Social Influence as a Cause of Disordered Eating in Women: Thin Ideal Internalization, Peer Pressure, and Self-Objectification

 Social Influence as a Cause of Disordered Eating in Women: Thin Ideal Internalization, Peer Pressure, and Self-Objectification

Xenia J Kozlov

New England College

Social Influence as a Cause of Disordered Eating in Women: Thin Ideal Internalization, Peer Pressure, and Self-Objectification

Xenia J Kozlov

New England College

Abstract

Social influence, acting implicitly or explicitly, is the main cause of the disordered eating in women. The influence itself can be divided into three types according to the subject of influence – general, environmental, and personal. Overall, our society influences women through gender role which is expressed, respectively, in the thin ideal promotion (general level), peer pressure (environmental level), and self-objectification (personal level). The research shows that in all three levels there is a relationship between social influence and disordered eating. The main driving force for causing disordered eating is the process of internalization, either common sociocultural norms or one's opinions and messages. After the toxic body standards get internalized, the inner mechanisms intervene. The main mechanism connecting disordered eating and social influence is self-objectification, which can be turned into disordered eating through various behavioral patterns.

Keywords: disordered eating, social influence, thin ideal, internalization, self-objectification, peer pressure.

Introduction

The strict social norms imposed on women within the framework of the gender build a pressure that can have a harmful impact on women's mental health and well-being. In this research, we suggest the two-level three-component model of social influence as a cause of disordered eating in women. We consider both implicit and explicit levels of social influence on women within gender role standards and suppose that three types of social influence could be distinguished according to the subject of the influence. Moving from general to the particular, the general, environmental, and personal types of influence are described.

Also, as an overwhelming number of different and multi-directed studies on the topic are present, a brief overview of the working terminology and necessary clarification precede the research. Finally, the existing directions for the disordered eating problem solutions are observed.

This research has the goal to integrate and analyze existing knowledge about disordered eating in women and to identify and describe the relationship between social influences and disordered eating behaviors.

Terminological Explanations and Establishing Links Between Categories

The amount of literature written on the topics of gender conformity, disordered eating in women, fat stigmatization, media impact and emotional self-silencing is sufficient to combine this knowledge into one study on the interaction of social pressure and disordered eating. But due to involving different theories and concepts the terminological systems seems to be in need of clarification and specification according to the goals of this research.

Terminology

In this paragraph, we observe clue terms which are used for the description of the topic. Relatively, we distinguish social influence and peer pressure, define gender, self-objectification, and thin ideal internalization in application to the subject of our work, and, finally, distinguish eating disorders and disordered eating.

Social Influence and Peer Pressure. According to Social Psychology Encyclopedia, influence means any noncoercive technique, device, procedure, or manipulation that relies on the social psychological nature of the organism as the means for creating or changing the belief or behavior of a target, regardless of whether or not this attempt is based on the specific actions of an influence agent or the result of the self-organizing nature of social systems. ... In other words, social influence uses tactics that appeal to the social nature of the organism" (Vohs, Baumeister, & Sage Publications, 2007, pp. 475-476). In the perspective of the gender roles, different scholars emphasize that women tend to experience much greater social influence than men (Vogel, Wester, Heesaker, & Madon, 2003; Cabello, Sorrel, Fernández-Pinto, Extremera, N., & Fernández-Berrocal, 2016; Parent & Moradi, 2011; Lafrance Robinson, Kosmerly, Mansfield-Green, & Lafrance, 2014). In this work, social influence would be distinguished from peer pressure which assumes the presence of the direct influence of the group, when individuals conform and follow their peers by changing their attitudes, values or behaviors. This type of pressure causes an individual to change in response to a feeling of being pressured or influenced by a peer or peer group (Marquis & Tilcsik, 2016).

Gender. Gender is a social construct which is governed by multiple sets of social beliefs, meanings, and dominant norms also called social discourse, that originates from powerful political and social institutions (Piran & Cormier, 2005). Gender, as a sociocultural construct, is correlated with the individual's biological sex and infused with masculine and feminine gender roles which instruct men and women to behave in a certain way (Henrichs-Beck & Szymanski, 2017).

Thin Ideal Internalization. The process of internalization is a key concept for understanding the impact of social pressure on the individual's well-being. The individual identifies with different social discourses, related to their understanding of themselves (e.g. gender role), and internalize them (Pirand & Cormier, 2005). Thus, in this work, we turn to the thin ideal internalization, which is the part of feminine gender identification at least in the Western culture. Thin ideal is a part of the beauty ideal which is crucial for expression of feminine gender role. Thin ideal internalization refers to the extent when a person consciously or unconsciously accepts the sociocultural prescriptions for attractiveness and assimilates its standards in their personal system of values and beliefs (Henrichs-Beck & Szymanski, 2017).

