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Ng S, Liu Y, Gaither S, Marsan S, Zucker N. The clash of culture and cuisine: A qualitative exploration of cultural tensions and attitudes toward food and body in Chinese young adult women. Int J Eat Disord 2021; 54:174-183. [PMID: 33382116 DOI: 10.1002/eat.23459] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/26/2020] [Revised: 12/08/2020] [Accepted: 12/10/2020] [Indexed: 11/06/2022]
Abstract
OBJECTIVE Accumulating evidence suggests that the prevalence of eating disorders among Chinese women is a public health concern. Prior studies have drawn linkages between conflicting cultural values, identity confusion, and eating disorder symptomatology, which may be relevant for understanding the rise of eating disorders amidst China's rapid economic and sociocultural transformation. Here, we explore how women's experiences with traditional eating norms and modernizing norms of femininity may shape their food and body attitudes. METHOD Chinese young adult women (N = 34; aged 18-22 years) participated in semi-structured interviews focusing on experiences with norms surrounding eating and ideal feminine appearance, perceived conflict between these norms, and their responses to perceived conflict. Interviews were conducted via email (n = 27) or via Skype (n = 7). Participants were not asked about past or present diagnoses of eating disorders. Analysis of responses was guided by the principles of thematic analysis. RESULTS Women reported encounters with cultural eating norms and feminine appearance norms, and described factors that motivated continued or discontinued adherence to these norms. Women reported strategies of conflict resolution, which resulted in different emotional and behavioral outcomes including eating disorder symptoms. DISCUSSION Women's experiences with norms surrounding eating and appearance indicate the centrality of these encounters in the formation of individual and interpersonal values. Our findings suggest the importance for clinicians to assist clients in exploring the meanings behind internalized attitudes toward food and body, and to help clients balance interpersonal and individual needs.
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Affiliation(s)
- Stephanie Ng
- Department of Psychology and Neuroscience, Duke University, Durham, North Carolina, USA
| | - Yining Liu
- Department of Biomedical Engineering, Pratt School of Engineering, Duke University, Durham, North Carolina, USA
| | - Sarah Gaither
- Department of Psychology and Neuroscience, Duke University, Durham, North Carolina, USA
| | - Samuel Marsan
- Department of Psychology and Neuroscience, Duke University, Durham, North Carolina, USA
| | - Nancy Zucker
- Department of Psychology and Neuroscience, Duke University, Durham, North Carolina, USA.,Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Duke University, Durham, North Carolina, USA
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Peng-Li D, Sørensen TA, Li Y, He Q. Systematically lower structural brain connectivity in individuals with elevated food addiction symptoms. Appetite 2020; 155:104850. [DOI: 10.1016/j.appet.2020.104850] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2020] [Revised: 05/30/2020] [Accepted: 08/18/2020] [Indexed: 12/19/2022]
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Wu M, Lang M. Female Questionnaire of Trait Self-Objectification: Initial Development and Validation in China. SEX ROLES 2018. [DOI: 10.1007/s11199-018-0972-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
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Cheng MY, Wang SM, Lam YY, Luk HT, Man YC, Lin CY. The Relationships Between Weight Bias, Perceived Weight Stigma, Eating Behavior, and Psychological Distress Among Undergraduate Students in Hong Kong. J Nerv Ment Dis 2018; 206:705-710. [PMID: 30124569 DOI: 10.1097/nmd.0000000000000869] [Citation(s) in RCA: 38] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
Abstract
Weight bias issues are rarely discussed in Asian. Therefore, we examined the relationships between weight bias, perceived weight stigma (PWS), eating behavior, and psychological distress among Hong Kong people. Using cross-sectional design, 400 undergraduate students (175 men) completed questionnaires and were assigned into a self-reported overweight (n = 61) or nonoverweight group (n = 339) using body mass index, and a self-perceived overweight (n = 84) or nonoverweight group (n = 316) based on self-perception. For self-reported and self-perceived overweight groups, more weight bias was related to higher depression (β = -0.403; p = 0.004). Self-perceived group additionally showed that weight bias was related to PWS and inappropriate eating behaviors; PWS related to inappropriate eating behaviors. For self-reported and self-perceived nonoverweight groups, weight bias was related to PWS, inappropriate eating behaviors, anxiety, and depression (β = -0.228 to -0.148; p's < 0.05); PWS was associated with inappropriate eating behaviors, anxiety, and depression. Thus, weight bias issues should not be ignored for both overweight and nonoverweight people.
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Affiliation(s)
- Man Yan Cheng
- Department of Rehabilitation Sciences, Faculty of Health and Social Sciences, The Hong Kong Polytechnic University, Hung Hom, Hong Kong, China
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Kim TY. Comparison study for body image education of domestic and overseas female college students. J Exerc Rehabil 2017; 13:634-640. [PMID: 29326894 PMCID: PMC5747197 DOI: 10.12965/jer.1735178.589] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2017] [Accepted: 12/07/2017] [Indexed: 12/05/2022] Open
Abstract
The 2016 health education index showed such tendency as well including their raised obesity index, and reported that they are much interested in body images appearing externally. Accordingly, in this study, we conducted the self-reported questionnaire aimed at a total of 389 subjects composed of domestic (n= 226) and overseas (n= 163) female college students from Asia, Europe, and Latin America so as to investigate their body images for face, figure and health through questionnaires. In this context, a survey was conducted with the method of this study, consequently indicating that overseas subjects are more greatly positive and active to body images (face, figure, and health) by health level, exercise preferences, extent of body activities and body weight than domestic ones. These results reflect a different viewpoint between those subjects and reveal that overseas subjects are more committed to maintaining their health through body activities compared to domestic ones. Moreover, it is considered that domestic subjects tend to place a higher value on external beauty rather than beauty in terms of physical health, thereby it is most important to change the beauty values. Therefore, in the future, health education should play a critical role in promoting discussions for plans and practical strategies of improving health between students and in participating actively in health behaviours.
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Affiliation(s)
- Tae-Young Kim
- College of Education, Hankuk University of Foreign Studies, Seoul, Korea
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Padavinangadi A, Xuan LZ, Chandrasekaran N, Johari N, Kumar N, Jetti R. The Impact of Eating and Exercise Frequency on Weight Gain - A Cross-Sectional Study on Medical Undergraduate Students. J Clin Diagn Res 2017; 11:IC01-IC03. [PMID: 28384887 DOI: 10.7860/jcdr/2017/25346.9458] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2016] [Accepted: 12/27/2016] [Indexed: 11/24/2022]
Abstract
INTRODUCTION Diverse factors influence an individual's ability to successfully achieve and maintain energy balance consistent with a healthy body weight. Eating frequency is one among the varied feature that thought to have a direct impact on the body weight gain. AIM The present cross-sectional study has been carried out with the intention of awareness of food habit that specifically emphasize the frequency of eating and its effect on weight gain of an individual. MATERIALS AND METHODS This cross-sectional study involved 265 medical undergraduate students. Faculty validated close ended questionnaire was distributed to the students and the responses given by them were then analysed. Statistical evaluation of data with Spearman correlation coefficient (r) was done. RESULTS Among the total 265 participants, 177 (66.8%) were noted to have normal Body Mass Index (BMI 18.5-24.9). Out of them, 113 (64%) found to have eating frequency 3-4 meals/day, 44 (25%) with 1-2 meals/day, 18 (10%) with 5-6 meals/day and 2 (1%) with more than 6 meals/day. Low positive correlation (r=0.09) between mean frequency of eating and the number of subjects with normal BMI was observed. CONCLUSION An increase in the eating frequency can also be correlated with an increased prevalence of normal BMI individuals provided adequate physical exercise.
