Eating Attitudes and Dieting Behavior Among Religious Subgroups of Israeli-Arab Adolescent Females

Original Paper

Abstract

Objectives The aim of the study was to compare the eating attitudes and behaviors, including weight concerns and dieting behavior, among three religious subgroups (Moslems, Druze, and Christians) and three age subgroups (12–13, 14–15, and 16–18 years old) of Israeli-Arab adolescent females. Methods The sample consisted of 1141 Israeli-Arab adolescent females, including 926 (81.2%) Moslem, 128 (11.2%) Christian, and 87 (7.6%) Druze schoolgirls in the seventh to twelfth grades. Participants were assessed using the EAT–26 questionnaire. Results The results showed that 75% of the students had a negative EAT-26 score (>20) and that 25% of the students had a positive EAT-26 score (<20). No significant differences were found in total scores, subscale scores, or scores above 20 between the age subgroups or the religious subgroups. The results demonstrated a high prevalence of disturbed eating attitudes and behaviors among Israeli-Arab adolescent schoolgirls. Discussion Higher prevalence of disturbed eating attitudes found among Israeli-Arab schoolgirls as compared to their Jewish counterparts. Although our sample is a communal based, there still remains an open question as to why the desired “slenderness culture” evident in the results is not reflected in the number of ED clinic referrals, among clinical population. These discrepancies were discussed in light of ethnicity-specific factors that may influence the perceived severity of eating disorders and the receptiveness of primary practitioners to address them.

