Fighting the “Thin Ideal”: A Psychology Professor's Efforts to Prevent Eating Disorders

By Lauren Boyle

October 11, 2010 — As I made my way toward the corner of 15th and Race Streets to conduct my final interview as an ASK staff writer, I thought about how strange it felt to explore a new part of the University as an alum. I was at Drexel's Center City Hahnemann Campus to meet with Dr. Meghan Butryn, a research assistant professor in the psychology department, whose research interests include eating disorders and obesity prevention. In addition to receiving my B.A. in English this past June, I also graduated with a minor in psychology, and have been interested in the subject since I was old enough to learn about it. The topic of eating disorders is one of the first and most often repeated topics I recall studying in my psychology courses. Difficult and pervasive psychological disorders, bulimia, anorexia and other eating issues affect millions of individuals in the United States, with sufferers ranging from pre-adolescents to mature adults. I have seen friends and acquaintances struggle with these issues, braving lengthy and challenging roads to recovery. Butryn’s clinical trial, which targets one of the primary risk factors for developing an eating disorder, could prevent many young women from ever traveling one of these dark roads.

Dr. Meghan Butryn

Recently, Butryn and colleagues received a $3.1 million grant from the National Institutes of Health to conduct a study titled “Eating Disorders Prevention: An Effectiveness Trial for At-Risk College Students.” This five-year study will take place at three primary research sites — Drexel University, Oregon Research Institute and the University of Texas, Austin — with Butryn serving as the principal investigator for Drexel. Teams at each of these universities will also conduct research at three other local sites, making it a total of nine universities participating in the prevention program, including the University of Pennsylvania and Temple in our area.

This project is an outgrowth of an 18-year line of research led by Dr. Eric Stice, whose primary appointment is at Oregon Research Institute. Stice’s research studies have focused on eating disorder prevention in high school-aged females. Butryn was first introduced to Stice as a graduate student, and he later served as one of the members on her dissertation committee. Informed by Stice’s existing research, her dissertation focused on eating disorder and obesity prevention in college-aged students. The two maintained contact after Butryn received her degree, and their shared research interests eventually brought them back together for this large-scale project.

From a research standpoint, the prevention program developed from the desire to eliminate the risk factor of internalization of the thin ideal, one of the most common links for individuals with eating disorders.

If it can be targeted early,” Butryn explained, “the chances of the disorder manifesting in a clinically troubling way may be greatly reduced.”

All of the participants in the study are young women, who are at a higher risk of developing an eating disorder due to their tendency toward significant body image dissatisfaction.

The program’s overall goal is to work against the internalization of “the thin ideal” by having participants engage in activities that challenge their previously held beliefs. The concept of the thin ideal involves not only the notion that thinner is better, but also the belief that it is acceptable to use unhealthy means to achieve an ultra-slender look. Participants will be asked to define the thin ideal, learn how it was created, critique it, and examine the costs of pursuing it.

The intervention is designed to decrease the extent to which they internalize the thin ideal; that in turn makes them less dissatisfied with their bodies and makes them less likely to develop an eating disorder,” said Butryn.

The program consists of four, one-hour group sessions (“an impressively brief intervention,” Butryn remarked). The sessions are interactive and include role-playing, as well as discussion exercises. The researchers will also ask participants to complete activities outside of the group, such as writing letters to younger, adolescent girls about the thin ideal and its contingent issues. In this process of fleshing out and examining these unreal standards, the hope is that participants will recognize the flaws or shortcomings of their original views and in turn, change their perspective.

According to the study’s design, participants will be divided into two groups: half will undergo the prevention treatment program and half will receive psychoeducational brochures with information about eating disorders and body image. The researchers will follow both of these groups for two years after the intervention is administered, and will conduct periodic assessments of their progress throughout.

