Mass Media, Social Networks, and Eating Disorders: Image, Perfection, and Death

Selection of our books indexed in the Book Citation Index in Web of Science™ Core Collection (BKCI) Interested in publishing with us? Contact [email protected] Numbers displayed above are based on latest data collected. For more information visit www.intechopen.com Open access books available Countries delivered to Contributors from top 500 universities International authors and editors Our authors are among the most cited scientists Downloads We are IntechOpen,the world’s leading publisher ofOpen Access booksBuilt by scientists, for scientists 12.2% 183,000 195M TOP 1% 154 6,800 1 Chapter Mass Media, Social Networks, and Eating Disorders: Image, Perfection, and Death Juan José LaboraGonzález Abstract Eating disorders are complex and have multiple causes, which may be genetic, biological, or psychological. Social factors are also relevant. In today’s societies, mass media and social networks play a fundamental role, acting as risk factors for eating disorders. This chapter analyzes the concept of image, differentiating between certain concepts such as reality, perception, and image. Image and self-image are difficult to differentiate and do not always coincide with the body object; one’s self-image may deteriorate to the point that it no longer coincides with the actual body. The mass media may serve as an instrument for the creation of reality. The images of women that are portrayed, especially in the media, tend to be based on sexist stereotypes that saturate social networks, video games, and movies. Currently, pro-ana and pro-mia websites promote identities based on unhealthy diets, exercise, and purgative practices. Therefore, pro-eating disorder socialization exists on Twitter and thinspiration image share is found on Instagram and other social networks. Keywords: eating disorders, mass media, image, social networks, identity 1. Introduction Eating Disorders (hereinafter, ED) are by definition, highly complex entities whose etiology is difficult to explain. Therefore, the explanatory models used to present ED risk factors tend to be based on the following division of these factors: predisposing, precipitating, and perpetuating, based on the 1980s proposal made by Garner and Garfinkel [1]. Certain classifications respond to this model. For example, see [2–4]. Therefore, explanations should be multi-causal and multidimensional [5, 6]. Dr. Toro [4], Spanish specialist on ED, defends the idea that the major dilemma refers to the importance of genetic factors as opposed to environmental ones. While some studies have demonstrated the importance of genetic factors, the importance of psycho-social factors cannot be underestimated. In fact, the influence of genetics tends to be attributed to a range of 40–60% [7]. Thus, rates of inheritance-based transmission are between 40 and 88% for anorexia, between 28 and 83% for bulimia, and between 40 and 82% for binge eating disorder (BED) [8]. More recently, the heritability of eating disorders such as anorexia nervosa and bulimia nervosa has Eating – Pathology and Causes 2 been quantified at between 22 and 62% [9]. However, if reviewing certain studies performed from a gender perspective, it may be concluded that “In girls, the four variables demonstrate a heritability component of 37.7% for ineffectiveness, 42.8% for perfectionism, 56.9% for the drive for thinness and 65.5% for body dissatisfaction. In boys, genetic influence is discarded for body dissatisfaction, which is influenced exclusively by environmental factors. The other variables demonstrate an inheritance component, although to a lesser degree than in girls [9].” As mentioned previously, the explanatory models for ED risk factors are multidimensional. In these models, having threefold classifications (predisposing, precipitating, and perpetuating), predisposing factors are those that most clearly respond to the definition of risk, since they appear before the illness presents itself. They correspond to situations, characteristics, etc., which, individually or collectively, make it more likely for the illness to appear. Precipitating factors arise in situations that serve as the spark igniting the flame of the illness. Finally, perpetuating factors are those which, once the individual has the ED, facilitate its presence and prevent improvement or recovery. In these explanatory models, individual factors may be distinguished: genetic factors, ways of thinking (temperament, perfectionist, and obsessive cognitive style), ways of feeling such as personality, low self-esteem, level of insecurity, the use of avoidance, the use of food as a compensation element, extreme emotional reactions in the face of real threats, and negative emotions. To this, eating habits must be added, as well as diets, excessive physical activity, and the body dissatisfaction felt by the individual. Finally, distinct forms of