- Eating disorders in teens can be due to cultural expectations, family gatherings, and social media pressures.
- Adolescent-onset eating disorders affect 10% of Americans in their lifetimes.
- Asian American women are particularly vulnerable due to cultural factors and acculturative stress.
Co-authored by Vicky Wang, B.S., and Eunice Yuen, M.D., Ph.D.
The end of the year can be stressful. It starts with decorating, shopping, traveling, and finally, celebrating with loved ones—often with a feast. Food can be comforting. A pre-pandemic caloric intake estimate of the average American on Christmas day was a staggering 6,500 calories, three times the daily recommended amount according to the U.S. Food and Drug Administration (FDA) guidelines.
In this post-pandemic era, food can also be the culprit. Since the onset of the COVID-19 pandemic, there has been a dramatic increase in the number of youths grappling with eating disorders, with cases among teens doubling in the pandemic’s initial year. Amplified with familial bonds and the pervasive influence of cultural expectations and social media, the celebrations are overwhelming for those grappling with food-related challenges.
While casting a glow of joy on family gatherings and elaborate meals, let us be aware of this silent epidemic and support young lives who are affected.
Eating disorders are complex medical and mental illnesses. The Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) classification includes anorexia nervosa, bulimia nervosa, binge eating, avoidant restrictive food intake (ARFID), and others. Research indicates a lifetime prevalence affecting 10 percent or 29 million Americans.
While these disorders can emerge at any age, as young as 5 years old to those as old as 80, adolescence is often the starting point. A new study suggests that 1 in 5 teens may grapple with disordered eating behaviors. The longevity of these struggles can last an average of eight-plus years.
Moreover, a comprehensive review delves into the profound impact of eating disorders on mental and physical health, a litany of psychiatric and medical comorbidities, including depression, anxiety, addiction, cardiovascular complications, metabolic syndrome, nutrition deficiencies, and more.
Cultural factors can have devastating effects on youth struggling with eating disorders. The holiday season, when Asian American families come together, brings heightened pressure to conform to societal appearance expectations. At the dinner table, harmful food dialogue can be presented bluntly, albeit with good intentions.
A scene from the Oscar Winning Best Picture Everything Everywhere All at Once exemplifies this. The mom, Evelyn, played by Michelle Yeoh, attempts to communicate with her daughter, Joy. However, instead of expressing her concern, she hesitates and blurts out, “You have to try and eat healthier. You are getting fat.”
In response, Joy stares back with teary eyes and slams her car door.
Commonly, many have assumptions regarding how Asian Americans are well-adjusted (“model minority” stereotype). However, research found that Asian American women are not immune to a mainstream cultural emphasis on thinness and show high rates of disordered eating. Sociocultural factors, including the perception of thinness as success and environments fostering fat-shaming, impact girls and women globally.
Beyond that, there are additional risk factors that contribute to why Asian American women are more vulnerable to eating disorders, such as biculturalism and acculturative stress.
It is well known that the surge of social media has heightened struggles across age groups, especially in teens. A study on grade 7 and grade 8 adolescents reveals a strong correlation between social media use and disordered eating behaviors. A global review underlines the adverse effects of social media on body image, mental health, social comparison, and self-objectification across 17 countries.