Anorexia Nervosa (AN) is often thought of as a Western phenomenon, deeply rooted in a culture that idealizes thinness as the hallmark of female beauty and aesthetics. Characterized by an intense fear of gaining weight and a distorted body image, this disorder - viewed through the lens of cross-cultural psychology - has revealed a far more complicated picture than believed in the simplistic stereotypes expressing purely Western explanations of its development. The roots and manifestations of AN are prevalent across cultures and countries. From Japan to the Middle East, women’s perception of their bodies is shaped by the need to meet societal expectations, seeking cultural conformity for acceptance, and even as a way of asserting self-control.
For decades, the persuasive glorification of ultra-thin bodies in Western media was blamed as the primary trigger of anorexia nervosa. While this theory holds some truth, it has turned out to be overly simplistic. Cases of AN in Japan, Hong Kong, and the Middle East have highlighted how the disorder can occur in societies with vastly different societal standards. In Japan, the focus on thinness is often considered as a reflection of self-discipline, self-restraint, and social harmony rather than physical beauty. In Hong Kong, psychologist Sing Lee uncovered cases of patients outright refusing any body-image issues, attributing their problematic diet to issues such as “bloated stomach” instead. In places such as the United Arab Emirates where religious thought prevails, women portray religious and spiritual motivations behind restrictive eating habits, often masking eating disorders under spiritual discipline. Though the global connectivity offered by the internet has benefited many, it has also fostered environments that exacerbate vulnerabilities to AN. Visual-centric platforms, the likes of Instagram and TikTok have amplified often unattainable and photoshopped beauty standards.
Traditional body ideals that were once strongly rooted in history and cultural identity are now merging with globalized Western standards, often creating internal conflicts regarding body image. This complexity is especially visible in cultures undergoing rapid modernization through exposure to global culture. Studies on Nigerian and Ghanaian women show a growing trend among young women towards Westernized body ideals, rejecting traditional preferences for curvier body types among older generations. In Asian countries like South Korea and Singapore, thinness is often viewed as a sign of upward social mobility, cosmopolitanism, and professional achievement. At the same time, familial or community influences may enforce traditional standards - creating a psychological tug-of-war between preserving cultural identity and adopting global trends. Another striking example of this phenomenon is Fiji: introduction to television in Fiji during the mid-1990s led to a greater number of women reporting disordered eating behaviors, which was previously rare in the community.
Pro-anorexia (pro-ana) and pro-bulimia (pro-mia) communities are another disturbing phenomenon, wherein members glorify eating disorders as a lifestyle rather than a mental health condition. Tips for avoiding food, hiding weight loss, and resisting treatments are often shared. At the same time, the internet also promotes acceptance of a balanced body, creating a much-needed counter-narrative to the harmful content. Organizations like the National Eating Disorder Association (NEDA) use social media to raise awareness about eating disorders.
As cultural values and beliefs differ across cultures, the treatments too need to adapt accordingly. Dr. Sing Lee, for example, realized that strictly Western methods of treatment wouldn’t apply to the Singaporean clients as they attribute the disorder to bodily pain and not body image issues. In collectivist countries, family involvement plays a crucial role in the treatment, but at the same time, the social pressure for perfection can worsen the situation. Including traditional beliefs can contribute to better treatment by making the clients feel understood and respected. Mindfulness-based meditations such as mindful-eating can be applicable in East Asian cultures with Buddhist traditions. Cross-cultural treatment is about understanding the influence of cultural contexts that shape the experiences of AN for tailoring personalized interventions and treatments for the clients.
The cross-cultural investigation of Anorexia nervosa unveils the underlying complexity beyond a simplistic Western stereotype. By understanding the way cultural norms, globalization, and social pressures shape the subjective manifestation of Anorexia Nervosa, we can foster culturally appropriate treatments that can ultimately promote recovery globally.
Ejaz Shaikh