Self-objectification. We use this term for designation of the spectrum of individual's self-perception and behaviors, which derives from feminine gender socialization. The clue for the understanding of self-objectification is the Objectified Body Consciousness Theory (Jackson & Chen, 2015) which implies body surveillance/body avoidance, body checking, self-silencing behavior, negative body image, and body dissatisfaction.

Disordered Eating and Eating disorders. According to DSM-V, “feeding and eating disorders are characterized by a persistent disturbance of eating or eating-related behavior that results in the altered consumption or absorption of food and that significantly impairs physical health or psychosocial functioning” (APA, 2013, p. 329). DSM-V distinguishes pica, rumination disorder, avoidant/restrictive food intake disorder, anorexia nervosa, bulimia nervosa, and binge-eating disorder.

Clinical eating disorders, however, are just the part of a wide spectrum of the disordered eating behaviors (usually named "disordered eating") that produce significant morbidity while not meeting clinical criteria (Pirand & Cormier, 2005). Among disordered eating behaviors the emotional eating, eating in the absence of hunger (ignoring body signals), overeating and excessive consumption of hedonic foods are distinguished (Ferrer, Green, Oh, Hennessy & Dwyer, 2017). According to Johnson and Wardle (2005), dieting is also related to the disordered eating.

Though both eating disorders and disordered eating are related to the social influence, in the case of eating disorders, the matter is not limited to social influence alone, but also involves genetics, physiology etc. (Ferguson, Winegard & Winegard, 2011).

Defining Relationship Between Social Influence and Disordered Eating in Women

The relationship between social discourse and individual body experience could be divided into two layers according to the type of impact. Thus, we can name implicit and explicit layers, which may be related to general social influence and peer pressure. Also, the three types of social influence can be distinguished.

The first level of the social influence – general social influence - as it has been written above, creates vulnerability in women due to their understanding of their role in society and social expectations they get with gender role. The response to this impact is the emergence of feelings of guilt and shame, gender conformity (Parent & Moradi, 2011), and thus creates prejudice against those who does not fit into the framework of gender roles, stress, stigmatization, and lack of self-awareness (Spanos, Vartanian, Herman, & Polivy, 2014). In this research, social influence is presented in thin ideal imposed through mass media and weight stigmatization.

The second level of social influence – peer pressure – imposes on women the standards of beauty directly, through interpersonal relationships. Peer-comparison, in-group concurrence (Ferguson, Winegard & Winegard, 2011), and size discrimination lead to maladaptive eating behaviors due to overall emotion dysregulation (Douglas & Varnado-Sullivan, 2016).

According to this two-level model, we can distinguish three types of social influence, related to Tripartite Influence Model suggested by Rodgers, McLean, and Paxton (2015). This model shows the relationships among media ideal, peer-comparison, and body dissatisfaction. If we accept media ideal as the expression of general social influence and clarify that in modern Western society the thin ideal is at play, we get the first type of social influence. Respectively, the second type is related to peer-comparison which is, if we look wider, the peer pressure, and the third type is, in a sense, self-pressure, or, in Tripartite Influence Model, body dissatisfaction. Our hypothesis, in particular, is that the main driving force of such self-pressure within the female gender is self-objectification.

Thin Ideal

The thin ideal internalization, or media internalization, refers to the process of the promotion of the specific standards of physical appearance and encouraging people to subscribe to this standards and try to fit them as much as it is possible (Rogers, McLean & Paxton, 2015). The thin ideal propagandizing involves both positive evaluations of women with thin bodies as healthy, beautiful, successful, attractive etc., and stigmatizing fat bodies as unhealthy, lazy, ugly, and infelicitous. Ferguson and Winegard (2011) argue that the roots of this sociocultural discourse are in the evolutionary need for reproduction, however, the historical justification does not make thin ideal less toxic in the modern society. Henrichs-Beck and Szymanski in their study claim that currently girls and women experience a huge impact on thin ideal due to higher social demand for feminine attractiveness, and find correlations between thin ideal internalization and body dissatisfaction. Parent and Moradi (2011) evaluated the feminine norm conformity using the Conformity to Feminine Norms Inventory-45 (CFNI-45) tool, listing thinnes and invest into appearance among 9 subscales which include modesty, sweet and nice behavior, care for children and other prescriptions of the female gender. They have found the relation between these prescriptions and the phenomenon of objectified body consciousness (OBC) which is a risk factor for the disordered eating (Jackson & Chen, 2015).

