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									   The Psychological, Sociological &
              Public Health
   aspects of Eating Disorders among
   Western and Non-Western Regions

Sorcha Turley
Diyana Ibrahim
Maisyatun Nazihah
John Frizelle
Paul Claffey
      What are Eating Disorders?
   Anorexia Nervosa – unwillingness to maintain
    healthy body weight

   Bulimia Nervosa – uncontrolled episodes of
    binge eating followed by purging

   Binge Eating – uncontrollable eating pattern

   Obesity?
        Western Countries           Non Western Countries
•     Anorexia: 0.1%-5.7% (♀)       Anorexia: 0.002%-0.9%

•     Bulimia: 0%-2.1% (♂)          Bulimia: 0.46%-3.2%
                0.3%-7.3% (♀)       Among females
                                     percentage of disturbed
•     Among females percentage       attitudes toward eating
      of abnormal eating attitudes   ranged from 0.8%-39.5%
      ranged from 8.3%-26%          Those of male subjects
                                     ranged from 2.4%
    Makino, M., Tsuboi, K., & Dennerstein, L., Prevalence of Eating Disorders: A Comparison of Western and Non-Western Countries.
    MedGenMed 2004; 6(3): 49.
     Why is it important to compare the
occurrence of eating disorders in Westernised
           and non-Westernised?

   “Culture-bound” syndrome
   May present differently in different cultures
   Differences in prevention methods and
   Different levels of support services and
    community support
   Different treatment methods
What triggers Eating Disorders?
   Psychological
   Environmental
   Media Influences – the desire to be thin
   Genetic
   Cultural Influences
      Summary of Possible Risk Factors for the Development of Eating Disorders
                                                                                                          Generalized Factors
                        Eating-Specific Factors
                                                                                                          (Indirect Risk Factors)
                        (Direct Risk Factors)

                        •ED-specific genetic risk                                                         •Genetic risk for associated disturbance
                        •Physiognomy and body weight                                                      •Temperament
Biological Factors
                        •Appetite regulation                                                              •Impulsivity
                        •Energy metabolism                                                                •Neurobiology (e.g., 5-HT mechanisms)
                        •Gender                                                                           •Gender

                                                                                                          •Poor self-image
                        •Poor body image
                                                                                                          •Inadequate coping mechanisms
                        •Maladaptive eating attitudes
Psychological Factors                                                                                     •Self-regulation problems
                        •Maladaptive weight beliefs
                                                                                                          •Unresolved conflicts, deficits, posttraumatic reactions
                        •Specific values or meanings assigned to food, body
                                                                                                          •Identity problems
                        •Overvaluation of appearance
                                                                                                          •Autonomy problems

                        •Identifications with body-concerned relatives, or peers                          •Neglect
Developmental Factors
                        •Aversive mealtime experiences                                                    •Felt rejection, criticism
                        •Trauma affecting bodily experience                                               •Traumata
                                                                                                          •Object relationships (interpersonal experience)

                                                                                                          •Family dysfunction
                        •Maladaptive family attitudes to eating, weight                                   •Aversive peer experiences
                        •Peer-group weight concerns                                                       •Social values detrimental to stable, positive self-image
Social Factors          •Pressures to be thin                                                             •Destabilizing social change
                        •Body-relevant insults, teasing                                                   •Values assigned to gender
                        •Specific pressures to control weight (e.g., through ballet, athletic pursuits)   •Social isolation
                        •Maladaptive cultural values assigned to body                                     •Poor support network
                                                                                                          •Impediments to means of self-definition
       Psychological Motivations
   Emotional Stress
   Childhood Depression
   Domestic Violence
   Peer Bullying
   Personality Type – High Achievers
   Low Self-Esteem
   Negative/ Altered Body Image
    Why does sociology relate to eating
   Diverse socio-cultural influences
   Criteria for measuring health and illness differs in
    different societies and may influence how eating
    disorders are diagnosed
   Different social classes may be more or less susceptible
    to eating disorders
   Ethnicity – perception of „beauty‟
   Perception of eating disorders and/or associated stigma
   Awareness of the causes and effects of eating disorders
            Sociological Factors
   Certain socio-cultural groups are more
   Certain professions
   More prevalent among athletes
   Higher prevalence is also associated with
    urbanization or population density
   Cultural and political situations contribute to the
    prevalence of eating disorders
   Celebrities & Models – Size zero
   TV– “Americas Next Top Model”
   Advertising – Bill Boards
   Magazines
   Internet – Pro-Anorexia websites
   Dolls – Barbie
                Public Health
   Health Promotion Practises
   More prevalent in young female adolescents and
   Healthy Eating Programmes
           Public Health cont’d
   Minority receive treatment in mental institutions
   Incidences important to ensure proper services
   Increase in Incidence = Better Detection Rate
    and Wider Availability of Treatment
   Lack of awareness and information in Non-
    Westernised countries – eating disorders may go

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