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SOCIAL MEDICINE Sharp Rise in Disordered Eating in Fiji Follows Arrival of Western TV Anne Becker says rapid social change in Fiji is altering the way adolescent girls view their bodies. A dramatic increase in disordered eating among teenage girls in the Pacific island nation of Fiji may be linked to the recent introduction of TV, Harvard Medical School researchers report.     The sudden infusion of Western cultural images and values through TV appears to be changing the way Fijian girls view themselves and their bodies, says Anne Becker, assistant professor of medical anthropology in the Department of Social Medicine, assistant professor of psychiatry at Massachusetts General Hospital, and director of research at the Harvard Eating Disorders Center. The result is a sharp rise in indicators of disordered eating, such as induced vomiting. Becker presented preliminary findings May 19 at the American Psychiatric Association annual meeting in Washington, D.C.     Eating disorders are most common in industrialized Western countries, and epidemiologic data suggest culture plays a central role. But Becker says she knows of no published studies using longitudinal ethnographic and survey data to document the onset of disordered eating amid cultural change. The Shift in Eating Habits In her 1998 survey, taken 38 months after TV came to Nadroga, Fiji, 15 percent of girls, aged 17 on average, reported they had vomited to control weight. By contrast, only 3 percent reported this behavior in 1995, just after TV was introduced. In addition, high scores on a test indicating risk for disordered eating were significantly more frequent among schoolgirls in 1998 compared with 1995. In 1998, 74 percent of the girls reported feeling "too big or fat" at least sometimes. Those who watched TV at least three nights per week were 50 percent more likely to see themselves as too fat, and 30 percent more likely to diet, although the more frequent TV watchers were not more overweight. And 62 percent of Fijian high school girls in 1998 reported dieting in the past month, a comparable or even higher proportion than reported in American samples.     Traditionally, Fijians have preferred robust body shapes, reflecting the importance placed on generous feeding and voracious eating. Sixty-two percent of Fijian high school girls in 1998 reported dieting in the past month, comparable to the proportion in the U.S. —Anne Becker     "Your social position is based on how well you can feed other people," Becker says. "At any meal, especially when you're a guest, you're supposed to eat as much as you can—often beyond satiety." Fijian society has historically been "hypervigilant" about people viewed as undereating, identifying a culture-specific illness called "going thin," meaning losing noticeable weight, she adds. Only in very recent years, likely reflecting the encroachment of Western beauty ideals and values, have Fijians begun to focus on heaviness as a concern. The Fijian diet is extremely high in fat, and Becker and colleagues found that 84 percent of village women in their sample were overweight or obese. Being Young and Slim Fiji is developing from an isolated, kinship-based society into one that participates in the global economy. "It is essentially going from a subsistence agricultural society straight into the information age," Becker says. The older generation's values are being questioned by the younger, and the desire to be slim may be a sign that young Fijians are striving to conform to Western cultural standards. They also show a keen interest in the careers and workplaces depicted on TV, looking to the characters as role models in a fast-changing world. Fijians often find it difficult to accept that TV does not depict real life in America, Becker adds.     As one girl said, "We can see [teenagers] on TV.... They are the same ages, but they are working, they are slim and very tall, and they are cute, nice.... We want our bodies to become like that ... so we try to lose a lot of weight." Advising these girls on diet is tricky, Becker says. Their health might benefit if they chose lower-fat foods, but an overemphasis on avoiding fat and keeping trim might encourage unhealthy behaviors.     Becker and colleagues plan to examine questions such as generational differences in eating behavior in Fiji. Preliminary results show, for example, that schoolgirls are 14 times more likely than older women to have ever dieted. —Tom Reynolds Back to Top