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Eating Disorders Essay, Research Paper
During any given day, the American society is inundated by our perception of the ideal woman. The ideal of a slim and slender body bombards young women on television, in magazines and even while walking across campus of their University. It is this ideal that is prevalent in our society that drives women and some men to starve and deprive their bodies of the necessary nutrients in order to achieve what appears to be most desirable. The motives behind each individual can vary, but most women do this to themselves because of their fear of fatness. These women suffer from low self-esteem and a distorted body image. (Crystal, 2000) However, these terms are how we define an eating disorder in Western society. There is no guarantee that these traits are universal for all cultures. Since one s culture defines who they are and what they believe in, the culture one lives in is one of the etiological factors leading to the development of eating disorders. As expected, rates of disorders appear to vary among different cultures and change as cultures evolve. For this reason, it is important to examine each culture individually and according to that culture s values and norms in order to accurately evaluate the psychopathologies. By looking at pathologies with a culturally universal perspective we risk entering a slippery slope to a worldwide misdiagnosis in which we are depriving some societies of the necessary therapy for the actual pathology at hand.
Historically, eating disorders have been a pathology concentrated within the white middle to upper class females in Western societies. (Bruch, 1966) However, it is wrong to assume that eating disorders are isolated to Western civilizations since they receive the majority of attention and research. There have been many studies that show the existence of eating disorders in non-Western cultures. Due to each culture s distinct history, beliefs and values, it is obvious that every culture will not share the same norms and values. For this reason the manner in which disorders are precipitated in individual cultures is bound to vary. For instance, in western society, the precipitators of anorexia nervosa have been found to be puberty and traumatic life stressors such as a move or family stress. (Crystal, 2000) These girls are often obedient, conscientious and characterized as anxious, guilty and working to live up to the demands of others. (Berenstein et al., 1991) Since the Western society is individualistic, these characteristics are stressed. It is not certain that in other, non-individualistic societies that these are the qualities that cause eating disorders. By defining these characteristics as the cross-cultural that factors influence the onset of eating disorders, we are excluding cultures in which these qualities may not be prevalent, therefore they may not act as precipitating factors.
In Western culture, the characteristics defined above are what trigger a young woman s fear of fatness, which is the underlying disposition behind an eating disorder. It is this intense and persistent fear of gaining weight that an anorexic is driven to continue dieting regardless of dramatic weight loss. (Worsnop, 1992) However, the fear of fatness does not hold true for every culture across the globe. A study in Hong Kong and India showed that anorexic individuals are not motivated by a fear of fatness and their distorted body image but rather by the desire to fast for religious purposes. During fasting, they are blinded from the subsequent health problems from following their religion. (Castillo, 1997) It is evident that the disease is present in instances, but the underlying goals differ across cultures. In another instance, researchers sampled Australian and Hong Kong born college students and looked at their eating attitudes. (Lake, 2000) The researchers found no difference in eating attitudes, but they did find a difference in body shape perceptions between the Australian-born and Hong-Kong-born individuals. Hong-Kong-born women had little body dissatisfaction when compared with Australian-born women. The traditional Chinese women showed more influence by Western values than the acculturated group. Their eating attitudes and body image perception was most similar to Australian-born women, which the authors felt supported the idea of the two cultures clashing then converging to one ideal. (Lake, 2000) The traditional group was more influenced by Western values than the acculturated group. A possible explanation for this is that traditional Chinese women feel in conflict with their family values when trying to emulate Western independence. Since the Australian and Hong Kong groups showed similar attitudes toward eating, but different body image perceptions, the authors thought that body image might not be a strong factor contributing to eating disorders in Hong-Kong-born women. (Lake, 2000) Once again, the motives behind the eating disorder vary cross-culturally and are not clear. It is impossible to universally define a disorder when the motives setting off the pathology diverge.
When you classify a disorder according to one culture, you may be overlooking key aspects such as language and emotional expression within that culture. For instance, a study done by Waller (1999) compared the relationship of eating problems to mood, since emotional eating is factor sometimes associated with eating disorders in Western society. It is difficult to define this as a factor associated cross culturally with eating disorders because rules for emotional expression vary in non-Western cultures. In this study, Waller compared emotional eating and bulimic attitudes among women in Japan and the United Kingdom (Waller, 1999). It is not well known whether or not emotional eating exists among Japanese women or if it is associated with eating disorders because the differences in rules of emotional expression between Western and non-Western cultures. In Japanese culture, women are found to be reluctant to express emotion and are poor at recognizing negative emotions through faces and body movements. (Waller, 1999) Alternatively, this may not be the case when examining the United Kingdom sample. When we examine one culture using the constructs of another, you are attributing aspects to the culture that are foreign to it. For this reason, it is necessary to define disorders within a culture according to its own values and traditions.
When we try to define a disorder universally, there is the possibility of finding cultures that do not fit the criteria. If there are exceptions to the rule, then the definition we are using should not be held true cross culturally. Frederick and Grow (1996) did a study which looks at how autonomy is related to self-esteem and the development of eating disorders. They define autonomy as freedom or being in control. The study found that “underlying deficits in autonomy were associated with reduced self-esteem, which, in turn, was related to eating disordered attitudes and behaviors” (Frederick &Grow, 1996). This says that cultures in which female social roles are restricted have lower rates of eating disorders. This is found to be true in cultures such as Muslim societies, where men dictate the behavior of women and the prevalence of eating disorders are close to none. (Bemporad, 1997) However, this does not hold true for American society itself. It has been found that eating disorders are prevalent in upper class women. (Bruch, 1966) It is often in upper class society that men have traditionally held a large amount of control over their wives because it is the men who are earning the income. Many of these women go to drastic measures to control their weight because they feel as though it is the only aspect of their lives they have control over. When we try to define a disorder universally then we clump all cultures into one category resulting in an incorrect description of the disorder for some cultures.
