The Fear Of Fat Criterion Within The Dsm Iv

1830 words - 7 pages

As our society is bombarded with the images of manufactured beauty and “thinness”, conversations increasingly center on dieting and body dissatisfaction. The media advertises weight loss products in the form of pills, drinks, surgery, fitness equipment and support groups to mold individuals into the proposed ideal form. This evidence alone suggests a strong case for the possibility of a pathological fear of fat. Is this fear, however, the driving force behind all cases of anorexia nervosa and bulimia? According to the DSM IV, the fear of gaining weight is essential for these diagnoses to be made. Strong arguments have been made both in favor and against modifying the existing criteria to allow for the diagnosis and treatment of individuals, regardless of whether or not a ‘fat phobia’ is present. Is it culturally insensitive to retain this particular criterion, a fear of gaining weight, if a patient has not been exposed to the same cultural pressures and orientation towards being thin?

Although western culture is thought to be the dominant culture, because of power and economics, non-western cultures make up eighty percent of the world’s population (Lee, 1995). Many of these ‘sub-dominant’ cultures are present in the melting pot of the modern United States. Are these non-Westernized individuals being denied the necessary treatments and interventions merely because a fear of gaining weight is not expressed? Such a strong focus on body dissatisfaction may cause one to overlook or disregard the pressures of societal systems, such as immigration or poverty, on the mental and physical well being of an individual. If ‘fat phobia’ is indeed a culturally constructed definition of anorexia nervosa, it lacks a strong psychological and biological foundation, and is therefore questionable in the eyes of many researchers and clinicians.

To observe the impact of culture on attitudes towards eating and perception of body shape, Lake, Staiger and Glowinski (1999) conducted a study using 140 female students from 2 Australian universities. The students were divided into 2 groups – those who were born in Australia (98) and those who were born in Hong Kong (42). The Students born in Hong Kong were further divided into 2 groups – a weak Chinese ethnic identity group (Western acculturized) and a strong Chinese ethnic identity group (Traditional) using the Ethnic Identity Scale (EIS).

All subjects were given the Eating Attitudes Test (EAT), a commonly used and well-validated measure (Garner et. al 1979; Garner et. al 1982), to assess attitudes towards eating. The Figure Rating Scale (FRS), used in similar research due to its high test-retest reliability (Thompson et. al, 1991), was used to determine perception of body shape. The scores from these tests were then compared with the subjects’ cultural orientation.

The results showed significantly higher scores on the EAT (indicating...

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