Abstract
The purpose of this study is to develop and identify the variables between acculturation and eating disorders. The study explores the factors of acculturation that influence eating habits. Previous studies identified that factors such as media influence, the existing cultural ideal and notions of western beauty have tremendous influence on the immigrants. Many of them respond to this influence through acculturation where they adapt those notions but they develop eating disorders. These studies found that the disorders of bulimia were predominant in the Mexican and Latin’s immigrants to the United States and London where Asian and African immigrants were affected by anorexia. High acculturation was prevalent among many of the female respondents and it led to high Eating disorder Index. Those had low ac titration had low eating disorders Index.
Introduction
The eating disorders manifested in the form of anorexia, bulimia and binge eating are on the rise in the western countries, and westernization is seen as the major reason of these eating disorders. The immigrant’s women are at higher risk of developing these disorders than other part of the population and acculturation is seen as the main drive that is behind the increase in the eating disorders among the immigrant community.
The Western society idolization of youthfulness and slender bodies is a major factor that leads to most of the eating disorders. However, researches done indicate that other factors such as the personality and genetics also contribute to the eating disorders. This discussion looks in to the various studies that have been done exploring the relationships between acculturation and eating disorders in western countries.
The eating disorders namely bulimia and anorexia are prevalent among immigrant students in the western countries who have to adapt to the western culture and beauty images perpetuated by western media. The first part of this essay is the literature that has been written exploring this relationship. The second part of this discussion will provide an explanation and a critique on the methodologies used in different studies. The third part looks into the findings of the study and the way forward to address eating disorders in western countries. The final part of the essay will provide recommendation and conclusions pertaining to eating disorders in western countries.
Literature Review
This review explores various studies done by scholars investigating the correlation between acculturation and eating disorders. To explore these studies effectively it is imperative to know their understanding on acculturation.
Acculturation
Acculturation is the extent in which the minority culture adopts the majority’s way of life. In this study, the majority culture refers to the western culture and the minority culture refers to the culture of the immigrants into those countries. A cultural metamorphism is initiated by one autonomous culture (Mussap 1567).
To make the study more relevant it is imperative to differentiate acculturation from assimilation. Assimilation is the total cultural change where one adopts a new way of life without retaining the previous cultural identity. However, in acculturation one retains the previous culture but takes some aspects of the dominant culture in order to fit in the dominant culture without completely losing the previous cultural identity. For the sake of the discussion, we shall narrow down this discussion to the United States as a representation of Western countries and the West. Then we shall look at immigrants from the Asia and Latin America as the minority cultures that are subject to acculturation.
Eating Disorders
They are dietary pattern, which is abnormal where an individual avoids certain diets or eats some diets to lose or gain weight thereby affecting the physical and mental health. This disorder is associated with ten conditions although the manifested conditions are anorexia and bulimia. Anorexia Nervosa is a condition in which an individual under eats or eats less food quantities until the Body Mass Index drops to unhealthy level. It is characterized by gaining weight, which leads to stop of menstruation in women. In addition, it exposes the individual to the risk of heart attack, bone loss and discoloring of the skin.
Bulimia is an eating disorder where an individual over eats food until they vomit because of excessive foods. It is usually characterized by binge eating and then the individual forces himself to vomit or excessive weightlifting to compensate for the excessive eating. It leads to high body mass index and medical conditions such as obesity and high blood pressure.
The other eating disorder is the compulsive easting, which is uncontrolled eating and is not followed by compensatory behaviors. It is common among all age groups and causes obesity, diabetes and high blood pressure. Pica disorder is another form of eating disorder and it is characterized by compulsive craving to eat non-food items or foods that have no nutritional value such as chewing gums, paintings and papers, which is common among children.
Causes of the Eating Disorders
There are various causes of eating disorders such as biological cases, which involve the genetic disposition of the individual and epigenetic. The other medical condition such as the PANDA (Pediatric Autoimmune Neuropsychiatric Disorders), which is a medical condition, is prevalent among children. The main cases of the eating disorders fronted and confirmed to be the greatest case of eating disorders are psychological causes. They are cases, which come because of influences on individual emotionally through attitudes permeated by the society.
