The document discusses using films about eating disorders in education and training. It notes that many studies have found links between media exposure and the development of eating disorders. Films can offer realistic depictions of eating disorders and the surrounding personal and family dynamics. Several films are described that portray characters struggling with anorexia, bulimia, and the impacts on their lives. The document argues that while not made for education, these films can be used to raise awareness, encourage discussion, and show patients they are not alone in their experience.

1. Using films about Eating Disorders (ED)
in education and training
Dr Yasir Hameed (MRCPsych)
Specialist Registrar
Norfolk and Suffolk NHS Trust

2.  There is strong tendency to blame the media for causing and
maintaining our patients’ eating disorders (Spettigue,
Henderson 2004)
 The majority of studies have demonstrated a direct
relationship 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)

3.  Studies even demonstrated that the media may have
an indirect effect on females’ body image through its
influence on boys’ expectations of females’
appearance (Hargreaves & Tiggemann, 2003).

4.  Women with anorexia nervosa engage in heavy media
use and describe their consumption of fashion
magazines as an “addiction,” with many saying that
their greatest media dependency occurred after their
eating disorders had begun to take control of their
lives (Thomsen et al., 2001).

5.  Every year, the average adolescent sees over 5,000 advertisements
mentioning attractiveness.
 Various surveys showed that majority of female respondents felt
that women in movies and television programmes made them feel
insecure about their bodies.
 The rate of eating disorders in Fiji surged following the introduction
of Western television programming (Becker et al. BJPsych. 2002)
 Actresses Cameron Diaz, Julia Roberts and the singer Diana Ross
meet the BMI criteria for anorexia.
 http://www.raderprograms.com/causes-statistics/media-eating-disorders.html

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

7.  Media literacy training involves teaching people to
think critically about different forms of the media,
increasing awareness of media use, and analysing the
content and intentions of the media producers.

8.  Through media literacy, adolescent girls learn how to
decode and discuss the visual images and the
messages in the media; they learn that all media
images are constructed, that what they see is not
necessarily reality, and that all media creations
represent a point of view (Steiner-Adair & Vorenberg,
1999)

9.  Films can offer realistic depictions of character styles and
psychopathologic disorders, as well as personal and family
dynamics, with subtexts alluding to the prevailing social norms.
 An advantage of using films for teaching is that they are well
produced, interesting and lively, and there are no concerns over
confidentiality.
 Characters experience their symptoms in the context of their
lives, not in an isolated clinical encounter.
Bughra D. Teaching psychiatry through cinema. Psychiatric Bulletin (2003) 27: 429-430

11.  Psychological thriller film directed by Darren
Aronofsky and starring Natalie Portman,
Vincent Cassel, and Mila Kunis.
 The plot revolves around a production of
Tchaikovsky's Swan Lake ballet by
a prestigious New York City company.
 Natalie Portman plays the innocent
and fragile ballerina (Nina) who is
struggling to achieve the expectations
of her mother the Director of the show.
Black Swan (2010)

13.  A documentary from Channel 4 following the journey
towards recovery of an 8 year old Dana and her stay
at a specialist unit (Rhodes Farm) in North London.
 Useful for CAMHS
professionals and
patients.
Dana (2007)

15.  Documentary film directed by Lauren Greenfield and is an
exploration of The Renfrew Centre; a 40-bed residential facility for
the treatment of women with eating disorders.
 The film mostly revolves around four
women with anorexia nervosa
and/or bulimia and their struggles
for recovery.
 Living at the centre for six months,
Greenfield and director of photography
Amanda Micheli received unrestricted
access
Thin (2006)

17.  A documentary focusing on the role that family issues
play in the life of four teens suffering from
eating disorders and the pressures exerted
on them to live up to what they perceive
as the high expectations of their family.
 “There was very good explanations of how
the family structure can affect a person
going through such a disorder and how they
can help the individual get well”
Patient’s review on Amazon.com
Perfect Illusions: Eating Disorders
and the Family (2003)

19.  In this TV drama from NBC, Kimberly McCullough
stars as a young aspiring dancer whose life is
threatened by anorexia.
 The film shows the impact of eating disorder on the
person’s relationships, health and work.
 The end is a happy one, which gives optimism
and hope of recovery to the viewers .
Dying to Dance (2001)

21.  Television drama film about a teenage girl's struggle with
bulimia and its effect on her parents and friends.
 Teenager Beth Moss (Alison Lohman) has an apparently
good life academically and as a ballerina,
however, she feels she is not living up to the
expectations and is not in control of her life.
 She turns to binging and purging
as a means to gain control over at
least one aspect of her life.
Sharing the Secret (2000)

23.  Television drama about the singer Karen Carpenter
and her struggle with eating disorder, which
eventually took over her career and ended her life at
the age of 32 due to heart failure.
 Her death lead to lasting media
attention to eating disorders and
number of celebrities later on went
public about their own struggle with
these disorders.
The Karen Carpenter Story (1989)

25. o Most films are not made for educational purposes but for
entertainment. However, they influence the public and can be
used to educate and raise awareness about various mental
health problems, including eating disorders.
o Using films in patients education and training of health care
professionals is encouraged by many authors.
o Inviting patients and their carers to watch these films can be
very helpful to encourage discussions about the patients’ own
experiences and how they relate to others with similar stories.

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

27. Any comments?