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Discuss the role of culture in our understanding of eating disorders. Specifically, address the influence of industrialized western cultures on prevalence, etiology, and maintenance of eating disorders
Unit: PSY3032 Tutor: Tutorial time: Tuesday 2pm Student Number: 22081941
This assumption has been strongly challenged. Telch and Tibbs (1998) in an almost identical study one year later. Schreiber. This was supported by Le Grange. 2000). enemas. fasting and excessive exercise in order to prevent weight gain (American Psychiatric Association. People with AN are known to lose extreme amounts of weight whereas someone suffering from BN may not necessarily be underweight. Anoxia nervosa (AN) can be diagnosed in an individual according to the DSM-IV if they refuse to maintain a body weight at or above 85% of their normal body weight for their age and height. Lee's (1995) theory that an attitude of 'fat phobia' is being adopted in non-western society is supported by findings of Szabo and Hollands' (1997) study which found that native black South African adolescent girls actually had a larger desire to be skinny then white adolescents from a western background living in South Africa. self induced vomiting. 1995). Wilfley and Rodin (1995) actually . Pike. It was once thought that eating disorders such as AN and BN were western culture bound syndromes (Lee. 2000). Bulimia Nervosa (BN) is a disorder which can be diagnosed in an individual showing symptoms such as experiencing a binge eating period (of less than 2 hours) in which they consume more food then would be normal under the circumstances followed by an inappropriate complementary behaviour such as taking laxatives. Similarly Striegel-Moore. even though underweight. Lee (1995) argues that this is a result of globalisation of the 'fat phobia' attitude in a rapidly urbanising non-western world. their etiology and how they retain in an individual so that they can be prevented. they have a disturbance in their perception of their own body and in females. behaviours effect eating disorders by discussing and critically analysing previous research into the area. if they experience amenorrhea ( the absence of at least three menstrual cycles) (American Psychiatric Association. have an intense fear of gaining weight or becoming fat. cured and better managed. This essay will explore how cross cultural differences between western and non-western societies in beliefs. The two main types of eating disorders are Anorexia Nervosa and Bulimia Nervosa. diuretics.2 Eating disorders are a serious health risk to sufferers and it is therefore important that we understand the impact of culture on how these disorders occur.
However results from the BITE showed only 0. Van Harten. 2005). The results also revelled a correlation between individuals being at risk of AN and their parents being from a lower socio-economic background. Similar findings to Marlowe (2005) were found by Hoek. al (1995) also report that black females have higher rates of obesity and lower rates of AN in America. cultural and socio-economic backgrounds in Bermuda . Children acquire their perceptions of beauty before adolescence and more specifically females acquire the desire to be skinny before puberty (Marlowe. the participants were asked to complete a Bulimic Investigatory Test. Results from the EAT40 showed that 7. While Marlowe's (2005) study does give support to AN and BN being effected by culture differently it must be noted that it was only testing for the existence of attitudes that have been suggested to predispose an individual to developing AN or BN and not the existence of the disorders themselves. or they were never western culture bound. Gard and Freeman (1996) report a similar relationship for BN in western cultures. Marlowe (2005) conducted a study on 836 adolescents from a range of ethnic. which is interesting because Stiegel-Moore et. Edinburgh (BITE) which tested for attitudes commonly associated with the development of BN and a 40 question Eating Attitudes Test (EAT-40) which tests for people at risk of developing AN. Van Hoaken and Susser (1998) in a study in the island of Curacao in a predominantly black population (which is noted as not a diet-driven culture) where . This could be indicative that just a drive to be skinny is not predictive of AN and Lee's (1995) assumption that eating disorders are no longer western culture bound because non-western cultures are adopting a 'fat phobia' attitude may be false and they may no longer be western culture bound for another reason.24% of participants were at risk of developing BN which is much lower than that found in western cultures.3% of adolescents were predicted to be at risk of developing AN which is similar to findings in western cultures.3 found that the drive to be skinny was higher in preadolescent black girls living in America than preadolescent white girls. This gives support that non-western individuals are just as at risk to develop AN when compared to western individuals however less at risk to develop BN.