As earlier stated the objective of the research is to understand the correlation between acculturation and eating disorders. To understand this it is imperative to understand the western culture images and their meaning to the immigrants. The western media portrays a success or an ideal western model as a thin tall woman. The media also portrays the macho image of a man who is huge and has toned up muscles as the standard western man. This means that most of the people aspire to live up to this ideal. The immigrants also find themselves absorbed into adopting these ideals although their body-make up and genetic composition dictates otherwise. The result has been malnutrition or unhealthy people in the quest to adopt cultural practices without considering one’s allele.
Studies Done on this Subject
We shall first explore a study done by Carina et al 2010, this study looks into the perfectionism among the Chinese and Korean immigrants in the United States, and how it affects their eating habits thereby leading to eating disorders. The Chinese culture has a different perception of beauty compared with the effect. To the Chinese society, slenderness was associated with malnutrition and poverty where being plump was associated with being rich and full. This meant that most of the people aspired to have high body weights unlike in the western society where female beauty is seen as being slender. When Chinese students come to the Western countries, they therefore find it hard to adapt to the Western ideals of beauty. However due to acculturation and the need to belong, most of them prefer to slender whereas others choose not to change.
The Chinese immigrants are under pressure to be slender mainly because other Western ideals such as long hair and height might be elusive to them. To gain acceptance they therefore diet or avoid fatty foods that might lead to gaining weight. The research was done online by Carina et al to immigrant Chinese women where they would respond as per how they felt about their bodies. Sixty percent indicated dissatisfaction with their appearance and that they were dieting as a measure to enhance their appearance. When asked about what made them have such feelings of the need to change their body appearance they indicated the media as the main source of this influence as well as the prevailing societal attitudes.
In response to the dietary adjustments, they had to make in order to lose weight and to improve their appearance as per the western images. They indicated drinking a lot of water as the first and most prominent course of action with a percentage of sixty. The second course of action that they took in order to change their personal appearance and fit in the society was to avoid eating lots of carbohydrates and fatty foods. Instead, they choose to eat a lot of fruits and vegetables. However, this was dependent on the levels of income that the respondents had. Those with high income indicated that they ate more fruits and drank lesser water whereas those with low income indicated that they drank more water frequently and that they ate fruits occasionally. High income was an average income of more than $30000 and lower income was less than $30000.
Margarlethe Goethe from Virginia University carried out the study on the relationship between acculturation of Latino’s and its effect on eating disorders. This research explored Latin women and the effect of their eating habits on their health. Their main reason of dieting was that of dissatisfaction with their body images and they had to adapt to western images of beauty. Several aspects of their dieting which they adopted reduced their overall food intake to the detriment of their health.
The first one was excessive intake of water, where they fasted. The other one was through abstinence of food in certain days of the week. The other one was through intake of high levels of fruits and vegetables. This was however predominant in homes that had high levels of income. Those who had low level of income could not afford consistent intake of fruits. This research was conducted on a sample of one hundred Latin students’ immigrants from Puerto Rico, Venezuela, Ecuador, and Brazil.
The second article is on the outcome of adolescent eating. It took a sample of n = 242 patients. The respondents were patients of eating disorders, East Berlin, Zurich, and Bucharest. It studied the symptoms of eating disorders among the patients, which included dieting, and vomiting. This article used the Eating disorder inventory to look into the symptoms of eating disorders among the patients. It however failed to link the symptoms with the acculturation. However, it noted that 60% of the students were international and expatriate workers who were dissatisfied with their body images (Steinhausen 1291). This led to the drive for thinness characterized by dieting, and low food intake to achieve the iconic body figure idolized by the western society (Steinhausen 1291).
The study carried out by (Chan and Owens 6) on perfectionism as acculturation confirms the hypotheses that westernization through acculturation leads to body disorders. This study looked for correlation between the westernization and eating disorders. The sample of the study came from international students from Japan, Taiwan, Hong Kong, and China. It had 106 female students from these countries. They used EAT26 or the Eating Attitude Tests as the instrument of measuring eating pathology and the reasons behind this pathology. They also utilized the AIRS American International Relations Survey to determine the extent of acculturation of the respondents of the survey. It tested aspects of acculturation such as prejudice, language usage, and attitude towards foreign cultural images on beauty (Chan and Owens 6).
