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Families do not cause anorexia nervosa: NEDA responds to Gisele Bundchen

The U.S. National Eating Disorders Association (NEDA) has responded to Gisele Bundchen’s statement blaming families for anorexia.  In short, Bundchen is ignorant; the culprits are some combination of 1) genetic factors, 2) personality traits such as obsessionality and perfectionist attitudes, which are themselves related to genetics, 3) environmental factors such as the high status of skinny high-fashion models and 4) various problems that an individual may be facing, such that women at risk for developing anorexia often come to believe that the attainment of perfection will make their problems go away, and conveniently find “perfection” in the skinniness of high-fashion models, thanks to the high status of high-fashion models.

The following report mentions societal pressure to be slender, which is incorrect since most people find the typical skinniness of high-fashion models socially unacceptable; the correct phrase is “the influence of high-fashion imagery.”      

NEDA statement:

PITTSBURGH, Jan. 22Misstatements and ignorance claiming that families “cause” eating disorders is like blaming parents for diabetes or asthma or cancer says an international group of eating disorders researchers. Recent damaging statements by fashion model Gisele Bundchen stating that unsupportive families cause anorexia nervosa only perpetuate misconceptions and further stigmatize eating disorders. Contrary to her claim, there is no scientific evidence that families cause anorexia nervosa. In fact, the researchers are finding that anorexia nervosa is far more complex than simply wanting to be slim to achieve some fashionable slender ideal. The data show that anorexia nervosa has a strong genetic component that may be the root cause of this illness.

“An uninformed opinion such as Bundchen’s causes harm on a number of levels. By contributing to the stigma, it drives sufferers underground and creates obstacles to seeking help. It damages attempts at advocacy and hurts parents who are desperately fighting for their child’s recovery,” said Allan S. Kaplan, M.D., Loretta Anne Rogers Chair in Eating Disorders at the University of Toronto. “Such thinking also misinforms third party payors who may not want to pay for the treatment of these biologically-based illnesses if they think its primary cause is family dysfunction.”

Dr. Kaplan is a member of the international group of researchers attempting to find which genes contribute to anorexia nervosa through a National Institute of Mental Health-funded study of families with a history of anorexia nervosa. The current study, which is being conducted at 10 sites across the world, hopes to further clarify which genes play a role in anorexia nervosa. The study builds on data from ten years of groundbreaking research on the genetics of eating disorders sponsored by the Price Foundation.

“We often hear that societal pressures to be thin cause many young women and men to develop an eating disorder. Many individuals in our culture, for a number of reasons, are concerned with their weight and diet. Yet less than half of 1 percent of all women develop anorexia nervosa, which indicates to us that societal pressure alone isn’t enough to cause someone to develop this disease,” said Walter H. Kaye, M.D., professor of psychiatry, University of Pittsburgh School of Medicine. “Our research has found that genes seem to play a substantial role in determining who is vulnerable to developing an eating disorder. However, the societal pressure isn’t irrelevant; it may be the environmental trigger that releases a person’s genetic risk.” Families should not be blamed for causing anorexia. In fact, they are often devastated and suffer from the consequences of this illness.”

Anorexia nervosa is a serious and potentially lethal illness, with a mortality rate greater than 10 percent. It is characterized by the relentless pursuit of thinness, emaciation and the obsessive fear of gaining weight. Anorexia nervosa commonly begins during adolescence, but strikes throughout the lifespan—it is nine times more common in females than in males. Personality traits, such as perfectionism, anxiety and obsessionality, are often present in childhood before the eating disorder develops and may contribute to the risk of developing this disorder.

“We need to understand all the factors that influence eating disorders, both genetic and environmental, and find ways to address them in order to prevent people from developing these potentially deadly conditions,” said Cynthia Bulik, Ph.D., William and Jeanne Jordan Distinguished Professor of Eating Disorders, University of North Carolina at Chapel Hill. “Understanding how genes and environment interact both to increase risk for eating disorders and to protect those who are genetically vulnerable from developing the disorder will require the cooperation of professionals in the eating disorders field, the media, and the fashion and entertainment industries. Only cooperatively, will we be able to move the field forward toward the elimination of this disease.”

