Context
A dearth of data concerning eating problems among adult women from diverse cultural origins leaves substantial knowledge gaps and constrains evidence-based interventions.
Objective
To examine prevalence and predictors of disordered eating behaviors (DEB) among adult Jewish women (21+) from distinct cultural origins.
Design
Community-based study includes 175 Israelis born to parents from Muslim countries (aka Sephardic) and 108 second generation Israelis mostly of European ancestry. DEB assessed with DSM-IV related symptoms. Hierarchical regressions examine influence of weight, self-criticism and psychological distress on DEB severity.
Results
Despite similar exposure to Israel's westernized norms, substantial group differences emerge. Considerably lower rate of DEB found among respondents of Sephardic origin (11.4%, 19.4%, p < .05); regressions reveal dissimilar patterns of clinical predictors.
Conclusions
Community cohesiveness and deeply-rooted cultural and religious traditions may be protective for Israelis of Sephardic origin. Additional research is needed to clarify cultural influences and enhance culturally sensitive interventions for multicultural populations.
Our understanding of cultural influences on eating problems remains ‘relatively rudimentary,’ especially regarding adult women. In contrast to numerous cultural studies of young females (under age 25), (Cummins et al., 2005 and Feinson, 2011) there is a dearth of empirical evidence concerning adults, leaving significant knowledge gaps and constraining evidence-based interventions (Le Grange et al., 1998, Marcus et al., 2007 and Striegel-Moore and Cachelin, 2001). Moreover, there are inconsistent findings concerning culture's contribution to anorexia nervosa (AN) and bulimia nervosa (BN) (Keel & Klump, 2003). With regard to binge eating behaviors (e.g. BED), there are relatively few studies (Cummins et al., 2005). Emerging evidence, however, suggests that “…the amount of exposure to white social norms may be irrelevant for an understanding of risk for BED.” (Striegel-Moore et al., 2005).
1.1. Cultural origin and eating problems—an Israeli study
A study of Israeli high school girls sheds light on some of the cultural complexities (Neumark-Sztainer, Palti, & Butler, 1995). Substantial weight concerns were found among students, regardless of cultural background1 leading researchers to consider Israel's predominantly westernized culture sufficiently strong to override students' ethnic differences. In contrast, mothers differed according to cultural origin; those born in westernized countries had greater weight and shape concerns compared to mothers from North African or Middle Eastern countries.
1.2. The present study
The influence of cultural factors on eating problems is complex and unresolved. An opportunity for exploring cultural issues exists with a demographically diverse sample of adult women in Israel (age 21 to 80). Large waves of immigration since Israel's founding in 1948 provide an invaluable milieu for exploring the issues. In this analysis, prevalence and predictors of disordered eating behaviors (DEB) for two culturally distinct groups with comparable exposure to Israel's westernized norms are explored. One group (Sephardic) has roots in North Africa and the Middle East, in Muslim countries2 considered more traditional and less influenced by westernized norms than European-American countries and Israel. Another cultural group consists of second generation Israeli-born Jews whose families immigrated to Palestine from Europe and Russia during the late 19th and early 20th centuries.3
More eating problems among Sephardic respondents might be expected due to many hardships, both as minorities in Muslim countries and in Israel (Cohen and Leon, 2008 and Datan et al., 1981). Also, women's traditional roles within patriarchal families, (Datan et al., 1981) including constant meal preparation for large families, may exacerbate disordered eating. Alternatively, aspects of Sephardic life may be protective and associated with fewer disordered eating behaviors (DEB). Among these are a stable family environments associated with deeply rooted religious rituals and Sephardic traditions.
Clearly, “growing up in a different culture raises the possibility of different influences regarding the development of eating disturbances” (Smolak & Striegel-Moore, 2002, p. 117). While socio-cultural perspectives have focused primarily on Westernized norms of thinness, the current findings challenge this explanation for adult Jewish women with disordered eating behaviors. Despite similar exposure to Westernized norms, divergent prevalence rates and clinical predictor patterns for Jewish women from contrasting cultural origins highlight the need for a “…more complicated explanatory model than ‘one size fits all’…” (Striegel-Moore et al., 2007, p. 485).