The third instrument that this research used was that of social cultural attitude towards appearance Questionnaire. This had its impact on the social development of the individuals by measuring their level of appreciation of western images and ideal on beauty. This research found out that western ideals had effect on the eating attitudes of the respondents (Chan and Owens 7). Those who had high level of acculturation had negated eating attitudes such that they practiced dieting, and they had conditions such as bulimia and anorexia nervosa. On the other hand, those who had low levels of acculturation like positive eating habits did not have body dissatisfaction and they were comfortable with the way they were. This research is one of the best scenarios on the effect of westernization on eating habits. The fact that the researchers have used different research instruments to assess this hypothesis makes it more authentic and credible (Chan and Owens 8)
The other research that has investigated on this subject is a research, which explored the association between gender and exposure to western culture, attitudes towards eating, 490 students, participated on the study, drawn from Israel, 216 were Israeli natives, and the rest were new immigrants from the former Soviet Union. This research used the eating attitude test. The research found out that the natives had higher BMI than the immigrants, mainly because the immigrants expressed their body dissatisfaction and the need to create a positive way of surviving in the country. Higher scores on the EAT test were young among women than among men indicating that women were the ones who were mostly affected by acculturation and the need to adopt to new cultural system (Cwikel, Greenberg and Mirsky 147).
Other factors other than acculturation lead to eating pathology. These factors are explored by a study on the role of interceptive awareness in eating disorders prevention program. This study focused on the sensitivity to stimuli originating from the body that make a person aware of the need to eat. This aspect is a major cause of eating disorders. This research utilized an existing awareness instrument that assessed the respondents’ appetite awareness and emotional awareness.
From these tests, it was found out that 73 percent of the respondent with the eating pathology did not have appetite awareness. This did not display a huge impulse for foods that is for Anorexia Nervosa other conditions such as bulimia indicated awareness of very high appetites. They associated the food displayed especially fatty foods with negative emotions that hindered their ability to enjoy the food. The emotional awareness on the other hand looked into the way in which the patients associated emotions with food.
Most of them indicated that they would eat more when happy and satisfied with themselves than when they were unhappy and dissatisfied. Emotions such as happiness resulted in increased appetite while stress and pressure made food and eating undesirable. Only ten per cent of the respondents who indicated that stress and unhappiness results in increased food intake (Joelle 7).
The eating disorders affected weight changes and eating attitudes of the Japanese adolescents who are under acculturative stresses. In a study conducted 144 adolescents participated and it involved having the students stay with their host families for a period of one year (Furukawa 74). During the year, they would be under supervision where their eating attitudes will be noted down. At first, their attitudes remained the same but as they adapted to the culture, they started having the desire for smaller weight and body figure. The research used the eating disorder inventory where the students tested their eating habits.
The results indicated that 71 per cent of the girls reported having problems with their weight after the period of one year and 34 per cent expresses their dissatisfaction with their bodies. They indicated that their ideal weight was lesser than the current weight that they headed. This study assess the influence that acculturation to western cultures have on the people’s desire to have ideal bodies (Furukawa 74).
Lau et al investigates the development and the validity of the eating disorder inventory as an appropriate tool for testing the prevalence of eating disorders in an individual. The tool has eight subscales that it uses to measure the various aspects that indicate the presence of eating disorders (Lau et al. 7). The first subscale is that of drive for thinness, which assess whether the individual has any desire to lose weight and the factors, which precipitate this drive for thinness. The second subscale measures the presence or absence of bulimia nervosa, which is mostly a symptom of eating pathology where the individual with vomits at volition. The third subscale of this condition is the body dissatisfaction, drive for thinness body dissatisfaction involves failure to appreciate oneself and use failure to eat as a way of punishing oneself.
The fourth subscale of eating disorder inventory deals with the presence or absence of perfectionism. It measures whether one has a drive to perfect his or her own bodies, the perfectionism may involve losing a little weight or gaining little weight to appear better and perfect. The other subscale is that of ineffectiveness, where one feels ineffective due to the body weight and unappreciated because of their appearance. The other subscale is the interpersonal distrust. This scale looks into the manner in which a person interrelates with others based on how they feel about themselves. Weight gaining and obesity usually result to an individual distrusting others and seeing them discriminating him based on weight (Lau et al. 9).
