Institute of Health and Clinical Excellence (NICE) guidelines.
Institute of Psychiatry Eating Disorders Research page.
Adult Psychiatry Morbidity Survey (2007)

The Fashion World

Beat would argue that fashion industry doesn't cause eating disorders; they are more complex. 

The fashion industry does however have a powerful influence that is highly toxic to some vulnerable people. Can add to an eating disorder - influence - or make it harder to recover.

Causes of an ED are complex, multi-factorial and not yet fully understood.
Include a mix of factors:
- genetic
- biological
- cultural
- environmental
- psychological
- trauma/bereavement
- personality traits
- brain structure and chemistry 
Some more prominent than in others, each case is different, making it hard to diagnose at times, and effects severity/recovery.

Fashion world are often blamed for the problem.

19 editors of Vogue magazines around the world have recently launched 'The Health Initiative', a pact to "reflect their commitment to the health of models who appear on the pages and the wellbeing of their readers". 

Fashion is a major influence and a contributing factor, but not necessarily a cause.

(See case studies via http://www.b-eat.co.uk/about-beat/media-centre/ or The Fashion World printout)

Pro-Anorexia and Bulimia Sites (Pro-Ana/Mia)

Pro-ana/mia sites are online communities promoting the eating disorders - some deny that they are mental illnesses, and promote them as 'lifestyle choices'.

'Thinspiration' images are often found on blogs/websites, to give followers inspiration to continue their weight loss and along with weight loss ideas and information.

We are exposed to on average, 5,000 photoshopped images a week.

'Virutally Anorexic - Where's the Harm' study by Emma Bond. 

See print out/pro-ana/mia document for Susan Ringwood, CEO, Interview.

Bullying

In Nov 2011, Beat published a report during Anti Bullying Week which found that bullying played a part in the development of an eating disorder in more than 75% of people surveyed. An increased of 67% on a similar survey 2 years previous.

600 individuals were surveyed:

90% said they had been bullied at sometime in their life.
78% acknowledged that this had led to their eating disorder.
40% said they were under the age of 10, when the bullying started.

Low self-esteem can lead to eating disorders as a result of bullying.

Body Image and the Media

A report published by the All Party Parliamentary Group (APPG) on Body Image revealed that over half the UK public suffer from negative body image which can lead to health and relationship problems, low self esteem and hinder participation at school and progression at work.

Poor body image and low self esteem are key factors in the development of eating disorders and social and cultural pressures are strong in this area.

Body image is a key part of our sense of identity and not a trivial matter or one of personal vanity. It is a fundamental part of our sense of self and affects our thoughts emotions, behaviour and actions. It is the belief that our size, shape and weight convey to the world what sort of person we are.

A preoccupation with weight and shape is one of the key features of current popular culture. Not solely relevant to women.

The media doesn't cause directly cause eating disorders, they're much more complex than that but the fascination with celebrities, their bodies, clothes and appearance has added to the pressure that people feel coupled with the phenomenon of airbrushing and digital manipulation. Both these technologies shape images to create a 'hyper-perfection' which can be toxic to those who already have a low sense of self worth.

An interesting study about the influence of the media and body image was carried out in Fiji before and after the wide exposure to television. The study found that key indicators of disordered eating were significantly more prevalent following exposure. Narrative data revealed participants interest in weight loss was a means of modelling themselves on television characters. The study was carried out by Professor Anne Becker et al in 2002 'Eating behaviour and attitudes following prolonged exposure to television among ethnic Fijian adolescent girls' and was published in the British Journal of Psychiatry 180, 509-14. 


Images and Use in the Media

As noted imagery can be very dangerous depending on its portrayal.

Often in the news.

'"Sugar Plump Fairy" ballet dancer says she suffered from eating disorders'
"Skinny Barbie blamed over eating disorders"
"1,500 young women seek help for eating disorders"
"Media blamed for rise in eating disorders"

"They always show pictures of a person at their worst which can b very triggering for sufferers"
"I think it's disgusting that some magazines only run stories if they have pictures of peoples' 'lowest weights' - they need to change, weight is just a symptom"

Images often published are the stereotypical image of an extreme thinness. It's distorting people's idea of what an eating disorder is really like.

B-eat held a Vox Pop - asked general public if they could name an eating disorder, 72% said anorexia, 3% said binge eating. Yet anorexia is the rarest of illnesses with only 10% of cases. When asked if they could tell if someone had an ED, half said Yes. Over 80% of those with an ED are overweight.

Images do not reflect the reality. Many will not be emaciated. 

1000 people surveyed with personal experience, 66% said media images had a negative impaxt on their self esteem, and 70% said it affected their body image. 

77% found the media too focused on weight and the physical symptoms of an ED, not recognising or reporting the significant mental distress suffered and psychological root of the illness.

"Generally my experience of media coverage has been damaging. It contributed to the development of my own eating disorder, although did not cause it, and in order to recover and stay well I have had to distance myself from media coverage".

Backed by --

"The media is a casual risk factor for body dissatisfaction, negative effect and eating pathology" - 2004, Spettigue and Henderson.

Media Guidelines for Reporting Eating Disorders

Facts and Figures as stated above.

"The media doesn't cause eating disorders, but the media can strongly influence attitudes, beliefs and actions" - Penny Junir, Writer and Broadcaster

Aimed to de-stigmatise eating disorders.

Constant clashing and contrasting of ideas, causes and actions.

People with eating disorders typically have very low self-esteem and feel worthless. They are more likely to wish to disappear and not be noticed than want to draw attention to themselves - opposite of media's portrayal - models, fashion, TV, media.
Daily pressures control society as a whole through the desire to be the ideal shape, weight and image.

Media reflects and amplifies that social and cultural environment - and it is one in which body image, perfectionism and control over appetite are highly prized. The growth of a celebrity culture where (mostly) young women are either idolised for their perfect bodies or else criticised for their failings creating a powerful influence that is unhealthy for many and toxic for a vulnerable few.

A study published in Oct 2010 by Dr Aric Sigman in The Biologist highlighted the risks involved and how new research shows there is a much stronger link between visual media and eating disorders. Repeated exposure to images of thin women alters brain function and increase the propensity to develop eating disorders.

The media's influence is that coverage of eating disorders that either glamorises or else revitalises the illness makes it harder to build the kind of compassionate understanding that it is so vital to beat an eating disorder.

Positive aspects of the media and eating disorders are very highly over looked, i.e. campaigns, raising awareness, calling for better treatment/research, advice, promoting the message of recovery and support and public discussion of a trivial/taboo topic.

"They make me want to be like the anorexic girl I was again. It makes me what to compete with the person and become thinner than them, or it makes me beat myself because I'm not like that anymore." - Ambassador for B-eat

"They make me feel that I must be at least as skinny as the photos they show before I can be considered as ill and deserving of help." - Ambassador for B-eat

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