Frozen dinners prevent eating disorders?

A recent magazine ad stopped me in my tracks. This ad didn't have over-sexualized images of women, or any anorexic-looking models. This ad--for Stouffer's frozen meals--had an average teenage girl just sort of sitting there. It was the copy that got me thinking. Some pictures of the ad: The photos aren't the best quality, so the top image says "Can you give your daughter a better body image by setting the table?" The bottom image says "Studies show that teen girls who have family dinner 5 times a week are 33% less likely to develop eating disorders. " that's why I have an eating disorder! My mom never served Stouffer's!

I got thinking about the ad a little more, and everything that it implied. My first step was to look up the study itself, which was published in January 2008 in the Archives of Pediatric and Adolescent Medicine under the title "Family Meals and Disordered Eating in Adolescents." The study, led by Dianne Neumark-Sztainer at the University of Minnesota, found that regular family meals (5 or more per week) were associated with a one-third reduction in extreme disordered eating behaviors five years later, even when sociodemographic characteristics, body mass index, family connectedness, parental encouragement to diet, and extreme weight control behaviors (at the time of the first survey) were accounted for. Neumark-Sztainer divided disordered eating behavior into two groups--extreme and less extreme--and defined them as follows:

Disordered eating behaviors assessed included unhealthy weight control behaviors (extreme and less extreme), binge eating with loss of control, and chronic dieting. Unhealthy weight control behaviors during the past year were assessed with the question "Have you done any of the following things in order to lose weight or keep from gaining weight during the past year?" (yes/no for each method). Responses classified as extreme weight control behaviors included (1) took diet pills, (2) made myself vomit, (3) used laxatives, and (4) used diuretics. Responses classified as unhealthy (less extreme) weight control behaviors included (1) fasted, (2) ate very little food, (3) used food substitute (powder/special drink), (4) skipped meals, and (5) smoked more cigarettes.
Several questions I had that weren't addressed in the paper: although the study factored in disordered eating behaviors at the time of the first survey, I didn't see any relationship mentioned between disordered eating behaviors at the second survey and rates of family meals. My thought is this: the period of adolescence which the study was examining is marked by an increase in disordered eating behaviors. Which is why they chose to study teens of this age in the first place. But if teens developed disordered eating between the first and the second survey, could that have resulted in a decrease in family meals at time two (because the teen is avoiding eating)? Avoidance of meals is so common in people with both disordered eating and eating disorders that I have to wonder if the connection could run both ways. Also, mealtimes may be more chaotic in families with a genetic predisposition to eating disorders and/or disordered eating (although I'm not sure that anyone has measured that).

The interesting differences (however quibbling they might seem to be) between the ad copy were that a) the study never measured body image at all and b) the study assessed disordered eating behaviors, not clinical eating disorders. The first difference just seems like sloppy research to me: no one bothered to read the full study completely. The second difference I find rather telling, because of how we tend to conflate disordered eating and eating disorders. There is probably some overlap, I'm sure, and I'm not saying that chronic dieting isn't problematic. It is. But it's different than an eating disorder. Just like dangerous binge drinking is different than alcoholism (though some binge drinkers may abuse alcohol), and measuring sad/bad moods is different than depression (most people who are depressed are in a bad mood, but if a bad mood meant depression, then humanity would be well and truly f*cked).

I'm going to be the last person to say that family meals aren't good and important- I'm guessing they were a factor as to why I didn't develop a full-blown eating disorder until I went to college. And family meals--a return to the more social aspects of sitting down with friends and family and just enjoying food--have been a major part of my healing. Disordered eating in adolescents is absurdly common, and any effort that helps prevent that is, in my mind, fantastic.

At the same time, this study isn't a "Get Out of Jail Free" card for people who do eat family meals. I know lots of people with EDs who did eat family meals, and they got eating disorders all the same. Nor is it a reason to blame yourself if you didn't eat regular meals (or didn't eat Stouffer's!) with your children and then they developed an eating disorder.

This post isn't ultimately intended to be a critique of the Neumark-Sztainer study, but rather a breakdown of what the ad actually said and what the study actually found. Still, the fact that a frozen dinner ad used this study in their ad copy rather intrigued me--I've never seen an our-product-prevents-eating-disorders ad before!


Charlie said...

There's no way that's true. I had dinners with my family all through my childhood. It didn't prevent shit. Actually, it usually encouraged my BED.

Cathy (UK) said...

Much of Neumark-Sztainer's research focuses on relations between obesity and EDs, as well as disordered eating and EDs - with the objective of aiming to prevent both obesity and EDs.

Like you Carrie, I agree that disordered eating is NOT the same as a clinical ED. In fact, what is 'normal' eating?

The main thing I dislike about the advert is the axiomatic connection between body image and EDs.... In other words EDs are caused by body dissatisfaction; something I disagree with.

mariposai said...

It's interesting how data gets distorted more and more each time it changes hands. The conflict that centred around family meal times for me I believe laid the foundations for my eating disorder. Maybe family meals might help some, but they certainly didn't help me.

marcella said...