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Affiliation(s)
- Abhinitha Padavinangadi
- Senior Grade Lecturer, Department of Anatomy, Melaka Manipal Medical College (Manipal Campus), Manipal University , Manipal, Udupi, Karnataka, India
| | - Lee Zi Xuan
- Student, Melaka Manipal Medical College (Manipal Campus), Manipal University , Manipal, Udupi, Karnataka, India
| | - Nishalini Chandrasekaran
- Student, Melaka Manipal Medical College (Manipal Campus), Manipal University , Manipal, Udupi, Karnataka, India
| | - Nursyahirah Johari
- Student, Melaka Manipal Medical College (Manipal Campus), Manipal University , Manipal, Udupi, Karnataka, India
| | - Naveen Kumar
- Assistant Professor, Department of Anatomy, Melaka Manipal Medical College (Manipal Campus), Manipal University , Manipal, Udupi, Karnataka, India
| | - Raghu Jetti
- Assistant Professor, Department of Basic Medical Sciences, College of Applied Medical Sciences, King Khalid University , Abha, Grainger, Saudi Arabia
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Cachelin FM, Veisel C, Barzegarnazari E, Striegel-Moore RH. Disordered Eating, Acculturation, and Treatment-Seeking in a Community Sample of Hispanic, Asian, Black, and White Women. PSYCHOLOGY OF WOMEN QUARTERLY 2016. [DOI: 10.1111/j.1471-6402.2000.tb00206.x] [Citation(s) in RCA: 108] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
The purpose of this study was to examine disordered eating, acculturation, and treatment-seeking in a community sample of Hispanic, Asian, Black, and White women. Participants were 118 women with disordered eating (49 Hispanic, 21 Asian, 23 Black, and 25 White) and 118 healthy controls. Interviews were conducted to assess eating and weight-related behaviors, psychiatric symptoms, acculturation, and health care usage. Results indicated that the four ethnic groups were equally likely to present behavioral symptoms of bulimia, anorexia, or a binge-eating disorder. Hispanics were the most likely to use diuretics, and Black women were the most likely to use laxatives. Despite psychological distress among the eating disorder group, only a small percentage had received treatment during the past year; the eating disorder group was more likely than the controls to report that they had been denied treatment. More acculturated individuals were more likely to suffer from eating problems, and among the eating disorder group, less acculturated individuals were less likely to have received treatment.
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Abstract
PURPOSE OF REVIEW This review summarizes and contextualizes the recent epidemiologic data on eating disorders in the Asia and Pacific regions. RECENT FINDINGS Gaps in epidemiologic data on eating disorders from the Asia and Pacific regions stem, in part, from omission of eating disorder-specific assessments in large nationally representative cohort studies of mental disorders. Available data - often from clinical and school-going cohorts - support that the prevalence of both eating disorders and associated attitudes and behaviors in many Asian and Pacific regions studied may be comparable to those reported in Europe and North America. Moreover, the prevalence of eating disorders in some regions of Asia may be increasing. Some of the national and subnational regions with the highest annual percent increases in disability-adjusted life years per 100 000 caused by eating disorders over the past two decades are located in Asia. SUMMARY Notwithstanding sparse epidemiologic data concerning eating disorders in Asia and the Pacific, available evidence supports comparable prevalence to other global regions and that associated health burdens in some regions of Asia may be rising. This further supports that eating disorders are trans-national in distribution and challenges the previous understanding that they were primarily culture-bound to the Global North.
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Stark-Wroblewski K, Yanico BJ, Lupe S. Acculturation, Internalization of Western Appearance Norms, and Eating Pathology Among Japanese and Chinese International Student Women. PSYCHOLOGY OF WOMEN QUARTERLY 2016. [DOI: 10.1111/j.1471-6402.2005.00166.x] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
In the context of the sociocultural model of eating disorders, this study investigated the hypothesis that Westernization would be positively associated with eating pathology among non-Western women. International participants from Japan ( n = 26), Peoples Republic of China ( n = 25), Taiwan ( n = 30), and Hong Kong ( n = 25) who were studying in the United States completed the Eating Attitudes Test, Symptoms Checklist, Sociocultural Attitudes Toward Appearance Questionnaire, the American–International Relations Survey, and a demographic questionnaire. Awareness and internalization of Western appearance norms were positively associated with eating disordered symptoms, but acculturation was not. Results lend further support for the sociocultural model. It is suggested that measures of eating pathology and acculturation be closely examined with respect to their cross-cultural relevance, particularly when conducting research involving international populations.
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Affiliation(s)
- Kim Stark-Wroblewski
- Kim Stark-Wroblewski, Department of Psychology, Central Missouri State University
| | - Barbara J. Yanico
- Barbara J. Yanico, Department of Psychology, Southern Illinois University
| | - Steven Lupe
- Steven Lupe, Department of Psychology, Central Missouri State University
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Choi Y, Choi E, Shin D, Park SM, Lee K. The Association between Body Weight Misperception and Psychosocial Factors in Korean Adult Women Less than 65 Years Old with Normal Weight. J Korean Med Sci 2015; 30:1558-66. [PMID: 26538998 PMCID: PMC4630470 DOI: 10.3346/jkms.2015.30.11.1558] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/04/2015] [Accepted: 07/29/2015] [Indexed: 01/09/2023] Open
Abstract
With society's increasing interest in weight control and body weight, we investigated the association between psychological factors and body image misperception in different age groups of adult Korean women with a normal weight. On a total of 4,600 women from the Korea National Health and Nutrition Examination Survey 2007-2009, a self-report questionnaire was used to assess body weight perception and 3 psychological factors: self-rated health status, stress recognition, and depressed mood. Through logistic regression analysis, a poor self-rated health status (P = 0.001) and a higher recognition of stress (P = 0.001) were significantly associated with body image misperception and this significance remained after controlling for several sociodemographic (Model 1: adjusted odds ratio [aOR], 1.62; 95% confidence interval [CI], 1.31-2.00), health behavior and psychological factors (Model 2: aOR, 1.59; 95% CI, 1.29-1.96; Model 3: aOR, 1.36; 95% CI, 1.01-1.84). Especially, highly stressed middle-aged (50-64 yr) women were more likely to have body image misperception (Model 2: aOR, 2.85; 95% CI, 1.30-6.26). However, the correlation between depressed mood and self-reported body weight was inconsistent between different age groups. In conclusion, self-rated health status and a high recognition rate of severe stress were related to body weight misperception which could suggest tailored intervention to adult women especially women in younger age or low self-rated health status or a high recognition rate of severe stress.
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Affiliation(s)
- Yoonhee Choi
- Department of Applied Life Chemistry, Seoul National University College of Agriculture and Life Science, Seoul, Korea
| | - Eunjoo Choi
- Department of Family Medicine, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea
| | - Doosup Shin
- Department of Education and Research, Seoul National University Hospital, Seoul, Korea
| | - Sang Min Park
- Department of Family Medicine, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea
| | - Kiheon Lee
- Department of Family Medicine, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Korea
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Abstract
Once concentrated among adolescent Caucasian females in high-income Western countries, today, eating disorders (EDs) are truly global. Building upon previous work describing the rise of EDs among cultures in transition, we contextualize the emergence of EDs in Asia by locating this development within the broader discourse about the processes of change that have radically transformed Asian societies over the last three decades. By identifying where EDs are emerging in the region, and by examining their particular expression, our aim is to explicate a fuller story of the relationship between culture and eating disorders. Much of the discussion of EDs in non-Western societies is predicated upon the assumption that an increase in EDs is the by-product of "Westernization", the term used to describe the process by which increased cultural contact with the West results in the transmission of so-called 'Western' ideas and cultural norms to a non-Western culture. While the Westernization literature represents a historical anchor in our understanding of EDs in Asia, we propose that this analysis is incomplete in that societal change in the form of industrialization and urbanization occurring independently from, or in tandem with, "Western" influence are critical factors contributing to the rise of EDs in Asia. Further, our review of eating disorders in Asia suggests that an understanding of the diversity and distinctiveness of the individual countries and cultures that comprise 'Asia' is crucial to understanding the emergence and rise of EDs across this vast region, suggesting that eating disorders are not culture-bound or culture-specific, but rather culture-reactive. Taking into account both the historical influence of Western culture and the more contemporary effects of Asian industrialization and urbanization, key distinctions among respective Asian cultures expands our understanding of the development and expression of EDs globally.
