Cultural Aspects of Eating Disorders
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Is
Obesity Really Bad For Your Health?
Professor Paul Campos, author of The Obesity Myth: Why
America's Obsession with Weight Is Hazardous to Your Health,
is standing up against the current tide of opinion that
obesity is bad.
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Stigma
of Obesity
The
news are full of stories about the increase in obesity in
our society. Most of us know about the physical health risks
associated with obesity - but what about the psychological
impact of obesity? A new study on the stigma of obesity
shows that negative opinions of people who are overweight
are far more pervasive than previously believed. We'll
discuss the stigma of obesity.
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Fatness has traditionally been a
greater preoccupation in western
societies than in third world countries. Women living in third world
countries appear much more content, comfortable and accepted with fuller
body shapes. In fact the cultural stereotype of attractiveness within these
societies includes a fuller figure. Studies have been done observing women
from these societies acculturating into areas in which there is a greater
preoccupation on thinness and the results appear disheartening. One study by Furnham & Alibhai (1983) observed Kenyan immigrants who resided in Britain
for only four years. These women began adopting the British viewpoint
desiring a smaller physique unlike their
African peers. Another study by Pumariege (1986) looked at Hispanic women acculturating into a Western
society finding that they began adopting the more stringent eating attitudes
of the prevailing culture within the same time frame as the previous study (Stice,
Schupak-Neuberg, Shaw & Stein, 1994; Wiseman, 1992).
These studies suggest that to fit the given cultural stereotype of
attractiveness, women may try to overcome their natural tendency toward a
fuller figure. It is apparently hard to "just say no" to society. A study by
Bulik (1987) suggests that attempting to become a part of a new culture may
encourage one to-over-identify with certain aspects of it. He also suggests
that eating disorders might appear in different cultures at various times
because of enormous changes which could be occurring within that society
(Wiseman, Gray, Mosimann & Ahrens, 1992).
Clinicians sometimes fail to diagnose women of color appropriately. This
may be due to the fact that eating disorders have been reported much less
among African Americans, Asian Americans and American Indians. Incorrect
diagnosis' may also come from the widely accepted false belief that eating
disorders only affect middle to upper-middle class white adolescent women.
This oversight reflects a cultural bias and unintended yet prevalent
bigotry. These unconscious tinges of prejudice can undermine appropriate
treatment (Anderson & Holman, 1997; Grange, Telch & Agras, 1997).
Individuals from other cultures should also not be excluded from the
possibility of an eating disorder diagnosis. Westernization has affected
Japan. In densely populated urban areas it has been found that Anorexia
Nervosa affects 1 in 500. The incidence of Bulimia is markedly higher. In a
study be Gandi (1991), anorexia has been found within the American Indian
and Indian populations. Five new cases were diagnosed out of 2,500 referrals
over a four year period. A study by Nasser (1986) looked at Arab students
studying in London and in Cairo. It found that while 22% of the London
students had impaired eating 12% of the Cairo students also exhibited
difficulties with eating. The interesting part of this study pointed out
through diagnostic interviews that 12% of the London group met full criteria
for bulimia while none of the Cairo students exhibited bulimic symptoms.
These results tend to lead one back to the theory of cultural stereotypes
and the over-identification which may occur when attempting to acculturate
into a new society. No culture appears immune to the possibility of eating
disorders. Research seems to point toward more incidences of eating
disorders in westernized societies as well as societies experiencing
enormous changes (Grange, Telch & Agras, 1997; Wiseman, Gray, Mosimann &
Ahrens, 1992).
Middle-aged women as well as
children can also develop eating disorders.
For the most part the development of these disorders appears linked to the
cultural standards. A study by Rodin (1985) states that in women over the
age of 62 the second greatest concern for them are changes in their body
weight. Another study by Sontag (1972) focuses on the "double standard of
aging" and reveals how aging women in Western society consider themselves
less attractive or desirable and become fixated on their bodies. The
scariest statistics of all are those surrounding 8-13 year old girls.
Children as young as 5 have expressed concerns about their body image
(Feldman et al., 1988; Terwilliger, 1987). Children have also been found to
have negative attitudes regarding obese individuals (Harris & Smith, 1982;
Strauss, Smith, Frame & Forehand, 1985), dislike an obese body build
(Kirkpatrick & Sanders, 1978; Lerner & Gellert, 1969; Stager & Burke, 1982),
express a fear of becoming obese (Feldman et al., 1988; Stein, 1986;
Terwilliger, 1987), and do not like to play with fat children (Strauss et
al., 1985).
A real tragedy and some of the scariest statistics of all are those
surrounding 8-10 year old girls and boys and are presented in a study by
Shapiro, Newcomb & Leob (1997). Their research indicates these children at
this young age have internalized a sociocultural value regarding thinness on
a personal level. Boys as well as girls reported very similar perceived
social pressures. The study goes on to state that these children have
demonstrated an ability to reduce their anxiety about becoming fat by
implementing early weight control behaviors. From this study 10% to 29% of
boys and 13% to 41% of girls reported using dieting, diet foods or exercise
to lose weight. One concern cited involved the possibility of using more
extreme measures, such as vomiting or using medication if the earlier
methods fail or the pressure to be thin intensifies.
In a study by Davies & Rurnham (1986) conducted with 11-13 year old
girls, one half of the girls wanted to lose weight and were concerned about
their stomachs and thighs. Of these girls only 4% were actually overweight
but 45% considered themselves as fat and wanted to be thinner and 37% had
already tried dieting. At this tender age girls apparently have equated
success and popularity with thinness, potentially planting the seeds for the
development of an eating disorder.
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