acting are signaled such as motivation for acting on feelings of lack of worth, the need for approval, and behavioral alterations. Likewise, family factors are proposed, such as a history of mental illness, family environments with high pressure on body image, and family functioning [3]. Individual factors complement other social ones such as the ideal model of thinness, thinness as a social status symbol, the influence of the mass media, social networks, peer groups (difficulties establishing or maintaining social relationships, past history of harassment, bullying, etc.), the reification of the image of the woman, and belonging to certain professional groups: gymnasts, dancers, athletes, models, or similar, the presence of certain environmental stressors (academic, work, or personal problems). In summary, the following may be stated: Scientific evidence supports an interactive model of bio-psycho-social influences on the etiology of eating disorders (ED). Novel studies on the association of the complete genome suggest a metabolic dysregulation base in anorexia nervosa. Of the psychological factors, body dissatisfaction (BD) may be considered the most consistent predictor in females. Low self-esteem, negative affect, and interiorizing of the ideal thinness determine BD. Certain personality traits and other individual factors such as a high body mass index, emotional problems, and certain metabolic and digestive illnesses, social factors such as sporting or professional activities focused on body shape pressure, family environment characteristics, and social or peer group pressure to be thin, mediated by the use or abuse of social networks, act as determinants of the risk of ED [10]. This chapter analyzes the etiology of ED from a social perspective focusing specifically on the concept of image. We will begin by establishing some conceptual clarifications regarding reality, perception, and image. Then, we will consider the 3 Mass Media, Social Networks, and Eating Disorders: Image, Perfection, and Death DOI: http://dx.doi.org/10.5772/intechopen.1002270 influence of the mass media on our image of ourselves and of others since the mass media may assume an instrumental role in the creation of reality [11]. And finally, we will briefly analyze the role of social networks in the increase in the prevalence of ED, which has taken place over recent years. 2. Perception, image, and reality The concept of body image is ever-changing and highly complex. First, there is our body (body object). To this, we must add our self-perception of the same (bodysubject). That said, it is also necessary to establish certain distinctions: first, the body object does not necessarily have to coincide with an individual’s perception of the same. In addition, self-perception is influenced by the symbolic universe: social imaginaries, the esthetic canon, etc., that is, by abstract social influences. To this, we must add the fact that the body and the image are influenced by social relations and exchanges established by each person. Moreover, position, role, and social status may influence the body and the images of the same that are created by the individual. Some studies, for example, have concluded that professionals relate a thin body image to an individual’s social success [12]. And finally, perception would have its own individual dimension, in which self-esteem, attitudes, beliefs, opinions, prejudices, and other personal characteristics all play a role. From a psychological perspective, Raich defined body image as “the representation of the body constructed by the individual in his/her mind [13].” This, however, is an overly simplified definition. It may be more appropriate to consider the limits of this concept mentioned by Rodríguez Testal and Senín when they stated that “Body image is a complex mental representation (with its neural correlate and organization) that is multi-faceted, stable, and constantly being updated with regard to our body and emotional experience [14].” However, this definition can also be considered overly individualistic and focused on the “I,” putting aside the social condition of being human. The body, as the social sciences have noted, is a biological structure in which social discourse is materialized, thus the need to understand that, from a social perspective, it is made up of social imaginaries [15–17]. In this sense, the body incarnates subjectivity. It is the site of the presence and articulation of practices (social, cultural, and bodily) and of hegemonic social representations that generate the imaginaries of distinct societies [18], so that, ultimately, the body is the source of identity. In general, four components of body image may be distinguished (see Table 1). Research assumes a level of dissatisfaction with body image that approaches 50% [19–21] and considers that most women are unsatisfied with their bodies at some time [22]. This level of dissatisfaction is