1. EDs are on the rise for the same reason that depression and anxiety are on the rise. Society continually becomes more fast-paced and competitive, and people are responding to that.

2. Soda is liquid shit in a can. Who cares what shape the can is. Pepsi is retarded for trying to make their liquid shit look sleek and attractive.

3. Prediction: Soon we will see pictures of idiot skinny girls wearing supersized sunglasses carrying around skinny cans of soda with their teenyweeny dogs in their hugeass purses. Probably because they're being paid by Pepsi.

I guess my feelings about this are as they have always been:

We/society/researchers/professionals/activists who wish to prevent EDs are focusing on the wrong things if we spend (actually waste...) time, effort and money on criticising the shape of Pepsi cans (BTW I actually like the new shape...), banning skinny models, banning Photoshop and comparable computer programmes, banning anything in the environment that might be misconstrued as promoting thinness. These are the reasons why:

1. We know that individuals who are susceptible to AN and BN have a particular cognitive style (comparable to that of ASD), a tendency to worry excessively and to develop OCD and phobias. Their attention to detail can be applied to body shape as well as calorie counting.

2. Most people with AN develop an aversion to skinny images AFTER they have become sick. These images can be triggering, but they didn't cause the ED.

3. Anxiety and depression often pre-date the onset of AN, such that the AN feels to become a solution to other problems in the person's life.

4. Many (most?) teens and women dislike their body shape, yet most do NOT develop EDs. There is little correlation between body dissatisfaction and the risk of developing either AN or BN.

The focus on cultural stuff detracts from the seriousness of EDs as real illnesses that require medical intervention. The more that professionals (et al.) harp on about the 'dangers' of skinny this, that, the-other in our society, the more likely that healthcare funders will say "change society - because this is a cultural problem not an illness".

We need to focus instead on the biological basis of EDs, and on prevention + early intervention.

I have come to realise that if I want to say something original in response to one of your posts, I've got to get here before Cathy does ;) she always says what I'm thinking. I personally think that it would be great if the fashion industry stopped using ladies who looked like coat hangers because it is more or less impossible to naturally have a BMI that low, and so the poor things must be suffering. But as you said, even if the media and fashion industry did suddenly change, something else would become the new raison d'être of anorexics everywhere. Religion used to be a common reason given for starving oneself - has anyone made the connection that people with eating disorders have started to obsess about thinness specifically as religion has become less important in society? The disorder didn't change, just the interpretation. There will always be something, because the disorder would exist regardless of the state of society, and people will always impose some sort of interpretation on that.

But of course I'm preaching (ranting) to the choir, I know you guys agree with me ;) I just wish I could get journalists and health professionals to understand this too.

You are right Katie, Cathy has already made the point so well. You have added a very useful point too.

To me, it matters a LOT that people don't waste time obsessing over the link between media images and eating disorders, partly because there isn't a clear one, and partly because that risks failing to notice and thus to intervene early with all those who develop eating disorders with no prior interest in media/fashion/shape.

Media literacy, campaigning against exploitation of vulnerable individuals, starving the diet industry of all publicity and money are all important things in their own right, but often they don't have a lot to do with eating disorders and people, especially those whose jobs give them responsibilities and opportunities for early detection and intervention with these potentially deadly illnesses (educators and medics) need to know that.

By the way, I also agree with you Cathy, the new can looks quite nice and would probably stack quite well on a corner shop shelf. I may buy one or two, although as I can't tell the difference between Pepsi and Coca-Cola and will probably drink it dressed in mumsy clothes from Asda or the charity shop, either in an office tucked away from anyone else or in a car that looks like a flying tip I don't think I'm the market Pepsi are looking for.

well, I'm probably going to be saying what I always do, too. I hate the can and what it stands for. not because I think it 'causes' eating disorders, but it's a clear symptom of the fixation with thinness in society which I believe probably does cause disordered eating. I don't think it has to be as simple as 'skinny can' -> 'disordered eating' -> ED. sure the can alone is fairly pointless and annoying and can't be said to 'cause' anything. but it can contribute to and be a symbol of the kind of pervasive thin-worshipping atmosphere which is so damaging to people all round the world. and sure, plenty of people with EDs never had body image issues or disordered eating, but I do think it's almost certain that SOME take this route into their illness. and even if we can't establish a direct flawless cause and effect, the media is still distasteful and it still sucks.

