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Comparison of eating disorders and body image disturbances between Eastern and Western countries

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Abstract

Factors associated with the development of eating disorders in countries with non-Western cultures have not been adequately investigated in relation to Westernized countries. We therefore studied 243 girls [age =16.5±1.2 (SD)], recruited from schools in India, Tibet, the US and France. They completed the Figure Rating Scale (FRS), the Eating Attitudes Test (EAT), and the Beck Depression Inventory (BDI). The Tibetan group had a lower body mass index (BMI) than the other groups (p<0.0001), which did not differ from each other. All groups differed significantly on socio-economic status (SES), with those living in India having the highest (p<0.0001). Prior to controlling for age, SES, and BMI, there were no significant differences on any psychological measure between the individual countries, or when collapsed by East vs. West. However, after controlling for the same covariates, the Tibetan group selected a significantly larger current (p<0.0001) and ideal body size (p=0.03), compared to all the other countries, and had more body image discrepancy than the American group (p=0.04). After controlling only for BMI, the girls from the East had a larger current and ideal, but no difference on body image discrepancy. Body image discrepancy scores were best predicted by EAT scores and BMI, accounting for 35% of the variance (p<0.0001). EAT scores themselves were best predicted by mother’s education, BDI, body image discrepancy, and drug and tobacco use, accounting for 33% of the variance (p<0.0001). Unlike some other studies, we did not observe greater body image discrepancy and eating pathology in Western cultures, whether or not controlling for age, SES, and BMI. There were no differences in eating and depression pathology between those in the US, France, or India. Indeed, the Tibetans, after controlling for their low BMI and SES, had the greatest body image discrepancy.

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References

  1. McCarthy M.: The thin ideal, depression and eating disorders in women. Behav. Res. Ther., 28, 205–215, 1990.

    Article  PubMed  CAS  Google Scholar 

  2. Bardwell Mumford D., Choudry I.Y.: Body dissatisfaction and eating attitudes in slimming and fitness gyms in London and Lahore: A cross-cultural study. Eur. Eat. Disord. Rev., 8, 224, 2000.

    Google Scholar 

  3. Pritts S.D., Susman J.: Diagnosis of eating disorders in primary care. Am. Fam. Physician, 67, 297–304, 2003.

    PubMed  Google Scholar 

  4. Mumford D.B.: Eating disorders in different cultures. Int. Rev. Psychiatry, 5, 109–113, 1993.

    Article  Google Scholar 

  5. Pritts S.D., Susman J.: Diagnosis of eating disorders in primary care. Am. Fam. Physician, 67, 297–304, 2003.

    PubMed  Google Scholar 

  6. French S.A., Story M., Neumark-Sztainer D., Downes B., Resnick M., Blum R.: Ethnic differences in psychosocial and health behavior correlates of dieting, purging, and binge eating in a population-based sample of adolescent females. Int. J. Eat. Disord., 22, 315–322, 1997.

    Article  PubMed  CAS  Google Scholar 

  7. Miller M.N., Pumariega A.J.: Culture and eating disorders: a historical and cross-cultural review. Psychiatry, 64, 93–110, 2001.

    PubMed  CAS  Google Scholar 

  8. le Grange D., Stone A.A., Brownell K.D.: Eating disturbances in White and minority female dieters. Int. J. Eat. Disord., 24, 395–403, 1998.

    Article  PubMed  Google Scholar 

  9. Striegel-Moore R.H., Silberstein L.R., Rodin J.: Toward an understanding of risk factors for bulimia. Am. Psychol., 41, 246–263, 1986.

    Article  PubMed  CAS  Google Scholar 

  10. Hargreaves D., Tiggemann M.: The effect of television commercials on mood and body dissatisfaction: the role of appearance-schema activation. J. Soc. Clin. Psychol., 21, 287–308, 2002.

    Article  Google Scholar 

  11. Stice E., Schupak-Neuberg E., Shaw H.E., Stein R.I.: Relation of media exposure to eating disorder symptomatology: an examination of mediating mechanisms. J. Abnorm. Psychol., 103, 836–840, 1994.

    Article  PubMed  CAS  Google Scholar 

  12. Tordjman S., Zittoun C., Anderson G.M., Flament M., Jeammet P.: Preliminary study of eating disorders among French female adolescents and young adults. Int. J. Eat. Disord., 16, 301–305, 1994.

    Article  PubMed  CAS  Google Scholar 

  13. Khandelwal S.K., Sharan P., Saxena S.: Eating disorders: an Indian perspective. Int. J. Soc. Psychiatry, 41, 132–146, 1995.