This subscale explains many of the reason why most of those who do not have increased weight get more into indoors making them gain even more weight. The eighth subscale of the eating disorder Inventory is the maturity index; this is because the most aspects of eating disorders are associated with young people who are mostly affected by the need to fit in and to be like others. The maturity subscale assesses one’s perspective on life and ability to handle disappointment, in terms of age and emotional maturity (Lau et al. 17).
The other article discusses the eminence of the western culture and its influence on eating disorders. The anti fat attitude prevails in the western cultures especially in North America and in Western Europe countries. Anti fat attitude, refer to the negative perspective that the individuals have against being overweight or obese (Pepper and Sonia 2). The western culture glorifies independence and hard work and they are presented through images of having a thin body and having a good body figure. Images of overweight and obese persons on the other hand are usually associated with laziness, lack of concern, and it shows a person who is not in control.
It is this negative images which have the most influence on most of the young people and it is the reason they fight hard to overcome the tag of being overweight or obese (Lau et al. 7). Considering that the environment surrounding the young people may not give them opportunities of physical exercise and with exposure to television where the individual s spend hours watching television throughout the day, the chance of becoming overweight become very high yet the pressure to become slim outweighs the predisposing factors influence. This leads to instances of food avoidance to ensure that ne is not over weight. Those who cannot diet or adopt compensatory measures where they vomit the food they have eaten at will bulimia nervosa to ensure that they keep fit. Others engage in perfectionism such as weight lifting exercises and fasting to ensure that they keep their bodies in the desired shape and form.
These anti fat attitudes are not only prevalent in the area among teenagers or young people alone. Recently some of the western airline companies wanted to introduce fat tax, which refers to the extra charges on people who are overweight and they are likely to take more space in the aircraft seats thereby making their neighbors uncomfortable. To give them special services without irritating the other passengers, the overweight individuals had to pay more. This proposal caused a stir and it has since then been withdrawn. However, the western culture is seen to be more anti fat (Lau et al. 7).
The other article about the relationship between acculturation and body eating disorders investigates Australian immigrants from different countries such as Hong Kong, South Africa, India, and Latin America (Ball and Kennedy 289). This research explored the factors that influenced women into body dissatisfaction. The research first acknowledges that eating disorders is not a western problem only but a problem, which affects minorities who have to adapt to new society.
They provide the example of South Africa, which has high rates of eating disorders (Ball and Kennedy 289). However, these disorders may be because of a Western influence prevailing over the current cultural ideals of beauty. This research surveyed over four thousand immigrant women to link the length of the stay in Australia and the prevalence of eating disorders. The research utilized questionnaires to derive information from the respondents. The research also used Body Weight Dissatisfaction Index to measure the level of dissatisfaction among women, which had a Likert scale of seven points (Ball and Kennedy 289).
The research used qualitative methods of data collection to know the reasons for body dissatisfaction. From the research, it was found out that women who had stayed in the country indicated high levels of body dissatisfaction. Those who had stayed in the country for a period of less than one year had the least levels of body dissatisfaction. The other issue dealt with age as a factor of body dissatisfaction. The older the women the lower the body dissatisfaction as women over fifty years expressed less dissatisfaction compared to those below thirty years. The research used descriptive statistics. The high body dissatisfaction led to anti fat attitudes and eventual development of Anorexia nervosa, which is the most prevalent form of eating disorder in the country (Ball and Kennedy 289).
The other article is on perfectionism and eating disorders in Korean women. The Korean society upholds most of the western values especially the western ideals of beauty. The research indicated that there was positive and negative perfectionism (Chan and Owens 8). Perfectionism is the need to improve body appearance and make it better to suit a certain image. The quest for perfectionism among South Korean women made them adopt dieting techniques to avoid weight increase. The research surveyed one hundred and twenty women using the Eating Disorder Index that has four parts of investigating the predominant factor behind body dissatisfaction.
Perfectionism was the major issue with the Korean women. They indicated that body appearance affected ones social acceptance as well as economic success. They indicated that obesity and being overweight had a connotation of laziness whereas slimness was associated with hard work and beauty. Other than minimising their food intake, they indicated other perfectionism quests such as weightlifting and drinking excess water. Perfectionism prevalence in Korean women goes to the extent of plastic surgery to reduce their body fat and enhance appearance. The eating disorders are predominantly present among women between the ages of thirteen to thirty five years (Chan and Owens 9).
