Cultural Aspects
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.
