Why Eating Disorders Are More Than a “Western” Problem

Screen Shot 2016-05-30 at 7.36.14 PMBy Kira Rakova for the World Eating Disorders Day blog, cross-posted with permission

A year ago, while I was in Morocco, I asked a Moroccan woman about eating disorders in the country. After spending time trying to explain what I meant by “eating disorder,” the woman replied this was not something that happened in Morocco. Sure, there was dieting, she said, but eating disorders? That simply could not happen, because meals were so central to family time. In a way, what she was suggesting is that culture protects Moroccans from developing eating disorders.

As I worked on my undergraduate honors thesis this semester, I kept returning to this idea. In researching about the way eating disorders are talked about in the United States versus Russia, I routinely came across the debate—are eating disorders culturally bound illnesses? The argument that they are is nothing new, and many studies have aimed to explore the link between western cultural practices, westernization, globalization and eating disorders. Even within Russian academic literature on eating disorders, there is a discussion on the role of Western cultural factors.

Look beyond the cultural influence

Largely however, the culturally bound or “westernization” argument is reductionist. While globalization, industrialization and exposure to western cultural values may play a role, this argument erases the national, international, and cultural context of countries. It ignores the specific roles and concepts of non-profits and the public health sector within each individual country. In addition, it does not account for the native language used to talk about eating, food, eating disorders, and mental illness.

Low on public health agenda

Yet the problem with this argument, especially when it is adopted by non-Western countries, goes beyond that. Aside from ideological and theoretical understandings, the culturally-bound argument has significant negative consequences on sufferers of eating disorders. Primarily, because it suggests that eating disorders are only (or predominately) a “western” problem.

For one, eating disorders are placed lower on the public health agenda in both national and international contexts. For instance, in Russia, eating disorders are not, to the extent of my knowledge, on the public health agenda. In fact, eating disorders treatment that is not privatized is usually available to only to those suffering significant physical consequences. Additionally, there are no educational non-profits that aim to educate and support those affected.

Missing from World Health Organization agenda

Moreover, eating disorders are not on the agenda of the World Health Organization, despite having the highest mortality rate out of all mental illnesses. To some degree, this is not surprising. If people are arguing that the West is disproportionately affected and Western cultural practices that are directly linked to eating disorders, the idea that they are not a pressing global health issue persists.

At the same time, the idea of eating disorders being a western or western influenced problem limits access to care in ALL countries, including Western ones. Our notions of the West are very much linked to ideas of race and ethnicity, with communities of color often being labeled as non-Westerners or foreign (regardless of nationality). Thus, when eating disorders are presented as western problems, it is people of color (among other marginalized groups), who are erased. Eating disorders become a white, middle-class issue.

More importantly, the particular experiences of marginalized communities remain unaccounted for, such as the role of systematic trauma and epigenetics in the development of mental illnesses. This then, constructs stigma within various communities (particularly within communities of color) and limits access to appropriate care.

Eating Disorders Day of Action, June 2

For me, World Eating Disorders Day of Action is about dispelling these notions and challenging these barriers. In creating a global platform for eating disorder justice, we are able to destroy the myth that eating disorders are a problem of the West. Together, we can cohesively demand that the WHO and other international organizations recognize eating disorders as a pressing global public health issue. At the same time, the inclusive approach of the day means that different countries and communities to advocate for their own needs with a global support system.

I truly see this day as a start to a global movement motivated by the already existent and developing local and national movements. It is a day for collective action that supports community needs through the sharing of information and other resources for the development of evidence-based treatments and public health agendas.

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