Culture, Medicine, and Psychiatry

, Volume 33, Issue 4, pp 623–638 | Cite as

Belief and Behavior Aspects of the EAT-26: The Case of Schoolgirls in Belize

  • Eileen P. Anderson-FyeEmail author
  • Jielu Lin


This study investigates components of eating attitudes in a sample of Belizean schoolgirls and argues for separate analysis of eating beliefs and eating behaviors using the EAT-26 in populations undergoing rapid cultural change. The EAT-26 was utilized in a novel manner, preserving the ethnographic and empirical distinction between belief and behavior components of eating attitudes. Participants included a sample of secondary schoolgirls (n = 80) undergoing acculturative stress. Participants reported more disordered eating beliefs than behaviors. Respondents having higher belief scores than behavior scores were more likely to prefer thinner body build and to be concerned about boys’ assessments of their bodies. Girls with higher behavior scores were less likely to report eating when hungry and stopping when full. In conclusion, discriminant validity was found between attitudinal and behavioral aspects of the EAT-26 as evidenced by face validity and patterns in predicting body image preference and desired weight change. Such a distinction has implications for assessing risk for disordered eating among populations undergoing acculturative stress. Among such populations, while behavioral symptoms might be absent or present in subclinical levels, disordered beliefs associated with psychological distress or potential precursors to eating-disordered behavior might be detected and should be investigated further.


Eating Attitudes Test 26-item version Belief Behavior Belizean schoolgirls 



The authors thank Anne Becker, Jill Korbin, Lawrence Greksa, Rebecca Lester, John Willett and an anonymous reviewer for comments on early versions of this paper. We also thank Kristi Ninneman for help with manuscript preparation.