so high that Rodin, Silberstein, and Striegel-Moore established the normative discontent category [23]. In other words, a subclinical phenomenon has been distinguished, and therefore, a nonpathological one, in which the general situation of the population coincides with dissatisfaction with one’s own body. In other words, it is normal to dislike one’s body. Furthermore, some studies have affirmed that in the 6 months prior to the study, 31.06% of the sample recognized the practice of at-risk eating behavior, while 35.23% recognized having engaged in two at-risk eating behaviors, and 6.82% admitted to having engaged in 3 or 4 at-risk eating behaviors [19]. The media, especially television and social networks, have been identified as sociocultural risk factors, especially through the influence exerted by advertising [24]. Moreover, reviews of existing research on beauty stereotypes and their influence Eating – Pathology and Causes 4 on the development of ED have concluded that 90% of the documents reviewed hold the media responsible for creating and influencing the esthetic canon and 85% of all adolescents aspire to resemble the socially established beauty prototype in order to be socially accepted [25]. If we introduce the gender perspective in our analysis, for women, dissatisfaction is more focused on weight and results in attempts to reduce it, either by not eating or by using purgative techniques. In the case of men, however, dissatisfaction focuses more on body shape and contour (image) as opposed to weight. Measures would be taken by men, such as excessive physical exercise, attempting to increase muscle mass using steroids (although without losing the slenderness of the figure), and preferring practices such as vomiting over the use of laxatives or diuretics [14]. In Spain, a study conducted by the Ministry of Health, Social Services, and Equality [26] concluded that almost 16% of all adolescents, regardless of their sex, are on some type of diet. And of the other surveyed individuals who are not on a diet, 21% believed that, despite their inaction, they need to lose weight. 3. Image, time, and space: the case of the sexes Regarding the image, it should be noted that the prototypical image over time does not coincide for men and women. Vernant [27] described how in Greece, the structuring of the image of men and women was influenced by mythology and led to the linking of women to the domestic space, reserving the public space of the agora and the polis for men. The French author interprets a sculptural work by Pausanias in which the Greek sculptor associated the gods in pairs, uniting Hestia and Hermes (two gods who were not originally united in the traditional Greek pantheon). This association is attributed to the fact that Hestia represents the goddess of the home and, by association, the immobile, to Perceptive Affective Cognitive Behavioral It ranges from the biological substrate that permits perception, the orientation established by the social imaginary to the esthetic canon. All of the dimensions are important since research has shown that from the time of birth, blind individuals have a lower level of dissatisfaction regarding their image, and fewer symptoms related to their eating behavior [19]. Body image is closely linked to emotions. For example, in the case of women with ED, after eating certain foods, specific thoughts regarding their weight or figure and emotions (shame, disgust, feeling fat, etc.) immediately appeared [20]. In the case of men, concern over image appears to be linked to sedentary habits, concern over body muscle, and the effort made to lose weight [21]. In psychology, the notion of schema is used as a mediator. It may be defined as “assumptions or beliefs about the importance and influence of bodily appearance [14]”. They are made up of incorrect or biased information that reactively activates in response to external influences. All behavior conducted by an individual influences their body image. Source: Adapted from: RodríguezTestal JF, Senín MC. Introducción. In: RodríguezTestal JF, editor. Alteraciones de la imagen corporal. Madrid: Síntesis; 2013, p. 17–56. Table 1. Components of body image. 5 Mass Media, Social Networks, and Eating Disorders: Image, Perfection, and Death DOI: http://dx.doi.org/10.5772/intechopen.1002270 that which does not change. Hermes, on the other hand, is the protector god of travelers, representative of what changes quickly, of the unstable, the god of the outdoors. Women would be linked to the inside of homes, remaining immobile and not changing over time. Men would be linked to the outside of the house, to the public space, and even to political areas of representation and defense of their own rights and those of others. This connection of women to the private space and men to the public one has become one of the main battle horses of feminism today. Galán pointed out that in studies conducted in the field of