Although research has pointed to the influence of culture and family in the etiology of eating disorders, few studies have examined how these influences conjoin in this process. This research explores how the family mediates cultural ideas about thinness and how the family conveys these messages to family members. Using a grounded theory approach, open-ended interviews were conducted with 32 White, middle-class women (with and without eating disorders) on the topic of body image and eating problems. In conjunction with this method, qualitative comparative analysis (QCA) was also performed to identify family characteristics, and their specific combinations, that were associated with eating disorders. The findings indicate that a critical family environment, coercive parental control, and a dominating discourse on weight in the household are salient conditions, and their specific configurations are discussed in relationship to current theoretical conceptualizations regarding the influences of culture and family in the production of eating disorders.
Key Words: body image, eating disorders, family dynamics, sociocultural influences.
I think it's real societal driven. And you can't help as you grow up, you know, having it passed on, whether your parents intend to do it or not. I'm sure I've done it with my kids to some degree (Manna).
In recent years, a growing body of literature has addressed the relationship between body image and the development of eating disorders (Bordo, 1993; Dolan, 1994; Garner & Garfinkel, 1980; Garner & Kearney-Cooke, 1996; Garner, Garfinkel, Schwartz, & Thompson, 1980; Johnson, Brems, & Fischer, 1996; Mahbobah, 1992; Moorey, 1991; Ogletree, Williams, Raffeld, Mason, & Fricke, 1990; Saukko, 1996; Taub & McLorg, 1994; Thompson, 1994; Way, 1995; Wiseman, Gray, Mosimann, & Ahrens, 1992). Competing explanations of how to theorize the etiology of eating disorders has emerged from this research. Two prominent perspectives within this debate implicate either the influences of culture or those of the family.
Proponents of cultural influence cite the higher prevalence rates of eating disorders such as anorexia or bulimia in Western culture (Garfinkel & Garner, 1982), among Whites (Hsu, 1987), and particularly among women (Gordon, 1990). They point to the disproportionate number of women with these disorders who are associated with occupational or professional fields (e.g., modeling, gymnastics, ballet) that place a high value on slenderness (Garfinkel & Garner, 1982; le Grange, Tibbs, & Noakes, 1994; Williamson et al., 1995). Furthermore, they underscore the power of cultural standards of beauty that emphasize slenderness as a key feature of feminine identity (SteinerAdair, 1986; Striegel-Moore, 1993), so that even women without eating disorders experience body dissatisfaction (Cohn & Adler 1992; Davies & Furnham, 1986; Pliner, Chaiken, & Flett, 1990; Turner, Hamilton, Jacobs, Angood, & Hovd Dwyer, 1997); and that dissatisfaction is pervasive enough to have been characterized as a "normative discontent" (Rodin, Silberstein, & StriegelMoore, 1985).
Proponents of a family perspective offer a different approach to studying eating disorders. They contend that individuals develop a normal or distorted body image in the context of family life; therefore, family influences should be the focus of investigation (Bruch, 1978; Foulkes, 1996; Johnson et al., 1996; Keel, Heatherton, & Harnden, 1997; Leung, Schwartzman, & Steiger, 1996; Rieves & Cash, 1996; Root, Fallon, & Friedrich, 1986). Some of these researchers even critique the cultural approach, arguing that although all women are exposed to cultural standards of beauty that might be linked to a "normative discontent," not all women develop eating disorders (Brumberg, 1988). But these two sets of research findingsone emphasizing cultural influences and the other family origins-represent a false dichotomy regarding the social etiology of eating disorders, because of a theoretical miscasting of the relationship between culture and family. …