How the US’s Policy Response to Eating Disorders Leaves Communities Hungry for More

Emma Dewhurst is a staff writer for Brief Policy Perspectives and a first-year MPP student.

With summer rapidly approaching and warmer weather on the horizon, health, wellness, and beauty industries have already launched ads evoking the elusive “perfect beach body.” Commercials and social media posts promising that their product will get you “bikini ready” inundate society like clockwork every spring. They conjure up images of perceived beauty standards and increase body dissatisfaction, create eating disorders, and encourage the use of extreme dieting tactics to lose weight. At least 30 million individuals in America, or approximately 9% of the population, are diagnosed with an eating disorder. As one of the deadliest mental health disorders, second only to opioid use disorder, this disease transcends across all ages, genders, and communities and kills over 10,200 people in the US per year. A health crisis of this magnitude should elicit a prompt and comprehensive policy response from the federal and state governments, but both have proved slow to pass policies regarding eating disorders. In fact, it took until 2016 for the federal government to finally address this issue. Because of the financial gain realized by its promoters, diet culture is here to stay. It is up to legislators to help protect consumers from its deadly grips. 

State Legislation

State policies aimed at protecting consumers from the effects of diet culture utilize a variety of government tools such as finestax incentives, and public awareness campaigns. Introduced in 2015, Massachusetts’s H.4783 aims to prohibit the sale of diet pills to minors and punishes its violation by retail establishments with a $2,000 fine. Six years later, as of January 2021, this bill remains in the Joint Committee on Health Care Financing. New YorkIllinois, and California are among states who have filed similar bills restricting the sale of diet supplements. However, as state legislatures give their full attention to COVID-19 response, none of these bills have made it through the legislative process. In lieu of a punitive response, Massachusetts’s state legislatures also introduced HD.3421, which incentivizes businesses with a tax credit if they use untouched and unaltered images of models. Finally, Kentucky passed its first eating disorder legislation in 2019, establishing the Kentucky Eating Disorder Council. This formal council in Kentucky’s state legislature works to curb eating disorders by overseeing the development and implementation of disordered eating awareness and assisting with research projects aimed to develop policy. Bills that aim to increase knowledge of and incentivize responses to eating disorders have received little push back. Conversely, bills that impose fines have received opposition, with opponents maintaining that such regulations will negatively impact businesses and stifle economic growth. 

Federal Legislation

Relative to states, federal public policy responses to eating disorders stagnate and focus more on education and treatment rather than regulation. Again, it wasn’t until 2016 that federal policy finally addressed eating disorders. The 21stCentury Cures Act, signed by President Obama, incorporated key provisions from the Anna Westin Act of 2015. These provisions included improvements for health insurance coverage, increased public informational resources on disordered eating, and mandated further training for medical professionals to identify disorders. The bill failed to pass a provision in the Anna Westin Act (named in observance of Anna Westin, who died from anorexia at the age of 21) that would require the Federal Trade Commission to study and report the effects of altered images in advertising on body image. While advocates have enjoyed further successes in federal policy, The 21st Century Cures Act remains the largest federal policy victory for eating disorder advocates. Why has federal policy been so slow to develop compared to state policy?

In their memo, “Top 6 for the 46,th” The Eating Disorders Coalition for Research, Policy, & Action (EDC) outlines obstacles standing in the way of robust federal public policy and presents recommendations for the Biden-Harris Administration to overcome barriers. Two main barriers, according to the EDC, is lack of a formal, organized committee on eating disorders and the failure of the Centers for Disease Control & Prevention (CDC) to collect data on disordered eating behaviors since 2015. As such, a few of their main recommendations involve establishing a formal Commission on Eating Disorders, increasing funding for research and treatment of eating disorders, and advocating for the CDC to resume collecting survey data on disordered eating. The EDC also started publishing Congressional Scorecards in 2018 to reflect each member of Congress’s support for eating disorder policy. The 2020 Congressional Scorecard can be found here

Effectiveness and Shortcomings 

Many social media platforms, including Facebook and Instagram, have already taken steps to monitor ads that promote weight loss. In addition, several retailers have stopped enhancing images of their models. These successes justify more public policy to encourage others to follow suit. One study found that simply labeling enhanced images was highly effective in combatting negative body image. Such policies are already commonplace in Europe. In addition to labeling enhanced photos, policies that would impose excise taxes on dietary supplements like those placed on tobacco, alcohol, and UV tanning were also effective, resulting in a 5.2% decrease in the purchase of these products. Still, critics of such policies argue that labeling enhanced photos is unenforceable and requires a clear definition of what constitutes an “unrealistic standard of beauty.” Some argue that “technology can’t fix social problems,” and call for a more substantial intervention aimed at changing society’s attitude toward healthy eating habits. One popular recommendation is for public schools to change how educators address obesity and incorporate eating disorders into their health education curriculum.

How To Be an Advocate 

Every 52 minutes, someone in the US dies as a result of an eating disorder. We need more policy to address this serious health issue. It is important for people to remain informed of current policy initiatives and express their concern and support by contacting the people in a position to do more. Government has a role here, as does private industry and social media platforms. Protect yourself and others from the effects of diet culture by making informed media choices and thinking before sharing or posting anything that supports it. Support companies that have stopped enhancing their ads and stop enhancing your personal photos. Finally, be an advocate for body positivity and work on cultivating your own body positive image.  

If you or someone you know is struggling with an eating disorder, call or text the National Eating Disorders Association (NEDA) at (800) 931-2237.

Leave a Reply

Fill in your details below or click an icon to log in: Logo

You are commenting using your account. Log Out /  Change )

Facebook photo

You are commenting using your Facebook account. Log Out /  Change )

Connecting to %s