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Affiliation(s)
- Kathleen M. Pike
- />Departments of Psychiatry and Epidemiology, Columbia University, New York, USA
- />New York State Psychiatric Institute, Unit 9, Rm. 5808, 1051 Riverside Drive, New York, NY 10032 USA
| | - Patricia E. Dunne
- />Department of Clinical & Counseling Psychology, Columbia University (Teachers College), New York, USA
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Watson HJ, Hamer RM, Thornton LM, Peat CM, Kleiman SC, Du S, Wang H, Bulik CM. Prevalence of screening-detected eating disorders in chinese females and exploratory associations with dietary practices. EUROPEAN EATING DISORDERS REVIEW 2014; 23:68-76. [PMID: 25407415 DOI: 10.1002/erv.2334] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2014] [Revised: 10/18/2014] [Accepted: 10/24/2014] [Indexed: 02/03/2023]
Abstract
OBJECTIVE China is undergoing dramatic Westernization, hence may be able to provide unique insights into the role of sociocultural factors in disease. The purpose of this exploratory study was two-fold: to describe the prevalence of screening-detected eating disorders and disordered eating in China at the first occasion of assessment in the large-scale China Health and Nutrition Survey (CHNS) and to explore the associations between dietary practices and disordered eating. Regarding the first objective, participants are provincially representative and in subsequent waves will be followed longitudinally. METHOD CHNS participants were recruited using multistage, cluster random sampling, beginning in 1989. In this study, participants comprised 259 female adolescents (12-17 years) and 979 women (18-35 years) who participated in the CHNS 2009 survey, which is the first CHNS survey to assess disordered eating. Dietary practice-disordered eating associations were investigated with logistic regression adjusting for age, body mass index, and urbanization. RESULTS Of the participants, 6.3% (95% CI: 4.8, 8.2) of adults and 7.8% (95% CI: 5.0, 12.0) of adolescents had a screening-detected eating disorder. Dietary practices had non-significant associations with disordered eating at the general population level, except for protein consumption among women. There was evidence that skipping meals and a high-fat diet may confer risk. DISCUSSION Screening-detected eating disorders in China are lower in prevalence than in developed countries. Dietary practices had fairly limited associations with disordered eating at the general population level; protein consumption, skipping meals, and a high-fat diet are candidate dietary practice exposures for disordered eating. Copyright © 2014 John Wiley & Sons, Ltd and Eating Disorders Association.
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Affiliation(s)
- Hunna J Watson
- Department of Psychiatry, The University of North Carolina at Chapel Hill, United States; Eating Disorders Program, Child and Adolescent Health Service, Department of Health in Western Australia, Australia; School of Psychology and Speech Pathology, Curtin University, Australia; School of Paediatrics and Child Health, The University of Western Australia, Australia
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Getz MJ. The myth of Chinese Barbies: eating disorders in China including Hong Kong. J Psychiatr Ment Health Nurs 2014; 21:746-54. [PMID: 25356465 DOI: 10.1111/jpm.12115] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Much of the literature on eating disorders deals with Western subjects. Although the majority of those seen in clinical settings are Caucasians, reports from Asia suggest that anorexia nervosa and bulimia nervosa do occur in the Chinese, sparking debate as to whether or not it is the result of Westernization. This project begins with a review of the current literature on eating disorders in Chinese populations and the role of culture as a mediating factor. A psychodynamic conceptualization and the potential role of traumatic experiences are explored in the emergence of pathological eating habits. Research suggests that applying Western models for Chinese subjects with eating disorders may not always be appropriate.
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Coker E, Abraham S. Body weight dissatisfaction: a comparison of women with and without eating disorders. Eat Behav 2014; 15:453-9. [PMID: 25064299 DOI: 10.1016/j.eatbeh.2014.06.014] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/29/2013] [Revised: 04/07/2014] [Accepted: 06/12/2014] [Indexed: 11/26/2022]
Abstract
OBJECTIVE Body dissatisfaction is present in a majority of women without eating disorders (EDs), and almost all women with EDs. We compared body dissatisfaction in women with and without EDs to determine at which BMI women are content with their weight, and to determine if body dissatisfaction is affected by the presence of purging behaviours. METHODS We assessed women, age 18 to 55 with an ED (N=431) and without an ED (N=719) using the discrepancy between their current and desired BMI. This measure of body weight dissatisfaction (BWD) has been validated as being representative of overall body dissatisfaction. We also measured perceptions of (i) Body Appearance and (ii) Body Image to confirm our results. RESULTS Women with and without EDs wished to lose weight until very low weights were achieved (BMI 15-16 kg/m(2) and BMI 18-19 kg/m(2) respectively). BWD is higher in women with EDs (median 1.77, IQR 0-4.61) than women without EDs (median 0.85, IQR 0-1.80, p<0.001). Purging behaviours in women with EDs were associated with lower BMIs to achieve body satisfaction (BMI 15-16 kg/m(2)) than women who did not purge (16-17 kg/m(2)). CONCLUSIONS Body weight dissatisfaction is highly prevalent amongst women with and without EDs. Understanding body weight dissatisfaction in women with EDs and its association with purging may assist in the prevention, detection and treatment of these disorders. Women with EDs should be informed that body weight dissatisfaction will not resolve with the cessation of their disorder, as it is prevalent within the general population.
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Affiliation(s)
- Elise Coker
- Department of Women's Health, University of Sydney, Royal North Shore Hospital, NSW 2065, Australia; Northside Clinic, 2 Greenwich Road, Greenwich, NSW 2065, Australia.
| | - Suzanne Abraham
- Department of Women's Health, University of Sydney, Royal North Shore Hospital, NSW 2065, Australia; Northside Clinic, 2 Greenwich Road, Greenwich, NSW 2065, Australia
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Liao Y, Liu T, Cheng Y, Wang J, Deng Y, Hao W, Chen X, Xu Y, Wang X, Tang J. Changes in eating attitudes, eating disorders and body weight in Chinese medical university students. Int J Soc Psychiatry 2013; 59:578-85. [PMID: 22733003 DOI: 10.1177/0020764012445862] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND Eating disorders is a particular problem for university students. However, little is known about this problem among medical students who often have high stress. AIMS The aims of this study were to describe the changes in eating attitudes and eating disorders from 2006 to 2008 in a medical student sample, and to compare the gender differences of eating attitudes and body mass index (BMI, kg/m(2)) with this sample. METHODS This study was conducted in Changsha city, Mainland China. Self-reported questionnaires, including the Eating Attitudes Test (EAT) and Eating Disorders Assessment Questionnaire (CETCA), were employed to examine the changes in eating attitudes and eating disorders from 2006 to 2008 in a medical student sample (N = 500). RESULTS Self-reported findings suggest that tentative eating disorders prevalence was 0.90% (anorexia nervosa (AN): 0; bulimia nervosa (BN): 4 females) in 2006 and 1.44% (AN: 1 male; BN: 1 male and 3 females) in 2008 of the full sample. The present data showed that 2.26% (2 males and 9 females) in 2006 and 2.47% (4 males and 6 females) in 2008 of all students obtained scores greater than 20 on the EAT-26 indicative of distorted eating attitudes and behaviour. Male students kept lower distorted eating attitudes and behaviours than female students, while female students kept a lower BMI than male students in both 2006 and 2008. However, there were no statistically significant changes in eating attitudes, distorted eating attitudes and CETCA in either male or female students from 2006 to 2008. CONCLUSIONS The results of this study suggest that there were no statistically significant changes from 2006 to 2008 in eating attitudes, distorted eating attitudes and CETCA. However, females showed significantly higher eating disorders and distorted eating attitudes compared to males in both 2006 and 2008. This study is furthering our understanding of eating disorders in a Chinese cultural context.
