Ethnocultural identity and eating disorders in women of color.

Abstract

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.

Addressing Gender and Cultural Diversity in Body Image: Objectification Theory as a Framework for Integrating Theories and Grounding Research

“…For example, pressures about skin tone, hair color and texture, facial features, and shape and size of body parts may shape manifestations of body surveillance, body shame, and other objectification theory constructs and contribute to body image and eating problems for racial or ethnic minority women (e.g., Buchanan et al 2008;Greene 1994;Harris and Kuba 1997;Root 1990;Overstreet et al 2010). Marginalization and stress associated with adapting to conflicting cultures may shape internalization of dominant cultural standards of attractiveness and be linked with body image and eating problems for racial or ethnic minority women as well as Deaf women (e.g., Moradi and Rottenstein 2007;Perez et al 2002).…”

The Association of Posttraumatic Stress Disorder with Fast Food and Soda Consumption and Unhealthy Weight Loss Behaviors Among Young Women

“…31 Multiethnic women may also struggle with a desire to fill the traditional European American standards of beauty and, at the same time, may struggle to resist this view of beauty. 32 This internalized struggle may manifest as the development of an eating disorder. 32 The findings from this study have serious implications for psychologic and healthcare treatment for young women.…”

“…32 This internalized struggle may manifest as the development of an eating disorder. 32 The findings from this study have serious implications for psychologic and healthcare treatment for young women. Young women who are identified as engaging in these unhealthy dieting practices should be clinically evaluated for the existence of an eating disorder.…”

Understanding the Role of Gender and Ethnic Oppression when Treating Mexican American Women for Eating Disorders

“…The focus of this stage involves the development of a healthy and culturally synchronous gender identity, which represents more positive attitudes and values toward the young woman, while creating a balance between the young woman, her family, and the two cultures. Our young woman begins to develop a healthy sense of ethnocultural identity, which may serve as a means to counteract the acquisition of eating disorder related pathology (Harris & Kuba, 1997). Healthy identity is marked by improved self-perception and acceptance of self and family.…”

“…The complexity of oppression suggests it is multidimensional; internalization is unique to the individual woman or girl. This experience, understood as holding prejudice against the self, can lead to the development of an eating disorder (Harris & Kuba, 1997;Warren et al, 2005) and intergenerational differences in definitions of ideal weight and shape (Chamorro & Flores-Ortiz, 2000). In this article, we attempt to ''peel off'' the layers of this oppressive onion by identifying the factors that contribute to the experience of racial, gender, and weight oppression.…”