For many college students, the ever-present pressure to be thin has trumped the goal of being healthy. Females face body-image issues throughout their lifespan. Our society glorifies thinness. Starting as early as mid-to-late childhood, girls are vulnerable to the psychological effects of pervasive images of thin females shown in the media. Their vulnerability increases as they hit adolescence and start to develop their identity. Stresses associated with the college years make young adults especially vulnerable to eating disorders.
Through the health courses we teach, my colleagues and I at Monmouth University in New Jersey became aware that an alarming number of students were struggling with body-image dissatisfaction (BID) and a range of disordered eating and exercise behaviors. According to the National Eating Disorders Association (NEDA), 20 million women and 10 million men in the United States have eating disorders, and millions more struggle with BID. Among experts, the general consensus is that BID is a leading antecedent to eating disorders in women.
NEDA’s Collegiate Survey Project “Eating Disorders on the College Campus: A National Survey of Programs and Resources” asked campus service providers what they’re doing to address eating disorder-related problems and how they assist students who have them. The survey found that the prevalence of eating disorders among college students continues to rise, indicating the need for more resources for mental health treatment as well as early detection, prevention, screening, and education.
Fat talk takes a toll
It’s almost normal to hear college-age women complain about their bodies, demean themselves, talk negatively about others, and compliment females exclusively on how thin they are. Research on BID is increasing, and speaking negatively about one’s own body now has a scientific name in the literature—fat talk. Fat talk includes fat-related comments in everyday conversation, such as, “I’m so fat,” and “She shouldn’t be wearing that,” and “Do I look fat in this?” Even statements that seem positive (“You look great. Have you lost weight?”) serve to reinforce the thin ideal. In a culture that associates happiness and attractiveness with thinness, many women become obsessed with their bodies and strive for this thin ideal. Their quest compromises their physical, mental, and emotional health.
Fat-Talk Free campaign
One of the most significant findings from a 2012 study is that women who don’t engage in fat talk and who reject the idea of having a perfect body are less likely to develop eating disorders. The Fat-Talk Free campaign is based partly on this research.
Fat-Talk Free Week is a national campaign held on college campuses around the country in mid-to-late October to raise awareness about the damaging impact of body-image issues on women. For the last 2 years, my colleagues and I have collaborated to ignite a campus-wide change in the conversation—specifically to get women to stop talking about the way we look and focus on our health, not our weight or size. The collaborative campaign has grown to include other faculty, staff, and student groups, with the goal of promoting a more positive body image for women. It’s now supported by strong undergraduate and graduate-student involvement, as well as the health education and nursing honor societies. At Monmouth, the campaign has interdepartmental support from Gender Studies, the Residential Life Program, Student Activities, and the departments of Counseling and Psychological Services and History and Anthropology. Additionally, Communications, the Art Department, Instructional Technology, and Athletics support or sponsor campaign events. (See “Fat-Talk Free” events at Monmouth University.)
Students are promoting the Fat-Talk Free Week campaign and raising awareness on bulletin boards around campus and through the Residential Life Program, the campus radio station, campus newspaper editorials, and distribution of promotional T-shirts. Among the most thought-provoking interventions is an anonymous blog that highlights troubling trends among women on campus, including faculty, staff, and students. Here’s one narrative on the blog:
“I truly feel that this campaign to end fat talk is an incredible way to let individuals know you are so much more than your body… thoughts like this have been in my mind since the time I could walk…I know I have placed on myself unreachable goals of…perfection. When in reality who really wants to be perfect?…Everyone, including myself, is so obsessed with the idea of the perfect size…this obsession almost cost me my life. Throughout high school, I was in and out of hospitals, treatments centers, and therapists’ offices. The physical and mental pain that I put myself through will haunt me forever. Being able to take part in this kind of campaign not only allows me to help others and give back, but also allows me to stay in check and remember how far I have come in my own recovery and that the constant obsessions that are in my mind every day about being too fat or not being pretty enough are never going to go away unless I challenge them and end this talk once and for all.”
The Fat-Talk Free Week campaign can be implemented in diverse settings and tailored to available resources. The largest costs associated with the Monmouth campaign are visiting lecturer fees and T-shirts. The rest of the events are supported or sponsored by various departments. Coordinating, organizing, promoting, and implementing the events can be time-consuming.
After the first year of the campaign, we discovered some members of our community were offended by the title “Fat-Talk Free Week.” Although “fat talk” is used in the literature and on other college campuses, we changed the name of the campaign to “Change the Conversation” for the second year.
Raising awareness among health professionals about the severity of BID and eating and exercise disorders is critical. Because nurses work in diverse settings and specialty areas, we can be influential in helping females across many segments of society deal with body-image issues. The “Change the Conversation” campaign can be adapted easily by school nurses and other nurses who provide care for girls and women. As educators and nurses, we can change the conversation—and it’s critical that we do so.
National Eating Disorders Association. Eating disorders on the college campus: a national survey of programs and resources. February 2013. www.nationaleatingdisorders.org/sites/default/files/CollegeSurvey/CollegiateSurveyProject.pdf. Accessed July 16, 2014.
National Eating Disorders Association. Collegiate survey project. 2013. www.nationaleatingdisorders.org/CollegiateSurveyProject. Accessed July 16, 2014.
Salk R, Engeln-Maddox R. Fat talk among college women is both contagious and harmful. Sex Roles. 2012:66(9-10):636-45.
Salk RH, Engeln-Maddox, R. “If you’re fat, then I’m humongous!” Frequency, content, and impact of fat talk among college women. Psychol Women Q. 2011;35(1):18-28.
Andrea Hope is an assistant professor in the Department of Health and Physical Education, Marjorie K. Unterberg School of Nursing and Health Studies, at Monmouth University in West Long Branch, New Jersey.