Keywords

Israel Arab Eating attitudes Religion EAT-26 

References

  1. Al-Issa, M. (1966). Psychiatry in Iraq. The British Journal of Psychiatry, 112, 827–832.PubMedCrossRefGoogle Scholar
  2. Al-Subaie, A. (1998). Eating attitude test in Arabic: Psychometric features and normative data. Annals of Saudi Medicine, 19, 447–453.Google Scholar
  3. Al-Subaie, A. S. (2000). Some correlates of dieting behavior in Saudi schoolgirls. The International Journal of Eating Disorders, 28, 242–246. doi :10.1002/1098-108X(200009)28:2<242::AID-EAT16>3.0.CO;2-Z.PubMedCrossRefGoogle Scholar
  4. Al-Subaie, A., Al-Shammari, S., Bamgboye, E., Al-Sabhan, K., Al-Shehri, S., & Bannah, A. R. (1996). Validity of the Arabic version of the Eating Attitude Test. The International Journal of Eating Disorders, 20, 321–324. doi :10.1002/(SICI)1098-108X(199611)20:3<321::AID-EAT12>3.0.CO;2-2.PubMedCrossRefGoogle Scholar
  5. Apter, A., Abu Shah, M., Iancu, I., Abramovitch, H., Weizman, A., & Tyano, S. (1994). Cultural effects on eating attitudes in Israeli subpopulations and hospitalized anorectics. Genetic, Social, and General Psychology Monographs, 120, 83–99.PubMedGoogle Scholar
  6. Barak, A., & Golan, G. (2000). Counseling psychology in Israel: Successful accomplishments of a nonexistent specialty. The Counseling Psychologist, 28, 100–116. doi:10.1177/0011000000281006.CrossRefGoogle Scholar
  7. Becker, A. E., Franko, D. L., Speck, A., & Herzog, D. B. (2002). Ethnicity and differential access to care for eating disorder symptoms. The International Journal of Eating Disorders, 33, 205–212. doi:10.1002/eat.10129.CrossRefGoogle Scholar
  8. Ben-Ari, A. (1998). Understanding of and attitudes towards self-help: Views from Palestinian and Israeli members of self-help groups. Journal of Social Service Research, 24, 131–148. doi:10.1300/J079v24n01_06.CrossRefGoogle Scholar
  9. Ben-Ari, A. (2001). Alternative modalities of help within socio-political and ethnic minorities: Self-help among Arabs living in Israel. Community Mental Health Journal, 37, 245–259. doi:10.1023/A:1017581130865.PubMedCrossRefGoogle Scholar
  10. Ben-Ari, A., & Azaiza, F. (2003). Effectiveness of helplines among sociopolitical minorities: A view from both sides of the line. Families in Society, 84, 417–422.Google Scholar
  11. Button, E. J., Loan, P., Davies, J., & Sonuga-Barke, E. J. S. (1997). Self esteem, eating problems, and psychological well being in a cohort of schoolgirls aged 15–16: A questionnaire and interview study. The International Journal of Eating Disorders, 21, 39–47. doi :10.1002/(SICI)1098-108X(199701)21:1<39::AID-EAT5>3.0.CO;2-4.PubMedCrossRefGoogle Scholar
  12. Central Bureau of Statistics. (2004). Statistical Abstract of Israel. Israel: Jerusalem.Google Scholar
  13. Cooper, Z. (1995). Epidemiology, etiology and course of eating disorders. In K. D. Brownell & C. G. Fairburn (Eds.), Eating disorders and obesity: A comprehensive handbook (pp. 199–244). The Guilford Press: New York.Google Scholar
  14. Choudry, I. Y., & Mumford, D. B. (1992). A pilot study of eating disorders in Mirpur (Pakistan) using an Urdu version of the eating attitudes test. The International Journal of Eating Disorders, 11, 243–251. doi :10.1002/1098-108X(199204)11:3<243::AID-EAT2260110307>3.0.CO;2-P.CrossRefGoogle Scholar
  15. Crago, M., Shisslak, C. M., & Estes, L. S. (1996). Eating disturbances among American minority groups: A review. The International Journal of Eating Disorders, 19, 239–248. doi :10.1002/(SICI)1098-108X(199604)19:3<239::AID-EAT2>3.0.CO;2-N.PubMedCrossRefGoogle Scholar
  16. Dancyger, I. F., & Garfinkel, P. E. (1995). The relationship of partial syndrome eating disorders to anorexia nervosa and bulimia nervosa. Psychological Medicine, 25, 1019–1025.PubMedGoogle Scholar
  17. Deter, H. C., Herzog, W., & Manz, R. (1994). Do patients with anorexia nervosa return to psychological health? Results of a 12-year follow-up of 103 patients. Zeitschrift fur Psychosomatische Medizin und Psychoanalyse, 40, 155–173. German.PubMedGoogle Scholar
  18. Devaud, C., Jeannin, A., Narring, F., Ferron, C., & Michaud, P. A. (1998). Eating disorders among female adolescents in Switzerland: Prevalence and associations with mental and behavioral disorders. The International Journal of Eating Disorders, 24, 207–216. doi :10.1002/(SICI)1098-108X(199809)24:2<207::AID-EAT10>3.0.CO;2-W.PubMedCrossRefGoogle Scholar