  1. Ajzen, I. 1996 The Directive Influence of attitudes on behavior. Pp. 385–403 in The Psychology of Action: Linking Cognition and Motivation to Behavior. P. Gollwitzer and J. Bargh, eds. New York: Guilford Press.Google Scholar
  2. Anderson-Fye, E. 2004 A “Coca-Cola” Shape: Cultural Change, Body Image, and Eating Disorders in San Andres, Belize. Culture, Medicine and Psychiatry 28(4):561–595.CrossRefGoogle Scholar
  3. Anderson-Fye, E. 2008 Cross-Cultural Issues in Body Image and Eating Problems among Children and Adolescents. Pp. 144–174 in Body Image, Eating Disorders, and Obesity in Youth: Assessment, Prevention, and Treatment. L. Smolak and J. K. Thompson, eds. Washington, DC: APA Press.Google Scholar
  4. Anderson-Fye, E. P., and A. E. Becker. 2003 Sociocultural Aspects of Eating Disorders. Pp. 565–589 in The Handbook of Eating Disorders and Obesity. J. K. Thomson, ed. Hoboken, NJ: John Wiley and Sons.Google Scholar
  5. Barnett, D., and H. Ratner 1997 The Organization and Integration of Cognition and Emotion in Development. Journal of Child Experimental Psychology 67:303–316.CrossRefGoogle Scholar
  6. Becker, A. 2004 Television, Disordered Eating, and Young Women in Fiji: Negotiating Body Image and Identity during Rapid Social Change. Culture, Medicine and Psychiatry 28(4):533–559.CrossRefGoogle Scholar
  7. Bordo, S. 1993 Unbearable Weight: Feminism, Western Culture, and the Body. Berkeley: University of California Press.Google Scholar
  8. Boyadjieva, S., and H. Steinhausen. 1996 The Eating Attitudes Test and the Eating Disorders Inventory in Four Bulgarian Clinical and Nonclinical Samples. International Journal of Eating Disorders 19:93–98.CrossRefGoogle Scholar
  9. Breckler, S. 1984 Empirical Validation of Affect, Behavior, and Cognition as Distinct Components of Attitude. Journal of Personality and Social Psychology 47:1191–1205.CrossRefGoogle Scholar
  10. Cameron, S. 1997 From Girls to Women: Growing up Healthy in Belize. Belize City: Government of Belize.Google Scholar
  11. Cash, T. 1994 Body-Image Attitudes: Evaluation, Investment, and Affect. Perceptual & Motor Skills 78:1168–1170.Google Scholar
  12. Choudry, I., and D. Mumford. 1992 A Pilot Study of Eating Disorders in Mirpur (Pakistan) Using an Urdu Version of the Eating Attitudes Test. International Journal of Eating Disorders 11:243–251.CrossRefGoogle Scholar
  13. Comrey, A. L., and H. B. Lee. 1992 A First Course in Factor Analysis. 2nd ed. Hillsdale, NJ: Erlbaum.Google Scholar
  14. Damasio, A. 1994 Descartes’ Error: Emotion, Reason, and the Human Brain. New York: Grosset/Putnam.Google Scholar
  15. D’Andrade, R. 1984 Cultural Meaning Systems. Pp. 88–119 in Culture Theory: Essays on Mind, Self, and Emotion. R. Shweder and R. LeVine, eds. Cambridge, UK: Cambridge University Press.Google Scholar
  16. Eagly, A., and S. Chaiken. 1998 Attitude Structure and Function. In The Handbook of Social Psychology. 4th Edition, Vol. 1. S.F.D. Gilbert and G. Lindzey, eds., pp. 269–322. Boston: McGraw-Hill.Google Scholar
  17. Erikson, E. 1968 Identity: Youth and Crisis. New York: W. W. Norton.Google Scholar
  18. Festinger, L. 1957. A Theory of Cognitive Dissonance. Evanston, IL: Row, Peterson.Google Scholar
  19. Garner, D., and P. Garfinkel. 1979 The Eating Attitudes Test: An Index of the Symptoms of Anorexia Nervosa. Psychological Medicine 9:273–279.CrossRefGoogle Scholar
  20. Garner, D., and P. Garfinkel. 1980 Sociocultural Factors in the Development of Anorexia Nervosa. Psychological Medicine 10:647–656.CrossRefGoogle Scholar
  21. Garner, D., M. Olmstead, M., Y. Bohr, and P. Garfinkel. 1982 The Eating Attitudes Test: Psychometric Features and Clinical Correlates. Psychological Medicine 12:871–878.CrossRefGoogle Scholar
  22. King, M., and D. Bhugra. 1989 Eating Disorders: Lessons from a Cross-Cultural Study. Psychological Medicine, 19:955–958.CrossRefGoogle Scholar
  23. Lee, S., T. Ho, and L. Hsu. 1993 Fat-Phobic and Non-Fat Phobic Anorexia Nervosa: A Comparative Study of 70 Chinese Patients in Hong Kong. Psychological Medicine 23:999–1017.CrossRefGoogle Scholar
  24. Leichner, P., J. Arnett, J. Rallo, and S. Srikameswaran. 1986 An Epidemiologic Study of Maladaptive Eating Attitudes in a Canadian school Age Population. International Journal of Eating Disorders 5:969–982.CrossRefGoogle Scholar
