How the Asian American Diaspora Influences Disordered Eating in Asian American Women
The Asian American Diaspora describes the immigration from Asian countries, where ancestry continues to culturally influence following generations. This passing down of culture can result in acculturative stress, referring to the psychological distress Asian American women experience as a result of pressure to balance their native Asian cultures and dominant White culture. Experiences associated with the Asian American diaspora and acculturative stress uniquely impact Asian American women, particularly in terms of body image and eating habits.
The concept of “interpersonal shame” seems to be associated with disordered eating in Asian American women, where the beliefs about body image and eating habits of their family members are regarded as integral in their own attitudes and behaviors.
A qualitative study by Javier examined the factors for the development of eating disorder behaviors in Asian American women and identified that particularly maternal family members (ie. mothers, grandmothers, etc.) are powerful in shaping the views of body image and eating habits. Often manifested in the form of negative remarks about their bodies or “jabs” at their eating habits, in turn, lead these women to restrict as an approach to avoid these comments and at times begin to endorse these messages as their own. This process was reflected in a qualitative interview I performed myself for a Cultural Psychology course, in which I interviewed Asian American women about the ways in which they were impacted by their Asian cultural background. When asked about the beauty standards of her Chinese heritage, an second-generation Asian American college student answered with the following:
“You have to be skinny. Everyone wants you to be skinny. Since I was a kid, my mom told me that I have to be skinny. People [in China] are really harsh and upfront about if you gained or lost weight… Honestly, I'm kinda glad my mom was honest about it to me because it seems like it was practical, and should teach kids to discipline themselves. It’s a cultural thing, you know?… Mom always told me, ‘just stop eating every time you want to.’ I used to eat as much as I wanted as a kid, but eventually developed discipline.”
It’s common for Asian American women to endorse the body ideals of the women who came before them– induced by cultural filial piety. Furthermore, it seems that Asian American women engage in restrictive eating behaviors, which are characterized as culturally-valued “discipline.” Similarly, a qualitative study by Smart investigated the experiences of therapists treating Asian American women for eating disorders, who cited the role of the patients’ cultural filial piety and a sense of self-sacrifice to achieve “optimal appearance”. Similar to how the aforementioned woman in my study regarded her mother’s brutal “honesty” as a lesson of practicality, Smart’s research found that a lack of social niceties from parents were often perceived as “a sign of love” and that criticism was regularly utilized to motivate their children. The role of Asian American diaspora’s impact on the ED development of post-immigrant generations can be seen in the continued application of Asian cultural elements; culturally normative methods of parenting and perception of “the family as a collective unit” that consequently leads “the parent sense of self being linked to the children’s achievement.” Similar to how the woman in my study echoed her mother’s emphasis on slimness as a socioculturally practical measure, Smart attributed Asian American parental encouragement of thinness to their notion that it is “key” to the success of their daughter in the US cultural context. Consistent with this, research conducted by Lee & Lock on female Asian American adolescents with anorexia nervosa reported 94% of the AAs to be of the restrictive subtype, and reported significantly higher levels of parental criticism than their White counterparts. Furthermore, in agreement with perfectionism as a common predictor in the development of restrictive eating disorders, most of the participants of Lee & Lock’s study reported extremely high levels of anxiety to meet the expectations of their parents, mirroring Smart’s findings that the female Asian American adolescents often “struggled with trying to be pleasing to others,” particularly parents.
However, the results of Lee & Lock’s study found that the young Asian American women with eating disorders appeared “less ill” on all conventional measures than their white counterparts, despite a lack of difference in the measures of BMI and duration of disordered eating behaviors: they reported lower levels of fatphobia, weight and shape concerns, and of restraint. An analysis of these results concluded that symptoms of complete denial and minimization of symptoms were much greater for the Asian American women, and was attributed to the application of Asian cultural norms that encourage emotionally repressive coping behaviors, and that overcompliance in the form of “the desire to give the ‘correct’ answer to please the interviewer” was possibly in itself a form of denial. Therapists often noticed Asian American women ED clients using restrictive behaviors as a culturally normative coping strategy in response to their “lack of voice” effectuated by cultural filial piety norms that limit children’s emotional expression, in which “eating disorders were a way to disconnect emotionally and express distress covertly.”
Furthermore, researchers have argued that conventional eating disorder measures have not been created to appropriately assess for the unique Asian American cultural factors, resulting in hidden symptoms and significant underdiagnosis of eating disorders. The Asian American diaspora and its connection to cultural family dynamics form particular cultural expectations for thinness and barriers in recognition of restrictive behaviors. Diagnostic criteria was created without concern for cultural factors in symptomatology and was primarily based on research conducted upon white populations. Because cultural factors are not taken into account in diagnostic criteria, many struggling Asian American women are left untreated and severely understudied. Ultimately, this exclusion of cultural factors has lethal capacity: restrictive eating disorders have the highest mortality rates of all mental illnesses and Asian American women display extremely low rates for seeking treatment. Future interventions and research of Asian American body image issues and eating habits must be inclusive and culturally receptive, and diagnostic criteria should adequately assess symptoms that impact minority populations.
Written by Kyra Torres, Intern with Cypress Wellness Collective
If you are seeking eating disorder treatment or mental health therapy for you or your adolescent, Cypress Wellness Collective can help. Cypress Wellness Collective is located in the San Francisco Bay Area where they specialize in Family Based Treatment (FBT), therapy, and nutrition counseling for teens, adults, and families going through eating disorder recovery. They offer in person and virtual appointments throughout all of California. Call today for your free consultation to see if Cypress Wellness Collective is right for you!
References:
Javier, Sarah J., and Faye Z. Belgrave. “‘I’m Not White, I Have to Be Pretty and Skinny’: A
Qualitative Exploration of Body Image and Eating Disorders among Asian American Women.” Asian American Journal of Psychology 10, no. 2 (2019): 141–53.
Smart, Rebekah. “Therapists’ Experiences Treating Asian American Women with Eating Disorders.” Professional Psychology: Research and Practice 4 (2011): 308–15.
Cheng, Hsiu-Lan, and Helen Youngju Kim. “Racial and Sexual Objectification of Asian American Women: Associations with Trauma Symptomatology, Body Image Concerns, and Disordered Eating.” Women & Therapy 41, no. 3–4 (2018): 237–55.
Lee, Huei‐Yen, and James Lock. “Anorexia Nervosa in Asian‐ American Adolescents: Do They Differ from Their Non‐ Asian Peers.” International Journal of Eating Disorders 40, no. 3 (2007): 227–31.