  19. Dolan, B. J. (1991). Cross-cultural aspects of anorexia nervosa and bulimia: A review. The International Journal of Eating Disorders, 10, 67–78. doi :10.1002/1098-108X(199101)10:1<67::AID-EAT2260100108>3.0.CO;2-N.CrossRefGoogle Scholar
  20. Eckert, E. D., Halmi, K. A., Marchi, P., Grove, W., & Crosby, R. (1995). Ten-year follow-up of anorexia nervosa: Clinical course and outcome. Psychological Medicine, 25, 143–156.PubMedGoogle Scholar
  21. Elsarrag, M. E. (1968). Psychiatry in the Northern Sudan: A study in comparative psychiatry. The British Journal of Psychiatry, 114, 945–948.PubMedCrossRefGoogle Scholar
  22. Fisher, M., Pastore, D., Schneider, M., Pegler, C., & Napolitano, B. (1994). Eating attitudes in Urban and Suburban Adolescents. The International Journal of Eating Disorders, 16, 67–94. doi :10.1002/1098-108X(199407)16:1<67::AID-EAT2260160107>3.0.CO;2-I.PubMedCrossRefGoogle Scholar
  23. Garner, D. M., Olmsted, M. P., Bohr, Y., & Garfinkel, P. E. (1982). The eating attitudes test: Psychometric features and clinical correlates. Psychological Medicine, 12, 871–878.PubMedGoogle Scholar
  24. Gotestam, K. G., Eriksen, L., Heggestad, T., & Nielsen, S. (1998). Prevalence of eating disorders in Norwegian general hospitals 1990–1994: Admissions per year and seasonality. The International Journal of Eating Disorders, 23, 57–64. doi :10.1002/(SICI)1098-108X(199801)23:1<57::AID-EAT7>3.0.CO;2-0.PubMedCrossRefGoogle Scholar
  25. Haj-Yahia, M. (1994). The Arab family in Israel: Cultural values and their linkage to social work. Society & Welfare, 14, 249–264.Google Scholar
  26. Haj-Yahia, M. (1995). Wife abuse in the Arab society in Israel: Some challenge for future change. Paper presented at the international study group on future intervention with battered women and their families. The School of Social Work, University of Haifa, Israel.Google Scholar
  27. Haj-Yahia, M. (1997). Culturally sensitive supervision of Arab social work students in Western universities. Social Work, 42, 166–174.Google Scholar
  28. Harel, Y., Ellenbogen-Frankovits, S., Molcho, M., Abu-Ashas, K., & Habib, J. (2002). Youth in Israel. Jerusalem, Israel: Brookdale Institute.Google Scholar
  29. Herzog, D. B., Greenwood, D. N., Dorer, D. J., Flores, A. T., Ekeblad, E. R., Richards, A., et al. (2000). Mortality in eating disorders: A descriptive study. The International Journal of Eating Disorders, 28, 20–26. doi :10.1002/(SICI)1098-108X(200007)28:1<20::AID-EAT3>3.0.CO;2-X.PubMedCrossRefGoogle Scholar
  30. Ianuca, I. (1990). Validation of the EAT in Israel. Unpublished doctoral dissertation. School of Medicine; Tel Aviv University, Israel.Google Scholar
  31. Katzman, M. A., Hermans, K. M. E., Hoken, D. V., & Hoek, H. W. (2004). Not your “Typical Island Woman”: Anorexia nervosa is reported only in Subcultures in Curacao. Culture, Medicine and Psychiatry, 28, 463–492. doi:10.1007/s11013-004-1065-7.PubMedCrossRefGoogle Scholar
  32. Kiriike, N., & Nagata, T. (1997). Cross–culture studies. Bailliere’s Clinical Psychiatry, 3, 339–351.Google Scholar
  33. Latzer, Y. (2003). Disordered eating and attitudes in Israel. In M. R. Giovanni (Ed.), Eating disorders in the Mediterranean area: An exploration in transcultural psychology. (Chapter 13, pp. 159–182). Huntington, NY: Nova Science Publisher.Google Scholar
  34. Latzer, Y., & Shatz, S. (1999). Comprehensive community prevention of disturbed attitudes to weight control: A three level intervention program. Eating Disorders: The Journal of Treatment and Prevention, 7, 3–31.Google Scholar
  35. Latzer, Y., & Shatz, S. (2001). Disturbed attitudes to weight control in female kibbutz adolescents: A preliminary study with a view to prevention. Eating Disorders: The Journal of Treatment and Prevention, 9, 225–237.Google Scholar
  36. Latzer, Y., & Tzischinsky, O. (2003). Weight concern, dieting and eating behavior: A survey of Israeli high-school girls. International Journal of Adolescents Medicine and Health, 15, 295–305.Google Scholar
  37. Latzer, Y., & Tzischinsky, O. (2005). Eating attitudes in a varied group of Israeli adolescent females: A comparison study. Journal of Adolescence, 28, 317–323. doi:10.1016/j.adolescence.2004.12.004.PubMedCrossRefGoogle Scholar