  25. Levine, M. P. 1987 Student Eating Disorders: Anorexia Nervosa and Bulimia. Washington, DC: National Education Association.Google Scholar
  26. Levine, M., and L. Smolak. 2001 Primary Prevention of Body Image Disturbances and Disordered Eating in Childhood and Adolescence. Pp. 237–260 in Body Image, Eating Disorders, and Obesity in Youth: Assessment, Prevention, and Treatment. J. K. Thomson and L. Smolak, eds. APA Press: Washington, DC.CrossRefGoogle Scholar
  27. Marsella, A. 1987 The Measurement of Depressive Experience and Disorder across Cultures. In The Measurement of Depression. A. Marsella, ed., pp. 376–397. New York: Guilford Press.Google Scholar
  28. Millstein, S., and I. Litt. 1990 Adolescent Health. Pp. 431–456 in At the Threshold: The Developing Adolescent. S. Feldman and G. Elliot, eds. Cambridge, MA: Harvard University Press.Google Scholar
  29. Mumford, D., A. Whitehouse, and I. Choudry. 1992 Survey of Eating Disorders in English-Medium Schools in Lahore, Pakistan. International Journal of Eating Disorders 11:173–184.CrossRefGoogle Scholar
  30. Nasser, M. 1994 The Psychometric Properties of the Eating Attitude Test in a Non-Western Population. Social Psychiatry & Psychiatric Epidemiology 29:88–94.Google Scholar
  31. Neumärker, U., U. Dudeck, M. Vollrath, K. Neumärker, and H. Steinhausen. 1992 Eating Attitudes among Adolescent Anorexia Nervosa Patients and Normal Subjects in Former West and East Berlin: A Transcultural Comparison. International Journal of Eating Disorders 12:281–289.CrossRefGoogle Scholar
  32. Nichter, M. 2000 Fat Talk: What Girls and Their Parents Say about Dieting. Cambridge, MA: Harvard University Press.Google Scholar
  33. Pumariega, A. 1986 Acculturation and Eating Attitudes in Adolescent Girls: A Comparative and Correlational Study. Journal of the American Academy of Child Psychiatry 25:276–279.CrossRefGoogle Scholar
  34. Rodin, J. 1992 Body Traps: Breaking the Binds That Keep You from Feeling Good about Your Body. New York: William Morrow.Google Scholar
  35. Rosen, J., N. Silberg, and J. Gross. 1988 Eating Attitudes Test and Eating Disorders Inventory: Norms for Adolescent Girls and Boys. Journal of Consulting and Clinical Psychology 56:305–308.CrossRefGoogle Scholar
  36. Soomro, G., A. H. Crisp, D. Lynch, D. Tran, and N. Joughin. 1995 Anorexia Nervosa in ‘Non-White’ Populations. British Journal of Psychiatry 167(3):385–389.CrossRefGoogle Scholar
  37. Stunkard, A. J., T. Sorensen, and F. Schulsinger, F. 1983 Use of the Danish Adoption Register for the Study of Obesity and Thinness. Pp. 115–120 in Genetics of Neurological and Psychiatric Disorders. S. Kety, L. P. Rowland, R. L. Sidman, and S. W. Matthysse. New York: Raven Press.Google Scholar
  38. Thompson, B. 1994 A Hunger So Wide and So Deep: American Women Speak Out on Eating Problems. Minneapolis: University of Minnesota Press.Google Scholar
  39. Wells, J. E., P. Coope, D. Gabb, and R. Pears. 1985 The Factor Structure of the Eating Attitudes Test with Adolescent Schoolgirls. Psychological Medicine 15:141–146.CrossRefGoogle Scholar
  40. Wilk, R. 1996 Connections and Contradictions: From the Crooked Tree Cashew Queen to Miss World Belize. Pp. 217-232 in Beauty Queens on the Global Stage: Gender, Contests, and Power. C. Cohen, R. Wilk, and B. Stoeltje, eds. New York: Routledge.Google Scholar
  41. Williams, R. 1987 Use of the Eating Attitudes Test and Eating Disorder Inventory in Adolescents. Journal of Adolescent Health Care 8:266–272.CrossRefGoogle Scholar
  42. Wood, A., G. Waller, J. Miller, and P. Slade. 1992 The Development of Eating Attitude Test Scores in Adolescence. International Journal of Eating Disorders 11:279–282.CrossRefGoogle Scholar
  43. World Health Organization. 2003 Caring for Children and Adolescents with Mental Disorders: Setting WHO directions. Geneva: WHO.Google Scholar

Copyright information

© Springer Science+Business Media, LLC 2009

Authors and Affiliations

  1. 1.Department of AnthropologyCase Western Reserve UniversityClevelandUSA
  2. 2.Case Western Reserve UniversityClevelandUSA

Personalised recommendations