An example of lies damn lies and the distortion and abuse of statistics? I would also comment that the decrease in family meals at time two could have been because the parent is told to avoid conflict and therefore stops pressing a reluctant teen to join the table. My only interest in the product is what do they taste like? As a poor cook I'm all for anything that puts a tasty meal on the table with ease, but most such products aren't that good.

Katie said...

I had perfectly calm, enjoyable dinners with my family as a child, and still developed an eating disorder at 13. I didn't eat with my family nearly as often afterwards and now, even though I still live at home, I only eat with others on special occasions like Christmas. Mostly now it's just that we have different schedules, but it used to be because I was avoiding eating with other people. When I was younger meal times weren't stressful at all, they only became so after I developed an eating disorder. I know this debate runs both ways - there used to be a theory that stressful meal times could trigger a vulnerable person to associate eating with anxiety and thus become anorexic, but that certainly wasn't the case for me either. I suppose this advert is more or less a positive thing, because encouraging families to spend more time together is good, but I have the same bones to pick as everyone else I think! The media do like to apply a liberal interpretation to research results ;)

Coco said...

family meals don't always equal stress-free meals. my family of 4 had family meals almost every day growing up (and we still do), but that also led to family dinner-table arguments. i once had a serving spoon of spinach thrown at me as a child when my mother went into a rage. so, "family dinner" doesn't mean we're all sitting down like a 1950's sitcom..

Cammy said...

Kind of funny, I think packaged foods such as frozen meals have facilitated my eating disorder at times, because it's all labeled and packaged and measured, no guesswork about calories and portions are automatically limited.

After I developed my eating disorder at age 13, I never ate dinner with the family except for special occasions. Prior to that, family dinners were routine. So maybe I'm in the 67% that wouldn't have benefited from Stouffer's family time, or maybe if my family hadn't given in so much to my ED tantrums and made me eat with them it would have turned out differently, similar to the point that Marcella made. Lots of maybes. Although I have to say, even if the Stouffer's ad may be misguided in some ways, it is good to see more ED awareness out there.

Anonymous said...

First off, Marcella, I find the Stouffers stuffed bell peppers to be tasty.
For me, family dinners did not help, my family put me on my first diet in 4th grade. Most nights I had a choice of one of 2 flavors at the time available of Lean Cuisine - also put out by Stouffer's, but not as tasty. There were a lot of apples involved as well. As a teen, I mostly foraged for myself & actually ate more healthy. I didn't have what could be classified as an ED until my 20s, then I got better, then it came back post partum with a vengeance. That's just personal & anecdotal, and it's just me saying that family dinners aren't what their cracked up to be.
I do like the idea that ads are trying to prevent rather than encourage EDs, but they are ads, which means there is nothing behind them other than the desire to move product, there is no concern for anything else on their part, & they will distort facts to their advantage.
I do eat dinner with my daughter at the table, & we use that time to talk, & I hope that she will be less likely to develop an ED, but what makes an ED for each individual is always different, so at some point I know I have to leave her body up to her. Parents are already blamed for everything - hell, I just blamed my parents for my ED, but the fact is, they were only trying to help & do their best & I love & appreciate them. They were never mean about it, & the things that made up my individual ED weren't all about having been a chubby little kid.
Oh, and the Stouffer's lasagna is tasty as well.

ex ana said...

I full agree with your comments about the Neumark-Sztainer's research.
Looking at BLS data (link below)I suspect that disordered eating exists in adolescents and also in other age groups. Only about one hour spent per day/person (mean)in eating and drinking activities seems real short time! (the survey only as for drinking and eating as first activity).

sunshine said...

What the hek...I've eaten meals with my family my whole life and still have an eating disorder...where is this study coming from?! Plus since when was skipping meals and fasting not extreme behaviour? Surely it depends how often and for how long. Interesting post :)

Kim said...

Ya, this is a bit of a stretch. My family did dinner together EVERY night when I was growing up. My anorexic tendencies developed when we were still eating nightly dinners, at the end of my senior year of high school. I would just restrict during the day, mostly. It is true that by the time I was on my own in college, I had free rein to self-destruct, so I'm sure the family structure is preventative to a certain extent. But, I think I would have developed anorexia even if I lived at home forever.

Adrianna said...

There are families that don't ever sit down to dinner, but find other ways to connect with each other. It's the connection, not the literal act of sharing a meal at the table, that matters. And I know more than a few truly twisted familes that had regular meals. I think they were trying to deny their problems and look good to others by looking like a painting by Norm Rockwell.

A possible interpretation is that chaotic family situations make family meals less likely, and the emotional stress of chaotic family situations exacerbate (but not cause)disordered eating.

Of course, this could just be another way to blame Mommy and Daddy. So I, too, am skeptical.

For the record, I hate family meals and always have. I am a high-end introvert and social situations are incredibly draining for me. So family meals, if I had an ED, would really screw me over.

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I'm a science writer, a jewelry design artist, a bookworm, a complete geek, and mom to a wonderful kitty. I am also recovering from a decade-plus battle with anorexia nervosa. I believe that complete recovery is possible, and that the first step along that path is full nutrition.

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