Editing Eating disorder (section)

===== Asian perspective =====
The West plays a role in Asia's economic development via foreign investments, advanced technologies joining financial markets, and the arrival of American and European companies in Asia, especially through outsourcing manufacturing operations.<ref name=Pike2015>{{cite journal |vauthors=Pike KM, Dunne PE |title=The rise of eating disorders in Asia: a review |journal=Journal of Eating Disorders |volume=3 |issue=1 |page=33 |date=2015-09-17 |pmid=26388993 |pmc=4574181 |doi=10.1186/s40337-015-0070-2 |doi-access=free}}</ref> This exposure to Western culture, especially the media, imparts Western body ideals to Asian society, termed Westernization.<ref name=Pike2015 /> In part, Westernization fosters eating disorders among Asian populations.<ref name=Pike2015 /> However, there are also country-specific influences on the occurrence of eating disorders in Asia.<ref name=Pike2015 />

====== China ======
In China as well as other Asian countries, Westernization, migration from rural to urban areas, after-effects of sociocultural events, and disruptions of social and emotional support are implicated in the emergence of eating disorders.<ref name=Pike2015 /> In particular, risk factors for eating disorders include higher socioeconomic status, preference for a thin body ideal, history of child abuse, high anxiety levels, hostile parental relationships, jealousy towards media idols, and above-average scores on the body dissatisfaction and interoceptive awareness sections of the Eating Disorder Inventory.<ref>{{cite journal |vauthors=Chen H, Jackson T |title=Prevalence and sociodemographic correlates of eating disorder endorsements among adolescents and young adults from China |journal=European Eating Disorders Review |volume=16 |issue=5 |pages=375–85 |date=September 2008 |pmid=17960779 |doi=10.1002/erv.837}}</ref> Similarly to the West, researchers have identified the media as a primary source of pressures relating to physical appearance, which may even predict body change behaviors in males and females.<ref name=Pike2015 />

====== Fiji ======
While colonised by the British in 1874, Fiji kept a large degree of linguistic and cultural diversity which characterised the ethnic Fijian population. Though gaining independence in 1970, Fiji has rejected Western, capitalist values which challenged its mutual trusts, bonds, kinships and identity as a nation.<ref>{{cite book |vauthors=Becker AE |title=Body, self, and society : the view from Fiji |date=1995 |publisher=University of Pennsylvania Press |isbn=978-0-8122-1397-3 |location=Philadelphia |page=15}}</ref> Similar to studies conducted on Polynesian groups, ethnic Fijian traditional aesthetic ideals reflected a preference for a robust body shape; thus, the prevailing 'pressure to be slim,' thought to be associated with diet and disordered eating in many Western societies was absent in traditional Fiji.<ref>{{cite journal |vauthors=Pollock N |date=1985 |title=The Concept of Food in a Pacific Society: A Fijian Example |journal=Ecology of Food and Nutrition |volume=17 |issue=3 |pages=195–203 |doi=10.1080/03670244.1985.9990896|bibcode=1985EcoFN..17..195P}}</ref> Additionally, traditional Fijian values would encourage a robust appetite and a widespread vigilance for and social response to weight loss. Individual efforts to reshape the body by dieting or exercise, thus traditionally was discouraged.<ref>{{cite journal |vauthors=Becker AE, Hamburg P |title=Culture, the media, and eating disorders |journal=Harvard Review of Psychiatry |volume=4 |issue=3 |pages=163–7 |date=January 1996 |pmid=9384990 |doi=10.3109/10673229609030540 |s2cid=30169613}}</ref>