advertising [women] continue to be represented by the same topics and stereotypes that are often associated with the areas of emotions, passivity, maternity, and sexuality, in private or intimate settings such as the home, while men are overwhelmingly granted attributes such as reasoning, leadership, and action, normally placing them in the public spheres [28]. Miguel Requena [29], analyzing this text by Vernant, argues that a dichotomous model of meanings was established for women, with the corresponding transgressions. The author extends the argument even further, indicating that the panoply of meanings is completed by assigning the characteristic of passivity to the female sex, and the characteristic of activity to the male sex (See Table 2). Thus, activity and passivity are essential elements of sexual differentiation, even more so than sexual orientation. In Greece, homosexual men who assumed passive roles, as well as homosexual women who assumed active roles, were censored, since they defied the fundamental structure of gender identity at the time. In any case, this type of analysis of female prototypes based on canons such as Virgin, Whore, Mother, etc., extends across all current literature analyzing the image of women, for example, see [30–32]. In this sense, some research on the female image in movies and video games has concluded that prototypical patterns linking women to passivity continue to be used (see Table 3). Galán, in his research on two fictional Spanish television series, concluded that the female image presented tends to correspond to a Spanish woman between the ages of 25 and 50. He suggested that these roles may be attributed to having an obsession with beauty [28]. All this leads to the objectification of the feminine image. Seven distinct means of objectifying people have been distinguished [32]: • Instrumentality: treating others as objects, tools for our service. • Denial of autonomy: treating others as being incapable, lacking autonomy and self-determination. Positive models Negative models Virgin: immutability Whore: mobility in space Mother: stability on the space/time axis Sterile woman: mobility in time Source: Adapted from: Requena M. De Hestia to Claudia Shiffer. La mujer inmóvil. In: Alba E, Ginés B, PérezOchando L, editors. De-construyendo identidades. La imagen de la mujer desde la modernidad. Valencia: University of Valencia; 2016. p. 75–92. Table 2. Models of meaning assigned to the woman in classic Greece. Eating – Pathology and Causes 6 • Inert being: treating others as being incapable of exercising motivation and, at times, also activity. • Fungibility: treating others as being interchangeable with other objects, whether they are the same or another type. • Violability: treating others as something that can be torn, broken, or violated. • Property: treating others as something that is possessed by another; and something that can be bought, sold, etc. • Denial of subjectivity: treating others as something whose experience and feelings (should they exist), need not be considered. The objectification of the woman may influence the type of image constructed for the other-masculine that looks at her [33]. It is an image that takes on the condition of dependency and de-substantiation, which goes on to be assumed by the one-masculine. Based on this starting point, we ask ourselves how image is created from a social perspective. In this sense, two of the main instruments for building social images through imaginaries are the mass media and the social networks; the last two sections of this work will be devoted to them. 4. The influence of the mass media A sequence of images has been established to represent the evolution of the feminine esthetic canon over distinct historical moments. The journey begins with the Venus of Willendorf, goes on to the Venus de Milo, the Portland Vase, the Primavera by Botticelli, Bathsheba at Her Bath by Rembrandt, and finally, the Naked Maja by Goya. Stereotype Description The “damsel in the refrigerator” The woman is the eternal victim of the killer, and given that she was not protected, the male bears the burden of her vengeance on his shoulders, being interpreted as an active hero-avenger of his lover. The “euthanized damsel” In this case, the woman not only dies, but she does so at the hands of her partner and for his benefit. Thus, there is a justification for violence against one’s own partner. The “damsel in distress” The woman unable to take care of herself, requiring help due to harassment from certain circumstances or people from whom she cannot escape. Of course, all of this suggests that a man should appear who will take on the role of the girl’s savior-asset. Source: Adapted from: Tur D. La evolución de la imagen de la mujer en los videojuegos. In: Alba E, Ginés B, PérezOchando L, editors. De-construyendo identidades. La imagen de la mujer desde la modernidad. Valencia: University of Valencia; 2016. p. 301–320. Table 3. Stereotypes of the female image in video games and films. 