Can Television Teach (This is) Us?

Historically, mental health problems did not make it to primetime but in the last few years, that’s been changing. This Is Us, a drama in its second season on NBC, is thoughtfully showcasing a range of issues related to weight and eating disorders, and not in a crude, “one-episode-and-done” manner of dated after-school specials. Typically, mainstream media’s depictions of eating disorders skew heavily towards anorexia nervosa or bulimia nervosa, the most uncommon of the eating disorders. This Is Us instead sheds light on binge eating and weight stigma, two topics rarely exposed on television.

This Is Us features Kate Pearson, a 37-year-old woman who has struggled with overeating and weight issues since childhood. The show documents Kate’s struggles with her weight over the course of her life. In elementary school, she is bullied and made fun of by her classmates (an experience that can have a lasting influence on kids). As a teen, she diets but the weight loss she experiences does not actually make her feel better about herself as she thought it might.

This Is Us Cast. Photo Credit: Creative Commons via Wikipedia.

As an adult, she attends overeaters anonymous and an immersive weight loss camp. We also get a window into the stressors of adulthood that trigger her urges to binge eat, from the mundane – comparing herself to other women her boyfriend has dated – to the exceptional – the loss of a pregnancy.

Binge eating disorder (BED) was recognized in the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) in May of 2013. The DSM-5, published by the American Psychiatric Association, is a manual that allows all health care providers to use the same criteria when they assess someone who may have an eating disorder. People with BED regularly experience binge eating episodes in which they eat an objectively large amount of food and experience a loss of control while eating. Those with subthreshold BED – a delineated Other Specified Feeding and Eating Disorder (OSFED) – experience the same symptoms to a slightly lesser degree but often find them just as distressing and impairing as those with full-syndrome BED.

BED is the most common eating disorder in the United States. In adults, it affects around 3.5% of women and 2% of men. Individuals with BED experience higher levels of depression and anxiety. Most adults with BED who seek treatment for the eating disorder are overweight or obese, but people with BED come in all shapes and sizes.

Notably, most individuals who are overweight do not have BED. In This Is Us, Kate’s fiancée, Toby, is a great example of someone who is overweight but not seeming to suffer from an eating disorder. Unlike Kate, he exudes confidence in himself and is not overly worried about his body shape or weight.

Just as the show demonstrates that people can be healthy and feel good about themselves at all sizes, This Is Us also depicts characters of different shapes and sizes struggling with body image and appearance. When Kate attends an overeaters anonymous group she meets a young, thin woman whom she instantly dislikes as this woman appears not appear to fit in with the rest of the support group. As their friendship deepens, Kate figures out that her friend has bulimia nervosa and that she jumped to the wrong conclusion, reminding us, the viewers, that we can never really know what someone else’s experience in the world is by assuming.

Although This Is Us is fictional, the viewer can learn many valuable lessons about mental health issues from this TV series. First, it is important that the media depict all types of eating disorders, and health in characters of all sizes, to decrease stigma about eating disorders and weight. Second, we benefit from depictions of eating problems that are nuanced, showing the complex contexts in which they develop and the ups and downs of recovery.

Photo Credit (Cover): By w:NBC [Public domain], via Wikimedia Commons

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