Trigger warning: This article explains some specific behaviours associated with eating disorders that some people may find distressing. If you or someone you know is struggling with an eating disorder, please visit the Beat charity website for support.
Eating disorders are a complex and sensitive issue. With a compassionate and empathetic approach, journalists can help the public understand the problem and discover the channels that offer support to those who need it.
However, reporting on this issue involves potentially vulnerable case studies and their loved ones, and it can trigger readers and viewers with eating disorders.
Approximately 1.25 million people in the UK have an eating disorder, according to Beat, the UK eating disorders charity.
What is an eating disorder?
There are five main types of eating disorders, according to the NHS. Before reporting on the subject, make sure you are clued up with all the terminology.
- Anorexia nervosa (commonly known just as anorexia): trying to control your weight by not eating enough food, exercising too much, or doing both.
- Bulimia: losing control over how much a person eats and then taking drastic action to not put on weight.
- Binge eating disorder (BED): eating large portions of food until a person feels uncomfortably full.
- Avoidant/restrictive food intake disorder (ARFID): when someone avoids certain foods, limits how much they eat or does both, possibly because of smell, past experiences (like choking or sick), or simple disinterest in eating or lack of hunger.
- Other specified feeding or eating disorder (OSFED): if a person does not exhibit the expected symptoms for any specific eating disorder.
Beat provides a comprehensive set of guidelines for journalists who are reporting on this issue.
The guidance was first published 10 years ago and is still used today. It stresses not to depict people at their lowest weight because this can encourage others to try and reach that weight themselves.
Dr Kate Herbert, a clinical psychologist with more than 12 years of experience in an NHS Eating Disorder service, echoes this point.
"It can impact on people comparing their body to the one in the image: that they are not 'thin enough' or that they need to 'try harder'," she says.
This could equally apply to people at their highest weight too, so try to use more generic photos in either case. Choice of image matters because it distorts public perception of the complexity of eating disorders, according to Tom Quinn, Beat's director of external affairs.
"Imagery can lead to quite unhelpful stereotypes about eating disorders, in terms of people's perceptions about what someone with an eating disorder looks like. The majority of people who have an eating disorder don't lose weight."
In fact, anorexia only accounts for 8 per cent of eating disorder cases. That is almost three times less than binge eating disorders (22 per cent), which has the opposite effect.
"Blanket rule: no numbers," says Harriet Clifford, a journalist who has written about her own experiences with an eating disorder. It is not just photos that can encourage unhealthy eating behaviour but also specifying weight or daily calorie count. That goes for both losing and putting on weight.
"The numbers are just not necessary because people will cling on to them and remember them. You might read one article and remember it for years," she says.
This applies especially to the peaks and troughs of their weight, as it can inadvertently create targets for people to reach.
"It implies that someone who has lost X amount of weight or is X BMI is much more ill than someone who hasn't, when it's not necessarily the case," says Clifford.
Case study advice
Telling a powerful story will often involve the voice of those who were affected and working with charities can be a great way to access these case studies.
However, when seeking out a case study yourself, Quinn encourages journalists to contact recovered individuals rather than those still contending with their eating disorder.
"I think those case studies will be able to speak very openly and honestly about challenges they've faced," he explains.
"One way you can really powerfully tell the story, without triggering content, is to ask about the thoughts and feelings that people [once] had.
"Ask them about the isolation they felt, the feelings of low self-worth. That helps the public understand the seriousness of the illness, without using information that can be triggering."
This is pulled into focus by the recent death of celebrity Nikki Grahame, 38, who battled with anorexia. Celebrities are humans too, and they have loved ones who will be affected by careless reporting. In fact, given their visibility, Quinn said journalists must be especially careful not to cause more damage.
"For example, if it's a story about a celebrity who people admire and they're talking about their eating disorder, and perhaps referencing specific weights or specific calories, unfortunately for people who are in the grips of their eating disorder, that could be an even greater incentive and encouragement than if it was another member of the public."
Dr Herbert believes that representation is also an important issue when it comes to eating disorders, adding that the stereotype is that eating disorders exist in one group: white, young women.
“Eating disorders do come in different shapes and sizes, people of different colours, genders, sexual orientations, ages, cultural and class backgrounds," she explains.
Media coverage has a big influence on societal stigmas and who comes forward for support, Herbert adds. She challenges journalists to find a diversity of case studies.
How the media can help
Beat outlines how the media can play a positive role in the reporting of eating disorders: by raising awareness of the issue, calling for better treatment and promoting a message of hope rather than of despair.
Dr Herbert says that ultimately, journalists should focus on the impact of the eating disorder as a whole.
"Eating disorders are complex and multifaceted. Being able to report on the psychological and physical consequences that it has had on a person's life could support a better understanding of the far-reaching impact way beyond calories consumed or what 'before and after' photos can convey," she concludes.
- Media guidelines (Beat)
- Media guidelines (The National Eating Disorders Association)
- IJNet responsible media coverage of eating disorders