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Affiliation(s)
- Yanhui Liao
- Mental Health Institute, Second Xiangya Hospital, Central South University, China
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Baillie LE, Copeland AL. Disordered eating and body image in Chinese and Caucasian students in the United States. Eat Behav 2013; 14:314-9. [PMID: 23910773 DOI: 10.1016/j.eatbeh.2013.05.010] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/01/2012] [Revised: 02/10/2013] [Accepted: 05/08/2013] [Indexed: 10/26/2022]
Abstract
OBJECTIVE This study evaluated the roles of exposure to Western culture and language choice and gender differences in disordered eating symptoms in Chinese and Caucasian students. METHOD 796 Caucasian and 194 Chinese students completed measures of eating disorder symptoms, body image, and body esteem. Participants chose their survey language (English or Chinese). RESULTS Caucasian women had higher levels of body dissatisfaction than Chinese women. Women of both ethnicities reported more disordered eating symptoms and body dissatisfaction than men; these differences were smaller for the Chinese group. Differences emerged on certain dimensions of body esteem between Chinese women who responded in Chinese and those who responded in English. CONCLUSIONS There were few differences between ethnicities, suggesting that mechanisms other than Western culture play a role. Cultural variables may account for the degree of intra-ethnic gender differences. Individuals who complete studies in their native language may differ from their English-responding counterparts in areas of body esteem.
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Affiliation(s)
- Lauren E Baillie
- Louisiana State University, Department of Psychology, Baton Rouge, LA 70806, USA.
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Dunne PE, Pike KM. Revisiting ‘Asia’: exploring the utility and limitations of the concept of ‘Asia’ in relation to discourse on eating disorders. ACTA ACUST UNITED AC 2013. [DOI: 10.1080/21662630.2013.742969] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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Jones-Smith JC, Gordon-Larsen P, Siddiqi A, Popkin BM. Emerging disparities in overweight by educational attainment in Chinese adults (1989-2006). Int J Obes (Lond) 2012; 36:866-75. [PMID: 21730966 PMCID: PMC3193889 DOI: 10.1038/ijo.2011.134] [Citation(s) in RCA: 55] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
OBJECTIVE To test whether a disparity in overweight by socioeconomic status (SES; represented by educational attainment) has emerged among men or women during a recent 17-year period in China. METHODS Data from the China Health and Nutrition Survey (CHNS), a panel study including 7314 women and 6492 men, are used to longitudinally track the body mass index (BMI) and odds of overweight by educational attainment among Chinese adults (baseline age 18-50) from 1989 to 2006 to determine whether individuals of low ( secondary school) educational attainment experienced a disproportionately faster increase in BMI or odds of overweight (BMI≥25) over time. The unadjusted mean BMI and prevalence of overweight by education are presented. Sex-stratified, random-effects models are used to estimate the associations, and interactions by birth cohort are included. FINDINGS Overweight prevalence doubled for women and tripled for men. In 1989, among women, the odds of overweight were not different for those of high versus those of low educational attainment; however, by 2006, the odds of overweight were significantly lower for those with the highest education in both the younger (odds ratio (OR) 0.22 (CI 0.11, 0.42)) and the older (OR 0.27 (CI 0.10, 0.72)) birth cohorts. The reverse trend is seen for men, who also begin with no difference in odds of overweight by SES, but by 2006, the OR for the highest versus the lowest education group was 3.4 (CI 1.82, 6.18). CONCLUSIONS Over 17 years, low SES has become associated with higher BMI and odds of overweight among Chinese women, whereas high SES remains a risk factor for overweight among Chinese men.
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Affiliation(s)
- J C Jones-Smith
- Center for Health and Community, The University of California-San Francisco, CA, USA
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Abstract
OBJECTIVE This study examines the risks of disordered eating among Hong Kong adolescents. SUBJECTS A total of 893 students (12-18 years old) participated in a cross-sectional study in 2007. METHODS Students' height and weight were measured and the Eating Attitudes Test (EAT-26) was completed. The risks of disordered eating were assessed by EAT-26 results and weight status. Sex differences in the risks of disordered eating were examined by logistic regression models with adjustment for age. RESULTS Based on the EAT-26 results, 18.5% of boys and 26.6% of girls were at risk of disordered eating with a significant adjusted odds ratio (OR) of 1.58 [95% confidence interval (CI) 1.15-2.18] for sex. A significant OR of 1.60 (95%CI 1.21-2.13) for sex was also obtained when both EAT-26 results and weight status were used for the screening. CONCLUSIONS Hong Kong adolescent girls have a higher risk of disordered eating than boys. EAT-26 results together with measured weight status are useful criteria for screening disordered eating attitudes and behaviors in adolescents.
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Affiliation(s)
- K-K Mak
- Department of Community Medicine and School of Public Health, Faculty of Medicine, The University of Hong Kong, 21 Sassoon Road, Pokfulam, Hong Kong.
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22
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Larrañaga A, Docet MF, García-Mayor RV. Disordered eating behaviors in type 1 diabetic patients. World J Diabetes 2011; 2:189-95. [PMID: 22087355 PMCID: PMC3215768 DOI: 10.4239/wjd.v2.i11.189] [Citation(s) in RCA: 50] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/27/2011] [Revised: 10/05/2011] [Accepted: 10/22/2011] [Indexed: 02/05/2023] Open
Abstract
Patients with type 1 diabetes mellitus are at high risk for disordered eating behaviors (DEB). Due to the fact that type 1 diabetes mellitus is one of the most common chronic illnesses of childhood and adolescence, the coexistence of eating disorders (ED) and diabetes often affects adolescents and young adults. Since weight management during this state of development can be especially difficult for those with type 1 diabetes, some diabetics may restrict or omit insulin, a condition known as diabulimia, as a form of weight control. It has been clearly shown that ED in type 1 diabetics are associated with impaired metabolic control, more frequent episodes of ketoacidosis and an earlier than expected onset of diabetes-related microvascular complications, particularly retinopathy. The management of these conditions requires a multidisciplinary team formed by an endocrinologist/diabetologist, a nurse educator, a nutritionist, a psychologist and, frequently, a psychiatrist. The treatment of type 1 diabetes patients with DEB and ED should have the following components: diabetes treatment, nutritional management and psychological therapy. A high index of suspicion of the presence of an eating disturbance, particularly among those patients with persistent poor metabolic control, repeated episodes of ketoacidosis and/or weight and shape concerns are recommended in the initial stage of diabetes treatment, especially in young women. Given the extent of the problem and the severe medical risk associated with it, more clinical and technological research aimed to improve its treatment is critical to the future health of this at-risk population.
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Affiliation(s)
- Alejandra Larrañaga
- Alejandra Larrañaga, Ricardo V García-Mayor, Eating Disorders Unit, University Hospital of Vigo, 36204 Vigo, Spain
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Cheung YTD, Lee AM, Ho SY, Li ETS, Lam TH, Fan SYS, Yip PSF. Who wants a slimmer body? The relationship between body weight status, education level and body shape dissatisfaction among young adults in Hong Kong. BMC Public Health 2011; 11:835. [PMID: 22039977 PMCID: PMC3305917 DOI: 10.1186/1471-2458-11-835] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2011] [Accepted: 10/31/2011] [Indexed: 02/07/2023] Open
Abstract
Background Body shape dissatisfaction has been thought to have an indispensable impact on weight control behaviors. We investigated the prevalence of body shape dissatisfaction (BSD) and explored its association with weight status, education level and other determinants among young adults in Hong Kong. Methods Information on anthropometry, BSD, and socio-demographics was collected from a random sample of 1205 young adults (611 men and 594 women) aged 18-27 in a community-based household survey. BSD was defined as a discrepancy between current and ideal body shape based on a figure rating scale. Cross-tabulations, homogeneity tests and logistic regression models were applied. Results The percentages of underweight men and women were 16.5% and 34.9% respectively, and the corresponding percentages of being overweight or obese were 26.7% and 13.2% for men and women respectively. Three-quarters of young adults had BSD. Among women, 30.9% of those underweight and 75.5% of those with normal weight desired a slimmer body shape. Overweight men and underweight women with lower education level were more likely to have a mismatch between weight status and BSD than those with higher education level. After controlling for other determinants, underweight women were found to have a higher likelihood to maintain their current body shapes than other women. Men were found to be less likely to have a mismatch between weight status and BSD than women. Conclusions Overweight and obesity in men and underweight in women were prevalent among Hong Kong young adults. Inappropriate body shape desire might predispose individuals to unhealthy weight loss or gain behaviors. Careful consideration of actual weight status in body shape desire is needed in health promotion and education, especially for underweight and normal weight women and those with a low education level.
