Today’s National Eating Disorder Association (NEDA) reports that 20 million American women will be diagnosed with an eating disorder in their lifetime. The 20 million women estimate is up from practically nothing in 1960. This statistic is staggering: one out of every eight women will be diagnosed with a mental illness around their body image and eating where practically no mental illness existed 50 years ago. 

These statistics are relevant to all women because we are all living in the same environment, our diet culture, that is causing the epidemic. All eating disorders have in common an underlying “body image disturbance.” Six of 8 women today live with a similar-in-kind body image disturbance, or simply a negative body image, from living in a time and place obsessed with youth, thinness, and having a perfect body.

Eighty percent of women polled say they are unhappy with their bodies. This 80% of all women are you and me. This is all of us who do not have an eating disorder or disordered eating, but who worry quite a bit about the food we eat because of the effect it will have on our bodies. 

How did we get SO wrapped up in our own bodies in the last 50 years?  What happened to us?  

There are many things that could explain our diet culture’s ramping up of appearance related concerns in the last 50 or so years. First on almost every list is media beginning with television. Television happened to our generation and digital media exposure has spiraled out of control since then. By the late 1960’s 90% of US households had television sets. Television brought images into our living rooms every day and every night.  


These images of genetically-blessed women -- like Twiggy, Farrah, and Cher and others -- have wreaked havoc in the minds of the girls and women who watched them. For adolescent girls forming their own identities, these images skewed the perception of what a normal woman looks like. Not only are these actresses and models genetically blessed representing 1% of the American woman's body type, but they also had a team of people working on them for hours getting them ready for these photo shoots.  And, most of the images themselves have been digitally altered.

The images that we saw as young girls have in part caused the negative body image statistics that we see today. Those images and others made 99% of the women who are NOT built like the models and actresses in the pictures feel flawed in comparison.

On some level deep down, a woman internalizes society’s standards and believes she needs to look a certain, very specific way to be attractive to find love or to fit in with her society. For those of us growing up in the late 60s, 70s, or early 80s, we may not have thought that we need to look exactly like Farrah. But we may have thought we need to weight 110 pound like her or wear a size 2 as she would have done. 

Many of us are still holding on to our diet culture's unrealistic standards for ourselves that we think we should look like even 30 or 40 years later.  These standards don't account for normal aging or have anything to do with our genetics, but just cause us to spend the time we have alive dissatisfied with our bodies.

The young women of Fiji

There was a famous study done about 20 years ago that confirms that television shares responsibility for some body image issues.  The island of Fiji was the last country on earth to start importing American TV in 1995. They didn’t just get our PBS Masterpiece Theater and Antiques Roadshow, they got our most American of exports: Melrose Place with Heather Locklear and Beverly Hills 90210.

A team from Harvard went down to study the effects of television on the population. Dr. Anne Becker, a psychiatrist and Harvard Medical School professor, was specifically interested in teenage girls -- a population concerned about appearance, identity, and fitting in. There were no reportable eating disorders before these American shows infiltrated their villages. But, three short years later, they found eating-disordered behaviors in the same percentage of young girls in Fiji as in the same population in the United States. Dr. Becker reported that “by the glow of the television” the girls of Fiji entered a new age for the island, an age in which they found themselves to be "poor and fat." 


  • The Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) is the 2013 update to the American Psychiatric Association's (APA) classification and diagnostic tool. DSM-5 Eating disorder definitions: 
    • Anorexia:  Disturbance in the way in which one's body weight or shape is experienced, undue  influence of body weight or shape on self-evaluation,
    • Bulimia: Self-evaluation is unduly influenced by body shape and weight.
    • Body Dysmorphic Disorder: Self-evaluation is unduly influenced by body shape and weight. 
  • Anne Becker, Television, Disordered Eating, and Young Women in Fiji: Negotiating Body Image and Identity during Rapid Social Change, Culture, Medicine and Psychiatry December 2004, Volume 28, Issue 4, pp 533–559.  Dr. Becker is part of the team that worked on the APA’s DSM-5 Eating Disorders revisions in 2013. 

  "Not that it was Twiggy's fault, but the ubiquity of her image created a sense in young women that to be stylish meant to be skinny."  -- Susie Orbach