SynopsisTwo matched samples of Arab female undergraduate students attending London and Cairo Universities were recruited to determine the relative prevalence of abnormal eating attitudes and the effect of exposure to Western culture upon this prevalence. A positive response was reported on the Eating Attitudes Test (EAT-40) in 22% of the students in the London group and 12% in the Cairo group, indicating that abnormal attitudes occur in this non-Western population. Six cases among the London sample fulfilled diagnostic criteria for bulimia nervosa, but no cases of either anorexia or bulimia were identified in the Cairo sample.

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"As periods of cultural change inevitably carry with them a greater degree of heterogeneity, in the history of any culture or subculture, periods will be found in which adequate social forms for expression of strain or tension will be lacking and the individual will be forced back upon his own body for symbolic expression."Margaret Mead 1947 Summary. The role of socio-cultural factors in the pathogenesis of eating disorders, anorexia nervosa and bulimia has been the object of recent interest. The phenomena, mainly described in the West, were partly attributed to the idealisation of thinness in Western culture. The paper reviews published epidemiological research from non-western countries in the area of eating disorders to elucidate the difference in prevalence, allowing for the lack of clarity in some of the methodology and the absence of operational criteria to define and diagnose the particular syndromes in these studies. The paper also examines research findings of the effect of cultural change on body weight. There is a strong indication that cultural change, i.e. identification with Western norms in relation to body weight, is consistently followed with an increase in weight consciousness and the risk of developing eating disorders.Preoccupation with body weight and the presentation of the eating disorders, anorexia nervosa and bulimia, for medical attention are commonly regarded as phenomena of the past century, the product of our civilisation and increasing affluence (Bruch 1978). The fact that anorexia nervosa has mainly been described in western literature as affecting young girls from upper and middle class backgrounds (Bruch 1973;Crisp et al. 1976;Morgan and Russell 1975) and characterised by a pursuit of thinness, usually ushered in by a shared dieting experience, suggests that socio-cultural factors may be salient determinants.Epidemiological research shows a recent increase in the incidence of anorexia nervosa over the last two decades (Theander 1970;Duddle 1973;Jones et al. 1980;Szmukler 1983). There is also an indication that bulimia, which shares with anorexia nervosa the basic psychopathology of a morbid fear of becoming fat, and manifests itself in binge eating, deliberate vomiting and purging, is probably more prevalent than was originally thought. Vomiting and purging are easily mimicked, and are viewed as a more successful means of keeping weight under control than dieting (Cooper and Fairburn 1982;Halmi et al. 1981;Chiodo 1983).These epidemiological findings were interpreted in the light of recent changes in the concept of female beauty with an increased emphasis on thinness . Dieting and weight control measures have become common preoccupations, evidenced by the number of low calorie diet foods in the market, the proliferation of commercial establishments for losing weight, and the many articles and advertisements on dieting and slimming in women's magazines and the media."Thinness" came to symbolise "the new woman", who is able to combine qualities of self-discipline, control and sexu...

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The Eating Attitude Test (EAT-40) was administered in the Arabic language to 50 Arab female undergraduates attending London University. The test had a positive predictive value (PPV) of 55%, sensitivity and specificity of 100% and 89% respectively, and proved useful when used in a non-Western culture.