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Affiliation(s)
- Yee Tak Derek Cheung
- Centre for Health Policy, Programs and Economics, School of PopulationHealth, The University of Melbourne, Melbourne, Australia
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24
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Tao Z. Epidemiological risk factor study concerning abnormal attitudes toward eating and adverse dieting behaviours among 12- to 25-years-old Chinese students. EUROPEAN EATING DISORDERS REVIEW 2010; 18:507-14. [DOI: 10.1002/erv.1032] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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Liao Y, Knoesen NP, Castle DJ, Tang J, Deng Y, Bookun R, Chen X, Hao W, Meng G, Liu T. Symptoms of disordered eating, body shape, and mood concerns in male and female Chinese medical students. Compr Psychiatry 2010; 51:516-23. [PMID: 20728010 DOI: 10.1016/j.comppsych.2009.11.007] [Citation(s) in RCA: 39] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/13/2009] [Revised: 11/15/2009] [Accepted: 11/18/2009] [Indexed: 02/03/2023] Open
Abstract
OBJECTIVE This cross-sectional study explored the prevalence of disordered eating attitudes, body shape concerns, and social anxiety and depressive symptoms in male and female medical students in China. METHOD Four hundred eighty-seven students from Central South University (Hunan Province, Changsha City, China) completed the following self-report measures: Eating Attitudes Test-26, Eating Disorders Assessment Questionnaire, Body Shape Questionnaire, Swansea Muscularity Attitudes Questionnaire, Social Interaction Anxiety Scale, and the Self-Rating Depression Scale. RESULTS A comparatively lower rate of at-risk eating attitudes (2.5%) and eating disorders (0.90%) were found compared to those reported in other studies. Significantly more female (3.2%) than male (1.2%) students had abnormal eating attitudes with 4 female students meeting Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, criteria for bulimia nervosa. Significant relationships were observed between eating attitudes, body shape concern, social anxiety, depression, and body mass index. For females, the most significant correlate of distorted eating attitudes was body shape concern, whereas for male students, social anxiety and concern with muscle size and shape were most strongly correlated with distorted eating attitudes.
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Affiliation(s)
- Yanhui Liao
- Mental Health Institute, Second Xiangya Hospital, Central South University, China
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26
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Chan CKY, Ku Y, Owens RG. Perfectionism and eating disturbances in Korean immigrants: Moderating effects of acculturation and ethnic identity. ASIAN JOURNAL OF SOCIAL PSYCHOLOGY 2010. [DOI: 10.1111/j.1467-839x.2010.01326.x] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Chen LJ, Fox KR, Haase AM. Body image and physical activity among overweight and obese girls in Taiwan. WOMENS STUDIES INTERNATIONAL FORUM 2010. [DOI: 10.1016/j.wsif.2010.01.003] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Preti A, Girolamo GD, Vilagut G, Alonso J, Graaf RD, Bruffaerts R, Demyttenaere K, Pinto-Meza A, Haro JM, Morosini P. The epidemiology of eating disorders in six European countries: results of the ESEMeD-WMH project. J Psychiatr Res 2009; 43:1125-32. [PMID: 19427647 DOI: 10.1016/j.jpsychires.2009.04.003] [Citation(s) in RCA: 285] [Impact Index Per Article: 17.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/16/2009] [Revised: 04/07/2009] [Accepted: 04/14/2009] [Indexed: 12/31/2022]
Abstract
Few data are available to estimate the prevalence of eating disorders (EDs) and their correlates in the community. This paper reports data on EDs obtained in the framework of the ESEMeD project, aimed at investigating the prevalence of non-psychotic mental disorders in six European countries (Belgium, France, Germany, Italy, the Netherlands and Spain), using a new version of the Composite International Diagnostic Interview. The ESEMeD study was a general population cross-sectional household survey. In total, 21,425 respondents aged 18 or older provided data for the project between January 2001 and August 2003. A subsample (N=4139) underwent a detailed investigation on EDs. Lifetime estimated prevalence of anorexia nervosa, bulimia nervosa, binge eating disorder, sub-threshold binge eating disorder, and any binge eating were 0.48%, 0.51%, 1.12%, 0.72%, and 2.15%, respectively, and they were 3-8 times higher among women for all EDs. However, since people under 18 were excluded from this study, our prevalence should be taken as lower-bound estimate of real frequencies. Indeed, cumulative lifetime prevalence analysis showed that the majority of eating disorders had their initial onset between 10 and 20 years of age. Role impairment and comorbidity with other mental disorders were highly common, yet only small proportions of patients with a lifetime diagnosis of EDs requested medical treatment. It still has to be proven whether early diagnostic identification and access to specialized care can reduce the burden caused by these disorders.
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Affiliation(s)
- Antonio Preti
- Department of Psychology, University of Cagliari, Cagliari, Italy
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29
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Abstract
Family and twin studies have indicated that genetic factors play a role in the development of eating disorders, such as anorexia and bulimia nervosa, but novel views and tools may enhance the identification of neurobiological mechanisms underlying these conditions. Here we propose an integrative genetic approach to reveal novel biological substrates of eating disorder traits analogous in mouse and human. For example, comparable to behavioral hyperactivity that is observed in 40-80% of anorexia nervosa patients, inbred strains of mice with different genetic backgrounds are differentially susceptible to develop behavioral hyperactivity when food restricted. In addition, a list of characteristics that are relevant to eating disorders and approaches to their measurement in humans together with potential analogous rodent models has been generated. Interspecies genetics of neurobehavioral characteristics of eating disorders has the potential to open new roads to identify and functionally test genetic pathways that influence neurocircuits relevant for these heterogeneous psychiatric disorders.
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Affiliation(s)
- Martien J H Kas
- Department of Neuroscience and Pharmacology, Rudolf Magnus Institute of Neuroscience, UMC Utrecht, The Netherlands
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30
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Tao ZL, Zhong WF. The correlation of Chinese mothers' eating attitudes and psychological characteristics with their children's eating attitudes, as well as the gender effect on eating attitudes of children. Eat Weight Disord 2008; 13:149-56. [PMID: 19011373 DOI: 10.1007/bf03327616] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/26/2022] Open
Abstract
OBJECTIVE No study has examined the connection between the mothers' weight concerns, their psychological characteristics as well as their educational level and their children's weight concerns in China. Nor has the gender effect on the eating attitudes of pre- to post-pubertal Chinese children been explored (aged 10-13). METHOD The children (girls N=138, boys N=103) were given a Chinese version of the EDI-C. Their mothers completed a Chinese version of the EDI-2. The Bivariate's (Pearson) correlation was used to examine the relationship between the mothers' weight concerns, psychological characteristics and educational level with their children's weight concerns. An Independent-Samples Ttest was conducted to comparing the EDI-C subscales of the girls and boys groups. RESULTS Regarding the mothers' and children's eating attitudes, there was a significant correlation between the mothers' weight concerns as well as their psychological characteristics with their children's eating attitudes. No significant relationship was found between the mothers' educational level and the children's eating attitudes. According to the scores of the EDI-C questionnaire, there was no general significant gender difference between Chinese children (aged 10-13). However, a differential gender effect on the body dissatisfaction of children was found for the subgroup of elders (aged 13) indicating a differential developmental dynamic. CONCLUSIONS The Chinese mothers' weight concerns and their psychological characteristics correlated with their children's eating attitudes. A gender effect on the Chinese children's eating attitudes (aged 13) was established.
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Affiliation(s)
- Z L Tao
- Department of Education, Faculty of Social Sciences, Georg-August-University, Goettingen, Germany.
