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Background: Cultural factors have been shown to shape eating disorder symptoms. The origins of this cultural influence have rarely been investigated, although identity development is known to be important in the development of eating disorders. This study explores the prominence of bulimic symptoms and acculturation indices in order to further explain the association of the two. Quantitative and qualitative methods are used. Method: In a mixed sex school in East London all teenagers over the age of 13 years were given the BITE questionnaire and an acculturation schedule. A random sample of students proceeded to a second stage unstructured interview, during which a diagnosis on DSM-III-R criteria was established to make sense of the qualitative data. Results: A total of 266 subjects completed the questionnaire. A sample of 31 were interviewed for qualitative accounts of their eating pattern and their identity development. Asians were more likely to think about food, to fast and to indulge in compulsive eating. African-Caribbeans were more likely to eat 'sensibly' in fron of others and make up in private. There were differences in acculturation items and bulimic symptoms among Asians appear to have more sociocentric origins. Conclusions: Cultural identity and acculturative process influence the development of and form of bulimia. Copyright © 2002 John Wiley & Sons, Ltd and Eating Disorders Association.

Original publication




Journal article


European Eating Disorders Review

Publication Date





46 - 57