ETIOLOGY & RISK FACTORS
introduction diagnostic criteria associated features etiology & risk factors prevalence course & prognosis links bibliography

What causes the onset of Eating Disorders?  Is it:

Modeling
Modeling seems to be a factor.  Modeling family members, peers, or even mass media can lead to an eating disorder such as anorexia (Gordon, 2000).  If a parent has a preoccupation about his or her own weight, or a preoccupation about the child's weight, this can lead to modeling which in turn can lead to anorexic or bulimic behavior (Gordon, 2000).  The influence of peers, in regards to anorexia or bulimic behavior, is potent for nineth-grade girls but seem to diminish by twelfth grade (Gordon, 2000).
Mass Media
While mass media includes models, actresses, and advertisements that all seem to scream out "you have to be thin to be beautiful," it also includes autobiographical books of anorexics, and educational books or movies about eating disorders.  In one study of anorexics (Gordon, 2000), one subgroup of anorexic patients developed their symptoms after the airing of a documentary program about eating disorders; an autobiographical book about her fight with anorexia provided new strategies for weight loss or for keeping it secret; movies in which the person with anorexia is played by an actress considered to be beautiful.  All these can be considered possible causes for the onset of eating disorders.
Personality and Family History
Other factors involved in the possible onset of eating disorders are:  perfectionism, dissatisfaction with body image, poor self-esteem, negative mind-set, suppression of feelings, and unsatisfied needs for parental relationships (Yancey, 1999).  In a population-based risk factor study from England (Nasser, Katzman, & Gordon, 2001), the variables found to distinguish between women with bulimia nervosa and psychiatric controls were low parental contact, high parental expectations, critical comments by the family about weight, shape, or eating, negative self-evaluation, parental alcoholism, childhood obesity, and parental obesity.  In terms of anorexia nervosa, the variables that differed between women with anorexia nervosa and psychiatric controls were negative self-evaluation and perfectionism (Nasser, Katzman, & Gordon, 2001).

Culture
Eating Disorders, including anorexia and bulimia, are most common in industrialized Western countries, and epidemiologic data suggest that culture plays a central role, (www.hms.harvard.edu).

In Eating Disorders and Cultures in Transition (Nasser, Katzman & Gordon, 2001), it is suggested that as the reach of Western cultural norms become more influential around the world, that eating disorders would become more common in areas that had previously been considered immune to them.  Almost all the countries that reported eating disorders prior to 1990 were European or North American, with the exception of Japan and Chile.  Countries reporting after 1990 include Hong Kong and mainland China, South Korea, Singapore, South Africa, Nigeria, Mexico, Argentina and India (Nasser, Katzman, & Gordon, 2001).  The first country to report eating disorders in Latin America was Chile, which can be linked to the influence of American policies in which Chile developed into an advanced capitalist economy (Nasser, Katzman, & Gordon, 2001).

Bellow are some articles documenting the link between culture and anorexia:

Sharp Rise in Eating Disorders in Fiji Follows Arrival of TV
After Three Years of Western Programming, Five Times as Many Teenage Girls Report Vomiting to Control Weight
 

"The sudden infusion of Western cultural images and values through TV appears to be changing the way Fijian girls view themselves and their bodies, says Anne Becker, director of research at the Harvard Eating Disorders Center, assistant professor of medical anthropology at HMS, and assistant professor of psychiatry at Massachusetts General Hospital.  The result is a sharp rise in indicators of disordered eating, such as induced vomiting."


Eating Disorders East and West:  A culture-bound syndrome unbound
Eating Disorders and Cultures in Transition
 

"As the reach of Western cultural norms became more influential around the world, as initially illustrated in the case of Japan, that eating disorders would become more common in areas that had previously been considered immune to them.  It is apparent that the almost all those countries that had reported eating disorders prior to 1990 were European or North American, with the exception of Japan and Chile.  Countries reporting after 1990 include Hong Kong and mainland China, South Korea, Singapore, South Africa, Nigeria, Mexico, Argentina and India."


Eating disorders and the politics of identity:  The South African experience
Eating Disorders and Cultures in Transition
 

"The notion of ethnicity as a protective factor has been dispelled in recent case reports and community studies among different ethnic groups and cultural affiliations from around the world."
"Multi-racial surveys have been conducted to investigate abnormal eating attitudes in adolescent females and young adults.  These studies have shown that significant levels of abnormal eating attitudes and behaviors are evident in females of all ethnic groups in South Africa, that is, black, Caucasian, mixed-raced, and Asian (from the Indian sub-continent).  One of the studies suggests pronounced disturbed eating attitudes among black college student.  Black female students scored significantly higher than whites on questionnaires that measure both anorexic and bulimic behaviors.  Moreover, a comparable percentage of black and white female students scored within the clinical range on these scales."
 
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