Wellman, Araiza, Newell, and McCoy (2017) relate thin ideal with weight stigmatization, as strict and long-lasting dieting, overexercising and different weight-loss competitions are advocated in popular media and social networks. The authors notice that this agiotage around losing weight leads to appetite dysregulation, disordered eating, and finally to weight gain which is really harmful in the conditions of weight stigmatization in modern society.

Though it is almost impossible to measure the actual impact of the thin ideal on individual's values and beliefs (Ferguson & Winegard, 2011) the thin image carries out basic support for further pressure on women.

Peer Pressure

Peer pressure is acknowledged by specialists as the most important to consider. Peers can influence our self-perception in two ways – by direct message and by appearance comparison (Ferguson, Winegard & Winegard, 2011). Johns, Zimmerman, Harper, and Bauermeister (2017) report that women with higher BMI experience elevated rates of harassment and discrimination due to social stigmatization of the overweight or obesity. The discrimination can be expressed in different forms, starting from direct insult and ending with the lack of provision for the plus-size body needs (i.e., clothes, places, and seats in transport and public places).

The other type of peer pressure refers to appearance comparison when individual compares one's physical appearance to someone else or is compared by somebody contrary to one's desire (Rodgers, McLean & Paxton, 2015). This may happen in different places and within different groups, including families and workplaces. The weight bias is the prevalent problem among the causes of the disordered eating because the bias against overweight or obesity is usually internalized by people with disordered eating which in its turn increases the maladaptive eating behaviors (Douglas & Varnado-Sullivan, 2016). Also, age may be involved in appearance comparison, as it was noticed by Fairweather-Schmidt, Lee, and Wade (2015). Authors found that being compared to younger female groups, mid-age women with the low quality of life showed higher incline to disordered eating, as mid-age women are the main group of risk, and showed poorer mental condition compared to the mid-age women with high life quality. Keeping in mind that the quality of life variable includes the level of social support and overall matching individual's place in society according to personal cultural values, goals, expectations, standards, and concerns (Ayala, Ellis, Grudev & Cole, 2017), the results of the study of Fairweather-Schmidt, Lee, and Wade could be interpreted as the important role of the peer pressure in individual's social life and thus its huge impact on disordered eating in women.

Finally, Spanos, Vartanian, Herman & Polivy (2014) emphasize that the role of social influence in eating behavior may be expressed also through lack of awareness about food intake or ability or nonability to recognize whether society impacts food intake or not. In other words, the higher awareness about food intake was noticed in more socialized people (high social eaters). Thereafter, low social eaters seem to deny the fact of social influences on their food intakes.

Self-objectification

The personal response to social influence and peer pressure varies depending on different factors. The basic tools for determining the interaction between social influence and disordered eating can be divided into two categories – condition-related and behavior-related. The condition-related category includes body image, body dissatisfaction, self-consciousness emotional experience, emotion regulation specificity, weight stigma, and objectified body consciousness. The behavior-related category includes self-discrimination, dieting, self-silencing behavior, and various types of disordered eating.

The main work which sets the tone to this part of research is the report on objectified body consciousness (OBC) as a risk factor for disordered eating in late adolescents (Jackson & Chen, 2015). Authors conclude that OBC is linked to the disordered eating through body dissatisfaction at least in Western countries. Three main facets of the OBC are body surveillance, body shame, and appearance-control beliefs. Using the first two as measuring subscales, authors found that though men experience negative social influence, the OBC itself refers to women. Negative social influence caused eating disturbance both in men and women, but in women, it had long-lasting duration.

The point that women experience OBC instead of men, is really important for this research, as it refers gender socialization as the basic expression of the social influence. The term objectification seems to be fundamental to the understanding of the mechanisms of women's socially caused disordered eating. Thus, body dissatisfaction, as it is referred in scholars studies, such as Tripartite Influence Model (Rogers, McLean & Paxton, 2015), or in research of Stapleton, Cringhton, Carter, and Pidgeon (2011), is directly linked to the objectification of women's bodies. Defined as "negative thoughts and feelings pertaining to one's weight and shape", it is recognized as a major source of suffering among women of all ages (Stapleton, Cringhton, Carter, and Pidgeon, 2011). It perfectly matches the body surveillance and body shame, traits of the OBC – individual's body is perceived not as the part of the self but as an object which needs to match certain parameters. The phenomenon of body dissatisfaction is related to the concept of the body image. According to Pellizzer, Tiggemann, Waller & Wade (2017), body image is multifaceted construct which, when being disturbed, can lead to the disordered eating. The two main behavioral manifestations of body image disturbance are body checking and body avoidance and, if worsen, are diagnostic indicators for eating disorders. These two parameters, again, coincide with the parameters of OBC: the latter can be related to body surveillance, and the former correlates with appearance-control belief.

