Cultural and Ethnic Differences in Eating Disorders and Disordered Eating Behaviors

The early literature on eating disorders focused primarily on young, White [GRAPHIC] women in the United States and Europe. However, there is alarming recent evidence showing that there are increasing rates of eating disorders both in the United States among non-European American ethnic groups and across the globe in previously non-Westernized countries. Some researchers attribute these increased prevalence rates to the growing role of Westernization across the world. It has also been suggested that eating disorders, specifically bulimia nervosa, may be culture-bound syndromes. Indeed, one of the primary theories behind the development of eating disorders is the socio-cultural model of eating disorders, which posits that eating disorders develop from a mixture of social and cultural risk factors. The current review focuses on the cultural and ethnic differences and similarities of eating disorders and disordered eating behaviors among (a) diverse ethnic groups in the United States (African American, Hispanic American, and Asian American) and (b) women in several Asian countries (Japan, China, India, and Pakistan). Specifically, we focus on cultural differences in excessive dieting, restriction, fears of fatness, body dissatisfaction, purging, and bingeing, which are core behavioral expressions of disordered eating that are common across the eating disorders. We pay special attention to socio-cultural factors and values present in each of these ethnic and cultural groups, which may influence the expression of these behaviors. Finally, we end by discussing the clinical implications that stem from the differences and similarities in these behaviors across groups and cultures.