The Fear of Fat Criterion Within the DSM IV

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Recommended: The impact of media on body image

As our society is bombarded with the images of manufactured beauty and “thinness”, conversations increasingly center on dieting and body dissatisfaction. The media advertises weight loss products in the form of pills, drinks, surgery, fitness equipment and support groups to mold individuals into the proposed ideal form. This evidence alone suggests a strong case for the possibility of a pathological fear of fat. Is this fear, however, the driving force behind all cases of anorexia nervosa and bulimia? According to the DSM IV, the fear of gaining weight is essential for these diagnoses to be made. Strong arguments have been made both in favor and against modifying the existing criteria to allow for the diagnosis and treatment of individuals, regardless of whether or not a ‘fat phobia’ is present. Is it culturally insensitive to retain this particular criterion, a fear of gaining weight, if a patient has not been exposed to the same cultural pressures and orientation towards being thin?

Although western culture is thought to be the dominant culture, because of power and economics, non-western cultures make up eighty percent of the world’s population (Lee, 1995). Many of these ‘sub-dominant’ cultures are present in the melting pot of the modern United States. Are these non-Westernized individuals being denied the necessary treatments and interventions merely because a fear of gaining weight is not expressed? Such a strong focus on body dissatisfaction may cause one to overlook or disregard the pressures of societal systems, such as immigration or poverty, on the mental and physical well being of an individual. If ‘fat phobia’ is indeed a culturally constructed definition of anorexia nervosa, it la...

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...ternational Journal of Eating Disorders, 17, 175-183.

King, M.B., & Bhugra, D. (1989). Eating disorders: Lessons from a cross-cultural study. Psychological Medicine, 19, 955-958.

Lake, A.J. Staiger, P.K., & Glowinski, H. (2000). Effect of Western Culture on Women’s Attitudes to Eating and Perceptions of Body Shape. International Journal of Eating Disorders, 27, 83-89.

Lee, S. (1993). How abnormal is the desire for slimness? A survey of eating attitudes and behaviour among Chinese undergraduates in Hong Kong. Psychological Medicine, 23, 437-451.

Lee, S. (1995). Self-starvation in context: Towards a culturally sensitive understanding of anorexia nervosa. Social Science and Medicine, 41, 25-36.

Thompson, J.K. & Altabe, M.N (1991). Psychometric qualities of the figure rating scale. International Journal of Eating Disorders, 10, 615-619.

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