Given the popularity of my post on how the media portrays eating disorders, I thought I’d do a follow-up entry by looking at more recent and comprehensive study on the topic. Specifically, I am going to review Shepherd & Seale’s 2010 paper, which built on the findings of O’Hara & Clegg-Smith, with a UK-focus. In particular, they: (1) compared UK and US media reporting of EDs, (2) tracked changes of in ED coverage over a 17-year period, and (3) studied the differences between newspapers with different target audiences.
Shepherd & Seale reiterate much of what O’Hara & Clegg-Smith wrote: ED specialists and researchers understand that EDs are complex, multi-factorial diseases with complex genetic and environmental underpinnings, that they are often associated with many medical complications and that they are hard to treat. The public, however, largely puts the blame on the patient and/or their parents, viewing it as a “moral failing… underestimating the severity and ease of recovery”, and viewing it as a largely young white female disease. (Unfortunately, some clinicians have this view of EDs as well).
O’Hara and Clegg-Smith (2007) studied 210 articles appearing in seven US newspapers between October 2004 and October 2005, largely focusing on stories containing personal proﬁles of individuals affected by anorexia or bulimia. These EDs were portrayed as arising from the struggle of individuals with the stress and low self-esteem caused by family dynamics and negative parental inﬂuence. Genetic or biological causation was mentioned in just two stories which did not link these to personal proﬁles. Proﬁles were largely of celebrities in the entertainment industry and younger white women. Clinical complications and medical treatments were rarely mentioned, recovery being shown as the outcome of willpower or chance event.
Essentially, Shepherd & Seale repeated the methodology of O’Hara & Clegg-Smith but studying UK newspapers (7 newspapers, same one-year period, same keyword searches, etc..). They picked Times, Telegraph, Independent, Guardian, the Sun and Mirror, and the Daily Mail. For the analysis of time trends, they looked at articles from the Times, Independent, Guardian and the Daily Mail from 1992 to 2008 (the others weren’t available for the entire duration), tracking changes in four-year time blocks and using the same keywords to search for articles. Finally, they analysed articles from 2001 – 2008 from the same newspapers mentioned above, except the Daily Mail (not sure why), and compared the reporting in “serious” versus “popular” newspapers.
Highlights & Summary of Main Findings:
UK vs. US
- similar demographic profiles (age, race, gender)
- genetic and biological causes are NOT MENTIONED at all in the 100 US articles analysed but mentioned in 8/141 UK articles
- clinical complications are 4 TIMES more likely to be mentioned in UK vs. US news
- treatment is 2 TIMES more likely to be reported in UK vs. US news
- recovery is MUCH LESS discussed in UK vs. US news
- Overall, UK coverage is less optimistic and contains more medical information
- summary ofthe evolution of ED reporting by keyword analysis reveals
- a growth of internet-related terms
- increased use of medical terminology (BMI, CBT)
POPULAR vs. SERIOUS
- “gene*” and “research”, as well as fashion industry/regulation and internet words (“pro-ana/mia”), were significantly more common in the serious press
- unexpectedly: words describing clinical complications and hospital-related words were more common in the popular press
- no differences were found in words describing etiology (causes) not related to genetics/biology (“abuse”, “parental”, “pressure”, “self-esteem”, etc..) or in treatment key words (“CBT”, “clinic”, etc..)
The findings highlighting the differences between US and UK media in reporting on eating disorders are really interesting. I didn’t expect to see such differences. But I wonder if that’s the result of the newspapers the authors chose to analyze: O’Hara & Clegg-Smith picked 2 national and 5 regional papers, whereas Shepherd & Seale picked 4 “serious” and 3 “popular” papers. I can’t comment on how comparable these newspapers are, because I really only read the NYTimes on a regular basis and don’t live in the US or the United Kingdom.
Does any one have any thoughts on this? Do you think the discrepancy in the findings could be the result of the newspapers they picked or insufficient sample size?
More interesting, however, is the finding that the “popular” articles mention clinical complications and hospital-related key words more often than “serious” articles. This finding, which was contrary to the authors’ hypothesis, prompted them to dig deeper:
The UK newspaper scene is markedly driven by a popular or ‘tabloid’ agenda (McLachlan & Golding, 2000), where personal proﬁles are an important vehicle for news reporters. To increase emotional impact, harrowing stories with often lurid accounts of clinical complications and hospital admissions are published. Thus the popular press is more likely to carry such information, contrasting with the expectation that the serious press might present more medical details of EDs.
Serious UK newspapers have traditionally been the platform for political news, science stories and issues affecting public health (see, for example, Seale, Boden, Lowe, Steinberg, & Williams, 2007), with the popular press predominantly reporting stories about sex and scandal. Some of our ﬁndings support this view, with serious newspapers focusing more on stories about research and genetic causation of EDs.
The authors also caution against: “the view that a populist agenda undermines the capacity of newspapers to present medical information, as the popular press in the UK is the vehicle for considerable emphasis on the serious nature of EDs, and on their status as diseases deserving medical attention.”
I don’t think a lot of these findings are specific to eating disorders. For example, with regard to the discrepancy between US and UK reporting on treatment outcomes, the authors note that:
UK coverage is more pessimistic than US coverage about the prospects of recovery from EDs, a ﬁnding consistent with the reporting of cancer experience in North American newspapers, where stories of bravery, recovery and survivorship predominate (Seale, 2002).
I’d love to hear your thoughts on the discrepancies between US and UK news articles on eating disorders. Do you think this is just sample bias or insufficient sample size, or do journalists and media outlets in these countries fundamentally approach reporting on eating disorders, and other health issues, in a different way? If you live(d) in the US or the UK, I would especially love to hear your thoughts. In general, I’m curious about the experiences of people who have lived in several countries for an extended period of time. If you have, did you notice any differences in how the media approaches (mental) health issues?
Shepherd, E., & Seale, C. (2010). Eating disorders in the media: The changing nature of UK newspaper reports European Eating Disorders Review, 18 (6), 486-495 DOI: 10.1002/erv.1006