Cultural differences in eating disorders with particular emphasis on British South Asian communities

Eating disorders have historically been considered "culture-bound" phenomena, confined to Western societies and specifically, young White females with, predominantly, anorexia nervosa. Eating disorder research tended to align with these perceptions and, until relatively recently, few studies had been conducted to establish the prevalence of eating disorders in non-Western countries. Evidence from epidemiological surveys, undertaken largely in the last three decades, have shown that eating disorders are present in African, Asian, Middle-Eastern and South American societies and in many cases the prevalence estimates are comparable to those in the West. However, there is evidence to suggest that precipitating factors, presentations and cultural perceptions of eating disorders differ between sociocultural contexts. This may result in underdiagnosis of eating disorders in non-white individuals and may be a barrier to successful management. These considerations are exemplified by studies in the South Asian population in the UK which have shown a different symptom profile than white individuals. Clinicians who are not attuned to these cultural differences, may fail to recognise an eating disorder diagnosis. South Asian populations may present with somatic concerns and the absence of "fat phobia". Culture-specific familial expectations, religious observances and issues of self-identity may have a greater role in the development and maintenance of eating pathologies in this, and other, minority ethnic groups. Greater awareness of these factors among clinicians would increase the prospects for recognition, diagnosis and successful outcomes.