A review of the literature on ethnocultural identity and eating disorders indicates a relationship between conflicted identity and eating disturbance. This article discusses that relationship by suggesting that eating disorders represent internalized means of oppression for women of color. Difficulties in diagnosis and treatment of eating disorders in women of color are identified. Suggestions for ways in which diagnosis, assessment, and treatment of eating disorders may become more culturally relevant and effective are offered.Eating disorders occur in men, but the incidence is much higher in women. According to the Diagnostic and Statistical Manual of Mental Disorders (4th ed.; DSM-FV; American Psychiatric Association, 1994), anorexia nervosa, the infliction of self-starvation for purposes of weight control and fat avoidance, is estimated at an incidence level of 0.5% to 1% of adolescent girls. Bulimia nervosa, the ritualistic bingeing on high-calorie foods and subsequent purging for purposes of weight control, is estimated at 1% to 5% of college-age women (Drewnowski, Hopkins, & Kessler, 1988) and 1% to 3% of adolescent and young adult females (American Psychiatric Association, 1994). Although compulsive eating is not considered a specific diagnosis in the DSM-IV, some authors suggest that its prevalence may be as high as 20% of men and women. The highest rate for the occurrence of this disorder occurs among 45-to 54-yearold African American women (Rand & Kuldau, 1990).The relationship between ethnocultural identity, eating practices, and cultural convergence is a complex one that crosses boundaries of nationality, ethnicity, culture, and immigration status. The purpose of this article is to provide clinicians with a framework for understanding eating disorders from a cultural perspective. We suggest that eating disorders may be symptomatic of conflicting cultural demands for beauty and acceptance. The suppression of these conflicting demands through internalized oppression may result in specific disordered eating symp-DIANE J. HARRIS is an associate professor in the Psychology Department and coordinator of the School Psychology Graduate Program at San Francisco State University. She also maintains an independent practice in Oakland, CA. She received her PhD from the University of Michigan. Her research interests include the effects of clinical issues (eating disorders, racism, and sexism) on the development of females of color. SUE A. KUBA received her PhD in clinical psychology from the California School of Professional Psychology (CSPP) in 1981. She is currently a professor of psychology at CSPP, Fresno, and is coordinator of the health psychology program, teaching and writing on eating disorders, women's health, clinical supervision, and diversity issues. She has also maintained an independent practice since 1984.

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The relationship between ethnocultural identity, eating practices, and cultural expectations is complex. When there are conflicting cultural demands, eating disturbances can occur. These disturbances affect many aspects of a woman's life, including her quality of life, health, relationships, and academic/career success. Contextual variables that may influence eating disorders in women of color include (a) level of acculturation, (b) socioeconomic status (SES), (c) peer socialization, (d) family structure, and (e) immigration status. This study examined these variables in a college sample of 115 Mexican American women. Each completed a demographic questionnaire and standardized instruments to measure acculturation, eating disorder symptoms, and family issues. Multiple regression analysis indicated that family rigidity contributes to an increased susceptibility for bulimic symptoms (p < .0001). Poor peer socialization and family rigidity were related to the preoccupation with body size and slimness, thus placing young Mexican American women at greater risk for developing self-destructive eating patterns such as severe weight control and dieting behaviors (p < .0001). Implications for health, quality of life, and appropriate therapeutic care are discussed.

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The relationship between ethnocultural identity, eating practices, and cultural expectations is complex. When there are conflicting cultural demands, eating disturbances can occur. These disturbances affect many aspects of a woman's life, including her quality of life, health, relationships, and academic/career success. Contextual variables that may influence eating disorders in women of color include (a) level of acculturation, (b) socioeconomic status (SES), (c) peer socialization, (d) family structure, and (e) immigration status. This study examined these variables in a college sample of 115 Mexican American women. Each completed a demographic questionnaire and standardized instruments to measure acculturation, eating disorder symptoms, and family issues. Multiple regression analysis indicated that family rigidity contributes to an increased susceptibility for bulimic symptoms (p < .0001). Poor peer socialization and family rigidity were related to the preoccupation with body size and slimness, thus placing young Mexican American women at greater risk for developing self-destructive eating patterns such as severe weight control and dieting behaviors (p < .0001). Implications for health, quality of life, and appropriate therapeutic care are discussed.