7 Mass Media, Social Networks, and Eating Disorders: Image, Perfection, and Death DOI: http://dx.doi.org/10.5772/intechopen.1002270 Unfortunately, this analysis has not been continued to the present day. However, there is the well-known example of the Barbie doll, a clear exponent of the present-day esthetic canon. The impossibility of her body shape is well known. If the Barbie doll were a real-life person, her measurements (in centimeters) would be: 100-45-80, with a height of 2 meters and a size 34 shoe; clearly, “these measurements are incompatible with real life [34]”. What is the effect of these canons to which we are all exposed? Over the years, a series of sociological theories have been developed to explain the influence of the mass media (see Table 4). All of the research conducted thus far agrees that the current beauty canon is a factor playing a very relevant role in image. This canon is linked to extreme thinness, and, from a very young age, it is internalized by women. In fact, research has suggested that this internalization may occur at only 3 years of age [38]. This internalization initiates the activation of a comparison mechanism, which, in turn, may lead to dissatisfaction with one’s body. In any case, the beauty canon is very important and receives extensive social reinforcement [39], to the point that adolescents may design their body image based on the media, overvaluing their appearance [40]. Moreover, research has also noted that the media presents a distorted female body [35] with all that this may mean, given the ongoing bombarding of images in today’s hyperconnected and information-saturated society. It may be concluded that “Mass media are an extremely important source, if not the principal source, of information, and reinforcement in relation to the nature of the thin beauty ideal, its importance, and how to attain it [36].” Furthermore, the influence of the media is not the same across the population, with some sectors being more vulnerable to this type of influence. For example, young girls with poor social support are more vulnerable to this type of influence [37, 41]. On the other hand, ethnicity appears to be a protective factor against the risk of dissatisfaction with one’s own image, and of potentially developing an ED [36]. In other words, Afro-American women tend to display a higher degree of satisfaction with their bodies, as compared to Caucasian women. Studies reveal, Theories Description Theory of Cultivation [35] The use of media cultivates a view of reality that is distinct from that of the real world and that associates meanings to thinness such as success, whereby unrealistic models are accepted as real body models without criticism Theory of Objectification [36] Women are socialized to be considered as objects, viewed by others. The primary definition of the woman is that of a body-object. The media are the main vehicle for the transmission of this objectification Theory of Internalization [37] The media presents the ideal body standard to be achieved and transmits the message that it is important to achieve it Source: Adapted from: Calado M, Lameiras M. Alteraciones de la imagen corporal, la alimentación y el peso: ¿Son los medios de comunicación tan influyentes? Valencia: Tirant Humanidades; 2014. Table 4. Explanatory sociological theories on the influence of the media on changes in image and eating behavior. Eating – Pathology and Causes 8 however, that with the acculturation of the Latin, Afro-American, and Asian populations in Western culture’s white canon of beauty, levels of dissatisfaction have begun to rise [42]. As for men, the influence is based on satisfaction with one’s own body, self-esteem regarding it, the possibility of increasing the risk of developing certain disorders such as depression, and the development of certain behaviors such as excessive exercise patterns. In males, the influence of the media is more pronounced in the university population as compared to the adolescent collective. It may be speculated that slightly older boys are more frequently exposed to the media than younger ones or than boys who have yet to reach puberty, which some research has cited as a biological factor that harms the influence of the media. The displayed image does not need to be especially muscular for the comparison process to begin. And this may stimulate negative emotions and dissatisfaction with one’s image [43]. Moreover, in the case of men, health, and esthetic ideals are more distanced than in females. This may function as a protective factor against ED. This should not suggest that few men suffer from body dissatisfaction, as this is the case for an especially high number of homosexual and single men. However, this perception appears to be determined not so much by an esthetic ideal, but rather, by the need to adjust to biological norms that