    Article  PubMed  CAS  Google Scholar 

  14. Srinivasan T.N., Suresh T.R., Jayaram V.: Emergence of eating disorders in India: Study of eating distress syndrome and development of a screening questionnaire. Int. J. Soc. Psychiatry, 44, 198, 1998.

    Article  Google Scholar 

  15. Sjostedt J.P., Schumaker J.F., Nathawat S.S.: Eating disorders among Indian and Australian university students. J. Soc. Psychol., 138, 351–357, 1998.

    Article  PubMed  CAS  Google Scholar 

  16. Jackson R.T., Rashed M., Saad-Eldin R.: Rural urban differences in weight, body image, and dieting behavior among adolescent Egyptian schoolgirls. Int. J. Food Sci. Nutr., 54, 1–11, 2003.

    PubMed  Google Scholar 

  17. Stene L.C., Giacaman R., bdul-Rahim H., Husseini A., Norum K.R., Holmboe-Ottesen G.: Food consumption patterns in a Palestinian West Bank population. Eur. J. Clin. Nutr., 53, 953–958, 1999.

    Article  PubMed  CAS  Google Scholar 

  18. Al-Subaie A.S.: Some correlates of dieting behavior in Saudi schoolgirls. Int. J. Eat. Disord., 28, 242–246, 2000.

    Article  PubMed  CAS  Google Scholar 

  19. Ko C., Cohen H.: Intraethnic comparison of eating attitudes in native Koreans and Korean Americans using a Korean translation of the eating attitudes test. J. Nerv. Ment. Dis., 186, 631–636, 1998.

    Article  PubMed  CAS  Google Scholar 

  20. Tsai G.: Eating disorders in the Far East. Eat. Weight Disord., 5, 183–197, 2000.

    PubMed  CAS  Google Scholar 

  21. Al-Subaie A.S.: Some correlates of dieting behavior in Saudi schoolgirls. Int. J. Eat. Disord., 28, 242–246, 2000.

    Article  PubMed  CAS  Google Scholar 

  22. Snooks M.K., Hall S.K.: Relationship of body size, body image, and self-esteem in African American, European American, and Mexican American middle-class women. Health Care Women Int., 23, 460–466, 2002.

    Article  PubMed  Google Scholar 

  23. Story M., French S.A., Resnick M.D., Blum R.W.: Ethnic/racial and socioeconomic differences in dieting behaviors and body image perceptions in adolescents. Int. J. Eat. Disord., 18, 173–179, 1995.

    Article  PubMed  CAS  Google Scholar 

  24. Stene L.C., Giacaman R., bdul-Rahim H., Husseini A., Norum K.R., Holmboe-Ottesen G.: Food consumption patterns in a Palestinian West Bank population. Eur. J. Clin. Nutr., 53, 953–958, 1999.

    Article  PubMed  CAS  Google Scholar 

  25. Al-Subaie A.S.: Some correlates of dieting behavior in Saudi schoolgirls. Int. J. Eat. Disord., 28, 242–246, 2000.

    Article  PubMed  CAS  Google Scholar 

  26. Chadda R., Malhotra S., Asad A.G., Bambery P.: Sociocultural factors in anorexia nervosa. Indian J. Psychiatry, 29, 111, 1987.

    Google Scholar 

  27. French S.A., Story M., Neumark-Sztainer D., Downes B., Resnick M., Blum R.: Ethnic differences in psychosocial and health behavior correlates of dieting, purging, and binge eating in a population-based sample of adolescent females. Int. J. Eat. Disord., 22, 315–322, 1997.

    Article  PubMed  CAS  Google Scholar 

  28. Striegel-Moore R.H., Silberstein L.R., Rodin J.: Toward an understanding of risk factors for bulimia. Am. Psychol., 41, 246–263, 1986.

    Article  PubMed  CAS  Google Scholar 

  29. Furnham A., Alibhai N.: Cross-cultural differences in the perception of female body shapes. Psychol. Med., 13, 829–837, 1983.

    Article  PubMed  CAS  Google Scholar 

  30. Furnham A., Alibhai N.: Cross-cultural differences in the perception of female body shapes. Psychol. Med., 13, 829–837, 1983.

    Article  PubMed  CAS  Google Scholar 

  31. Ko C., Cohen H.: Intraethnic comparison of eating attitudes in native Koreans and Korean Americans using a Korean translation of the eating attitudes test. J. Nerv. Ment. Dis., 186, 631–636, 1998.

