Using films about Eating Disorders (ED)in education and training

Dr Yasir Hameed (MRCPsych)

Specialist Registrar

Norfolk and Suffolk NHS Trust

There is strong tendency to blame the media for causing andmaintaining our patients’ eating disorders (Spettigue,Henderson 2004)

The majority of studies have demonstrated a directrelationship between media exposure and eating pathology,body dissatisfaction and negative affect (Stice, Schupak-Neuberg, Shaw, & Stein, 1994; Stice & Shaw, 1994; Utter,Neumark-Sztainer, Wall, & Story, 2003)

Studies even demonstrated that the media may havean indirect effect on females’ body image through itsinfluence on boys’ expectations of females’appearance (Hargreaves & Tiggemann, 2003).

Women with anorexia nervosa engage in heavy mediause and describe their consumption of fashionmagazines as an “addiction,” with many saying thattheir greatest media dependency occurred after theireating disorders had begun to take control of theirlives (Thomsen et al., 2001).

Every year, the average adolescent sees over 5,000 advertisementsmentioning attractiveness.

Various surveys showed that majority of female respondents feltthat women in movies and television programmes made them feelinsecure about their bodies.

The rate of eating disorders in Fiji surged following the introductionof Western television programming (Becker et al. BJPsych. 2002)

Actresses Cameron Diaz, Julia Roberts and the singer Diana Rossmeet the BMI criteria for anorexia.

http://www.raderprograms.com/causes-statistics/media-eating-disorders.html

Much of the literature on the role of the media in thetreatment and prevention of eating disorders hasfocused on media literacy, activism, and advocacy(Levine et al., 1999; Levine, Smolak, & Schermer, 1996;Posovac, Posovac, & Weigel, 2001; Steiner-Adair &Vorenberg, 1999).

Media literacy training involves teaching people tothink critically about different forms of the media,increasing awareness of media use, and analysing thecontent and intentions of the media producers.

Through media literacy, adolescent girls learn how todecode and discuss the visual images and themessages in the media; they learn that all mediaimages are constructed, that what they see is notnecessarily reality, and that all media creationsrepresent a point of view (Steiner-Adair & Vorenberg,1999)

Films can offer realistic depictions of character styles andpsychopathologic disorders, as well as personal and familydynamics, with subtexts alluding to the prevailing social norms.

An advantage of using films for teaching is that they are wellproduced, interesting and lively, and there are no concerns overconfidentiality.

Characters experience their symptoms in the context of theirlives, not in an isolated clinical encounter.

Bughra D. Teaching psychiatry through cinema. Psychiatric Bulletin (2003) 27: 429-430

Psychological thriller film directed by DarrenAronofsky and starring Natalie Portman,Vincent Cassel, and Mila Kunis.

The plot revolves around a production ofTchaikovsky's Swan Lake ballet bya prestigious New York City company.

Natalie Portman plays the innocentand fragile ballerina (Nina) who isstruggling to achieve the expectationsof her mother the Director of the show.

Black Swan (2010)

A documentary from Channel 4 following the journeytowards recovery of an 8 year old Dana and her stayat a specialist unit (Rhodes Farm) in North London.

Useful for CAMHSprofessionals andpatients.

Dana (2007)

Documentary film directed by Lauren Greenfield and is anexploration of The Renfrew Centre; a 40-bed residential facility forthe treatment of women with eating disorders.

The film mostly revolves around fourwomen with anorexia nervosaand/or bulimia and their strugglesfor recovery.

Living at the centre for six months,Greenfield and director of photographyAmanda Micheli received unrestrictedaccess

Thin (2006)

A documentary focusing on the role that family issuesplay in the life of four teens suffering fromeating disorders and the pressures exertedon them to live up to what they perceiveas the high expectations of their family.

“There was very good explanations of howthe family structure can affect a persongoing through such a disorder and how theycan help the individual get well”

Patient’s review on Amazon.com

Perfect Illusions: Eating Disordersand the Family (2003)

In this TV drama from NBC, Kimberly McCulloughstars as a young aspiring dancer whose life isthreatened by anorexia.

The film shows the impact of eating disorder on theperson’s relationships, health and work.

The end is a happy one, which gives optimismand hope of recovery to the viewers .

Dying to Dance (2001)

Television drama film about a teenage girl's struggle withbulimia and its effect on her parents and friends.

Teenager Beth Moss (Alison Lohman) has an apparentlygood life academically and as a ballerina,however, she feels she is not living up to theexpectations and is not in control of her life.

She turns to binging and purgingas a means to gain control over atleast one aspect of her life.

Sharing the Secret (2000)

Television drama about the singer Karen Carpenterand her struggle with eating disorder, whicheventually took over her career and ended her life atthe age of 32 due to heart failure.

Her death lead to lasting mediaattention to eating disorders andnumber of celebrities later on wentpublic about their own struggle withthese disorders.

The Karen Carpenter Story (1989)

o Most films are not made for educational purposes but forentertainment. However, they influence the public and can beused to educate and raise awareness about various mentalhealth problems, including eating disorders.

o Using films in patients education and training of health careprofessionals is encouraged by many authors.

o Inviting patients and their carers to watch these films can bevery helpful to encourage discussions about the patients’ ownexperiences and how they relate to others with similar stories.

“You are not alone, and it will get better if weworked together”, is the message we need to sendto all our patients.

Any comments?