Cultural Considerations in Eating Disorder Treatment

Young Woman already impacted by societal norms and body dissatisfaction

“The beauty of the world lies in the diversity of its people.” This quote is undoubtedly true, as our various cultural and societal experiences make us each invaluably unique human beings. It also relates to Cultural Considerations in Eating Disorder Treatment.

These cultural experiences and backgrounds are important to consider when interacting with others, recognizing that they may not have the same worldview as you do. These cultural experiences are also important in eating disorder treatment, as the cultural perceptions of the body, food, and the relationship one has with both are influenced by culture.

From East to West

Among various regions and cultures, there are thousands of micro-cultures that vary in their view of politics, religion, gender, marriage, body image, ethical values, social norms, etc.

Geographic location is not the only factor influencing culture, however, as there are numerous diverse cultures within the United States, where a reported 4% of non-Caucasians are diagnosed with anorexia nervosa (AN) or bulimia nervosa (BN) [1].

One study found that Jewish, Catholic, and Italian populations had a higher rate of eating disorder diagnoses, leading the researcher to consider how cultural attitudes on the importance of food impact eating disorders [1]. Culture can also change how one’s disordered eating views and behaviors manifest.

One example is that individuals diagnosed with anorexia nervosa (AN) in more Easternized countries, such as China, Japan, Singapore, Malaysia, and India do not present with fat-phobic ideas about the body, whereas this is generally seen as a traditional AN symptom in Western cultures [2].

Additionally, a survey of South African adolescents found that many of those that had scored positive on the Eat Attitudes Test (EAT) reported their preoccupation with food was not because of an eating disorder, but, instead, was related to poverty, food shortage, and hunger [2].

Asking About Culture

All of this is incredibly important because it shows the many ways an individual’s cultural experiences and upbringing can impact their beliefs related to the body, food, and the self. Treating an individual with AN from Japan by normalizing fat might not be applicable based on the trend that AN commonly exists without fat-phobia in that culture.

Girls from Vietnam walking with bicycleThe crux of treatment lies in understanding that each individual is different as so their experience of the world and their eating disorder. Do not assume to understand why an individual feels or behaves the way they do.

Ask them.

What is their relationship to the body? What do they feel the body is intended for? How are they connected to it?

What is their relationship with body image? How does this relate to their eating disorder, or, does it? What is their relationship with their family and how does this impact their disorder eating behaviors?

Is their religion important to them? What do they believe and how does this relate to their body or eating habits? How do they view societal ideas of body image and nutrition and is this different from what they have been taught or what they believe?

There are so many questions to be asked that open up door after door on what an individual’s cultural experience is and how that plays into their relationship with the body and food. Every individual is an expert on their own life and perspective, remain open and understanding to letting them tell you how their cultural experiences impact them.


[1] Miller, M. N., Pumariega, A. J. (2001). Culture and eating disorders: a historical and cross-cultural review. Psychiatry, 64:2.

[2] Becker, A. E. (2007). Culture and eating disorders classification. International Journal of Eating Disorders.

Image of Margot Rittenhouse.About the Author: 

Margot Rittenhouse, MS, PLPC, NCC is a therapist who is passionate about providing mental health support to all in need and has worked with clients with substance abuse issues, eating disorders, domestic violence victims, and offenders, and severely mentally ill youth.

As a freelance writer for Eating Disorder Hope and Addiction Hope and a mentor with MentorConnect, Margot is a passionate eating disorder advocate, committed to de-stigmatizing these illnesses while showing support for those struggling through mentoring, writing, and volunteering. Margot has a Master’s of Science in Clinical Mental Health Counseling from Johns Hopkins University.

The opinions and views of our guest contributors are shared to provide a broad perspective on eating disorders. These are not necessarily the views of Eating Disorder Hope, but an effort to offer a discussion of various issues by different concerned individuals.

We at Eating Disorder Hope understand that eating disorders result from a combination of environmental and genetic factors. If you or a loved one are suffering from an eating disorder, please know that there is hope for you, and seek immediate professional help.

Published on February 22, 2019.
Reviewed & Approved on February 22, 2019, by Jacquelyn Ekern MS, LPC

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About Baxter Ekern

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