BMA press releases archive

Eating disorders, body image & the media - a new BMA report

(issued Tuesday 30 May 2000)

Eating disorders, such as anorexia and bulimia nervosa have one of the highest mortality rates of all psychiatric illnesses and even when not fatal can lead to serious medical consequences. Schoolgirls and young women are particularly vulnerable and the number of sufferers is rising. A new report from the British Medical Association examines the role of the media in causing body dissatisfaction and triggering eating disorders.

Eating Disorders, Body Image and the Media* ( is published today (30.5.00) by the BMA’s Board of Science and Education. Its foreword states: “Female models are becoming thinner at a time when women are becoming heavier, and the gap between the ideal body shape and the reality is wider than ever. There is a need for more realistic body shapes to be shown on television and in fashion magazines.”(p2)

At any one time there are an estimated 60,000 people with eating disorders in the UK. One in ten sufferers is male but the majority are young women. Anorexia nervosa affects 1-2% of the UK female population between the ages of 15 and 30 and of these between six and 10 of every one hundred patients die as a result of their disorder. The report states: “The crude mortality rate for anorexia nervosa at 20 years follow up may be as high as 15-20%”.(p8)

Eating disorders are caused by a complex interplay between genetics, family history, and the cultural environment. The report states: “The media provide particular examples of role expectations and images of beauty which may influence young people’s perceptions of acceptable body image…Dieting is an important precipitant factor in the developing of eating disorders. Young women are dieting at an increasingly young age, and expressing dissatisfaction with their body shapes.” (p18) The images of slim models in the media are a stark contrast to the body size and shape of most children and young women who are becoming increasingly heavier. Research has found that most female characters on television are thinner than average women. The report states: “It has been estimated that models and actresses in the 1990s have 10%-15% body fat – the average body fat for a healthy woman is 22-26%.” (p29)

Low self esteem plays a part in the development of eating disorders and the portrayal of abnormally thin women in the media can contribute to this. The report states: “In recent years the socially represented ideal body has become increasingly thin, and much thinner than the average objective body shape of the population, putting pressure on women to view their bodies as fatter and heavier.” Research has shown that girls with low self esteem at age 11-12 were at significantly greater risk of developing severe signs of eating disorders and other psychological problems at age 15-17 . (p35)

The BMA is particularly concerned about the use of very thin models to advertise products and to model clothes for the fashion industry (p36). The report states: “The degree of thinness exhibited by the models chosen to promote products is both unachievable and also biologically inappropriate and provide unhelpful role models for young women.”

In its Discussion section, the BMA report concludes: “We considered that the media play a significant role in the aetiology of eating disorders, although we cannot blame an individual advertisement, television programme or model for their onset, and there is a clear need for more comprehensive research to be conducted on this issue.”(p43).

A positive influence can be exerted by the media, says the report. They can encourage young women to feel confident about themselves and their role in society, and can play a crucial role in encouraging healthy eating habits and relationships to food. The media are a major source of health information and can help people with eating disorders identify the problem and seek help.

Schools, too can play a part, says the BMA report: “Children who are overweight should not be teased or made self conscious about their weight in physical education classes and every attempt should be made to include them fully in sporting activities.” (p41).

Eating Disorders, Body Image & the Media has recommendations for the media, diet and nutrition, education, for Government health strategy and for further research.


Note to Editors

*Eating Disorders, Body Image and the Media, price 7.95 from BMJ Bookshop 020 7383 6244/6638 or email orders:



The Media

1. Broadcasters (or programme makers) and magazine publishers should adopt a more responsible editorial attitude towards the depiction of extremely thin women as role models, and should portray a more realistic range of body images.
2. Producers of TV and printed advertisements should consider more carefully their use of thin women to advertise products, in particular the Independent Television Commission should review its policy on the use of thin women to advertise products other than slimming aids.
3. Health professionals should work with the television industry to increase awareness of the possible impact of programming on young people, and encourage the inclusion of healthy eating patterns into their programming.

Diet and nutrition

4. Health professionals should work with food manufacturers, and advertising agencies to increase awareness of the key nutritional issues that affect young people. In particular there should be increased awareness of the impact of faulty nutrition in young adolescents going through puberty.
5. The school curriculum should include the development of critical viewing skills in order to interpret food advertising. Consideration should be given to implementing media literacy programmes, particularly for young children.
6. Health care workers who work directly with children and teenagers must ensure that dieting is not part of a routine unless it is absolutely necessary; it is crucially important that being put on a ‘diet’ is clearly distinguished from ‘dieting’ — ie food restriction. Clear, achievable and biologically appropriate targets should be set by heath care professionals if dieting is considered necessary.


7. Schools should have clearly defined anti-bullying policies, and strongly discourage the teasing of overweight children. This should encourage a greater acceptance of normal variation in body size and shape within the population.
8. Schools should develop policies on eating disorders, to enable early detection of the signs and symptoms in children, which could be related to anorexia or bulimia nervosa.
9. School counselling and mentoring services should provide an arena in which young people can address issues of self-esteem, body shape and social popularity.
10. Consideration should be given to the problems faced by young people during physical education classes, eg self consciousness about body shape, fearing being ‘picked last’ in a team due to perceived physical unsuitability. Fitness and enjoyment should be considered the key priorities, and children of all body shapes and sizes should be made to feel included in lessons and valued for their contributions, even if they are unable to achieve high levels of success.

Government health strategy

11. The Government’s mental health strategy as set out in Our Healthier Nation should set clearly defined targets for the reduction in the number of eating disorders, by consideration of preventive measures.
12. There should be increased public education on the connections between, dieting, physical activity and health, and health risks associated with eating disorders and being underweight.
13. More resources should be given for mental health services, specifically eating disorder clinics.

Further Research

14. The greatest research priority should be given to trials of primary prevention for eating disorders, especially among children and adolescents. These trials should include the provision of a control group, full assessment, optimum follow-up after a reasonable time-lag, with minimum drop out rates.
15. There should be more research into the subject of the media and possible related effects on children and adolescents, particularly the impact on perceptions of body shape and healthy eating.
16. There should be more research into the ‘protective’ factors which seem to result in greatly reduced incidence of eating disorders in certain sectors of the population (eg men, certain ethnic minorities).

End recommendations

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