The media does suck, I don't think anyone disputes that. I do think some people get into eating disorders in this way - peer pressure/media influence could trigger a person to diet, and if that person has the necessary biological predisposition they may well develop an eating disorder, just as accidental weight loss through stress or illness could trigger the same end result. But what gets me and others annoyed is that this idea gets mixed up and generalised, so the upshot is that the general public believe that eating disorders are a simple over reaction to the media emphasis on thinness. This makes sufferers seem like shallow, selfish, rather stupid people, which of course is not true. No one is suggesting that body dysmorphia is not to be taken seriously as a symptom, just that it should be treated as part of a complex puzzle rather than being the main focus in discussions of cause and prevention.

^^ hey I don't disagree, I'm just putting forward a slightly different view otherwise all of Carrie's comments are the same! diversity is the spice of life ;)

I read your thoughts Katie :D. I also agree that some very thin models' health must be suffering.

I think we need to 'get real' about business, society and the economy... Let's face it, businesses advertise to sell products. If they didn't sell they'd collapse, and many people would lose their jobs. Thses businesses know that promoting slimming products, in slim cans, drunk by slim pretty women, or bronzed, muscular men will sell. Their message is not: 'you are all too fat, too greedy and too ugly and should therefore drink Diet Pepsi.' We interpret media messages in a very individual way. And when we are suffering from an ED, our minds and our world becomes focused on all things related to our ED. Unfortunately, we become our ED; it becomes a big part of our identity. And when we are very sick we don't want others to take it away from us. We have a love-hate relationships with it.

I was never triggered by thin models, but I was triggered by all things to do with exercise. I was a competitive (child) athlete before I became anorexic and I exercised dangerously while anorexic (to control anxiety; not to be thin). When I was in the early stages of recovery I found media and scientific messages promoting exercise very triggering - because hard exercise was disallowed, yet I was surrounded by loads of stuff around me promoting exercise for health and happiness!

I had to learn to live with it; to de-sensitise myself to it and not to let it affect me. I honestly believe that rather than protest against some of these media messages, we just have to learn to not let them affect us.

I think the cause of eating disorders is very complicated, and there are still many *theories* out there. I'm not sure we exactly know what causes someone to develop an eating disorder — genetics, societal influences, or a combination of things. I also think it is individual — I developed AN for different reasons than someone else did. For me, it started when I lost weight due to an unrelated illness and then first I became terrified of regaining the weight and then I felt compelled to lose more. Why? I still don't have many clues.

I can relate to what Cathy said about anxiety and depression predating the development of an eating disorder. I have struggled with both since I was about seven years old (yes, that young.) The question I always have in back of my mind is why I didn't develop anorexia until my early forties (and no, it wasn't because of empty nest syndrome or the skinny actresses on Desperate Housewives.) The best answer I can come up with is that AN became both the ultimate weapon against myself and the ultimate coping mechanism, and once I developed AN, it became hard give it up because of those two things.

Back to the can. I think it can send a message that thin is better. I also think that society as a whole still sends the message that being thin is the ultimate achievement for women. Until we combat that, the rest of this is a red herring.

I also think the skinny can will disappear as soon as people realize it doesn't fit in their little cup holders in their cars that they are so used to having, and the first time someone has the skinny can spill soda all over her car because it is, well too skinny, will be the last time she buys the skinny can. I wonder if Pepsi even thought about that.

(P.S. I agree with hm's opinion about soda. I rarely drink it myself.)

Sia Jane

Get real. I have dealt with an eating disorder, as a parent of a 12 year old child. I can assure you that talking about it did no one in the family any good.

Evidence based treatment, based in science, did.

Sia Jane

with respect, saying F* science on a science writer's blog is somewhat rude don't you think?

I do see that science for science's sake kept in the lab isn't going to help people down on the ground much, but neither is just listening and sympathising. People need tools and treatment to recover so that they can live lives to their full potential not blighted by the awful deadly diseases that eating disorders are. Yes, that will include being listened to and understood, just as good nursing for cancer or heart disease does, but it also includes proper, validated, scientific treatment - to offer anything less is to short change them.

Sia Jane,

Since when does science necessary preclude listening? As much as I rolled my eyes about the endless weekly lab meetings, that's when a lot of the good science happened. While we were talking and exchanging ideas and griping about all the stupid contamination, etc, etc, etc. Science is just a way of asking questions so that we can get verifiable answers.

When I had severe bronchitis last summer, I didn't go to the doctor to sit and talk about it. I went to the doctor for antibiotics for the Cough that Wouldn't Go Away. Yes, it was good that the doctor at the urgent care clinic was nice and listened and all that (it's really important for GPs to have that skill!) but I was there for the antibiotics.

Same when I go to therapy. Yes, I talk. Psychotherapy does involve talking and sharing and all of that. But if I'm just relating to someone else, I'm not going to cough up $100 each week. I can do that for free with my friends. I go to therapy because I know CBT and DBT and ACT (the modalities Dr. H generally uses, in about that order of preference) have been shown to work. Dr. H and TNT and all of them aren't "paid friends." They're treatment providers.