The eating pathology is not prevalent in western societies alone. There are other societies where this pathology prevails. They indicate that it is only that in some other societies, this pathology is not worthwhile of attention and it is not exposed. In the Indian cultures, the individuals may refuse to eat to ensure that food impulse does not dominate their lives (Abdullahi and Traci 243). They may also refuse to eat, as a religious practice, or as a rite like fasting.
In addition, it may inevitably lead to weight loss and anorexia. However, the objective of their low food intake is not to lose weight or to perfect their body image but is a religious practice. The other society where there were tokens of eating disorders even though they do not have exposure to the western societies is in Iran. Women expressed that it is not western images, which influence tem not to eat but an intrinsic desire to keep fit and to ensure that their bodies are attractive and beautiful even though public display of one’s bodily features is highly prohibited in Iran (Nasser 231).
The study is further supported by the study on the rates of eating disorders symptoms in Iran. The study involved comparison between the women in Iran and in America. It is a comparison between Iranian women and in America. Women in the sample of women in America were Iran from 40 students living in Los Angeles. The other sample from Iran had 59 students in Tehran. The women in Iran are not allowed to display their bodies in public and they have to wear dark robes and hijabs to cover their bodies. They also do not have much information on western culture as their government censors information on American culture.
The study utilized the eating disorder examination questionnaires as the research instrument to derive information from the respondents. Both the American and the Iranian women expressed body dissatisfaction and symptoms of anorexia nervosa. The results of the study did not indicate stark differences from the findings. The research showed that acculturation does not necessarily have the major influence on eating disorders.
However, the case of Iran is one in isolation as a case study on Muslim women who are in Australia indicated high levels of acculturation. These women were exposed to the western culture and ideals. The study used the eating disorder examination questionnaire to identify the prevalence of eating disorder symptoms among the participants of the study. The research found that 64 per cent of the women had the eating disorder symptoms. This shows that westernization has high influence in determining the ideals of beauty which when women are exposed to them aspire to this beauty.
The other researches on Arab culture indicate that anorexia is uncommon in Arab countries. The Arab culture viewed slimness as a weakness. It appreciated plump women who are regarded as fertile and strong enough to raise healthy children. The study involves looking for cases of Anorexia nervosa in Arab countries and only five cases that emerged and two were from the United Arab Emirates, two from Oman, and one from Sudan. The two cases from both Oman and the UAE were because of westernization where the women feared increasing weight because of seeing television characters and glorification of western ideals of beauty. Other than those five cases, other countries did not have such cases.
The other research focuses on Geller who looks into the link between eating disorders and immigrant women. Unlike other researches which have used primary sources. This research utilises the secondary data from health institution and researches on immigrant women (Cheryl and Geller 289). The research also analyses case studies of fourteen immigrant women and the effects of western culture on the eating disorders. The research shows that eating disorders are characterised by body dissatisfaction and purging. This research however shows that eating disorders are not western phenomenon alone.
Countries in non-western culture are nowadays experiencing cases of eating disorders. Countries with high levels of social economic development are the ones mostly affected. Such countries include South Africa and United Arab Emirates. The research indicates that non-western societies have a different perception of beauty where being plump and fat is associated with increased fertility, motherhood as well as social economic well-being (Cheryl and Geller 289).
Methodologies
This research articles discussing the influence of westernization on the eating disorders have utilized different methodologies to support their arguments and findings. Most of the researches have utilized secondary sources to provide a basis for their arguments. They have used different approaches of research to gather data and to support their findings. The most common is that they have used the eating disorder inventory that they have to show that it has some influence on determining the extent of the eating pathology on the individual. Most of the researches have used these instruments to measure the prevalence of eating pathology.
The other research instrument which been most useful is that of Eating attitude test which assist in assessing the attitudes of individuals affected by the eating pathology. It explores their eating habits in terms of food intake and food digestion. The other is the American International relations Study questionnaire that assists in the development of the necessary information on how cultured and individual is. However not all of the researches which measured this aspect of acculturation.