sustain health, in a strictly biological sense [44]. A series of factors increasing the media’s influence on ED has been determined: • The media is the tool that allows the beauty ideal to be transmitted to people “Not only do the media glorify a slender ideal, they also emphasize its importance, and the importance of appearances in general [45]”. • Media exposure appears to increase the typical symptoms of ED, making it one of many risk factors for developing an eating disorder [36, 41, 46]. • The media are instruments that facilitate the so-called normative discontent [47]. • The media would also work not only as a risk factor for suffering some ED but also as a factor that maintains the disorder [48]. At this point, we ask, what view of ED is portrayed in the media? The following aspects may be highlighted [49]: • Articles related to ED tend to appear in the culture and entertainment sections. In this research, 48% of the articles appeared in the mentioned section. • 95% of the articles referred to cases of women having some type of ED. And when men appeared, it was presented such that the ED developed in response to certain events, such as drug dependence or sexual abuse. • 94% of the individual cases presented referred to Caucasians. • When discussing casual factors, only one tends to be cited. The most frequently mentioned factors are parental influence, verbal abuse, sexual abuse, and emotional distress persisting for an extended period of time. • Only 21% of the articles discuss treatments. And when they do, simplified solutions are presented. In fact, only 8% of the articles discussed medical treatment or psychological therapy. Mass Media, Social Networks, and Eating Disorders: Image, Perfection, and Death DOI: http://dx.doi.org/10.5772/intechopen.1002270 15 Author details Juan José LaboraGonzález University of Santiago de Compostela, SantiagodeCompostela, Spain *Address all correspondence to: [email protected] © 2023 The Author(s). Licensee IntechOpen. This chapter is distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Eating – Pathology and Causes 16 References [1] Garner DM, Garfinkel DE. Handbook of Psychotherapy for Anorexia Nervosa and Bulimia. New York: Guilford Press; 1984 [2] Baños RM, Miragall M. Los trastornos alimentarios y sus causas. In: Martínez Martín, MA, director. Todo sobre los Trastornos de la Conducta Alimentaria. Tarragona: Altaria; 2015. pp. 51-96 [3] La JI. imagen de una sociedad enferma: anorexia, bulimia, atracones y obesidad. Barcelona: Grafema; 2006 [4] Toro J. Riesgo y causas de la anorexia nerviosa. Barcelona: Ariel; 2004 [5] Cervera M. Riesgo y prevención de la anorexia y la bulimia. Madrid: Pirámide; 2007 [6] Garfinkel PE, Garner DM. Anorexia Nervosa a multidimensional perspective. New York: Brunner/Mazel Publishers; 1982 [7] Trace SE, Baker JH, Peñas-Lledó E, Bulik CM. The genetics of eating disorders. Annual Review of Clinical Psychology. 2013;9:589-620. DOI:10.1146/annurev-clinpsy050212-185546 [8] Mercader JM, Ribasés M, Gratacòs JR, Bayés M, de Cid R, Badía A. Altered brain-derived neutrophic factor blood levels and gene variability are associated with anorexia and bulimia. Genes, Brain and Behavior. 2007;6(8):706-716. DOI:10.1111/j.1601-183x.2007.00301x [9] Rojo-Moreno L, Iranzo-Tatay C, Gimeno-Clemente N, Barberá-Fons MA, Rojo-Bofill LM, Livianos-Aldana L. Influencias genéticas y ambientales en rasgos psicológicos y actitudes alimentarias en una población escolar española. Revista de Psiquiatría y Salud Mental. 2017;10(3):134-142. DOI:10.1016/j.rpsm.2015.05.003. p. 134 [10] Canals J, ArijaVals V. Factores de riesgo y estrategias de prevención de los trastornos de la conducta alimentaria. Nutrición Hospitalaria. 2022;39(2):16-26. DOI:10.20960/NH.04174. p. 16 [11] La LN. realidad de los medios de masas. Barcelona: Anthropos; 2000 [12] LaboraGonzález JJ. A evolución da percepción social dos trastornos da conduta alimentaria dos profesionais da saúde en Galicia [thesis]. Santiago de Compostela: University of Santiago de Compostela; 2018 [13] Raich RM. Imagen corporal. Conocer y valorar el propio cuerpo. Madrid: Pirámide; 2000. p. 23 [14] RodríguezTestal JF,Senín MC. Introducción. In: Rodríguez Testal JF, editor. Alteraciones de la imagen corporal. Madrid: Síntesis; 2013. pp. 17-56. p. 18 [15] LaboraGonzález JJ. El cuerpo y los trastornos de la conducta alimentaria: los imaginarios sociales del cuerpo de los profesionales de la salud. Sociología y tecnociencia. 2018;8/2:112-130. DOI:10.24197/st.2.2018.112-130 [16] Le Breton D. La sociología del cuerpo. Madrid: Siruela; 2018 [17] Moraña M. Pensar el cuerpo. Historia, materialidad y símbolo. Barcelona: Herder; 2021 [18] Suárez, Alcántara MC. Belleza y salud en espacios pro Ana y pro Mía. Mass Media, Social Networks, and Eating Disorders: Image, Perfection, and Death DOI: http://dx.doi.org/10.5772/intechopen.1002270 17 Anorexia y Bulimia en la Web. In: Sánchez Neira MA, Oyosa Romero A, Álvarez Corona LG, editors. Miradas convergentes frente a cuerpos disidentes. Politics & Social Sciences Kindel eBooks; 2018. pp. 2-29 [19] Berengüí R, Castejón MA, Torregrosa MS. Body dissatisfaction, risk behaviors eating disorders in university students. Revista Mexicana de Trastornos Alimentarios. 