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Tam CK, Ng CF, Yu CM, Young BW. Disordered eating attitudes and behaviours among adolescents in Hong Kong: prevalence and correlates. J Paediatr Child Health 2007; 43:811-7. [PMID: 17803673 DOI: 10.1111/j.1440-1754.2007.01195.x] [Citation(s) in RCA: 43] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
AIMS To study the prevalence of disordered eating attitudes and behaviours among adolescents in Hong Kong and to examine the socio-demographic and behavioural correlates. METHODS Three secondary schools with different academic performance were selected from the Eastern District of Hong Kong. A total of 2382 students enrolled in Forms 1-7 at the three schools completed a specially designed questionnaire. The questionnaire contained questions on socio-demographic information, body weight satisfaction, exposure to mass media, health behaviours as well as the Eating Attitudes Test - 26 (EAT-26). Data were analysed using Student's t-test, chi2 analysis and multivariate logistic regression models. RESULTS Disordered eating (EAT score > or =20) was present in 52 (3.9%) adolescent boys and 68 (6.5%) adolescent girls. The youngest case was only 11 years old. A high degree of body weight dissatisfaction was shared by our adolescents. Teenage girls, overweight youths and those with poor academic performance were at increased risk of having disordered eating. Strong associations were found between disordered eating and other health-compromising behaviours including smoking, alcohol and soft drug use, delinquent behaviours, suicidal ideation and self-harm behaviours. Exposure to entertainment, beauty and youth magazines was positively related to disordered eating. CONCLUSIONS Disordered eating is prevalent among adolescents in Hong Kong. It remains a significant public health challenge to our community. Prevention programmes targeting youths at the greatest risk should be considered.
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Affiliation(s)
- Carmen Km Tam
- Department of Paediatrics and Adolescent Medicine, Pamela Youde Nethersole Eastern Hospital, Chai Wan, Hong Kong.
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Page RM, Suwanteerangkul J. Dieting among Thai adolescents: having friends who diet and pressure to diet. Eat Weight Disord 2007; 12:114-24. [PMID: 17984635 DOI: 10.1007/bf03327638] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/26/2022] Open
Abstract
The purpose of this study was to assess dieting behavior, the number of friends who diet, and number of friends who pressure to go on a diet among a sample of 2,519 Thai adolescents. More than half of the girls (52.2%) and over one-fourth of boys (28.0%) reported going on a diet in the past 30 days. Dieting among friends was very common with only 14.2% of girls and 34.3% of boys saying none of their friends dieted. Results also showed significant associations between 1) number of friends who diet and 2) number of friends who pressure to diet with dieting behavior, body mass index (BMI), weight satisfaction, perceived body fatness, effort to look like people in the media, and frequency of thinking about wanting to be thinner in girls. In addition, several of these associations for boys were significant. The role of BMI in these relationships was also explored.
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Affiliation(s)
- R M Page
- Department of Health Science, 221 Richards Building, Brigham Young University, Provo, Utah 84602, USA.
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Tseng MMC, Fang D, Lee MB, Chie WC, Liu JP, Chen WJ. Two-phase survey of eating disorders in gifted dance and non-dance high-school students in Taiwan. Psychol Med 2007; 37:1085-1096. [PMID: 17349103 DOI: 10.1017/s0033291707000323] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
BACKGROUND Despite a growing body of literature reporting eating disorders (EDs) in non-Western countries in recent years, most of these studies are limited to questionnaire-based surveys or case-series studies. This study aimed to investigate the prevalence and correlates of EDs in Taiwanese high-school students. METHODS The study subjects consisted of all the female high-school students enrolled in the gifted dance class in 2003 in Taiwan (n=655) and non-dance female students randomly chosen from the same school (n=1251). All the participants were asked to complete self-report questionnaires, including the 26-item Eating Attitudes Test (EAT-26) and the Bulimic Investigatory Test Edinburgh (BITE). All the screen positives and an approximate 10% random sample of the screen negatives were then interviewed using the Structured Clinical Interview for DSM-IV-TR Axis I Disorders Patient Version (SCID-I/P). RESULTS The prevalence of individual EDs was much higher in the dance [0.7% for anorexia nervosa (AN), 2.5% for bulimia nervosa (BN) and 4.8% for EDs, not otherwise specified (EDNOS)] than in the non-dance (0.1, 1.0 and 0.7% respectively) students. Multivariate logistic regression analyses revealed that being in the dance class, higher concern about body shape and lower family support were correlates of EDs for all students, whereas lower parental education level was associated with EDs only for non-dance students. CONCLUSION EDs were more prevalent in the weight-concerned subpopulation. Although AN is still rare, BN has emerged as a comparable prevalent disorder in Taiwan, as in Western countries.
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Affiliation(s)
- Meg Mei-Chih Tseng
- Department of Psychiatry, National Taiwan University Hospital and College of Medicine, National Taiwan University, Taipei, Taiwan
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Dearth-Wesley T, Wang H, Popkin BM. Under- and overnutrition dynamics in Chinese children and adults (1991-2004). Eur J Clin Nutr 2007; 62:1302-7. [PMID: 17637598 DOI: 10.1038/sj.ejcn.1602853] [Citation(s) in RCA: 69] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
OBJECTIVE To examine trends in under- and overweight prevalence from 1991 to 2004 among adults and children in China by income and residence differentials. METHODS/SUBJECTS Prevalence, average annual changes and annual relative changes in under- and overweight were determined. In 1991, 2848 children and 6806 adults were surveyed. The 2004 survey included 1566 children and 6172 adults. RESULTS Higher average annual reductions in underweight prevalence were found among children, particularly rural children, when compared with adults. With respect to income, low-income children and adults experienced the greatest average annual reductions in underweight prevalence. The trend for increased overweight was more pronounced than the trend for decreased underweight. Intensified trends were found among adults (versus children) and males (versus females). Relative to baseline prevalence, overweight increased fastest among adults in low-income and rural populations. CONCLUSIONS Rapid increases in the overweight prevalence, particularly as found among low-income and rural Chinese adults, will likely lead to a shift in the burden of obesity-related chronic diseases toward the poor. Associated economic and health implications will further challenge the country's health care system, restrain economic development and widen existing disparities between the rural and urban as well as between the rich and poor populations of China.
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Affiliation(s)
- T Dearth-Wesley
- Department of Nutrition and Carolina Population Center, University of North Carolina at Chapel Hill, Chapel Hill, NC 27516-3997, USA
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Chen H, Jackson T, Huang X. The Negative Physical Self Scale: Initial development and validation in samples of Chinese adolescents and young adults. Body Image 2006; 3:401-12. [PMID: 18089244 DOI: 10.1016/j.bodyim.2006.07.005] [Citation(s) in RCA: 113] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/20/2006] [Revised: 07/16/2006] [Accepted: 07/17/2006] [Indexed: 11/15/2022]
Abstract
This research presents four studies on the initial development and validation of the 48-item Negative Physical Self Scale (NPS), a multidimensional measure of body image concerns for use with Chinese samples. In Study 1 (N=1095), exploratory factor analyses identified five dimensions underlying the NPS (General Appearance, Facial Appearance, Shortness, Fatness, Thinness). In Study 2 (N=1057), confirmatory factor analyses replicated this factor structure. In Studies 3 and 4, the validity of all NPS dimensions except Thinness Concern was supported via their patterns of relation with both objective physical characteristics/behaviors and other self-report measures of body image and general self worth. Because Chinese adolescents and young adults expressed relatively more concerns about General Appearance, Shortness, and Facial Appearance than about Fatness, the NPS may have greater utility for assessing body image disturbances in China than existing measures that focus exclusively on general body satisfaction and body size/weight.
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Affiliation(s)
- Hong Chen
- School of Psychology, Southwest University, Chongqing, China.
