Assessment Of Disordered Eating By Israeli And American College Women

College Student Journal, Dec, 2000 by Martin Heesacker, Amanda W. Samson, Jodi L. Shir

Generalizing from research showing that group norms influence disordered eating, college women from Israel. whose culture differs from America's in important ways, were predicted to show lower levels of disordered eating than comparable Americans. We assessed disordered eating in typical Israeli and American college women, using two validated measures of disordered eating. Multivariate analysis of variance comparing scores from 113 Americans and 124 Israelis on the two measures indicated that Americans indeed scored significantly higher than Israelis (p [is less than] .0001). The greatest differences were in body dissatisfaction (p [is less than] .006) and introceptive awareness (p [is less than] .006). Internal consistency reliabilities and subscale intercorrelations were similar for the two samples, suggesting that factor-structure differences cannot account for the national effects.

The occurrence of disordered eating behavior among American college women and other women from Western cultures is widespread. For example, in one study. 64% of American college women sampled exhibited some degree of disordered eating behavior (Mintz & Betz, 1988), suggesting that disordered eating is the rule rather than the exception among these women. A recent study of American collegiate women indicated that 40% had intentionally vomited to control their weight (Tsai, Hoerr, & Song, 1998). Even among American college women who perceived themselves as of normal weight, 88% reported wanting to be thinner (Raudenbush & Zellner, 1997). These studies and others (e.g., Fairburn & Garner, 1986; Hawkins & Clement, 1980; Patton, 1988; Wardle, 1980) suggest a problem of major proportions in American society.

One explanation for the prevalence of disordered eating focuses on the role of sociocultural factors (e.g., Garner & Garfinkel, 1982; Swift & Stern, 1982). Because of the overrepresentation of disordered eating in the Western, adolescent female population, investigators have argued that the unrealistic standards of beauty in American and other Western cultures are a primary factor in the development and maintenance of disordered eating.

Crandall (1988) has tracked the influence of social norms on binge eating in two American collegiate social sororities. His results clearly indicate that sociocultural forces can facilitate disordered eating via the influence of social norms. This work revealed that such norms were significant predictors of the extent of student binge eating in American samples.

Within American culture, different subcultures also can differ in their disordered-eating rates. Black collegiate women suffer from disordered eating less than White collegiate women (Abood & Chandler, 1997; Powell & Kahn, 1995). Consistent with Crandall's (1988) results, Powell and Kahn (1995) found that normative pressures to be thin were less intense for Black then for White American women. For example, Black American men had greater desire to date heavy women then did White American men, and the Black American men were less likely than the White men to believe they would be ridiculed for dating heavy women.

There is some controversy in this field regarding the relationship between anorexia and bulimia, on the one hand, and disordered eating that is not clinically diagnosable, on the other. This article is concerned with disordered eating, generally, including both clinically-diagnosable and other forms. Like other researchers (e.g., Mintz & Betz, 1988; Schwitzer, Bergholz, Dore, & Salimi, 1998; Vernado, Williamson, & Netemeyer, 1995), we view disordered eating along a continuum, with healthy eating at one end, subclinical disordered eating in the middle, and such disorders as anorexia and bulimia at the other end. Both formal eating disorders and subclinical forms of disordered eating constitute important problems in and impediments to the development of Western women.

Research on anorexia suggests that cultural pressures on women to be thin may have a causal role in the manifestation of anorexia (e.g., Garner & Garfinkel, 1980; Habermas, 1990). Most conceptualizations of anorexia are consistent with Garner and Garfinkle's notion that cultural factors are important in the development or maintenance of anorexia (Swartz, 1985).

Culture and Disordered Eating

If sociocultural factors actually influence disordered eating, cultures without an emphasis on thinness should show less disordered eating. For example, disordered eating patterns should differ outside of Western nations because non-Western cultures often hold standards of beauty that do not emphasize thinness. In fact, plumpness is considered attractive in much of the non-Western world and obesity is sometimes considered a secondary sexual characteristic (Buhrich, 1981; Hamodi, 1960; Meyer & Tuchelt-Gallwitz, 1968; Orbach, 1978; Rudofsky, 1972).

Consistent with this notion that sociocultural factors influence disordered eating, research indicates that at least until recently anorexia has been rare or absent in non-Western cultures (German, 1972; Neki, 1973; Okasha, Kamel, Sadek, Lotaif, & Bishry, 1977). Taking a somewhat different perspective on the issue of the influence of Western culture, Goldblatt, Moore, and Stunkard's (1965) Midtown Manhattan study found an inverse relationship between the length of exposure to the American society and obesity. Likewise, Furnham and Althai (1983) demonstrated that Kenyan women with Asian backgrounds rated larger human figures more favorably than Kenyan women with British backgrounds, suggesting that exposure to British culture may have led to a valuing of thinness. Similarly, Fichter, Weyerer, Sourdi, and Sourd (1983) identified a higher incidence of anorexia among Greek girls in Munich than among Greek girls in Greece. Nasser (1988) assessed two matched samples of Arab female students attending universities in London and Cairo. Six cases of bulimia were identified in the London sample and none in the Cairo sample. Cogan and her colleagues found that Ghanian collegians rated larger body sizes as ideal significantly more often than Americans did, and that Americans dieted more and more often viewed weight as a social impediment (Cogan, Bhala, Sefa-Dedeh, & Rothblum, 1996). These studies document that for citizens of countries experiencing recent social upheaval (China, the Czech Republic, and South Africa) greater Western influence has been accompanied by increases in disordered eating (Krch, 1995; Le Grange, Telch, & Tibbs, 1998; Lee, Leung, Lee, Yu, & Leung, 1996). Taken together, this group of findings lend support to the notion that Western culture may influence disordered eating.