2016;7:1-8. DOI:10.1016/j. rmta.2016.02.004 [20] Cash TF. A “negative body image”: Evaluating epidemiological evidence. In: Cash TF, Pruzinsky B, editors. Body Image: A Handbook of Theory, Research, and Clinical Practice. New York: Guildford Press; 2002. pp. 269-276 [21] Tiggermann M. Sociocultural perspectives on human appearance. In: Cash TF, Slomak L, editors. Body Image: A Handbook of Science, Practice, and Prevention. 2nd ed. New York: Guildford Press; 2011. pp. 12-19 [22] Infante Faura JR, Ramírez Luna CM. Uso de Facebook y la autopercepción de la imagen corporal en mujeres. Avances en Psicología. 2017;252:209-222. DOI:10.33539/avpsicol.2017.v25n2.356 [23] Rodin MP,Silberstein L, Striegel-Moore RH. Women and weight: A normative discontent. In: Sonderegger TB, editor. Nebraska Simposium on Motivation 1984. Lincoln: University of Nebraska Press; 1984. pp. 267-307 [24] García Ruiz LJ, González Romero Y. Los factores psicosociales de la anorexia y la bulimia en adolescentes [thesis]. Medellín: Universidad Cooperativa de Colombia; 2019 [25] Gualdron Castañeda TL. Anorexia y bulimia asociada a estereotipos de belleza en mujeres adolescents de 13 a 17 años de edad [thesis]. Medellín: Universidad Cooperativa de Colombia; 2020 [26] Ministerio de Sanidad. Servicios Sociales e Igualdad. Los adolescentes españoles: estilos de vida, salud, ajuste psicológico y relaciones en contextos de desarrollo. 2017. Available from: https:// n9.cl/zsjy8 [27] Vernant JP. Mito y pensamiento en la Grecia Antigua. 2nd ed. Barcelona: Ariel; 1985 [28] La GE. imagen social de la mujer en las series de ficción. Cáceres: Instituto de la mujer; 2007. p. 15 [29] Requena, M. De, Hestia a Claudia Shiffer. La mujer inmóvil. In: Alba, E, Ginés, B, Pérez Ochando, L, editors. De-construyendo identidades. La imagen de la mujer desde la modernidad. Valencia: Universitat de València; 2016. pp. 75-92 [30] Hepworth J. The Social Construction of Anorexia Nervosa. London: Sage; 1999 [31] Ussher J. Women’s madness. In: Misogyny or Mental Illness. London: Harvester Wheatsheaf; 1991 [32] Nussbaum MC. Objectification. Philosophy & Public Affairs. 1995;24(4):249-291 [33] Gil Calvo E. Medias miradas. Un análisis cultural de la imagen femenina. Barcelona: Anagrama; 2000 [34] Raich RM, Sánchez Carracedo D, López GG. Alimentación, modelo estético femenino y medios de comunicación. 2nd ed. Barcelona: Ministerio de Educación y Ciencia/Universitat Autónoma de Barcelona; 2008. p. 38 [35] Seva Ruiz M, Casadó Marín LC. La construcción de la identidad e imagen Eating – Pathology and Causes 18 corporal en la adolescencia a través de los medios de comunicación social: estrategias para el Desarrollo de un modelo de prevención. Revista Científica del Colegio Oficial de Enfermería de Valencia. 2015;108:68-73 [36] Lopez Guimerá G, Levine MP, Sánchez-Carracedo D, Fauquet J. Influence of mass media on body image and eating disordered attitudes and behaviors in females: A review of effects and processes. Media Psychology. 2010;13:387416. DOI:10.1080/15213269.2010.525737. p. 406 [37] Helgeson VS. The Psychology of Gender. 3rd ed. Upper Saddle River: Pearson Prentice Hall; 2009 [38] Dittmar H, Halliwell E, Ive S. Does Barbie make girls want to be thin? The effect of experimental exposure to images of dolls on the body image of 5 to 8-year-old girl. Developmental Psychology. 2006;42:283-292. DOI:10.1037/0012-1649.42.2.283 [39] Jiménez-Rodríguez D. La anorexia nerviosa y los medios de comunicación. Paraninfo digital. 2007:1 [40] Lozano Sánchez ZB. La familia y las redes sociales en los trastornos alimenticios en adolescents de la época moderna contemporánea. In: Crescendo. 2012;3(2):299-301. DOI:10.21895/ incres.2012.v3n2.11 [41] Stice E. Risk and maintenance factors for eating pathology: A meta-analytic review. Psychological Bulletin. 2002;128(5):825-848. DOI:10.1037/0033-2909.128.5.825 [42] Perloff RM. Social media effects on young Women’s body image concerns: Theoretical perspectives and an agenda for research. Sex Roles. 2014;71:363-377. DOI:10.1007/SL11199-014-0384-6 [43] Barlett CP, Vowels CL, Saucier DA. Meta-analyses of the effects of media images on men’s body-image concerns. Journal of Social and Clinical Psychology. 2008;37(3):279-310. DOI:10.1521/ jscp.2008.27.3.279 [44] Morgan JF, Arcelus J. Body image in gay straight men: A qualitative study. European Eating Disorders. 2009;17:435443. DOI:10.1002/ERV.955 [45] Spetiggue W, Henderson KA. Eating disorders and the role of the media. The Canadian child and adolescent psychiatry. Review. 