Weight stigma is also can be related to self-objectification as it refers to individual's experience of social devaluation due to one's weight (Wellman, Araiza, Newell & McCoy, 2017). It can elicit a fear of fat, which actually reduces the body perception to the percentage of fat in it. As a negatively affecting motivation for the weight loss, fear of fat may lead to eating disorders or to disordered eating, either directly, or through dietary restraint. According to Johnson and Wardle (2005), restraint theory postulates a direct path from dietary intake restrictions to the disordered eating.

Finally, the emotion regulation plays its role in disordered eating. But what is the connection between emotional regulation and social influence? The study reports that there are complex relationships among gender, disordered eating and emotional regulation (Robinson et al., 2014). According to it, women who, as it has been found, are the main group of risk in disordered eating, tend to show more difficulties in emotion regulation skills, such as emotional clarity, ability to use adaptive emotions, ability to engage in goal-directed behaviors. Authors conclude that it is gender which impacts both phenomena. Furthermore, feminine gender role creates a number of stressful situations, such as an obligation to take care of the family no matter if the woman works or not – Livingston and Judge (2008) have studied the gender role in family-work conflict and came to the conclusion that guilt is the outcome for traditionally-oriented women. Piran and Cormier (2005) argue that self-silencing behavior which is demonstrated by women and girls in order to meet female gender expectations lead to eating disorder and externalized self-perception. The mostly articulated analysis on this topic is "Gender Differences in Self-Conscious Emotional Experience" (Else-Quest, Higgins, Allison & Morton, 2012) which suggests that the subset of self-conscious emotions (SCE) motivate one's adherence to social norms and develop in the early childhood. According to this work, feminine gender socialization refers rather to negative SCE, such as guilt, shame, and embarrassment, while male gender experiences more pride. At the same time, SCE is involved in different domains of psychological functioning, including anxiety, disordered eating, and suicidality.

So, we can see that one way or another, self-objectification plays the integrating role in emerging disordered eating as a personal response to gender-oriented social influence.

Limitations, Implications for Further Research, and Existing Solutions for the Disordered Eating

Though the main goal of this work is integrating of the existing knowledge on the topic of the social impact on the disordered eating within female gender construct, it has limitations related to limitations of the female gender itself. Thus, given information could be inaccurate or misleading for peripheral areas of the gender domain and need to be clarified. As for implication for further research, this work may be integrated with disordered eating studies, gender, and feminist studies. Also, the possible solutions of the raised issue can become an object for the further study.

Currently, several directions for the gender-oriented social influenced disordered eating problem are present. They are the dissonance-based approach, body-focused approach, behavioral interventions, and feminist approach.

Dissonance-Based Approach

The dissonance-based approach is represented by the group dissonance-based eating disorder preventing program, named BodyProject in which young women critique thin ideal and social norms related to it (Stice, Rohde, Durant & Shaw, 2012). Studies showed positive outcomes, the program reduces eating disorder symptoms and risk factors, and the trial prototype for the internet-based modification of the program was suggested.

Body-Focused Approach

The body-focused approach is presented by yoga intervention which in its turn was compared to dissonance-based approach (Mitchell et al., 2007). The studies showed that yoga intervention itself has no significant outcomes for disordered eating treatment, but is combined with other approaches or being focused on disordered eating especially, it increases its efficiency.

Cognitive-Behavioral Approach

The main focus of the cognitive-behavioral treatment for the disordered eating is body image disturbance. Typically, the first step is recognizing the overvaluation of the control over shape and weight, with further movement to acceptance- and mindfulness-based approaches regarding one's disordered eating itself (Pellizzer, Tiggermann, Waller & Wade, 2017).

Feminist Approach

Using feminist theory in disordered eating intervention is called to implement the strategies which counteract the gender construct itself or certain gender biases which impact an individual's eating behaviors. Since feminist theories are focused on the specificity of women's experiences within existing sociocultural discourses, it may increase the efficiency of the intervention responding to women's social and personal issues related with disordered eating (Enge, 2013).

Conclusion

In this research, we've identified and described the three types of social influence causing disordered eating in women, establishing the mechanisms of the interaction between gender role, social influences, and personal respond expressed in self-objectification. Although the number of studies on the topic seems to be sufficient, the clarification of the existing links was necessary. The further research can involve both disordered eating behavior and gender studies, while special strategies for treating or preventing of disordered eating in women using the knowledge about the systematic social influence that was obtained in the framework of this research.

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