Adolescent Eating Disorders Awareness Campaign (AEDAC) 1

Eating disorders are severe and often chronic mental disorders that are

associated with impaired cognitive and emotional functioning, restricted quality

of life, lifelong physical and psychosocial morbidity, and increased risk of

mortality (Ali et al., 2017). Eating disorders were once linked only with

adolescent, White, middle-class females however as the incidence of eating

disorders continues to increase, there is a dire need for health promotion and

care to cater for and reflect more diverse populations. Akey, Rintamaki and Kane

(2013) emphasise the potential dangers of misconceptions regarding the types

of people who suffer from eating disorders as they often usurp their detection,

which places non-stereotypical individuals at risk for long-term, adverse effects

from these conditions. Body dissatisfaction and eating disorder symptoms are

culturally bound issues, powered by general societal pressures to fit the mould of

the ideal definition of attractiveness (Peterson, Paulson & Williams, 2007).

Adolescence is a particular period of vulnerability within an individuals life,

characterised by a phase of growth and exploration that enables one to move

towards a sense of identity (Kendal, Kirk, Elvey, Catchpole & Pryimachuk, 2017).

Appreciating the vulnerability of adolescence is crucial in constructing an

effective health promotion campaign that accounts for the unique context of the

target group.

The stress-diathesis model of psychopathology suggests that all people

have, to varying degrees, vulnerabilities that predispose them toward developing

mental health problems (Macneil, Esposito-Smythers, Mehlenbeck & Weismoore,

2012). When these vulnerabilities interact with stressful life events, they trigger

the onset of mental health problems. The importance of an individuals self-

efficacy is paramount in their perceived ability to cope with lifes challenges and
Adolescent Eating Disorders Awareness Campaign (AEDAC) 2

the onset of mental instability. According to Banduras Social Cognitive Theory,

human agency functions within a structure of reciprocal causation between

three classes of determinants including personal factors, behaviour and

environment (Berman, 2006). Self-efficacy beliefs, defined as ones ability to

achieve a particular outcome or goal, occupy a pivotal role in Social Cognitive

Theory because they are perceived to act upon the three classes of determinants

that influence human behaviour. Berman (2006) claims that self-efficacy beliefs

are an important determinant of health behaviour change and maintenance

within a number of domains, and as such should form the basis of health

promotion campaigns, which aim to empower the target audience.

The personal development and circumstances of young people influence

their help seeking, and limits to privacy, money, transport, or freedom of

movement can be effective obstacles to accessing health services (Kendal, Kirk,

Elvey, Catchpole & Pryjmachuk, 2017). Young people may not disclose emotional

health difficulties to others, preferring instead to manage these independently.

Lapinski (2006) identified internet-based information sources as a particularly

successful way for those with sensitive health concerns to obtain information

and support without face-to-face interaction. Individuals may use the Internet

rather than other media due to the perception that the Internet can offer

convenience, anonymity and reliability whilst also being engrained within

adolescents social fabric of ways of doing things (Lapinski, 2006). Subsequently,

individuals may feel more comfortable in seeking help and exploring their

options on a website-based campaign, as they are in control as to how interactive

and intimate they become in accessing and engaging with the information and

resources provided.
Adolescent Eating Disorders Awareness Campaign (AEDAC) 3

The immense vulnerability felt by adolescents suffering from an eating

disorder amalgamates into many other potential barriers that often prevent the

effectiveness of health promotion campaigns. Health behaviour theories provide

insight on how and why people with eating disorders may so seldom seek social

support when managing these illnesses. The Health Belief Model (HBM) is such a

theory, which is widely used to determine the likelihood that a person will

engage in health-promotion activities (Ali, 2002). The five factors of health-

related attitudes, which form the foundation of HBM, were considered

individually and relationally with other theories throughout the construction of

the campaign to ensure the likelihood of the target audience engaging with the

programs.

Perceived Susceptibility:

The degree to which people perceive a health threat to be severe dictates

the extent to which they will mobilise resources and take action to protect

themselves. Akey, Rintamaki and Kane (2013) suggest that denial, in the case of

eating disorders, is the equivalent of low perceived susceptibility.

Perceived Severity:

The degree to which people perceive a health threat to be severe dictates

the extent to which they will mobilise resources and take action to protect

themselves. In the context of eating disorders, those who perceive the disorder

to be inconsequential or believe themselves relatively well off in comparison to

others appear more likely to forgo seeking social support (Schwartz, Thomas,

Bohan & Vartanian, 2007).

Perceived Benefits:
Adolescent Eating Disorders Awareness Campaign (AEDAC) 4

In HBM, the extend to which people feel a specific course of action will

effectively manage a problem or be beneficial to their overall well-being greatly

predicts the likelihood of engaging in said behaviour.

Perceived Self-Efficacy:

The degree to which a person believes he or she is personally capable of

performing specific health behaviour describes self-efficacy. The two key issues

regarding self-efficacy, involved the ability to articulate the need for support to

others, and social withdrawal (Bandura, 2012). Individuals may know they need

to ask for help, but are rendered either unsure how or emotionally unsure to do

so. In addition, shame over their circumstances, or fear of hurting others,

sufferers may feel the need to conceal their illness and even withdraw from their

social networks when coping with an eating disorder.

Perceived Barriers:

Barriers constitute factors that inhibit or fully disrupt ones ability to

perform specific health behaviours (Smalec & Klingle, 2000). Access to sources of

support is a barrier consistently identified across a number of studies. Lack of

knowledge about resources available and the limited number of local clinicians

and therapeutic agencies qualified to sufficiently treat patients with eating

disorders majorly impacted access to support. In addition, concern for the social

stigma surrounding eating disorders served as another primary barrier.

Individuals with eating disorders are not immune to the disdain many in the

general public have for mental health issues. Griffiths, Mond, Murray and Touyz

(2015) found that individuals with eating disorders were more likely to be

blamed for their disorder and to be perceived as using their illness for attention

seeking. This links directly to lack of support, encouragement, and

Adolescent Eating Disorders Awareness Campaign (AEDAC) 5

understanding from others being a perceived barrier to help seeking. Specifically

lack of family support, a lack of understanding from peers, the unwillingness of

others to provide help, and a feeling that no one can do anything about the eating

disorder prevented individuals from seeking support (Hackler, Vogel & Wade,

2010).

In addition to this theoretical perspective, it the acute importance in

considering the language that is utilised throughout the campaign. McVittie,

Cavers and Hepworth (2005) suggest that eating disorders, specifically anorexia

nervosa are commonly viewed by psychiatric practioners and society alike, as a

condition that predominantly occurs in girls and young women. These views

arguably have less to do with incidence of individual pathology than with social

practices that surround the condition. Gendered social ideals accordingly are

mirrored in individual experiences and reflected in discursive practices that

specifically present eating disorders as a womens disorder. Evidence suggests

that when eating disorders are diagnosed in men, it is done in the context of

eating disorders being viewed as predominantly disorders of women (Mallyon,

Holmes, Coveney & Zadoroznyj, 2010). These misguided practices suggest to

broader society that eating disorders are more commonly attributed to

homosexual men and to men with a weak or not fully developed sense of

masculine gender identity. In addition, men diagnosed with eating disorders are

found to be more likely viewed by health professionals as feminine and as having

atypical masculine identities, explicitly distinguishing men with eating disorders

from other men (McVittie, Cavers & Hepworth, 2005). These health services and

practices are conforming to the beliefs that underpin hegemonic masculinity, and
Adolescent Eating Disorders Awareness Campaign (AEDAC) 6

are contributing to the system that initially created this epidemic of people not

feeling good enough about the way they look and feel.