Exam 14: Feeding and Eating Disorders

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Anorexia has been observed in Western countries as well as every non-Western region of the world, suggesting that anorexia may not be a "culture-bound" syndrome as once believed (Sohl, Touyzl, & Surgenor, 2006). It is becoming increasingly clear that eating disorders do not always manifest the same way in different cultures. In Hong Kong, for example, studies suggest that anorexia may be divided into fat-phobic and non-fat-phobic subtypes and that questionnaires used in Western countries to assess eating disorders may not be sufficiently sensitive to detect the Chinese non-fat-phobic subtype (Lee, Lee, & Leung, 1998). However, the cross-cultural evidence for bulimia and BED outside of a Western context tells a different story. Keel and Klump's (2003) review of culture and eating disorders found no studies reporting the presence of bulimia in individuals who have not been exposed to Western ideals. Epidemiological data for bulimia in non-Western nations suggest that bulimia has a lower prevalence than anorexia in these countries, and even when it is found in non-Western nations, it is not found in the absence of Western influence. A meta-analysis examining the role of ethnicity and culture in the development of eating disturbances found few differences across ethnic groups for bulimia (Wildes & Emery, 2001). These findings seem to suggest that bulimia is a culture-bound syndrome, arising predominantly in Western regions of the world or in places where individuals probably or definitely have been exposed to Western ideals and culture (Anderson-Fye, 2009).