  38. Latzer, Y., Tzischinsky, O., & Azaiza, F. (2007a). Disordered eating related behaviors among Arab schoolgirls in Israel: An epidemiological study. The International Journal of Eating Disorders, 40(3), 263–270. doi:10.1002/eat.20348.PubMedCrossRefGoogle Scholar
  39. Latzer, Y., Tzischinsky, O., & Geraisy, N. (2007b). Comparative study of eating related attitudes and psychological traits between Israeli Arab and Jewish schoolgirls. Journal of Adolescence, 30(4), 627–637. doi:10.1016/j.adolescence.2006.06.002.PubMedCrossRefGoogle Scholar
  40. Latzer, Y., Vander, S., & Gilat, I. (2008). Socio-demographic characteristics of ED patients in an outpatient clinic: A descriptive epidemiological study. European Eating Disorders Review, 16, 139–146.PubMedCrossRefGoogle Scholar
  41. Lee, A. M., & Lee, S. (1996). Disordered eating and its psychosocial correlates among Chinese adolescent females in Hong Kong. The International Journal of Eating Disorders, 20, 177–183. doi :10.1002/(SICI)1098-108X(199609)20:2<177::AID-EAT8>3.0.CO;2-D.PubMedCrossRefGoogle Scholar
  42. Lichener, P., Arnett, J., Rallo, J. S., Srikameswaran, S., & Vulcano, B. (1986). An epidemiologic study of maladaptive eating attitudes in a Canadian school age population. The International Journal of Eating Disorders, 5, 969–982. doi :10.1002/1098-108X(198609)5:6<969::AID-EAT2260050602>3.0.CO;2-P.CrossRefGoogle Scholar
  43. Malach-Pines, A., & Zaidman, N. (2003). Israeli Jews and Arabs: Similarities and differences in the utilization of social support. Journal of Cross-Cultural Psychology, 34, 465–480. doi:10.1177/0022022103034004006.CrossRefGoogle Scholar
  44. Mckay, M., & Fanning, P. (2000). Self esteem (3rd ed.). CA, Oakland: New Harbinger Publications, Inc.Google Scholar
  45. Mann, A. H., Wakeling, A., Wood, K., Monec, E., Dobbs, R., & Szmulker, G. (1983). Screening for abnormal eating attitudes and psychiatric morbidity in an unselected population of 15-year-old schoolgirls. Psychological Medicine, 13, 573–580.PubMedCrossRefGoogle Scholar
  46. Mitrany, E., Lubin, F., Chetrit, A., & Modan, B. (1995). Eating disorders among Jewish female adolescents in Israel: A 5-year study. The Journal of Adolescent Health, 6, 454–457. doi:10.1016/1054-139X(95)00005-D.CrossRefGoogle Scholar
  47. Mumford, D. B., Whitehouse, A. M., & Choudry, I. Y. (1992). Survey of eating disorders in English-medium schools in Lahore, Pakistan. The International Journal of Eating Disorders, 11, 173–184. doi :10.1002/1098-108X(199203)11:2<173::AID-EAT2260110208>3.0.CO;2-L.CrossRefGoogle Scholar
  48. Nakamura, K., Hoshino, Y., Watanabe, A., Honda, K., Niwa, S., Tominaga, K., et al. (1999). Eating problems in female Japanese high school students: A prevalence study. The International Journal of Eating Disorders, 26, 91–95. doi :10.1002/(SICI)1098-108X(199907)26:1<91::AID-EAT12>3.0.CO;2-M.PubMedCrossRefGoogle Scholar
  49. Nasser, M. (1986). Comparative study of the prevalence of abnormal eating attitudes among Arab female students of both London and Cairo Universities. Psychological Medicine, 16, 621–625.PubMedGoogle Scholar
  50. Nasser, M. (1988a). Culture and weight consciousness. Journal of Psychosomatic Research, 32, 573–577. doi:10.1016/0022-3999(88)90005-0.PubMedCrossRefGoogle Scholar
  51. Nasser, M. (1988b). Eating disorders: The cultural dimension. Social Psychiatry and Psychiatric Epidemiology, 23, 184–187. doi:10.1007/BF01794786.PubMedCrossRefGoogle Scholar
  52. Nasser, M. (1994a). Culture and research instruments: The performance of the eating attitudes test questionnaire in the Arabic culture. Arab Journal of Psychiatry, 5, 1–11.Google Scholar
  53. Nasser, M. (1994b). Screening for abnormal eating attitudes in a population of Egyptian secondary school girls. Social Psychiatry and Psychiatric Epidemiology, 29, 25–30.PubMedGoogle Scholar
  54. Nasser, M. (1994c). The psychometric properties of the Eating Attitude Test in a non-Western population. Social Psychiatry and Psychiatric Epidemiology, 29, 88–94.PubMedGoogle Scholar
  55. Nasser, M. (1997). The EAT speaks many languages: Review of the use of the EAT in eating disorders research. Eating and Weight Disorders, 2, 174–181.PubMedGoogle Scholar
  56. Nasser, M., Katzman, M. A., & Gordon, R. A. (Eds.). (2001). Eating disorders and cultures in transition. London: Brunner-Routledge.Google Scholar
