Eating Disorders: Do Body and Food Issues Differ by Culture?
Eating Disorders, Body Image and Cultural Contexts
Although a great deal of early research on body image and eating disorders focused on upper/middle class Caucasians living in America or under the influence of Western ideals, many researchers are realizing that eating disorders are not isolated to this particular group. They are also realizing the differences in body image between occur in different races and genders (Pate, Pumariega, Hester 1992). Recently, several studies have shown that eating disorders transcend these specific guidelines, and increasingly, researchers are looking at differences of eating disorders in male and female differences, cross-cultural variation and variation within cultures as well. It is impossible to broach the concept of body image without including the general sentiment of the population being studied as it changes from society to society. Americans, Blacks and Asians have been the focus of a significant amount of research on the cultural attributions of eating disorders and differences in body image between cultures.
When a researcher considers body image and eating problems in African-American women, they must also take into account the socio-cultural factors and factors of oppression, such as racism and sexism (Davis, Clance, Gailis 1999). Without specific etiologies for individual eating problems and body dissatisfaction, these issues become very important to individual cases and treatments. Psychologists must consider religions, coping methods, family life, and socio-economic status when assessing a patient. These all vary within cultures and between cultures making this a difficult job and complex subject to tackle. Fortunately, a great deal of research has been done to assess the body images of Black women. One extensive study compared Black women living in Canada, America, Africa and the Caribbean and took into account several of the above factors to analyze and reach an understanding about the black woman's perception of body image. They found that black women overall prefer a more voluptuous and robust body shape; the women seem to correlate this with wealth, stature and fitness across cultures (Ofuso, Lafreniere, Senn, 1998). Another study that looked at how women view their bodies supports these findings. This study shows how perceptions of body image vary between African American and Caucasian women. African American women tended to be happier with themselves and have a higher self esteem. The women were all college women from two small community colleges in Connecticut; this is very important that their surroundings are essentially the same (Molloy, Herzberger, 1998). Although these studies reveal that African American and Black women across the world have different cultural constraints and body image ideals than other ethnic groups, other studies urge researchers not to forget that Black women are not unsusceptible to eating disorders and low self esteem. One literature review cautions that the dominant culture of a society may impose its views on individuals and cause a deterioration or change in values and perceptions (Williamson, 1998). Interestingly, Black women with high self-esteem and more positive body images also possess more masculine traits than other women studied.
This raises the question about gender difference and the concept of body image and prevalence of eating disorders. Females generally tend to report greater body dissatisfaction than males; this is not a surprise considering that eating disorders are much more prevalent in the female population. Male students, however, usually report greater weight dissatisfaction than females; this usually comes from being underweight. These findings are consistent with research done between students in China and Hong Kong (Davis, Katzman, 1998).
With the idea that Western ideals and White populations have a higher occurrence of eating disorders, comes a great deal of research that compares Western and Eastern cultures. One study explored the differences in body image perception, eating habits and self esteem levels between Asian women and Asian women who had been exposed to Western ideals and Australian born women. Eating habits and attitudes were similar between all three categories, but the judgments of body shape varied distinctly. Australian women were much less satisfied with their body images than the Chinese women. Although the Australians showed great dissatisfaction, the Chinese women who have undergone acculturation of traditional Western ideals showed even lower scores on the (FRS) figure rating scale. When male and female Asian students were compared to male and female Caucasian students, the results were consistent (Lake, Staiger, Glowinski, 2000). Males in both cultures shared a drive to be larger, and women share a drive to be smaller (Davis, Katzman, 1998). Although the difference in the women, appears to come from the definition of the word smaller. For Asian women this seems to mean more petite, but for Caucasian women it means thinner. These are the important cross-cultural differences that researchers must regard. Another study suggests that Asian women do not develop eating disorders through acculturation but instead, a clash of cultures (McCourt, Waller, 1996). Little evidence supports this claim, but it is a good example of different stances taken on the issue of how culture may affect eating habits and body image. In an early study comparing Asian girls and Caucasian girls, the two groups were administered the Eating Attitudes Test and the Body Shape Questionnaire. 3.4% of the Asian girls and 0.6% of the Caucasian girls met DSM-III criteria for bulimia nervosa; these diagnoses appear to be due to cross-cultural differences. The scores that got the diagnosis were also correlated with more traditional Asian culture (Mumford, Whitehouse, Platts, 1991). This study points to the need for a more culturally sensitive method of diagnosing or testing for eating disorders.
Although several people hold that Western ideals still account for the majority of eating disorders and body image distortions in the world, evidence is very controversial. Regardless, it is important to realize that although eating problems may be prevalent in that narrow cultural realm, they are not limited by those standards. Eating disorders and body image misperceptions are becoming increasingly prevalent in a number of societies and the amount of research done on different cultures and ethnic groups supports this. The idea of Western ideals being the cause of eating disorders makes the etiology far too simple, and makes treatment of eating disorders even more obvious, which it is not. An important distinction to make when assessing eating disorders as the last study pointed out is to consider whether the test results are biased because of culture or whether the differences in culture account for the differences in body perception and attitudes.