Mirror, mirror on the wall ...

In November, celebrity Web site TMZ.com, posted pictures of actress Jennifer Love Hewitt wearing a black bikini. Her face was bare, and her size-2 body looked curvier than usual, according to TMZ. "We know what you ate this summer, Love - everything!" the caption beneath the photo taunted.

Hewitt responded to TMZ's comments on her Web site saying: "A size 2 is not fat, nor will it ever be."

Before Hewitt, the entertainment media, always a watchdog for female celebrity waistlines, outed actress Mary-Kate Olsen's bout with anorexia and hinted that Angelina Jolie's slight frame was the result of an eating disorder.

Emaciated celebrities regularly make the covers of tabloids, arguably affecting how other women view their bodies. Eating disorders affect millions of other American women.

In 2006, the Eating Disorders Coalition for Research, Policy & Action reported that 10 million Americans had eating disorders, 90 percent of them women. Anorexia and bulimia are both eating disorders with dramatically different symptoms: those suffering from anorexia starve themselves while bulimics binge on food and then purge it.

Conflicting messages from the medical community and from the advertising/

entertainment media make women's body image "a complex animal," said Dr. Retta R. Evans, a professor at the University of Alabama at Birmingham's School of Education, who works with school health professionals and community health agencies. "It's extremely contradictory."

Studies supporting the dangers of obesity, as well as the adverse effects of eating disorders, can cause confusion when coupled with advertisements. Children, especially those younger than age 5, are more vulnerable to mixed messages because they don't have the life experience to process fact from fiction, Evans said.

Formerly regarded as a disease that affected primarily wealthy white women, anorexia "seems to cross all lives at this point," said Dr. Warren Scott, a psychiatrist at Riverbend Center for Mental Health in Florence. Six percent of women with eating disorders will die and about 20 percent will not recover, Scott said.

Family environment, relationships and personality types - especially high-fuctioning Type A personalities - are suspect of putting a woman at high risk of developing an eating disorder.

The symptoms of eating disorders, such as binging, stopped menstrual cycles and brittle hair, lead to long-term health problems including malnutrition and early osteoporosis, said Beth Kitchin, a nutritionist at UAB.

Halted menstrual cycles can result in difficulty conceiving.

But, "you don't have to have an eating disorder to have an unhealthy relationship with food," Kitchin said.

Yo-yo dieting and excessive dieting often yield dangerous symptoms similar to those of an eating disorder.

Evans views media reaction to Hewitt as part of, a "kind of thin, youth-obsessed (image) pre-laid out in anything you watch on TV, (when you) open magazines or surf the Web."

Fashion designers justify using thin models, saying their clothes hang better on curveless bodies. Evans pointed out the "images of beautiful, perfect, thin women who permeate night-time TV" as an example of the entertainment media's influence on body image.

Evans said she does see strides in the media toward representing heavier woman.

"You do see more diversity in size than 10 to 15 years ago," she said.

Scott said he thinks the fashion industry's tendency toward thinness may contribute to anorexia, but "this is a disorder that's been along well before fashion."

In September 2006, a Spanish fashion show gained publicity for using the Body Mass Index to determine healthy weights for its models and turning away those who were underweight.

Modeling agencies fought back, saying the fashion industry was the scapegoat of eating disorders.

A healthy body image free of eating disorders is something University of North Alabama cheerleading coach Wendy Rotton stresses to her students. Cheerleaders are penalized if they start to look too thin.

"In our bylaws, the only discipline actions we have is if they start to look unhealthy,"

Rotton said.

When she cheered, she had strict height and weight requirements to maintain a thin

aesthetic.

"We don't do that anymore," she said.

Thinness, Rotton said, "is not something we put a whole lot of emphasis on."

Scott thinks less emphasis on thinness will lead to women having a healthy body image.

"There has to be a happy medium in how we see ourselves and how we think other people see us," he said.

Jennifer Crossley can be reached at 740-5743 or jennifer.crossley@timesdaily.com.