Another problem with defining a disorder cross-culturally is that not every culture adheres to the same ideologies. Their separate identities may or may not facilitate the occurrence of a disorder. In many non-Western societies plumpness is considered
attractive and desirable, and may be associated with prosperity, fertility, success and economic security. (Nassar, 1988) Obese bodies are desired in these countries because fat deposits are beneficial for survival when food is limited. A thin, lanky body is considered malnourished and unhealthy. (Nassar, 1988) In such cultures, eating disorders are found less commonly than in Western nations. It is due to the cultural identity in the specific culture that determines whether the development of an eating disorder will occur. However, if we look at the same culture with Westernized constructs and study individual s insecurities and self-esteem, it is possible, not acknowledging the cultural identity, to see someone who is poor and cannot afford food as anorexic. Where, in fact, these feelings and emotions can be a result of some separate, unrelated aspect of their life. It is here that we see the problem with ignoring the cultural aspect of pathologies and adopting a universal method for diagnosis.
It is obvious that there are drastic differences between cultural values and ideas. The values that we have in American culture are another factor that may affect other cultures as a precipitator for eating disorders. The ideals of self-control and success are values of American society; being unable to live up to the ideal image causes feelings of failure and self-hate (Berenstein et el., 1991). For individuals from non-Western cultures that do not share these ideals, but have recently moved to a western culture, this may add extra pressure and stress on their lives. These people may strive to integrate themselves into the lifestyle and therefore may be more likely to develop an eating disorder because the stresses affect them more severely than someone native to American life. In fact, many studies have shown that the incidence of eating disorders tends to increase in non-Western women who enter Western society.
This was evident in a study done by Nassar (1986) comparing the eating attitudes of Arab female undergraduates at London and Cairo Universities. The study showed that significantly more Arab females in London scored positively with eating disturbances. The author attributed the finding to a difference in the students levels of Westernization. Nassar (1986) noted the London Arab students were more similar to Europeans in their behavior and dress. It is possible that the style of clothing in London is more revealing and less conservative than the dress in their native Arab culture. Therefore, the girls feel more self-conscious of the way they look, thus forcing them to be more concerned about their physical appearance due to the influence of the Western culture. It is also suggested that the London students have become more achievement-orientated and more competitive. (Nassar, 1986) Once again, competitiveness is an attribute commonly linked to western culture, so these girls are adopting that ideology into their lifestyle. It is evident that the Arab students in London have assimilated themselves into the western culture and adapted their ideals. This adaptation has caused them to be more prone to eating disorders than the Arab group in Cairo. It is the western ideals that precipitate the disorder. By defining the disorder cross culturally, we ignore alternative aspects that may facilitate the occurrence of an eating disorder such as the stress of fitting in when moving to a western culture.
Disorders such as Anorexia Nervosa or Bulimia have been historically associated with Western society. Eating disorders themselves are becoming more prevalent worldwide, appearing in numerous cultures as Western values are becoming widespread. However, even though we have distinct methods of diagnosing eating disorders within western cultures, these methods cannot be universally extended to all cultures. Each culture has its own ideologies and beliefs that they live by. It is these ideologies that may influence the onset of a disorder differently than in western culture. If we use a universal description and definition of eating disorders we may be ignoring the individual constructs within a culture that cause the disorder to develop. Additionally, by ignoring cultures individuality and imposing western treatment we will not be caring for the disorder at hand correctly, thereupon denying the person s opportunity for rehabilitation. Since we are all influenced and affected by the environment we grow up in, it is apparent that examining a disorder according to the beliefs and ideas of the culture it is emerging within is of utmost importance.
Bemporad, J R (1996). Self-starvation through the ages: reflections on the
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Berenstein, Veronica, Shelly Chaiken, Jennifer Vookles, and Timothy J. Strauman (1991). Self-Discrepancies and Vulnerability to Body Dissatisfaction and Disordered Eating. Journal of Personality and Social Psychology, 61 (December 6), 946-957.
Bruch H (1966). Anorexia Nervosa and its Differential Diagnosis. Journal of Nervous Mental Disorders. 141. 555-566.
Castillo RJ (1997). Eating disorders. Culture and Mental Illness: A
Client-Centered Approach. Castillo RJ, ed. Pacific Grove, Calif.: Brooks/Cole Publishing Co.
Crystal, D. (2000). Culture and Psychopathology: Lecture notes. Fall 2000.
Frederick, C. M. ET Grow, V.M. (1996). A mediational model of autonomy, self-esteem, and eating disordered attitudes and behaviors. Psychology of Women Quarterly. 2-0, 2.
Lake, A., Staiger, P., & Glowinski, H. (2000). Effect of Western Culture on Women s Attitudes to Eating and Perceptions of Body Shape. International Journal of Eating Disorders. 27. 83-89.
Nassar M (1986). Comparative Study of the Prevalence of Abnormal Eating Attitudes among Arab female Students of both London and Cairo Universities. Psychological Medicine. 16. 621-625.
Nassar M (1988). Eating disorders: the cultural dimension. Social Psychiatry Psychiatric Epidemiology 23:184-187.
Waller, G., Matoba, M. (1999). Emotional Eating and Eating Psychopathology in Nonclinical Groups: A Cross-Cultural Comparison of Women in Japan and the United Kingdom. International Journal of Eating Disorders, 26, 333-340.
Worsnop, Richard L. (1992) Eating Disorders. CQ Researcher. 2 (47). 1099-1115.
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