There has been a veritable explosion of “anti-fat talk” movements in the body image and eating disorder prevention realms over the past few years. Indeed, campaigns like the Tri-Delta Sorority Fat Talk Free week have become relatively well known. Events like the “Southern Smash,” where participants literally smash scales are other iterations of this social phenomenon encouraging a more positive conversation around bodies.
I am, of course, a fan of the idea that we shouldn’t put our bodies down; I’m a huge proponent of the need to avoid putting our own and others’ bodies down. I think that initiatives like Fat Talk Free week are good practice as they help move conversations in more productive directions and help to redirect our focus from bodies as our only source of value.
One of my concerns about these initiatives is that in signing up to do a Fat Talk Free week or smashing a scale, we start to think that we are “doing enough” to prevent eating disorders. Here is where nuance comes in: do I think that these initiatives might be effective in reducing poor body image? Yes, I do. I think that they help people become more comfortable, at least in the short term, with the idea that we can actually value other aspects of ourselves. I’ve written about the difference between being media literate and loving our bodies elsewhere, but in general I am hesitant to be too critical of initiatives that might be experienced as empowering.
However, do I think that these kinds of initiatives are effective in preventing eating disorders? Not really, to be honest. While some people’s eating disorders may have a great deal to do with body image, this is certainly not a universal experience. At the very least, the body image-eating disorder tie-in is more complex than a direct causal link between disliking one’s weight and shape and developing an eating disorder.
Importantly, this link is muddled by a number of other factors, and shaped by personal history (biological and experiential) and social context. So, where I think the danger comes in is that by engaging in these kinds of events, other work around changing the sociocultural conditions that might lead to either actual prevention or early intervention and treatment for eating disorder might get swept under the rug.
All this is to foreground an exploration of a recent study in the International Journal of Eating Disorders in which Sharpe, Naumann, Treasure & Schmidt (2013) explore the link between fat talk and body dissatisfaction. Given that this study was published in an eating disorders specific journal (and that I am now writing about it on an eating disorders blog), I think it is important to note that the authors specifically refer to the links between fat talk and body dissatisfaction, not eating disorders per se- this is another level of linkage.
The authors conducted a systematic review and meta-analysis of studies looking at the links between fat talk and body dissatisfaction. In order for the study to be included, it needed to:
- Be published Jan. 1990-Jan. 2013
- If it was cross-sectional (i.e. participants measured at one point in time), the study needed to measure both fat talking and body dissatisfaction
- If it was prospective (i.e. measuring at a time point and looking for an outcome later), the study needed to measure fat talk at the first point in time and to measure body dissatisfaction at the first time point and at least once in the future
- If it was experimental (i.e. participants were assigned to groups), the study needed to change fat talk exposure and assess body dissatisfaction before and after exposure to the fat talk
They searched databases for “fat talk” (a term coined in 1994 by Nichter & Vuckovic) and “appearance conversations.” From an initial 68 studies, they narrowed their review to 24 studies that fit their criteria. Of these:
- All were published between 2003-2013
- 14 had all female samples
- 8 had mixed gender samples
- 2 had all male samples
- None used random sampling, which the authors note could mean that their results may not be generalizable to the whole population
Measures used to assess fat talk in the 24 studies included:
- The Appearance Conversations with Friends Scale, which asks participants about the frequency and content of their body-talk with peers (13 of 24)
- The Fat Talk Scale, which presents scenarios and asks participants to evaluate how often they encounter these (2 of 24)
- The Fat Talk Questionnaire, which asks participants to rate (on a 5-point scale) how often they engaged in fat talk (1 of 24)
- The Negative Body Talk Scale, which asks participants (on a 7-point scale) how often they say specific fat talk statements (1 of 24)
Measures used to assess body dissatisfaction included:
- The Eating Disorders Inventory Body Dissatisfaction subscale (9 of 24)
- The Body Esteem Scale (7 of 24)
- The Satisfaction and Dissatisfaction with Body Parts Scale (3 of 24)
- The Children’s Figure Rating Scale (2 of 24)
- The Contour Drawing Rating Scale (1 of 24)
THE MAIN FINDINGS
Overall, the authors concluded that there was not a great deal of strong evidence that fat talk leads to increased body dissatisfaction. While some of the long-term studies showed increases in body dissatisfaction, these effects were not pronounced. Where links did exist, they were much stronger among adults than children. As the authors note, this may be because children are less likely to have these kinds of conversations.
This points to an argument that fat talk might percolate in people’s minds for a while before impacting how they feel about their bodies. On the other hands, the authors highlight effects from experimental studies indicating that fat talk could provoke body dissatisfaction right after exposure, presenting conflicting evidence for how long it takes for fat talk to “sink in.”
Interestingly, though Sharpe et al. suggest that there is not strong evidence for causal links between fat talk and body dissatisfaction, they also note that the effect sizes from the studies are actually similar to those of thin-ideal internalization and perceived pressure to be thin on body dissatisfaction (i.e. effect sizes found in Stice et al., 2003). I can’t help but wonder whether fat talk and “perceived pressure to be thin” are really discrete constructs or whether they are actually tied into one another? A rose by any other name…
The authors are appropriately skeptical about the connections between fat talk and body dissatisfaction in the face of somewhat lacking evidence. They also do not try to make any claims that stopping fat talk will actually reduce the incidence of eating disorders.
So, to me, this begs the question: if stopping fat talk is not going to reduce the incidence of eating disorders, why is it such a big focus of prevention efforts?
I’ve discussed my skepticism about eating disorder prevention efforts in previous posts (here and here). At the risk of coming off as a pessimist, I remain unconvinced that our efforts to prevent eating disorders and body dissatisfaction are having much impact. Mostly, as I mentioned earlier in this post, I am concerned that by wrapping up our efforts and money in the kinds of “feel good” initiatives like anti-fat talk and scale smashing, we will feel like we are “doing enough” to prevent eating disorders.
I want to be crystal clear that I do not think these efforts are without value. I absolutely think we need to be doing all this and more to change the conversation around bodies and weight. More than that, I think we need to see more conversations about how to remove the morals and values placed onto different body types, and not just looking for a “new skinny.” We need to advocate for body acceptance, certainly. Whether or not it leads to an eating disorder, body dissatisfaction is neither fun nor without implications for mental and physical well-being.
We also need to engage in meaningful conversations about other factors that might contribute to the development of eating disorders, beyond the proliferation of thin bodies and conversations about bodies. We need to make space for people to express what they personally feel contributed to the development of their distress around food, weight, and shape, whether that is body dissatisfaction or genetic predisposition.
The conversation around fat talk is an interesting one, and one that represents broader social factors: the fact that it is hard to imagine a body that is not scrutinized, the fact that we more easily accept certain bodies (i.e. bodies of a certain race, class, size, and ability) as bodies that “can have eating disorders” and “can recover” (and what recovery looks like and how weight complicates this picture), the fact that weight stigma is so proliferate that it can seem like everyone from your neighbor to your doctor imbues your body with moral characteristics linked to your exterior appearance.
So, what I’m getting at here: working against fat talk is an important enterprise, but it isn’t enough, in my opinion. Where they may be more useful is in helping to combat weight stigma, if done effectively, deeply, and at a systems level.
What do you think, readers?
Sharpe H, Naumann U, Treasure J, & Schmidt U (2013). Is fat talking a causal risk factor for body dissatisfaction? A systematic review and meta-analysis. The International Journal of Eating Disorders, 46 (7), 643-52 PMID: 23818118