Binge eating and binge eating disorder in a small‐scale, indigenous society: The view from Fiji

Abstract

Objective: Although the cross-cultural prevalence of anorexia and bulimia nervosa has been investigated in multiple studies, little is known about the prevalence and correlates of binge eating and binge eating disorder (BED) cross-culturally. No published studies to date have explored BED in small-scale, indigenous, or developing societies. The current study investigated the prevalence and correlates of binge eating in a community sample of Fijian women living in rural Fiji. Methods: Fifty ethnic Fijian women completed a self-report measure developed for this study on dieting and attitudes toward body shape and change, a Nadroga-language questionnaire on body image, and the Questionnaire on Eating and Weight Patterns-Revised (QEWP-R). Their height and weight were also measured. Patterns of dieting, high body mass index (BMI), and attitudes toward eating and body image were compared between women with and without a history of binge eating. Results: Ten percent of respondents reported at least weekly episodes of binge eating during the past 6 months and 4% endorsed symptoms consistent with BED. Binge eating in this sample was associated significantly with a BMI value above 35, a history of dieting, and a high concern with body shape. Binge eating was not associated with several markers of acculturation in this sample, although it was associated with a key, nontraditionally Fijian (i.e., acculturated) attitude toward the body. Discussion: Binge eating occurred in a social context with traditions concerning weight and diet widely disparate from Western populations. However, correlates of binge eating in this sample suggest that nontraditional Fijian attitudes toward weight and body shape play a contributory role. # 2003 by Wiley Periodicals, Inc. Int J Eat Disord 34: 423-431, 2003.

Change in binge eating and binge eating disorder associated with migration from Mexico to the US

“…This hypothesis has received support from studies of exposure to Western popular media in Fiji (Becker et al, 2002; Becker et al, 2003; Becker et al, 2011). Some studies have compared non-representative samples from related Western and non-Western populations, finding mixed support.…”

“…Cultural differences in eating habits and body image ideals have been hypothesized to affect risk for eating disorders, with greater emphasis on control of eating and value of thinness hypothesized to lead to higher prevalence of eating disorders in Western countries (Becker et al, 2002; Becker, Burwell, Navara, & Gilman, 2003; Becker et al, 2011; Lynch, Heil, Wagner, & Havens, 2007; Mousa, Al-Domi, Mashal, & Jibril, 2009; Toro et al, 2006). This hypothesis has received support from studies of exposure to Western popular media in Fiji (Becker et al, 2002; Becker et al, 2003; Becker et al, 2011).…”

Body dissatisfaction and dietary restraint influence binge eating behavior

“…Restraint may trigger binge eating when breaking strict dietary rules results in disinhibited eating [24]. In support of this model, several authors found a strong correlation between body dissatisfaction and binge eating [25], and moreover, there is clear evidence linking binge eating and a history of dietary restraint [6,19,26,27]. In a 10-year longitudinal study, Goldschmidt et al [10] confirmed that dieters were at higher risk for binge eating onset than nondieters.…”

Culture and eating disorders classification

“…10,21 Culturally sanctioned overeating-sometimes associated with distress-as well as purging in this society in the absence of indigenous recognition of illness suggest that variation in universal behaviors may sometimes be recognized as symptoms only in relation to the social context. 22 In addition, there is an indigenous category-commonplace in Pacific societies, but without a clear analog in Western biomedical nosology-for an appetite disorder (macake, Fijian) which is characterized by poor appetite and food refusal and arouses intense social concern and intervention, 10 but otherwise bears little resemblance to any DSM established eating disorder. Individuals with macake are characteristically distressed by the poor appetite and generally willingly take prophylactic or therapeutic doses of traditional herbal medicines to restore appetite.…”