“Anorexia nervosa has the highest death rate of any mental illness, yet so few dollars are dedicated to the cure,” stated Lynn Grefe, CEO of the National Eating Disorders Association. “These scientific advances demonstrating a genetic component are significant and so meaningful to our families, wiping away the myths and emphasizing the need for even more research to help the next generation.”

The team of researchers involved in the Genetics of Anorexia Nervosa collaboration invites families to help them unravel the genetic underpinnings of this disorder. Families in which two or more relatives have had anorexia nervosa (this includes siblings, cousins, aunts, uncles or grandparents) are encouraged to contact them for more information about participation. The study involves phone interviews, questionnaires and a blood draw. Participants are compensated for their time. For more information, call 1-888-895-3886, e-mail EDResearch [at] upmc.edu or visit the study’s Web site at www.angenetics.org

Study sites are located in seven US cities (Pittsburgh, New York, Philadelphia, Baltimore, Los Angeles, Fargo, N.D., and Tulsa, Okla.); and in Toronto, Canada; Munich, Germany; and London, England.

Contact:

Jocelyn Uhl Duffy (UhlJH [at] upmc.edu)
Kelli McElhinny (McElhinnyKM [at] upmc.edu)
Phone: (412) 647-3555
Fax: (412) 624-3184

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Comments

People with the same problems that factor in the development of anorexia or bulimia will exist when the beauty standards in the fashion industry change, for example to a more feminine ideal as you would like it.
How will these people try to obtain "perfection". I don't believe they will lie back and just accept the way they are built. Breast implants, liposuction and severely constricting corsets aren't very healthy either.
While I wouldn't mind publications meant for men to showcase a more feminine beauty standard, I don't see why the women's fashion and cosmetics industry should. There I'd much rather see the "every body shape is beautiful when it's healthy" ideal put forward by Dove for example, which is also hugely popular with women. I can see other companies adopting it soon.

Susie: Whereas it is true that if the fashion industry were using feminine and healthy-looking women, there would still be women around who lean toward the belief that perfection of some sort will make their problems go away, starving oneself is inexpensive and doesn’t require any special equipment, but breast implants, liposuction and other major cosmetic surgeries are expensive and beyond the reach of a large number of women. A feminine appearance is dependent on overall looks and for most women, a few simple cosmetic procedures are not going to help achieve feminine beauty. Therefore, those seeking perfection will likely focus on an area apart from their looks or if they seek to radically alter the looks, then very few women would have the financial resources and willingness to deal with the pain and risks of multiple cosmetic surgery procedures.

I doubt that the Dove beauty campaign is hugely popular with women. Dove has a commercial motive. It sells products women use to maintain/improve their looks, and hence feminists aren’t exactly enthusiastic about Dove’s campaign.

It is certainly possible to have a fashion alternative that uses models with a much wider range of looks, but high-fashion requires that models convey a sense of exclusivity, i.e., it is unrealistic to expect a high-fashion alternative using models with very diverse looks.

How often do you think most women view high fashion imagery Eric? Compare number to how often they watch movies and read celebrity magazines or websites. Most high fashion models are not well known outside of the high fashion industry. They don't have half the status that the skinny starlets have. If any high profile people are inspiring sick girls to starve themselves then it would be the skinny movie stars and celebrities. Gemma Ward can't compete with Nicole Ritchie and the Olsen twins in terms of visibility.

PS. Society does presure women to be thin. They do not need women to be as skinny as high fashion models but they need them to be slender.

Danielle: Whereas stars like Nicole Ritchie and the Olsen twins influence many girls and women, they themselves are influenced by high-fashion models, and hence their influence is an indirect/trickle-down effect of high-fashion models.

I am tired of repeating the well-documented observation that most people optimally prefer women within a subset of the medically healthy weight range, not thin women. If this is a source of pressure on some women, then women are at least as much to blame as men.

Eric, those studies don't satisfy me. Those pictures were awful. It would have been better if they had used 3D models or actual women.

Danielle: Read carefully; two studies that I cited used pictures of women.

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