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.

The changing face of eating disorders calls for a new conceptualization of culture in both the emergence and spread of eating disorders across the globe.

Eating disorders have long been recognized as problems afflicting a narrow segment of select populations: Caucasian, adolescent or young adult women from high-income Western countries. This review highlights recent data that reexamine and revise this constricted view of eating disorders in two specific ways. First, data are steadily accumulating that document the increasing prevalence of eating disorders among younger and older individuals. Pre-pubertal children and women in middle and late adulthood are increasingly presenting for eating disorder treatment. Second, data from around the globe indicate that there is nothing uniquely "Western" about eating disorders. As highlighted in this review, eating disorders are a global health problem, and they are predictably on the rise in many parts of the world. The data are also clear that ethnic and racial minority groups and immigrants within North America are vulnerable to eating disorders. This growing knowledge base expands the boundaries of what has historically been considered the "typical" eating disordered patient and should raise awareness among health care providers of the needs of the broader community that is at risk for eating disturbances.

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