Disordered eating attitudes among Canadian teenagers

Pierre Leichner has queried whether there has been a recent change in the prevalence of eating disorders in Western countries such as Canada. Our cross-sectional study¹ was not designed to address this question. However, there is now considerable evidence that there has been a rise in the prevalence of eating disorders, particularly those of the binge–purge variety, in Western and Westernized countries over the past 3 or 4 decades.² As Leichner notes, the extent to which the prevalence has changed in Canada in the past 1 or 2 decades is not clear.

Leichner also raises the interesting question of how cultural attitudes toward women in less Westernized countries may affect the prevalence of eating disorders. There is consistent evidence that the prevalence of eating disorders is on the rise in Asia, Eastern Europe, the Middle East and parts of Africa and that this increase is inversely related to the body mass index desired by women.³ Such attitudes toward female weight and shape are inextricably linked to factors affecting the social roles and perceived power of women in society.⁴ In recent times, a thin body ideal for women has been most often associated with more liberalized and egalitarian attitudes toward women, as well as with increased pressures for them to compete and to perform in diverse spheres.^4,5,6 Further, with more plentiful global food supplies, an increasing prevalence of obesity and a more pervasive influence of the media, cultural determinants of eating disorders may now be tied more to modernity than to specific geographic locations.⁷ The occurrence of clinical eating disorders presumably depends upon the interaction of these cultural factors with the vulnerabilities of individual women.