The Syndemic of the Hot Mess – Reality Television as Disease

She’s a hot mess.

It’s an easy “catch-all” term for the substance using, extension wearing, stalker friends among us. Hot messes never have just ONE thing wrong with them – it’s lots of things. These people need a mega-intervention – stylist, hairdresser, psychologist, trainer, nutritionist, physician, and lawyer.

And we scientists actually kind of have a word for this.


In a pure public health sense – a syndemic is a rapidly escalating combination of two or more diseases and as a result –both need to be treated if the patient is to improve (e.g. HIV, substance abuse, and Hep-C).

If we re-purpose the word syndemic to apply to the rapid spread of lots of bad stuff in the population – bad behavior, bad hair, bad clothes, bad boob jobs – then syndemics are the bread and butter of reality television. No one on a reality show has just one thing wrong with him. Almost all of them have personality disorders – rampant narcissism, sociopathy, unstable relationships, and some or all of the following: obesity, drug and alcohol use, sexual impulsivity, eating disorders, DUIs, violence, French manicures, bad extensions, fake breasts, fake tans, vulgar materialism, tacky houses, and chunky jewelry.

Hot messes make great television. As a rule however, integrating them into the daily fabric of your life is not so wise.

Sadly – one of the downside of our syndemic friends is that they can cause us to lose empathy for people with very real problems. When Snooki recently came out about having an eating disorder – she was berated in most circles. And few of us aspire to be her or to have our kids turn out like her. That said – if indeed she had an eating disorder, it was a brave disclosure, and as a psychologist I hope that anytime someone in the media eye discloses a stigmatized health problem that others will come out of the shadows so we can help them.

However, the backlash over Snooki and the revelation by most syndemic type folks on television would be more apt to put someone back into the shadows. If “the Situation” said he was depressed – don’t expect much empathy, if one of the “Real Housewives” came out about cancer – there is equal likelihood she would be criticized as supported. Interestingly, in the case of Snooki, the mockery, dismissal etc were not necessarily about her eating disorder but the rest of the surplus syndemic junk she carries. She was dissed for her appearance, her behavior, her excess.

Reality TV aint going anywhere. It is our new town square, the modern circus sideshow, an exaggeration of normal human traits to the point of farce. But you can watch a weight loss reality show and walk away with some weight loss tips, watch a Real Housewives show and learn how NOT to deal with your adolescent child, watch a Bachelorette type show and think twice before entering the rather serious institution of marriage. If you can get a life lesson and walk off entertained, then perhaps the syndemic was worth it.

Speaking of syndemics – please tune in Monday nights – Bravo – THINtervention. Shame there isn’t more Dr. Ramani on that show – they may actually have gotten too mentally healthy to be on a reality show.

Stay tuned.


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This entry was posted on Monday, September 27th, 2010 at 11:11 am and is filed under Media and Mental Health. You can follow any responses to this entry through the RSS 2.0 feed. You can leave a response, or trackback from your own site.

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