Ellen S. Rome, MD, MPH
Head, Center for Adolescent Medicine, Cleveland Clinic Children's Hospital
Professor of Pediatrics, Cleveland Clinic Lerner College of Medicine at Case Western University

Last summer, I was asked to write a perspectives piece for Advances in Nutrition. The topic? The “Barbie” movie, which at the time was the biggest blockbuster and has since earned over $1.4 billion globally following its midsummer release in July 2023. The Barbie of days past was known to promote body dysmorphia, imprinting on little girls an unrealistic body ideal that might plague them forever. That Barbie had an impossible figure, which in life-sized proportions would be 5'9”, 110 pounds, with a 39 inch bust, an 18 inch waist, 33 inch hips, and a size 3 shoe. Margot Robbie's figure in the “Barbie” movie may feel equally impossible for the rest of us, but to my surprise, the movie had enough redeeming features to be article-worthy, and now blog-worthy.

I grew up with Barbie. I appreciated that she could do or be anything, and I confess, I also wanted to be blonde haired and blue-eyed, just like Barbie and almost all the Disney princesses of my growing up years. I did find it a bit odd that she never mentioned any parents, a fact also noted by my kids when we read Barbie books together. When I entered the workforce and made it up to the C-suite as an Associate Chief of Staff at the Cleveland Clinic, I wore my Barbie heels, adding 3 inches of height and the confidence to live the expected gravitas of that new role. Years later, I strive to stretch those tightened heel cords as well as parents' and youth consciousness of choices, media driven or not, that impact health and wellbeing.

On to the movie, which provided belly laughs and tears to our cohort of Adolescent Medicine doctors watching it together. Greta Gerwig captured perfectly exactly how little girls experience Barbie. She wakes, takes an imaginary shower - on her toes permanently, as her heels stay up with or without shoes - and eats an imaginary breakfast before floating down to her car, as if some little girl's hands had carried her there. And the pretend eating? Ouch - that could be a moment of THINspiration for all our patients who restrict intake inappropriately. Another ouch involved the conspicuous consumerism of Barbie's Dream House; her car, accessories, and bling, all recognizable merchandise from childhoods' past. Barbie is forced into a hero's journey to discover what is wrong with her - her heels had fallen, and that might lead (gasp) to a future with cellulite! These references were delivered again with perfect comedic timing, but that messaging still is ready for instant assimilation for my patients with body image distress. Even though the myriad Barbies in the movie did come in various shapes and sizes, there was not one obese Ken to be found and the majority of characters came in fairly perfect proportions, even the allegedly human ones. Weird Barbie, played by Kate McKinnon, is valued, yet isolated. Social Learning Theory would suggest that these subliminal messages are not lost on the viewer.

Yet the implicit and explicit messaging had a lot of redeeming features. America Ferrera's speech, as Gloria, has been widely quoted. She speaks directly to Barbie and indirectly to both her daughter and all of us viewers (and readers). I quote it in its entirety here, just in case you missed it or wish to peruse it more thoroughly:

• “It is literally impossible to be a woman. You are so beautiful and so smart, and it kills me that you don't think you're good enough. Like we have to always be extraordinary, but somehow, we're always doing it wrong.
• You have to be thin, but not too thin. And you can never say you want to be thin. You have to say you want to be healthy, but also you have to be thin. You have to have money, but you can't ask for money, because that's crass. You have to be a boss, but you can't be mean. You have to lead, but you can't squash other people's ideas.
• You're supposed to love being a mother, but don't talk about your kids all the damn time. You have to be a career woman, but also always be looking out for other people. You have to answer for men's bad behavior, which is insane, but if you point that out, you're accused of complaining.
• You're supposed to stay pretty for men, but not so pretty that you tempt them too much or that you threaten other women because you're supposed to be a part of the sisterhood. But always stand out and always be grateful. But never forget that the system is rigged. So find a way to acknowledge that but also always be grateful.
• You have to never get old, never be rude, never show off, never be selfish, never fall down, never fail, never show fear, never get out of line. It's too hard!
• It's too contradictory and nobody gives you a medal or says thank you! And it turns out in fact that not only are you doing everything wrong, but also everything is your fault.
• I'm just so tired of watching myself and every single other woman tie herself into knots so that people will like us. And if all of that is also true for a doll just representing a woman, then I don't even know.”

This speech captured the positive essence of the “Barbie” movie, its spine or backbone driving the plot and what its characters do and say. It revels in the themes of body love and self-acceptance bumping up against society's unrealistic expectations for women, highlighting how the normative societal patriarchy can negatively impact both women and men. The movie encourages all individuals to be what they want to be, a message of mainly female empowerment that social impact theory calls “The Dream Gap.” Capitalism can be reinvigorated when goods and services provide both profit and positive impact and the “Barbie” movie represents this lens: a blockbuster, revenue generating movie that both drives Barbie sales and delivers messages of women's empowerment designed to help the world evolve. The movie addresses dark topics, with Gloria's depression in the Real-World causing Barbie's flat feet and drive for self-knowledge. Gloria's speech serves as a bridge back to loving respect and connection between Gloria and her teen daughter, as well as a powerful commentary on how the current patriarchy limits women in all areas, and doesn't do a great job of empowering or enlightening the Kens, either.

My favorite part of this movie, which began even before I had seen it, is the opportunity to teach media literacy live-time to patients and families. Starting last summer, I asked, “Did you see the “Barbie” movie? What did you think of it?” Overwhelmingly, my patients came out with the same messages of female empowerment and to my surprise, body positivity. I especially appreciated the response of a 14-year-old trans male patient, who has been living as a boy for years, out to his family, friends, school and community. He particularly loved the mother-daughter theme and “how they learned to see and appreciate each other's strengths“ a response that warmed both his mother's heart and mine. If we engage in listen-ask-reflect and listen-some-more, we can hear what messages our kids receive, validate their authentic responses, and perhaps help shine a light on the positives that they were able to glean or might have missed.

The “Barbie” movie generates ample fodder for reflection and values clarification. When I asked my 26-year-old son what he thought, he shared, “The message of the ‘Barbie' movie is about how everyone should take time to figure out who they are and what makes them happy, since they can't live life trying to fit into the expectations of others. And every girl needs to see a gynecologist.” From the perspective of this Adolescent Medicine doctor, his response is spot on!

References

1. Rome ES. Perspective: Barbie: Food for the Soul or Fanciful Nostalgia? Adv Nutr. Published online February 2024:100182. doi:10.1016/j.advnut.2024.100182
2. Steinhauer J. . Deconstructing Barbie's Disproportion. Published July 5, 2013. Accessed February 15, 2024. https://hyperallergic.com/74913/deconstructing-barbies-disproportion
3. Edwards S. America Ferrera's glorious “Barbie” monologue explained. Published August 2, 2023. Accessed October 14, 2023. https://screencraft.org/blog/america-ferreras-glorious-barbie-monologue-explained/
4. Souder K. Positive Impact from Barbie: The Hidden Heroes Behind It All. Published July 29, 2023. https://kirksouder.medium.com/positive-impact-from-barbie-the-hidden-heroes-behind-it-all-19850d33934a