I agree that we need to talk to eating disorder sufferers. Understanding what it's like to have an eating disorder is something I think a lot of people could stand to know more about. But understanding the experience of an ED isn't nearly the same as understanding what causes an ED. The breast cancer community does both amazingly well. Talking to a breast cancer survivor can be enormously powerful, but honey, that didn't create tamoxifin.

I personally have found more inspiration and solace in science and research on EDs than reading a lot of the drivel that's out there.

Rachel, there doesn't need to be a disconnect between science and the lived experience of eating disorders. Learning about the biology behind eating disorders saved my life - I would never have found the motivation to fight my anorexia if I hadn't learnt that it was an illness which was controlling me. Science as understood by the parents and therapists involved with F.E.A.S.T. and Family Based Treatment saves the lives of children and young adults with eating disorders all the time. Science is never irrelevant, whether you're talking about a physical or mental illness. You take medication - that wasn't developed by talking to people, it was through scientific experiments.

I want to be a therapist myself, I know the value of talking to people. I also know the value of science, and I completely and utterly believe that they are compatible and complimentary.

I once made the very argument you're making to none other than Janet Treasure at an ED conference, and I shudder to think what she must have thought of me now, but that was before I understood what she was saying about genetics and biology. But that was how strongly I used to believe that science was less important than the thoughts and feelings of people with eating disorders - I was quite happy to stand up and argue with the foremost expert on eating disorders in the UK about it. And my opinion has been totally and utterly changed by the sheer amount of evidence and the sense it all makes. Now I think that science explains those thoughts and feelings. Maybe one day your opinion will change too. Don't discount it.

By the way, I hope all my friends here will still talk to me now they know that I once picked a fight with Janet Treasure - what can I say, I've never been afraid to stand up for things I believe in! I may have been just a little bit misguided that time though :P I did go up to her afterwards and tell her that I really admired her and that she was "like eating disorder royalty". How cool am I?!

I don't see why anyone would, or should, consider treatment of EDs to comprise merely lab-based science. No-one has suggested, or is suggesting, that EDs belong solely in the remit of the brain and its chemistry. That includes the likes of those researchers/psychiatrists who view EDs as being biology based.

I have had many hours of talking therapy, and it has been incredibly helpful in me understanding myself and all the factors that contributed to the development of my AN. It has been exceptionally helpful to have the support of a therapist who validates my fears and helps me to tackle them. But I also know, from having participated in the research of Janet Treasure et al., that I have a particular cognitive style that made me both vulnerable to developing an ED and becoming 'locked' in that mindset. Recognising my cognitive style has also assisted my recovery.

Furthermore, doing my own lab-based research, which related to the physiology and biochemistry of energy deprivation, helped me to comprehend the essential roles of nutrition and malnutrition in EDs - because I viewed the evidence first hand.

If science and listening were mutually exclusive, I'd pick listening. Luckily, science IS listening - to more than just the surface meanings or random noise, though those are part of it - but to larger patterns and relationships and meaning.

Brutal frankness: rejecting science as a concept sounds to me like a nihilistic approach to not doing one's homework.

Cathy, brilliant post! I really identify with what you said about depression and anxiety pre-dating an ED.

I find that I never noticed the cultural stuff before or when I was ill but it's only now in some sort of recovery that I can see that it's everywhere and it really doesn't HELP. About the can: I can see the connection between DIET pepsi and a skinny can, it makes sense. I don't think it's entirely a good thing that that connection was made but I don't *mind* it. I think it's pretty! I just wonder why the designer thought 'Hmmm, how do I sell it? I know, I'll make it super svelte!' It WILL stand out though. I wish people wouldn't say silly things like 'Is the new diet Pepsi can promoting anorexia?'- I saw that headline. It's ridiculous, like anorexia is some sort of fun new fad akin to speed knitting or something. The PC police make EVERYTHING into an issue, it's a bloody CAN. Why don't people spend more time actually treating AN like the illness it is instead of acting like every tiny thing that can be seen as the 'pressure to be thin' is the newest cause of AN?
Stupid marketing idea tbh, because diet pepsi tastes awful! Diet coke is much better. :p

I'm sick of the 'It's society!', 'It's the media!', 'It's the diet mentality!' catch-all 'explanations' for EDs. I don't know what caused my anorexia, but it sure as hell wasn't Victoria Beckham or Kate Moss. It can't be explained by one factor, it's reductionistic, simplistic and thoroughly unfair on the sufferer.

I think brain chemistry is a better explanation, if only because it can be proved. Like others have said, take the media away and people will blame something else for anorexia.