They assumed that the drive for thinness and body dissatisfaction is because of westernization. The other instrument, which was used in many of the studies to assess the influence of acculturation on eating disorders, was on the area of qualitative discussions where the individuals stayed with the host families and then the oswt5t facility assesses the individuals on their acculturation eating attitudes. These methodologies however fail to conduct a qualitative research using focus groups or using open-ended questions that will give the reasons why most of these individuals seek to perfect their bodies or to lose their weight. The likert scale questionnaires utilized by most of these studies do not delve into the real reasons for the acculturation and the way it leads to the eating disorders.
Discussion
The literatures show that the eating pathology is directly linked to the need to adapt to the environmental images prevailing in the society. This builds pressure in the individuals to change or perfect their bodies in order to fit the western ideals of perfect body. When these ideal are taken into consideration, they serve as stimuli of the eating disorders especially to immigrants from all over the world who are in western societies. Although the disorders are not always influenced by the westernization as indicated by the studies it remains to be a key influence factor on individuals and their perception on eating disorders and ideal western body images.
This research is imperative mainly because it provides information to clinical practitioners on the causes of eating disorders among immigrant patients. It may help the clinicians and medical practitioners to develop family eating therapy and encourage the patients to increase their food intake.
Most of the researchers failed to investigate other factors that may link to eating disorders such as the economic vulnerability and low self-esteem. The low self-concept may be a major factor behind acculturation and excessive weight loss (Cheryl and Geller 289).
Recommendations
Dealing with the eating disorders is challenging especially in western societies where these images are prevalent and there is the need to create dietary supplements that will assist patients to overcome the eating disorders (Castillo, Gleaves and Warren 15). To overcome this challenge it is necessary to do away with the prevailing pop images that glorify culture of thinness among women and subject them to unhealthy conditions that affect them negatively. Adopting the use of the supplements will also go a long way in helping to reduce these conditions. Most importantly, these patients require clinical therapy to help them to accept themselves the way they are. Low self esteem and peer pressure in the new culture is the main reason behind the loss of appetites and drive for thinness (Nelisa Surgenor and Touyoz 56).
This can only be catered for by looking at how it is well shaped and organized to help the patients recover from attitudes that lead to these conditions. It is also important to create awareness about the negativity of these conditions such as the reduced general body weakness and loss of menstruation periods in women, which is equivalent to loss of fertility. Individuals with anorexia nervosa are also prone to heart attack and they are therefore at risk. Supporting the immigrants with information on the disadvantages of the drive for thinness and the risks posed by those factors will help them to appreciate themselves and accept their bodily features without having to succumb to pressures in the western society (Chamorro and Flores 34).
In treating the eating disorders, there are measures and medication practices that are necessary in developing the appropriate attitudes among patients. The first one is that the individuals must add weight as part of the treatment as their current weight is usually below the body mass index. The individuals who are suffering from eating disorders and specifically, Anorexia Nervosa develop eating phobia. It is imperative to have a psychotherapy treatment for these patients.
The psychotherapy for individuals suffering from the eating disorders may involve three aspects of psychotherapy, which are group therapy, individual therapy and family therapy. Individual therapy helps the patient to develop a healthy self-image and a positive self-esteem. The family based therapy involves the family to ensure that the patient follows the dieting patterns recommended by the doctors. The family based therapy is usually effective for teenagers or individuals who are living with their parents. The other type of therapy is the group based family therapy. This involves having support groups for helping the patient to eat and to regain positive self-esteem.
There is need to educate women on nutrition and the negative effects of excessive weight loss. However, beauty is important especially to western society. Compromising ones’ health due to beauty is an ignorant decision. The anorexia nervosa that eventually leads to heart failure is a dangerous condition which if the immigrants remain uninformed about they may end up losing their life. The western society has to formulate lessons on nutrition when orienting immigrant students in their societies. The media must also make an effort of showing other images of beauty that are non-western to reduce the increased influence of Western beauty that affects teenagers (Ball and Kennedy 289).
Conclusion
Eating pathology still remains a modern phenomenon, as it proves hard to be classified as pathology because it is self induced and in many cases promoted by the popular culture that exists in the society especially the western societies. Without having proper measures on how to deal with this pathology, it may continue to affect more people especially the immigrants who find themselves into cultural attitudes and practices incompatible with their physiques and genetic makeup.
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