    Article  PubMed  CAS  Google Scholar 

  32. Al-Subaie A.S.: Some correlates of dieting behavior in Saudi schoolgirls. Int. J. Eat. Disord., 28, 242–246, 2000.

    Article  PubMed  CAS  Google Scholar 

  33. Gluck M.E., Geliebter A.: Body image and eating behaviors in Orthodox and Secular Jewish women. J. Gend. Specif. Med., 5, 19–24, 2002.

    PubMed  Google Scholar 

  34. Akan G.E., Grilo C.M.: Sociocultural influences on eating attitudes and behaviors, body image, and psychological functioning: a comparison of African-American, Asian-American, and Caucasian college women. Int. J. Eat. Disord., 18, 181–187, 1995.

    Article  PubMed  CAS  Google Scholar 

  35. Silverstein B., Perlick D.: The cost of competence: Why inequality causes depression, eating disorders, and illness in women. New York, Oxford University Press, 1995.

    Google Scholar 

  36. Brumberg J.J.: Fasting girls: The emergence of anorexia nervosa as a modern disease. Cambridge, MA, Harvard University Press, 1988.

    Google Scholar 

  37. Fisher M., Schneider M., Pegler C., Napolitano B.: Eating attitudes, health-risk behaviors, self-esteem and anxiety among adolescent females in a suburban high school. J. Adolesc. Health, 12, 377–384, 1991.

    Article  PubMed  CAS  Google Scholar 

  38. Garner D.M., Garfinkel P.E.: The Eating Attitudes Test: an index of the symptoms of anorexia nervosa. Psychol. Med., 9, 273–279, 1979.

    Article  PubMed  CAS  Google Scholar 

  39. Stunkard A.J., Sorensen T., Schulsinger F.: Use of the Danish adoption register for the study of obesity and thinness. Res. Publ. Assoc. Res. Nerv. Ment. Dis. 60, 115–120, 1983.

    PubMed  CAS  Google Scholar 

  40. Beck A.T., Rush A., Shaw B., Emery G.: Cognitive therapy of depression. New York, Guilford Press, 1979.

    Google Scholar 

  41. Beck A.T., Ward C.H., Mendelson M., Mock J., Erbaugh J.: An inventory for measuring depression. Arch. Gen. Psychiatry, 4, 561–571, 1961.

    Article  PubMed  CAS  Google Scholar 

  42. Furnham A., Alibhai N.: Cross-cultural differences in the perception of female body shapes. Psychol. Med., 13, 829–837, 1983.

    Article  PubMed  CAS  Google Scholar 

  43. Al-Subaie A.S.: Some correlates of dieting behavior in Saudi schoolgirls. Int. J. Eat. Disord., 28, 242–246, 2000.

    Article  PubMed  CAS  Google Scholar 

  44. Snooks M.K., Hall S.K.: Relationship of body size, body image, and self-esteem in African American, European American, and Mexican American middle-class women. Health Care Women Int., 23, 460–466, 2002.

    Article  PubMed  Google Scholar 

  45. Gupta M.A., Chaturvedi S.K., Chandarana P.C., Johnson A.M.: Weight-related body image concerns among 18-24-year-old women in Canada and India: an empirical comparative study. J. Psychosom. Res., 50, 193–198, 2001.

    Article  PubMed  CAS  Google Scholar 

  46. Ogden J., Chanana A.: Explaining the effect of ethnic group on weight concern: finding a role for family values. Int. J. Obes. Relat. Metab. Disord., 22, 641–647, 1998.

    Article  PubMed  CAS  Google Scholar 

  47. Gluck M.E., Geliebter A.: Racial/ethnic differences in body image and eating behaviors. Eat. Behav., 3, 143–151, 2002.

    Article  PubMed  Google Scholar 

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Authors and Affiliations

  1. New York Obesity Research Center, Departments of Medicine and Psychiatry, St. Luke’s/Roosevelt Hospital Center, Columbia University College of Physicians and Surgeons, New York, USA

    B. Rubin, C. M. Knoll, M. Lorence & A. Geliebter

  2. Obesity and Diabetes Clinical Research Section, Phoenix Epidemiology and Clinical Research Branch, National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, 4212 North 16th Street, Room 541, Phoenix, AZ, 85016, USA

    M. E. Gluck PhD

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  1. B. Rubin
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  2. M. E. Gluck PhD
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  4. M. Lorence
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Correspondence to M. E. Gluck PhD.

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Rubin, B., Gluck, M.E., Knoll, C.M. et al. Comparison of eating disorders and body image disturbances between Eastern and Western countries. Eat Weight Disord 13, 73–80 (2008). https://doi.org/10.1007/BF03327606

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