I don't think science is invalid and I also, despite the tone of my post, don't think society is entirely blameless. I just think the scare-mongering eejits who sensationalise the media's influence on EDs should realise not everybody with anorexia got ill because they read too many magazines and saw a skinny diet pepsi bottle!

I'll stop ranting now. :p

Definition of "science":
-(from the Latin scientia, meaning "knowledge")
-any systematic knowledge-base or prescriptive practice that is capable of resulting in a correct prediction, or reliably-predictable type of outcome

Working with young people for years and coming up with logical conjectures as to what they might need IS SCIENCE.

Life is science. Living is science. Even good listening is a science in that it is a carefully honed skill.

And rule #1 for good listening is: Stay open minded.

If you're already shut down to this or to that viewpoint, then you will not be a good listener, except to the people who share YOUR viewpoints.

michal - your post resonated w/ me a lot. this may surprise all who have read my posts on here but I'm in vehement opposition to the 'it's all b/c of the media' lobby. I remember having a therapist in IP who pushed some kind of victoria beckham related theory and I argued with her for hours and actually got really offended. it's more that I feel the extreme, passionate tone of many on here who shoot down the media explanation in any scenario makes me actually feel shallow all over again as a sufferer who DID assign a limited amount of blame to society and believes that that isn't anything to be ashamed of ;)

I have great interest in the nature vs. nurture debate (wherein 'nature' describes inherited/genetic characteristics, and nurture includes relations with others and environmental exposure/culture). But I never understand why some people view these as being mutually exclusive. In terms of EDs, BOTH nature and nurture play a role - to different degrees in different individuals.

Why does the brain stuff make sense to me? Because I had severe childhood anxiety and OCD (+ other characteristics) that were present from me being a baby. NONE of this was due to bad parenting. Most likely, I had/have an over-active amygdala, and my pattern of neurological function obviously influenced the way that I interacted with my environment and other people.

My AN (restricting type) started at age 11, and I had never, ever read a glamour magazine. I wasn't even a 'girly-girl'; I was interested in animals and cars. The behaviours of my AN were VERY similar to the OCD that I had always had, but they were much more powerful - because I was starving. Lab-based research has clearly shown that starvation augments pre-existing obsessive-compulsive characteristics. And, these lab studies are very repeatable. There is CLEAR evidence that the brain is involved.

I had a couple of therapists who tried to push the idea that I wanted to look like a model, or that our 'thin-is-in' culture had triggered my AN. No way. I was aware of all the media stuff but it never interested me. The feminist theory model has never explained my AN, and I am very familiar with that branch of Sociology.

The most important treatment in my recovery has been FOOD and WEIGHT GAIN - because these 'unlocked' my pattern of anorexic behaviours. Therapy based upon understanding myself and accepting how I am has also been enormously helpful. In summary: Both science and talking have helped me.

Yep- nature AND nurture. What I am AND what I've been through. I found starving pleasurable and anxiety-relieving at about 6 or 7 years old. I didn't find motivation for it from a skinny culture. I found it inside my own body and brain.

It was science geeks in lab coats (Carrie, I am including you in that mental picture, even though you probably don't wear a lab coat anymore-) and stone cold logic that got me to recognize my disorder for what it was, and start to get a handle on it before it took my life.

It is science that helps me every day to connect the dots between who I am and what I do.

Sia Jane- We are sufferers too. Can you hear OUR voices?

I'm speechless after reading the brilliant comments in response to a thought provoking post. And that's saying a lot for me ; )

I guess I'm odd one out because I don't have a problem with the can. I see it as being aimed at its competition, i.g., Diet Coke and other diet beverages, and those who drink them, particularly female users - the message being: "If you want the best/coolest/chicest diet soda, drink ours ! Look at the beautiful can, it's different from those". I'm old enough to remember the TV ads for Virginia Slims cigarettes: "Slimmer than the fat cigarettes men smoke". There may have been a subliminal messag there about smoking to keep slim, but I think it was more about femininity. A whole other can of worms.

Nothing I said was personal.
I was just rambling about some of the key points that hit me as I read the post.
I did write to Katie and express some of that.
I just came at it from a totally different angle.
But in no way was it meant offensively to anyone here.
I just wrote my reaction to it.
So if I upset anyone, that certainly wasn't my intention.
So I am sorry if it came across that way.
And I never realised this was a "science" blog xxxx

Interestingly enough--all sodas in India are like the new pepsi can including, coke, diet coke, regular pepsi, diet pepsi, sprite, red bull etc, etc, and so on.

I think the shape of the can will slowly change in North America to include all sodas and not just diet sodas.