Socio-cultural context of eating disorders in Poland

Abstract

BackgroundThe goal of this study was to assess the relationship between sociocultural factors and clinical eating disorders during the intensive process of Westernisation in Poland that occurred after 1989. The study population included girls diagnosed with an eating disorder according to DSM-IV criteria (n = 47 anorexia nervosa restrictive type [ANR], n = 16 anorexia binge/purge type [ANBP], n = 34 bulimia nervosa [BN], n = 19 eating disorder not otherwise specified [EDNOS]) who received consultation for the first time between 2002 and 2004 in the Department of Clinical Child and Adolescent Psychiatry, University Hospital, Kraków, Poland. The study included an age-matched normal control group [NOR] of 85 schoolgirls from Kraków.MethodsRelationships between two given qualitative features were investigated using the chi-square test or Fisher’s exact test. Correspondence analysis was applied to graphically explore the relationship. The Kruskal-Wallis test with the Bonferroni was performed to compare quantitative results across groups.ResultsObjective sociodemographic variables and responses to the 62-item Questionnaire of Socio-cultural Context were measured. The mothers of ANBP and BN patients were less professionally active than mothers of ANR patients and NOR subjects. Subjective socio-cultural factors were more relevant for the BN group than the ANR group. Questionnaire responses in the ANBP group were more similar to those in the BN group than to those in the ANR group. The most unambiguous and specific characteristic of the ANR group was a sense of belonging to the middle class. Variables that differentiated the BN group from the NOR group included the importance attached to thinness treated as an expression of power and control over one’s self, as well as a multifaceted negative evaluation of one’s own family, including a negative assessment of the position of women and parental lack of concern for appearance and principles of nutrition. All patients, regardless of diagnosis, identified with other people with similar problems and considered anorexia and bulimia to be a major issue of their generation and social environment.ConclusionsThe results of this first in Poland exploratory study of socio-cultural context of eating disorders indicate the importance of both objective and subjective socio-cultural factors in eating disorders in the group studied.

Body Dissatisfaction, Restrictive, and Bulimic Behaviours among Young Women: A Polish–Japanese Comparison

“…Analysis of the source literature confirms the continual increase of the number of people suffering from eating disorders worldwide [1,2]. Epidemiological data confirm the increasing importance of the problem in European countries [3,4], including Poland [5,6], the United States of America [7], Latin America [8], Arab countries [9,10], Africa [11], and Asia [12][13][14][15][16], with the risk of development of eating disorders being especially high in Japan [17]. The Global Burden of Disease (GBD) study from 2015 [18] confirmed the steady increase of eating disorders in women all around the world [19].…”

“…Analysis of the literature suggests that the basic risk factors of eating disorders are directly related to the development of personal dissatisfaction with one's body, excessive pursuit of thinness, and restrictive and bulimic eating behaviours, and this relationship is noted by authors conducting research in both Western cultures [1], including Poland [6,42], and Eastern cultures [13] such as Japan [17,43]. According to the literature from the last several years, people who suffer from anorexia or bulimia are dissatisfied with their bodies and are characterized by excessive perfectionism and a desire for control.…”

Culture Change and Eating Patterns: A Study of Georgian Women

“…Disordered eating patterns represent eating related unhealthy behaviors (e.g., excessive concern about weight and shape, excessive dieting, self-induced vomiting) that resemble Eating Disorders (ED) but are exhibited in a smaller degree in terms of frequency and intensity (1). Traditionally believed to be affecting women of affluent societies (2, 3), the prevalence of EDs has been increasing among diverse populations and cultures (4–8). While researchers are trying to find out more about the main determinants, risk and protective factors of EDs, it is recognized that they are culturally influenced (9–13).…”

“…The link between culture change and disordered eating has attracted researchers’ interest towards the end of the twentieth century as EDs started emerging in non-Western countries, including Eastern Europe, and among immigrant/minority populations (8, 26–29). Cases of EDs in some parts of the world, e.g., the island of Curacao and South America, appeared very low primarily affecting elite groups exposed to North American and European influence (14, 27, 30), which further strengthened the hypothesis linking EDs with acculturation to Western culture and values.…”

Pro Ana (1): eating disorder or a lifestyle?

“…This is the case of the Pro ana movement, where the participants of the movement try to give a new meaning to the concept of normal weight, in which thinness should be accepted as a normal range, while they determine their health status as a lifestyle, demanding acceptance for their own choices (54). As Maciej W. Pilecki, Barbara Józefik and Kinga Sałapa draw attention, due to such "phenomena" eating disorders cease to be perceived as a disease, and they become an expression of personal transgression, selfcreation supported by other participants of such movements (55).…”