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Eating Drinking, Overthinking: The Toxic Triangle of Food, Alcohol, and Depression -- and How Women Can Break Free Excerpt from Eating Drinking, Overthinking: The Toxic Triangle of Food, Alcohol, and Depression -- and How Women Can Break Free

by Susan Nolen-Hoeksema

Beauty Queens and Other Dangerous Ideas

Our icons of beauty -- the models in glossy magazines, the stars on TV and in the movies, the singing sensations -- are getting skinnier and skinnier. Indeed, when researchers tracked the average weight of Playboy centerfolds and Miss Americas over the last forty years, they found that the average weight of these women has become much less; by today's standards, these women weigh about 20 percent less than what would be expected for a woman of their height. The average model in a fashion magazine these days is pencil-thin, with a figure that is physically unattainable by the majority of adult women.

Pressure to be thin doesn't come only from the media and from marketers of Barbie dolls. Women also exert these pressures on one another. We judge women who are thin as more feminine and attractive than those who are heavier, and we judge women who dare to eat as much food as they want in public settings (such as in a dormitory cafeteria) as less attractive than those who eat less. Women pick up on these cues and change their behaviors to conform to social expectations. For example, women eat less in situations where they want to appear desirable and feminine, or in situations in which they want to show superiority over or compete with other women. Just think back for a moment to college or high school, when girls would sit around the cafeteria, watching what each other was eating. Being thin is difficult, however, in our high-fat, fast-food culture. And so girls and women seldom feel they are thin enough, and want to lose more weight.

A Psychological Corset

Can the social pressures toward thinness really lead to symptoms of the toxic triangle in girls and women? Many studies have been done to examine this question, and the answer seems to be yes. Adolescent girls and women who are exposed to persistent messages that they are not thin enough are, not surprisingly, less satisfied with their own appearance. They are also more likely to follow highly restrictive diets, including unhealthy diets. For example, they may restrict themselves to nothing but green salads (no dressing) and herbal tea. It's nearly impossible for people to stay on such restrictive diets, however, and women who feel pressured to be thin are actually more likely to lapse into binge eating. Then they may use purging (vomiting, laxatives, and exercise) to try to lose the weight gained from their binges.

Women who feel pressured to be thin also experience more sadness and symptoms of depression. This sadness and sense of defeat seems to be tied to their dissatisfaction with how their bodies look, as well as to the hopelessness they feel that they will ever be thin enough. Being thin is such a core component of women's and girls' self-esteem these days that failure to achieve this goal can lead to self-loathing and depression.

Even brief exposure to our social icons of beauty is enough to put some women on the road to the toxic triangle. For example, in a study, researchers showed one group of young women images from fashion magazines of ultra-thin models, while another group of young women saw images from nature magazines. Both groups of women saw these images for only three minutes. Those women who saw the ultra-thin models experienced increases in depression, shame, guilt, stress, insecurity, and body dissatisfaction, while those who saw the images from the nature magazines did not. In addition, women who saw the ultra-thin models and who had already subscribed to the thin ideal for women, showed increases in symptoms of bulimia. If just three minutes of exposure to fashion models can have such effects, think what the constant exposure young women experience does to their self-image and well-being!

Another study looked at what chronic exposure to the thin ideal in fashion magazines does to adolescent girls' mental health. Researchers randomly gave one group of girls, ages thirteen to seventeen, a 15-month subscription to a leading fashion magazine and the other group none. They found that girls who already felt pressured to be thin and who were dissatisfied with their bodies became more depressed over time if they had been given the subscription to the fashion magazine. In addition, girls who had little social support from family members and friends became more dissatisfied with their bodies, dieted more, and showed more bulimic symptoms if they were given the fashion magazine subscription.

Adolescent girls and women can, to some extent, avoid pressures to be thin by avoiding these fashion magazines and other media depictions of the thin ideal. We can't completely avoid our friends, however, and it is sometimes they who are the worst carriers of the thin-ideal message. In another clever study, researchers asked young women students to talk to a young woman whom they thought was just another student but who was actually a confederate or an accomplice in the study. The accomplice was a thin, attractive nineteen-year-old woman, 5 foot 10 inches tall, who weighed 127 pounds. First, both the participant in the study and the accomplice watched a neutral film about a seascape, supposedly so they could rate the film. After the film, the accomplice launched into a pre-scripted conversation with the participant. In the pressure condition, the accomplice complained about how dissatisfied she was with her weight and discussed the extreme exercise routine and restrictive diet she was using to reduce. In the neutral condition, the accomplice talked about classes she was currently taking and her plans for the weekend. A researcher then entered the room and asked both women to fill out questionnaires about how they felt about their bodies. The participants in the pressure condition became significantly more dissatisfied with their own bodies after talking with the thin accomplice about her own weight concerns. In contrast, the women in the neutral condition did not become more dissatisfied with their bodies after talking with the accomplice about matters unrelated to weight or dieting.

Again, this research shows how much power the messages we get from others about our bodies can hold over us. If just a few minutes of talking with a complete stranger can lead women to become more dissatisfied with their bodies, think what hearing these messages from an admired peer can do a young woman's self-perception!

Copyright 2005 Susan Nolen-Hoeksema