  57. Neumarker, K. J. (1997). Mortality and sudden death in Anorexia Nervosa. The International Journal of Eating Disorders, 21, 206–212. doi :10.1002/(SICI)1098-108X(199704)21:3<205::AID-EAT1>3.0.CO;2-O.CrossRefGoogle Scholar
  58. Neumarker, U., Dudeck, U., Vollrath, M., Neumarker, K. J., & Steinhausen, H. C. (1992). Eating attitudes among adolescent anorexia nervosa patients and normal subjects in former West and East Berlin: A transcultural comparison. The International Journal of Eating Disorders, 12, 281–289. doi :10.1002/1098-108X(199211)12:3<281::AID-EAT2260120308>3.0.CO;2-G.CrossRefGoogle Scholar
  59. Nobakht, M., & Dezhkam, M. (2000). An epidemiological study of eating disorders in Iran. The International Journal of Eating Disorders, 28, 265–271. doi :10.1002/1098-108X(200011)28:3<265::AID-EAT3>3.0.CO;2-L.PubMedCrossRefGoogle Scholar
  60. Patton, G. C. (1988). The spectrum of eating disorders in adolescence. Journal of Psychosomatic Research, 32, 579–584. doi:10.1016/0022-3999(88)90006-2.PubMedCrossRefGoogle Scholar
  61. Patton, G. C., Johnson-Sabine, E., Wood, K., & Mann, A. H. (1990). Abnormal eating attitudes in London schoolgirls: A prospective epidemiological study: Outcome at twelve month follow-up. Psychological Medicine, 20, 383–394.PubMedGoogle Scholar
  62. Sasson, A., Lewin, C., & Roth, D. (1995). Dieting behavior and eating attitudes in Israeli children. The International Journal of Eating Disorders, 17, 67–72. doi :10.1002/1098-108X(199501)17:1<67::AID-EAT2260170109>3.0.CO;2-B.PubMedCrossRefGoogle Scholar
  63. Scheinberg, Z., Bleich, A., & Kolovsky, M. (1992). Prevalence of eating disorders among female Israel Defense Force recruits. Harfeuah, 123, 73–78. Hebrew.Google Scholar
  64. Stein, D., Meged, S., Bar-Hanin, T., Blank, S., Elizur, A., & Weizman, A. (1997). Partial eating disorders in a community sample of female adolescents. Journal of the American Academy of Child and Adolescent Psychiatry, 36, 1116–1123. doi:10.1097/00004583-199708000-00019.PubMedCrossRefGoogle Scholar
  65. Steinhausen, H. C., Winkler, C., & Meier, M. (1997). Eating disorders in adolescence in a Swiss epidemiological study. The International Journal of Eating Disorders, 22, 147–151. doi :10.1002/(SICI)1098-108X(199709)22:2<147::AID-EAT5>3.0.CO;2-F.PubMedCrossRefGoogle Scholar
  66. Stice, E., Schupak-Neuberg, E., Shaw, H. E., & Stein, R. I. (1994). Relation of media exposure to eating disorder symptomatology: An examination of mediating mechanisms. Journal of Abnormal Psychology, 103, 836–840. doi:10.1037/0021-843X.103.4.836.PubMedCrossRefGoogle Scholar
  67. Smolak, L., & Strigel-Moore, R. H. (2001). Challenging the myth of the mythy of the golden girl: Ethnicity and eating disorders. In R. H. Strigel-Moore & L. Smolak (Eds.), Eating Disorders: Innovative directions for research and practice (pp. 111–132). Washington, DC: American Psychological Association.Google Scholar
  68. Toro, J., Castro, J., Garcta, M., Perez, P., & Cuesta, L. (1989). Eating attitudes socio-demographic factors and body shape evaluation in adolescence. The British Journal of Medical Psychology, 62, 61–70.PubMedGoogle Scholar
  69. Whitaker, A., Davies, M., Shaffer, D., & Johnson, J. (1989). The struggle to be thin: A survey of anorexic and bulimic symptoms in non-referred adolescent population. Psychological Medicine, 19, 143–163.PubMedGoogle Scholar
  70. Wichstrom, L. (1995). Social, psychological and physical correlates of eating problems. A study of the general adolescent population in Norway. Psychological Medicine, 25, 567–579.PubMedGoogle Scholar
  71. Witzum, E., Stein, D., & Latzer, Y. (2005). Anorexia Nervosa as a cultural related syndrome in the age of globalization. In R. Lev-Wizal, J. Tzvikal & N. Barak (Eds.), Women’s mental health in Israel: Save your soul (pp. 205–228). Jerusalem: Brookdale Institute.Google Scholar

Copyright information

© Blanton-Peale Institute 2008

Authors and Affiliations

  1. 1.Eating Disorders Clinic, Psychiatric DivisionRambam Medical CenterHaifaIsrael
  2. 2.School of Social Work, Faculty of Social Welfare and Health SciencesUniversity of HaifaHaifaIsrael
  3. 3.Behavioral SciencesEmek Yezreel CollegeEmek YezreelIsrael

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