Eating Disorders Part 4: Eating Disorders among Asian- American Women

By: Abby Erasmus

Unique cultural values and experiences of Asian Americans can lead to the development of an eating disorder for individuals in the community. Similar to Western culture, Asian American (AA) culture idealizes the thin body and individuals face scrutiny from family members if they don’t meet this ideal; paradoxically, food is said to be the love language of Asian culture. Many AAs report being “force fed” by the same family members who criticize their weight. This creates pressure and anxiety around food, and due to this paradox, the complex relationship between food, love, and weight, bulimia nervosa (BN) tends to be the most pervasive ED in the AA community. Furthermore, AAs have to go through the process of acculturation: they must adapt to the practices and values of the dominant culture while maintaining their own. This can result in acculturative stress which is a positive predictor of disordered eating. In turn, research shows that AA college students report higher rates of restrictive eating, purging, and muscle building in comparison to their white counterparts. Also, second generation AA women report more ED behaviors than first and third generation women. This gives us insight into who is more likely to be affected within the community and what the ED behaviors are.

Different cultural values in the AA community such as interdependency, a complete reliance on the family for help rather than a stranger (therapist), and stigma surrounding mental health in general, contribute to the lack of help seeking. Further, some mental health providers are unable to recognize ED- like behaviors in the AA community as they are an under researched group when it comes to this pathology; lack of diagnosis and treatment can thus lead to poor prognosis. Once EDs are officially seen as a disorder that affects all ethnic and demographic groups at similar rates, stigma can be lessened and providers will recognize ED symptoms in this community. Again, cultural competency must be encouraged. Providers should understand the unique stressors AAs face like acculturative stress, as well as the complex relationship between food, showing love, and the idealization of the thin body. Although anorexia nervosa is prominent in the AA community, BN and binge- eating behaviors are the most common in the community; 1.50% are diagnosed with BN and 4.74% experience binge eating behaviors (See Eating Disorders Part 1 for DSM definitions). Once providers are more familiar with BED and BN, as well as the unique factors AAs face, they will be able to have culturally appropriate treatment for AAs with EDs.

If you or someone you know is seeking therapy for an eating disorder, please contact our psychotherapy offices in New York or New Jersey to talk to one of our licensed professional psychologists, psychiatrists, psychiatric nurse practitioners, or psychotherapists at Arista Counseling & Psychotherapy. Contact our Paramus, NJ or Manhattan, NY offices respectively, at (201) 368-3700 or (212) 722-1920 to set up an appointment. For more information, please visit


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