If you were looking for new and creative ways to feel bad about your shape and weight, Weibo, the Chinese version of twitter, has delivered. The "Belly Button Challenge" meme has gone viral in China, reaching over 130 million hits in a week, and has inevitably made its way to our shores.

The "challenge" is to prove your thinness by wrapping one arm behind your back and touching your belly button. Though it is arguably a better assessment of shoulder flexibility than anything else (not to mention the confounds of arm and finger length).

Then you either triumphantly post your contorted "selfie" online, or, presumably, suffer in silent, offline, shame. Considering that a picture posted online is forever, ask yourself whether your Belly Button Challenge selfie is more likely to be a source of pride or embarrassment in 10 years. (Planking, anyone?)

Unlike the "Ice Bucket Challenge," the Internet meme that helped raise $220 million for ALS, there is no philanthropic goal here. If anything, the Belly Button Challenge promotes the over-evaluation of shape and weight (a key feature of anorexia and bulimia nervosa), and can be "triggering" to those at risk for developing, or who have already developed, an eating disorder.

Unfortunately, the internet already abounds with "pro-ana" websites that "celebrate" anorexia nervosa, the most deadly psychiatric disorder, as a "lifestyle choice." Such sites foster a community in which anorexia nervosa is not only normalized, but revered. These websites are repositories for images of emaciated (predominantly female) bodies, intended to reinforce the "motivation" to maintain the disorder ("thinspiration" or "thinspo"). Pro-ana websites also feature pathological, pro-anorexia propaganda, and message boards to enable readers to "cheer each other on" and share "tips." (I will not link to any such sites for obvious reasons.)

A look back at lessons from Fiji

While anorexia nervosa has a significant genetic component, there is good evidence that exposure to media images can promote eating disorder behaviors. Our best example of this comes from a remarkable study by Harvard researcher, Anne Becker, MD, PhD and colleagues, conducted on the island of Fiji. The researchers interviewed Fijian girls in 1995 about their attitudes toward shape and weight and assessed their eating behaviors. At that time, Fiji was an underdeveloped country, relatively isolated from the modernized world. There was virtually no television; they had only had electricity for about a decade. The cultural beauty ideal for women was plumpness. Dieting was virtually unheard of. "Skinny legs" was an insult and if you were "going thin" you were regarded with worry.

After that first assessment, Fiji got television…in a big way. Fijians got shows from the UK: predominantly reruns of 90210, Melrose Place, and Xena Warrior Princess. In 1998, after the introduction of modern television, Becker and her colleagues again assessed Fijian girls. By then, more than 1 in 10 reported having used self-induced vomiting to control weight in the past month (compared to zero percent only three years prior). In fact, this represented the first instances of purging for weight control ever recorded in Fiji's history. Whereas dieting had been virtually unheard of, now the majority of girls were restricting their meals, with almost 3 in 4 reporting they felt "too fat." (The direct quotes from the Fijian girls, found in the appendix of the article, are well worth a read.)

Images glorifying extreme thinness are not without risk, particularly for those vulnerable to experiencing negative body image. The Belly Button Challenge is one export you can do without.

Stacey C. Cahn, Ph.D. is associate professor of clinical psychology at the Philadelphia College of Osteopathic Medicine. She specializes in eating disorders, obesity, body image and cognitive-behavioral therapy.


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