4 similar incidence levels of AN was found in participants compared to western societies yet no cases of BN. the results found that 77 females and 3 males were diagnosed with the disorder in the 5 day timeline. not the amount of people actually suffering from it. Nakamura et. the response rate was 94. which would suggest BN would have a much lower incidence rate in these cultures.000 15-29 year old females in the 5 day period in which the study was conducted which is much lower than that of western cultures. al. Swain and Beumont. Rieger. This assumption is supported by Nakamura's et.. Lee.326 clinics to report patients diagnosed AN as defined by the DSM-IV from 20th 24th of October 1997. Touyz. This is evidence that AN is not a culturally bound disorder. While this is significantly lower than for a western population it is only the people treated for the disorder. Kuboki. Jaeger et al. The results found that the least westernised countries showed the lowest levels of body dissatisfaction. (2001) argue that while AN appears in non-western contexts. (2000) asked medical professionals from 130 hospitals and 1. (2002) sampled 1751 medical and nursing students from 12 different countries and showed them 10 silhouettes of body types that were considered to not have any cultural traits and asked which ones they found the most attractive . it cannot be attributed to the acceptance of the western thinness ideals because non-western practices are likely to be etiologically relevant. Ho and Hsu (1993) studied the symptoms of 70 Chinese patients suffering from AN and found that less than half of all the patients reported experiencing a 'fear of being fat' at any stage of their illness. Body dissatisfaction is the most predictive factor in developing BN (Jaeger et al. Ide and Suematsu. fear of food itself or simply eating less. 1751). . loss of appetite.79 per 100. While there is strong evidence to suggest that AN appears cross culturally. (1996) found that the estimated amount of patients treated for AN in Japan to be somewhere between 4500 to 4600. Nomura. as it has been diagnosed in a non-western country. and that reasons for weight loss often included stomach bloating. it is another story with BN. al (2000) study which found that BN prevailed in only 5.4%.
Anorexia nervosa or Bulimia nervosa are often what they think of. and lastly countries considered to be not westernised such as Ghana. Vernon and Lee (1996) found the prevalence of BN in 1152 American undergraduate university students to be 1. (2002) study in which the countries which were considered the most westernised such as germany had the highest levels of body dissatisfaction (a strong predictor of BN). Past studies give evidence to support that culture does seem to have significant relationship with eating disorders. al. Dolan and Ford (1991) conducted a study on Egyptian university students found that the disorder was more prominent in men and only some cross cultural differences was found when compared with other studies which indicates it may not be culture bound. Webb. followed by countries considered to be semi-westernised such as South Africa which showed medium levels of body dissatisfaction. 2010). (2000) argue that BN increases as countries start to adopt western ideals and behaviours. When people hear the term eating disorder. In a study of 488 African American and European American participants in which a 'Questionnaire on Eating and Weight Patterns-Revised' was completed it was found to have a significant correlation with type 2 diabetes. While not currently included in the DSM-IV.5 Pumberton. specifically the levels that are detected in populations and how the disorders . This is supported by Jaeger's et. BED has been proposed as an addition in the DSM-V when completed (American Psychiatric Association. BN is considered to be a culture bund disorder which is supported by the significantly higher levels reported in westernised countries. However Dolan and Ford's (1991) study did not account for socio economic status of participants and the University from which the sample was collected was an American run campus. which had the lowest levels of body dissatisfaction. Huon and Zheng. Guewardene. A lesser understood eating disorder is binge eating disorder (BED). It was also found the African American males were much more likely to suffer from the disorder.3%. Applegate and Grant (2011) characterise BED as eating excessive amounts of food periodically and noted that it could be existent in people of normal weight.
Binge Eating disorder does not seem to differ significantly from one culture to another. The general consensus among the past findings discussed is that BN is a culture bound disorder that appears mainly only in westernised countries and very rarely in nonwesternised countries. . although it is still not as common as it is in western countries. More research is needed to investigate further the causes of these disorders. When it is found in non-western countries some literature argues that it could likely be caused by western influences on that country. AN appears to not be a culture bound disorder. On the other hand. in particular longitudinal studies that can measure the adoption of some western ideals in non-western countries in relation to the occurrences of eating disorders. This gives some evidence to suggest that the reasons for the development of AN may be different to that of BN.6 manifest themselves. with significant incidences being detected in non-westernised countries.
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