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36
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Multidimensional Assessment of Body Dissatisfaction and Disordered Eating in Korean and US College Women: A Comparative Study. SEX ROLES 2006. [DOI: 10.1007/s11199-006-9058-3] [Citation(s) in RCA: 31] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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le Grange D, Louw J, Russell B, Nel T, Silkstone C. Eating attitudes and behaviours in South african adolescents and young adults. Transcult Psychiatry 2006; 43:401-17. [PMID: 17090625 DOI: 10.1177/1363461506066984] [Citation(s) in RCA: 18] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
We examined the presence and severity of disordered eating attitudes and behaviours in a group of 895 South Africans. The Eating Attitude Test-26 (EAT-26), the Bulimic Investigatory Test, Edinburgh (BITE) and the Rosenberg Self-esteem Scale (RSE), were administered to high-school and college students (515 White, 126 Black, and 254 'Coloured'). There were few differences between these three groups on measures of eating disorder pathology and self-esteem. A small number of participants (3.5%) were identified as at 'high risk' for an eating disorder as shown by scores in the clinical range for both the EAT-26 and BITE. Weight, self-esteem and age were predictors for this subgroup. This study suggests that ethnicity per se may not 'protect' against the development of disordered eating attitudes and behaviours in nonwestern black populations. These findings remain tentative until future survey studies employ interviews to confirm eating disorder diagnosis.
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Affiliation(s)
- Daniel le Grange
- Department of Psychiatry, Section for Child and Adolescent Psychiatry, University of Chicago, IL 60637, USA.
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Makino M, Hashizume M, Tsuboi K, Yasushi M, Dennerstein L. Comparative study of attitudes to eating between male and female students in the People's Republic of China. Eat Weight Disord 2006; 11:111-7. [PMID: 17075237 DOI: 10.1007/bf03327555] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/26/2022] Open
Abstract
OBJECTIVE This study was conducted to compare eating attitudes and lifestyles of male and female college students in China (Beijing). SUBJECTS AND METHODS The subjects of this study consisted of 217 male and 177 female college students. They were asked to fill out the Eating Attitudes Test-26 (EAT-26) and a lifestyle questionnaire. RESULTS The percentages of those above the cutoff point on the EAT-26 for abnormal eating attitudes were 4.7% of male and 6.2% of female students. Body perception of being fat (distorted body image) was the factor most associated with abnormal eating attitudes. DISCUSSION Weight related concern was prevalent amongst the Chinese students. This suggests that the culture of the beauty of thinness is common among young students in Beijing, particularly female students.
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Affiliation(s)
- M Makino
- Office for Gender and Health, Department of Psychiatry, The University of Melbourne, Melbourne, Victoria, Australia
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Jennings PS, Forbes D, McDermott B, Hulse G, Juniper S. Eating disorder attitudes and psychopathology in Caucasian Australian, Asian Australian and Thai university students. Aust N Z J Psychiatry 2006; 40:143-9. [PMID: 16476132 DOI: 10.1080/j.1440-1614.2006.01761.x] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
OBJECTIVE To examine eating disorder attitudes and psychopathology among female university students in Australia and Thailand. METHOD Participants were 110 Caucasian Australians, 130 Asian Australians and 101 Thais in Thailand. The instruments included the Eating Attitudes Test (EAT) and the Eating Disorders Inventory (EDI). RESULTS Eating disorder attitudes and psychopathology scores in the Thai group were found to be highest. The Asian Australian group did not have significantly higher scores on the EAT-26 than the Caucasian Australian group, but had higher scores in some subscales of the EDI-2. That the Thai group had the highest scores in susceptibility to developing an eating disorder and eating disorder psychopathology may be partially explained in sociocultural terms, with pressure to be thin more extreme in Thailand than in Australia. The evidence suggested that unhealthy eating disorder psychopathology is not limited to Western societies but is already present in Thai and other Asian societies.
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Affiliation(s)
- Piangchai S Jennings
- School of Psychiatry and Clinical Neurosciences, Princess Margaret Hospital for Children, The University of Western Australia, Perth, Australia.
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Santonastaso P, Scicluna D, Colombo G, Zanetti T, Favaro A. Eating disorders and attitudes in Maltese and Italian female students. Psychopathology 2006; 39:153-7. [PMID: 16531691 DOI: 10.1159/000091801] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/07/2004] [Accepted: 07/08/2005] [Indexed: 11/19/2022]
Abstract
BACKGROUND No study to date has investigated the frequency of eating disorders (ED) in Malta. The aim of the present study was to provide a cross-cultural comparison between Malta and Italy as regards the frequency of ED and problematic eating attitudes among female students. SAMPLING AND METHODS 128 Maltese and 135 Italian female students aged 16-20 were surveyed. Subjects underwent a structured clinical interview and completed some self-reported questionnaires: the Eating Attitudes Test, the Inventory for the Screening of Eating Disorders and the Eating Disorders Examination-Screening Version. RESULTS The rates of ED are very similar in the two samples with the exception of the frequency of binge eating disorder which is zero in the Italian sample and 4% among Maltese students. Maltese female students weighed significantly more than their Italian counterparts. They also reported more frequent dieting, fear of fatness and experience of low self-esteem related to body shape and weight. CONCLUSIONS Despite the fact that Maltese female students have a greater tendency to be overweight and display more problematic eating and body attitudes, their risk of developing ED, with the exception of binge eating disorder, is similar to that of their Italian counterparts.
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Soh NL, Touyz SW, Surgenor LJ. Eating and body image disturbances across cultures: a review. EUROPEAN EATING DISORDERS REVIEW 2006. [DOI: 10.1002/erv.678] [Citation(s) in RCA: 91] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
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Nunes MA, Camey S, Olinto MTA, Mari JJ. The validity and 4-year test-retest reliability of the Brazilian version of the Eating Attitudes Test-26. Braz J Med Biol Res 2005; 38:1655-62. [PMID: 16258635 DOI: 10.1590/s0100-879x2005001100013] [Citation(s) in RCA: 45] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
In a cross-sectional study conducted four years ago to assess the validity of the Brazilian version of the Eating Attitudes Test-26 (EAT-26) for the identification of abnormal eating behaviors in a population of young females in Southern Brazil, 56 women presented abnormal eating behavior as indicated by the EAT-26 and the Edinburgh Bulimic Investigation Test. They were each matched for age and neighborhood to two normal controls (N = 112) and were re-assessed four years later with the two screening questionnaires plus the Composite International Diagnostic Interview (CIDI). The EAT results were then compared to diagnoses originating from the CIDI. To evaluate the temporal stability of the two screening questionnaires, a test-retest design was applied to estimate kappa coefficients for individual items. Given the prevalence of eating disorders of 6.2%, the CIDI psychiatry interview was applied to 161 women. Of these, 0.6% exhibited anorexia nervosa and 5.6%, bulimia nervosa (10 positive cases). The validity coefficients of the EAT were: 40% sensitivity, 84% specificity, and 14% positive predictive value. Cronbach's coefficient was 0.75. For each EAT item, the kappa index was not higher than 0.344 and the correlation coefficient was lower than 0.488. We conclude that the EAT-26 exhibited low validity coefficients for sensitivity and positive predictive value, and showed a poor temporal stability. It is reasonable to assume that these results were not influenced by the low prevalence of eating disorders in the community. Thus, the results cast doubts on the ability of the EAT-26 test to identify cases of abnormal eating behaviors in this population.
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Affiliation(s)
- M A Nunes
- Departamento de Psiquiatria, Universidade Federal de São Paulo, São Paulo, SP, Brazil.
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Cummins LH, Simmons AM, Zane NWS. Eating disorders in Asian populations: a critique of current approaches to the study of culture, ethnicity, and eating disorders. THE AMERICAN JOURNAL OF ORTHOPSYCHIATRY 2005; 75:553-74. [PMID: 16262514 DOI: 10.1037/0002-9432.75.4.553] [Citation(s) in RCA: 55] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/05/2023]
Abstract
There is increasing evidence that eating disorders are present among ethnically diverse populations, and researchers have suggested that investigations in this area may inform the field's understanding of how sociocultural factors are related to the development of eating disorders. Although it is generally accepted that sociocultural factors are key in eating disorder etiology, knowledge on how best to study these influences in diverse groups is still limited. In this article, the authors review how the research literature has explored relationships among culture, ethnicity, and eating disorders in Asian populations and critically examine strategies that have been used to investigate these issues across 1 ethnic/racial group. The methodological challenges encountered in these approaches are identified and considered in the provision of recommendations for future endeavors to improve the field's understanding of how culture is related to eating disorders.
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Affiliation(s)
- Lillian Huang Cummins
- California School of Professional Psychology, Alliant International University, CA 94133, USA.