However, studies conducted in 1995 and 1998 both demonstrated a link between the introduction of television in the country, and the emergence of eating disorders in young adolescent ethnic Fijian girls.<ref>{{cite journal |vauthors=Becker AE, Gilman SE, Burwell RA |title=Changes in prevalence of overweight and in body image among Fijian women between 1989 and 1998 |journal=Obesity Research |volume=13 |issue=1 |pages=110–7 |date=January 2005 |pmid=15761169 |doi=10.1038/oby.2005.14 |doi-access=free}}</ref> Through the quantitative data collected in these studies there was found to be a significant increase in the prevalence of two key indicators of disordered eating: self-induced vomiting and high Eating Attitudes Test- 26.<ref name="Eating behaviours and attitudes fol">{{cite journal |vauthors=Becker AE, Burwell RA, Gilman SE, Herzog DB, Hamburg P |title=Eating behaviours and attitudes following prolonged exposure to television among ethnic Fijian adolescent girls |journal=The British Journal of Psychiatry |volume=180 |issue=6 |pages=509–14 |date=June 2002 |pmid=12042229 |doi=10.1192/bjp.180.6.509 |doi-access=free}}</ref> These results were recorded following prolonged television exposure in the community, and an associated increase in the percentage of households owning television sets. Additionally, qualitative data linked changing attitudes about dieting, weight loss and aesthetic ideas in the peer environment to Western media images. The impact of television was especially profound given the longstanding social and cultural traditions that had previously rejected the notions of dieting, purging and body dissatisfaction in Fiji.<ref name="Eating behaviours and attitudes fol"/> Additional studies in 2011 found that social network media exposure, independent of direct media and other cultural exposures, was also associated with eating pathology.<ref>{{cite journal |vauthors=Becker AE, Fay KE, Agnew-Blais J, Khan AN, Striegel-Moore RH, Gilman SE |title=Social network media exposure and adolescent eating pathology in Fiji |journal=The British Journal of Psychiatry |volume=198 |issue=1 |pages=43–50 |date=January 2011 |pmid=21200076 |pmc=3014464 |doi=10.1192/bjp.bp.110.078675 |doi-access=free}}</ref>

====== Hong Kong ======
From the early- to-mid- 1990s, a variant form of anorexia nervosa was identified in Hong Kong.<ref name=":5">{{cite journal |vauthors=Miller MN, Pumariega AJ |title=Culture and eating disorders: a historical and cross-cultural review |journal=Psychiatry |volume=64 |issue=2 |pages=93–110 |date=May 2001 |pmid=11495364 |doi=10.1521/psyc.64.2.93.18621 |s2cid=21186595}}</ref> This variant form did not share features of anorexia in the West, notably "fat-phobia" and distorted body image.<ref name=":5"/> Patients attributed their restrictive food intake to somatic complaints, such as epigastric bloating, abdominal or stomach pain, or a lack of hunger or appetite.<ref name=Pike2015/> Compared to Western patients, individuals with this variant anorexia demonstrated bulimic symptoms less frequently and tended to have lower pre-morbid body mass index.<ref name=Pike2015/> This form disapproves the assumption that a "fear of fatness or weight gain" is the defining characteristic of individuals with anorexia nervosa.<ref name=":5"/>

====== India ======
In the past, the available evidence did not suggest that unhealthy weight loss methods and eating disordered behaviors are common in India as proven by stagnant rates of clinically diagnosed eating disorders.<ref>{{cite journal |vauthors=Mammen P, Russell S, Russell PS |title=Prevalence of eating disorders and psychiatric comorbidity among children and adolescents |journal=Indian Pediatrics |volume=44 |issue=5 |pages=357–9 |date=May 2007 |pmid=17536137}}</ref> However, it appears that rates of eating disorders in urban areas of India are increasing based on surveys from psychiatrists who were asked whether they perceived eating disorders to be a "serious clinical issue" in India.<ref name=Pike2015 /> One notable Indian psychiatrist and eating disorder specialist Dr Udipi Gauthamadas is on record saying, "Disturbed eating attitudes and behaviours affect about 25 to 40 percent of adolescent girls and around 20 percent of adolescent boys.<ref>{{Cite web |title=At war with the Body |url=https://www.newindianexpress.com/lifestyle/health/2019/jul/28/at-war-with-the-body-2009347.html |access-date=2023-08-05 |website=The New Indian Express|date=28 July 2019}}</ref> While on one hand there is increasing recognition of eating disorders in the country, there is also a persisting belief that this illness is alien to India. This prevents many sufferers from seeking professional help.<ref>{{Cite web | vauthors = Chaudhuri ZR |date=2018-01-05 |title=Over 25% of teenage Indian girls suffer from eating disorders. This art project shows how they feel |url=https://scroll.in/magazine/863540/over-25-of-teenage-indian-girls-suffer-from-eating-disorders-this-art-project-shows-how-they-feel |access-date=2023-08-05 |website=Scroll.in}}</ref>"

23.5% of respondents believed that rates of eating disorders were rising in Bangalore, 26.5% claimed that rates were stagnant, and 42%, the largest percentage, expressed uncertainty. It has been suggested that urbanization and socioeconomic status are associated with increased risk for body weight dissatisfaction.<ref name="Pike2015" /> However, due to the physical size of and diversity within India, trends may vary throughout the country.<ref name="Pike2015" />