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Eating disorders such as anorexia and bulimia are thought to be relatively rare in non-Western cultures and among non-Caucasians living in the West. Presumably, this is because there is greater cultural emphasis on being slim in Western societies. Attitudes regarding body image have been shown to differ across cultures. The Eating Attitudes Test (EAT) and the Body Shape Questionnaire (BSQ) are two instruments that have been developed to screen for eating disorders and measure dissatisfaction with body shape in those with eating disorders. They have not been used to any degree with non-Caucasians. A study was designed to assess the validity of the EAT and BSQ with Asian schoolgirls living in Britain, to measure the prevalence of eating disorders in this population, and to determine which social and cultural factors might correlate with high scores and eating disorders. Two hundred four Asian girls and 355 Caucasians girls were administered the questionnaires. Age ranged from 14 to 16 years and, among the Asian girls, 88 percent were Muslim, nine percent were Sikh, and three percent were Hindu. Statistical analysis of the results suggest that the instruments were as valid for the Asian subjects as they were for the Caucasians. Regarding social and cultural factors, it was found that Asian girls who paid the most importance to language and dress were more likely to achieve high scores on the questionnaires. The use of English in the home showed no effect, and, surprisingly, girls diagnosed as bulimic scored higher on traditional items as opposed to Western items. This is explained in terms of the internal conflict between traditional values and Western ideas, and rigidity in traditional Asian families that may foster greater intergenerational conflict. The EAT and BSQ are thus valid instruments for the measurement and differentiation of eating disorders in Asian girls living in Britain. These disorders do exist in this population. (Consumer Summary produced by Reliance Medical Information, Inc.)

All children in the eighth grade (aged 14.5 to 15.5 years) of all schools in Goteborg, Sweden in 1985 were screened for anorexia nervosa (AN) by using school health service growth charts, nurse reports, and self-reports of food interests, weight, and desire to lose weight. The 330 girls and 55 boys who demonstrated AN symptoms were then repeatedly weighed by school nurses for a one-year follow-up period and were extensively interviewed. At the end of the follow-up period, 38 girls and 5 boys were diagnosed with AN and agreed to participate in a more complete diagnostic study, which included a neuropsychiatric examination. Seventeen children fulfilled all criteria for AN, including a real or projected weight loss of 25 percent or more and extreme anorectic behavior (e.g., refusal to maintain body weight over a minimal normal weight, intense fear of weight gain, and disturbed bodily perceptions). A partial AN syndrome (real or projected weight loss of 15 percent and mild anorectic behavior) was diagnosed in three girls, bringing an accumulated AN frequency to 0.84 percent of the general population of girls 15.5 years of age or younger. The rate of cases for boys was about one tenth of that for girls. Findings show that AN is more widespread in the general population than previously thought. (Consumer Summary produced by Reliance Medical Information, Inc.)