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Page RM, Lee CM, Miao NF. Self-perception of body weight among high school students in Taipei, Taiwan. Int J Adolesc Med Health 2005; 17:123-36. [PMID: 15971733 DOI: 10.1515/ijamh.2005.17.2.123] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/03/2023]
Abstract
Self-perception of body weight and other weight-related factors were assessed among 2665 Taipei, Taiwan high school students. A high percent of the girls (70.7%) and boys (42.2%) reported that they were too fat and these percentages were much higher than those reported by U.S. students in a recent Youth Risk Behavior Survey. In addition, only 13.2% of girls and 22.0% of boys reported being completely satisfied with their weight and the level of dissatisfaction with weight appeared to be greater than among U.S. students. Yet, in comparison to U.S. students, the Taiwanese students were considerably less likely than their U.S. counterparts to engage in weight management practices (e.g., dieting, eating less food, using diet pills). Taiwanese students with a self-perception of being too fat were more likely than those with perceptions of being just right or too thin to engage in weight management practices, to be dissatisfied with their weight, feel that they were unattractive, estimate that their same-sex peers were trying to lose weight, and have a higher body mass index. The findings from this study showed a relationship between self-perception of body size and engaging in weight control behaviors was consistent with other research. It suggested that self-perception of body weight, more so than objective weight status, was predictive of weight loss behavior and also negative psychological outcomes associated with poor body weight image. As a result, self-perception of weight may be an important point of focus for the design and implementation of clinical and public health initiatives targeted at this adolescent population as well as others.
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Affiliation(s)
- Randy M Page
- Department of Health Science, Brigham Young University, 221 Richards Building, Provo, UT 84602, USA.
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Lai BPY, Tang CSK, Tse WKL. Prevalence and psychosocial correlates of disordered eating among Chinese pregnant women in Hong Kong. Eat Disord 2005; 13:171-86. [PMID: 16864340 DOI: 10.1080/10640260590918991] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
Three-hundred-and-fifty-nine Chinese pregnant women were surveyed to determine prevalence and psychosocial correlates of eating disturbance in pregnancy. About 9.8% of participants reported disordered eating symptoms. Prevalence of these symptoms was related to general factors of drive for thinness, body image dissatisfaction, and traditional gender role attitudes. These general factors were, in turn, associated with factors specific to pregnant women. In particular, drive for thinness was related to poor spousal support; body image dissatisfaction was related to poor maternal-fetal attachment; and traditional gender role attitudes were related to strong maternal-fetal attachment and spousal support. Limitations and implications of these findings are discussed.
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Affiliation(s)
- Beatrice Pui-Yee Lai
- Department of Psychology, the Chinese University of Hong Kong, Shatin, New Territories, Hong Kong
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Marlowe K. A preliminary study of EAT and BITE scores for one school year in Bermuda: increased early anorexic measures related to socio-economic factors. Int J Soc Psychiatry 2005; 51:5-12. [PMID: 15864970 DOI: 10.1177/0020764005053265] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND Bermuda is a unique heterogeneous ethnic population in which it is possible to study the interaction of ethnicity, culture, gender and economic factors that influence abnormal eating attitudes. METHOD A cross-sectional survey of 836 adolescents, one total school year in Bermuda. The BITE and EAT self-report questionnaires were administered in a classroom setting. The analysis was for caseness and for total scores. Caseness represents possible developing anorexic or bulimic eating disorder pathology for this non-adult population. RESULTS 7.3% fulfilled EAT caseness, 0.24% fulfilled BITE caseness. There was no gender or ethnic difference for caseness. Multivariate analysis for EAT caseness found Odds Ratios of 2.89 (95% CI 1.37, 6.11) for Manual maternal job status. CONCLUSION Despite the limitation of a questionnaire analysis, lower socioeconomic status increases the risk of possible eating disorder pathology in this adolescent population. Developing anorexic eating attitudes were more prevalent compared to bulimic attitudes for schoolchildren in this unique cultural setting.
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Affiliation(s)
- Karl Marlowe
- Lambeth Early Onset Services, South London and Maudsley NHS Trust, London, UK.
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A comparison of body-image dissatisfaction and eating disturbance among Australian and Hong Kong women. EUROPEAN EATING DISORDERS REVIEW 2005. [DOI: 10.1002/erv.641] [Citation(s) in RCA: 18] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
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Nevonen L, Norring C. Socio-economic variables and eating disorders: a comparison between patients and normal controls. Eat Weight Disord 2004; 9:279-84. [PMID: 15844400 DOI: 10.1007/bf03325082] [Citation(s) in RCA: 17] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/26/2022] Open
Abstract
OBJECTIVE Previous research demonstrates that the relationship between socio-economic status (SES) and eating disorders is not consistent. The present study compares SES and demographic factors among Swedish women, randomly drawn from the population register and female patients seen for treatment. METHOD 223 consecutive eating disorder patients (ED) between 18 and 24 years of age (anorexia, n=26, bulimia, n=127, Eating disorder not otherwise specified, n=70) were compared with 750 normal controls (CONT) between 18 and 24 years of age. Both groups were assessed using the same questionnaire regarding SES and demographic factors. RESULTS ED's have a higher SES background and live in more privileged socio-demographic areas than CONT. ED's have lower social status, have more separations, and are more often single than CONT. CONCLUSION These data demonstrate a connection between high socio-economic and demographic data, low social status and eating disorder patients compared to normal controls.
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Affiliation(s)
- L Nevonen
- Child and Adolescent Psychiatry Centre, Queen Silvia Children's Hospital, Göteborg, Sweden.
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Humphry TA, Ricciardelli LA. The development of eating pathology in Chinese-Australian women: acculturation versus culture clash. Int J Eat Disord 2004; 35:579-88. [PMID: 15101073 DOI: 10.1002/eat.10269] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
OBJECTIVE Recent research suggests there has been an increase in the incidence of eating pathology among Asian women residing in the West. Two alternate explanations for the development of this eating pathology have been proposed; acculturation versus culture clash. The current study was designed to further examine the influence of acculturation versus culture clash on the development of eating pathology in Chinese-Australian women. METHOD Eighty-one Chinese-Australian women completed a questionnaire investigating their level of eating pathology, perceived sociocultural influences to lose weight, parental overprotection and care, self-perceptions of physical appearance, sociability and global self-worth, and the strength of their ethnic identity. RESULTS It was found that, overall, low levels of satisfaction with physical appearance, high levels of parental overprotection, and high levels of perceived pressure from best female friends to lose weight predicted greater eating pathology in both acculturated and traditional women. However, acculturated women who perceived higher levels of pressure from their fathers and best male friends to lose weight and traditional women who experienced higher levels of parental care reported the greatest eating pathology. DISCUSSION The findings suggest that there are both similarities and differences between the risk factors that correlate with eating pathology between acculturated and traditional women.
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Ball K, Kenardy J. Body weight, body image, and eating behaviours: relationships with ethnicity and acculturation in a community sample of young Australian women. Eat Behav 2004; 3:205-16. [PMID: 15000999 DOI: 10.1016/s1471-0153(02)00062-4] [Citation(s) in RCA: 37] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 03/19/2002] [Indexed: 10/27/2022]
Abstract
A study was conducted to investigate associations between ethnicity and acculturation status and risk factors for eating disorders among young adult women. A community sample of 14,779 women aged 18-23 completed a comprehensive mail-out survey, which incorporated questions on country of birth, length of time spent in Australia, body weight, weight dissatisfaction, dieting, binge eating, and compensatory disordered eating behaviours. Results showed that risk factors for eating disorders were present across a range of ethnic groups. Further, a strong acculturation effect was observed, such that the longer the time spent in Australia, the more women reported weight-related values and behaviours similar to those of Australian-born women. Results challenge claims that risk factors for disordered eating are restricted to Caucasian females in Western societies. Implications for understanding ethnic and sociocultural influences on body weight, dieting, and disordered eating are considered.
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Affiliation(s)
- Kylie Ball
- School of Health Sciences, Deakin University, 221 Burwood Highway, Burwood, Victoria 3125, Australia.
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