Many cultures around the worldview food as a way to nourish the body and bring people together without having anything to do with weight whereas other cultures view food concerning fat-phobia. Geography, religion, gender, marriage, ethical values, and social norms all contribute to an individual culture and as a result perceptions regarding food, body image, and their relationship are all shaped by each culture. For example, fasting is a cultural tradition in many religions in the eastern world; however, fasting is viewed as a way to lose weight in the western world.

Individuals diagnosed with anorexia nervosa in eastern countries, such as China, Japan, Singapore, Malaysia, and India do not present with fat-phobic ideas about their body, whereas this is generally seen as a traditional anorexia nervosa symptom in western cultures such as in the United States. Additionally many individuals in South Africa and Sub-Saharan Africa have a preoccupation with food but not because of an eating disorder, but, instead, because of poverty, food shortage, and hunger. As a result of these stark differences among cultures and individuals, cultural considerations in treatment for eating disorders is a crucial part of the healing process.

Body image perceptions across the globe

The Western culture in general, for example, is one that tends to be hyper-focused on dieting and body appearance. Digitally retouched photos are the norm that saturates the western world, which can contribute to a negative influence on body image. Other cultures are focused on celebrating what the physical body is capable of doing rather than focusing on the body’s physical appearance, which may more effectively support the building of a positive body image. Another stark contrast is how cultures view body weight. For example, many Latin and African cultures view that a larger body type is a sign of wealth, fertility, and success whereas individuals in North America view larger body types as shameful and unhealthy. If one is underweight in Africa people will most likely associate them with poverty whereas this person will be deemed attractive in the western world. Cultures, where female social roles are restricted, appear to have lower rates of eating disorders; reminiscent of the lower rates observed during historical eras in which women lacked choices. For example, some modern affluent Muslim societies limit the social behavior of women according to male dictates; in such societies, eating disorders are virtually unknown. This supports the notion that freedom for women is a sociocultural factor that may predispose to the development of eating disorders.

Body image plays a significant role in eating disorder treatment, and many experts argue that body weight and size should not be a contributing factor when making an eating disorder diagnosis, but rather diagnostic criteria should focus more on the individual’s behaviors and their mindset regarding their self-image.

Treatment for eating disorders by incorporating culture

The crux of eating disorder treatment is recognizing that each individual is different in regards to food and body image. Ask your client questions about where they grew up, where their family is from and how they were raised.

  • Did they have family dinners?
  • Did their parents talk about weight?
  • Are they from a different culture than what you are used to?
  • What is their relationship to the body?
  • What do they feel the body is intended for?
  • How are they connected to it? Is their religion important to them?
  • What do they believe and how does this relate to their body or eating habits?
  • How do they view societal ideas of body image and nutrition and is this different from what they have been taught or what they believe?
  • How do their culture view food and body image?