If the study is successful, Butryn and her colleagues expect to find that the onset rate of eating disorders is much lower for participants who underwent the prevention program than for those who received the informational brochures. In earlier studies conducted by Stice using this design, researchers found approximately a 75% reduction in eating disorder symptoms and development of eating disorders in participants who underwent the prevention program.

Impressed by the simplicity and apparent effectiveness of the study, I remarked that this type of intervention would have benefited many of my peers, from elementary school through college. Butryn revealed that eating disorder prevention is a much younger field than eating disorder treatment, which has been practiced for decades. Unfortunately, psychologists are still searching for a highly effective treatment program, particularly for those with anorexia. Because both diagnosis and treatment involve such heavy physical and psychological suffering, Butryn felt an effective prevention program was quite worth pursuing.

Aside from this humanistic motivation, Butryn designed this unique program specifically with universities in mind. Treatment is a long process that can require a number of sessions over many months and may even involve medical treatment or monitoring. A prevention program is an ideal alternative that could help decrease the number of university students who need access to these valuable resources.

Butryn’s project is the first empirically-supported study to test an eating disorder prevention program in a broad-scale effectiveness design. If this phase of the study is successful, Butryn and her fellow researchers will disseminate the program in the real world, practicing it on a mass scale. Because the prevention program is meant to be used broadly by women of varying demographics, the study’s design purposely includes a diverse geographic sample. In earlier trials, the treatment providers have come from academic, university-based teams, and subjects have had to fit multiple criteria for enrollment. For this study, there are very few inclusion or exclusion factors, and the treatment administrators are the counselors from the university centers; these are the people who would actually employ the prevention program, should it prove successful. Five years from now, college-aged women across America may very well have the opportunity to engage in this program at their own university, diminishing the possibility of an insidious and potentially deadly disorder.

The prospect of success is exciting for any researcher; to see their project come to fruition as a legitimate, practicable treatment. But five years seems like a long wait for the results of an effort that has taken a remarkable amount of time, diligence and planning.

What will get you through?!” I asked Butryn,

She smiled pleasantly and reminded me of something I had almost forgotten during the course of our interview: she is a teacher.

"Teaching is the best,” she said. “It is so invigorating and enjoyable. I end up spending most of my time on research, but teaching is always one of my favorite parts of the week.”

Butryn teaches three courses at Drexel: two at the doctoral-level and one undergraduate. In the Ph.D. program, she teaches Multi-Cultural Perspectives in Clinical Psychology and a course on Eating Disorders and Obesity. In the past, Butryn has taught the Psychology of Sexual Behavior to undergrads, but this year she will be teaching a new course on eating disorders designed specifically for students who have had less exposure to the material. As Butryn herself became interested in the subject as an undergrad, she looks forward to sharing her expertise with other hungry young learners.

Butryn completed her own undergrad work at Cornell University, as a human development major. It was here that she became interested in eating disorder prevention after working at Cornell’s psychiatric hospital in their in-patient eating disorder clinic. She came from Cornell to Drexel for the competitive Ph.D. in clinical psychology program and began working with psychology professor Dr. Michael Lowe to study eating disorders and obesity. She completed her clinical internship at Brown University and then returned to Drexel to complete her post-doctoral fellowship, explaining that it was the quality of the academic community that brought her back.

"The people here are really exceptional at being collegial and creative. They were a fantastic team to work with as a graduate student, so it was an easy decision to come back and continue my post-doc training here.”

Butryn did post-doc work for a year and graciously accepted a faculty position in 2007.

Our conversation ended with a few friendly goodbyes and questions about what happens next in the interview process. As I made my way back down the elevator, I considered the last few moments of our conversation. I thought about the people I met here at Drexel as an undergraduate, about my dwindling time as an ASK staff writer, and about my place in the University community as a whole. This place has become my home. Although I am thrilled to have completed my bachelor’s degree, a career path like Butryn’s does pique my interest. Perhaps after a few more years of experience and education, I could return to the place where I started as well…

Lauren Boyle graduated in June of 2010 with a B.A. in English.