2004;13(1):16-19. p.16 [46] Calado M, Lameiras M. Alteraciones de la imagen corporal, la alimentación y el peso ¿Son los medios de comunicación tan influyentes? Valencia: Tirant Humanidades; 2014. p. 80 [47] Groesz LM, Levine MP, Murnen SK. The effect of experimental presentation of thin media images on body satisfaction: A meta-analytic review. International Journal of Eating Disorders. 2002;31:1-16. DOI:10.1002/eat.10005 [48] Williams MS, Thomsen SR, McCoy JK. Looking for an accurate mirror: A model for the relationship between media use and anorexia. Eating Behaviors. 2003;4:127-134. DOI:10.51302/tce.2003.743 [49] O'Hara SK, Clegg K. Presentation of eating disorders in the news media: What are the implications for patient diagnosis and treatment. Patient Education and Counselling. 2007;68:43-51. DOI:10.1016/J.PEC.2007.04.006. p. 49 [50] Traversa O. Cuerpos de papel. In: Figuraciones del cuerpo en la prensa 1918-1940. Barcelona: Gedisa; 1997. p.252 [51] Montesinos A. La mujer en el ciberespacio. In: Alba E, Ginés B, Pérez Mass Media, Social Networks, and Eating Disorders: Image, Perfection, and Death DOI: http://dx.doi.org/10.5772/intechopen.1002270 19 Ochando L, editors. Dec-construyendo identidades. Valencia: University of Valencia; 2016. pp. 329-336 [52] Lafuente MB. La anorexia en blogs: para un cambio de perspectiva de las autoridades sanitarias y de la opinion pública [grade thesis]. Zaragoza: University of Zaragoza; 2012 [53] Deiana F. Nadie dijo que fuera fácil ser una princesa: una etnografía virtual de las webs Pro Ana. Revista de Antropología Iberoamericana. 2011;62:215-252 [54] Benavides A, Cuevas DD. Estilos de vida en un grupo de personas participantes en una página virtual. Psycología avances de la disciplina. 2008;2(2):193-209 [55] Suárez, Alcántara MC. Belleza y salud en espacio pro Ana y pro Mia. Anorexia y Bulimia en la Web. In: Sánchez Neira MA, Oyosa Romero A, Álvarez Corona LG, editors. Miradas convergentes frente a cuerpos disidentes. Politics & Social Sciences Kindle eBooks; 2018. pp. 2-29 [56] Levine MP, Chapman K. Media influences on body image. In: Cash TF, Slomak L, editors. Body Image: A Handbook of Science, Practice, and Prevention. 2nd ed. New York: Guilford Press; 2012. pp. 101-109 [57] Fox N, Ward K. Health identities: From expert patient to resisting consumer. Health. 2006;10(4):461-479. DOI:10.1177/1363459306067314. p. 471 [58] Behar R. La construcción cultural del cuerpo: El paradigma de los trastornos de la conducta alimentaria. Revista Chilena de Neuro-Psiquiatría. 2010;48(4):319-334 [59] Wilson J, Peebles R, Hardy K, Mulvihill L, Kretzschman A, Litt I. Pro-eating disorder website usage and health outcomes in an eating disordered population. In: Pediatric Societies Academic’s Annual Meeting. Washington; 2005 [60] Arseniev-Koehler A, Lee H, McCormick T, Moreno MA. #Proana: Pro-eating disorder socialization on twitter. Journal of Adolescent Health. 2016;58:659-664. DOI:10.1016/ jadohealth.2016.02.012 [61] Olivier Toledo C, Zúñiga Martínez VS. De hombres y mujeres a príncipes y princesas: la idea de la naturaleza de la belleza en las páginas virtuales pro-ana y pro-mia. Revista Electrónica de Psicología Iztacala. 2021;24(4):1369-1396 [62] Agència de Qualitat d’Internet/ Asociación contra la Anorexia y la Bulimia. Las páginas “ProAna” y “ProMia” inundan la red. Asociación contr la Anorexia y la Bulimia. pp. 1-13. Available from: chrome-extension:// efaidnbmnnnibpcajpcglclefindmkaj/ http://www.f-ima.org/fitxer/382/ resumen_informe_anorexia_y_bulimia_ en_internet.pdf [63] Las redes sociales fomentan en la sombra la anorexia y la bulimia [Internet]. 2016. Available from: https://www.uoc.edu/portal/es/news/ actualitat/2016/233-anorexia-bulimia. html [64] Vásquez B. Medios de comunicación y el desarrollo de la anorexia en los adolescents [grade thesis]. Quetzaltenango: University Rafael Landivar; 2013 [65] Lladó G, González-Soltero R, Blanco MJ. Anorexia y bulimia nerviosas: diffusion virtual de la enfermedad como estilo de vida. Nutrición Hospitalaria. 2017;343:693-701 Eating – Pathology and Causes 20 [66] Stein DJ, Naslund JA, Bantjes J. The hidden burden of eating disorders during COVID-19 pandemic. The Lancet Psychiatry. 2022;9:9-11 [67] Vindegaard N, Benros ME. COVID-19 pandemic and mental health consequences: Systematic review of the current evidence. Brain, Behavior, and Immunity. 2020;89:531-542. DOI:10.1016/j.bbi.2020.05.048 [68] Taquet M, Geddes JR, Luciano S, Harrison PJ. Incidence and outcomes of eating disorders during COVID19 pandemic. The British Journal of Psychiatry. 2021;220(5):1-3. DOI:10.1192/bjp.2021.105 [69] Huete Cordova MA. Trastorno de la conducta alimentaria durante la pandemia del SARS-CoV-2. Revista Neuropsiquiatría. 2022;85(1):66-71. DOI:10.20453/rnp.v85il.4156. p. 70 [70] Villardel Saz Bedmar M, Baile Ayensa JI. La incluencia de las redes sociales como factor de riesgo en el Desarrollo de la anorexia y la bulimia nerviosas durante la adolescencia. Tecnología, Ciencia y Educación. 2023;24:141-168. DOI:10.51302/ tce.2023.743. p. 141