Eating Disorders Among Second-Generation Canadian South Asian Female Youth: An Intersectionality Approach Toward Exploring Cultural Conflict, Dual-Identity, and Mental Health

  • Nida MustafaEmail author
  • Nazilla Khanlou
  • Amanpreet Kaur
Part of the Advances in Mental Health and Addiction book series (AMHA)


Introduction to the Topic

As of 2011, the South Asian community became the largest visible minority group in Canada, made up of individuals from Afghanistan, Bangladesh, India, Pakistan, and Sri Lanka. Youth between the ages of 15 and 24 represent the largest portion of this population, and have unique historic, social, and cultural upbringings as a result of being raised with both South Asian and Canadian values. Many of these youth are second-generation, either migrating at young ages to Canada or belonging to immigrant families. Research on second-generation youth within this community has shown that they experience issues of dual-identity formation and cultural conflict, as well as concerns of mental health tension. Eating disorders, for example, have recently been observed to be prevalent in South Asian communities in the West, with self-dissatisfaction beginning at very young ages.

This chapter presents research findings exploring the intersection of identity and culture in second-generation Canadian South Asian female youth who have had an eating disorder. The main aim of this study was to question how adolescent mental health within this community has been influenced by dual-cultural upbringings, social tensions, and intergenerational conflict.

Main Body (e.g., Literature Review and/or Research Findings)

Eight women between the ages of 21 and 29 participated in a semi-structured interview. These young women were identified as being second-generation South Asians, as well as having sought help for an eating disorder. Findings show that cultural tension exists when balancing South Asian values within a Canadian society, and this imbalance significantly influences youth identity and mental health. This culture conflict and gendered-cultural expectations led to isolation, alienation, and self-dissatisfaction in the youth in this study.


Taking an intersectionality approach reveals that participants’ experiences with an eating disorder were influenced by multiple intersecting identities, as well as dissonant integration. Being raised in South Asian families in Canada created a unique set of conflicts for these women, as they felt pressure abiding to traditional values and customs. Many of the women also had restrictions and limitations enforced by parents in adolescent years, which caused rebellion, guilt, and anxiety as youth. Intergenerational conflict with parents further led to isolation and confusion, which these women attribute to influencing their mental health –effecting disordered eating behavior. Participants overcame many of these challenges through professional counseling, and breaking stigma. Resiliency and strength have made these women current advocates for youth mental health.


Due to the rapid growth of the South Asian population within Canada, it is essential that mental health concerns specific to youth within these communities be explored. Mental health is often silenced within South Asian cultures, making it difficult for adolescents to seek help and treatment. This research contributes to the literature on raising awareness on the cultural, social, and familial factors which intersect to influence the mental health experiences of South Asian female youth. We hope this work informs health care professionals who interact with the community, in an attempt to increase culturally sensitive care.


Youth mental health South Asian youth Eating disorders Identity Intersectionality 


  1. Ahmed, S. (1996). Moving spaces: Black feminism and post-colonial theory. Theory, Culture and Society, 13(1), 139–146.CrossRefGoogle Scholar
  2. American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (DSM-5®). Arlington, Virginia: American Psychiatric Pub.CrossRefGoogle Scholar
  3. Anderson-Fye, E. (2004). A “Coca-Cola” shape: Cultural change, body image, and eating disorder in San Andres, Belize. Cultural Medicine and Psychiatry, 28, 561–595.CrossRefGoogle Scholar
  4. Bastia, T. (2014). Intersectionality, migration and development. Progress in Development Studies, 14(3), 237–248.CrossRefGoogle Scholar
  5. Berry, J. W. (2005). Acculturation: Living successfully in two cultures. International Journal of Intercultural Relations, 29(6), 697–712.CrossRefGoogle Scholar
  6. Bourke, B. (2014). Positionality: Reflecting on the research process. The Qualitative Report, 19(33), 1–9.Google Scholar
  7. Bowleg, L. (2012). The problem with the phrase women and minorities: Intersectionality—An important theoretical framework for public health. American Journal of Public Health, 102(7), 1267–1273.CrossRefGoogle Scholar
  8. Boyce, W. F., King, M. A., & Roche, J. (2007). Healthy settings for young people in Canada. Health Canada. Retrieved from
  9. Brah, A., & Phoenix, A. (2004). Ain’t I a woman? Revisiting intersectionality. Journal of International Women’s Studies, 5(3), 75–86.Google Scholar
  10. Bush, H. M., Williams, R. G. A., Lean, M. E. J., & Anderson, A. S. (2001). Body image and weight consciousness among South Asian, Italian, and general population women in Britain. Appetite, 37, 207–215.CrossRefGoogle Scholar
  11. Canadian Mental Health Association. (2014). Advancing equity in mental health within the South Asian community. Retrieved from
  12. Chang, E. C., Perera, M. J., & Kupfermann, Y. (2014). Predictors of eating disturbances in South Asian American females and males: A look at negative affectivity and contingencies of self-worth. Asian American Journal of Psychology, 5(3), 172.CrossRefGoogle Scholar
  13. Denzin, N. K. (1989). The research act: A theoretical introduction to sociological methods. Englewood Cliffs, NJ: Prentice Hall.Google Scholar
  14. Frabutt, J. M. (2006). Immigrant youth mental health, acculturation, and adaptation. Journal of Catholic Education, 9(4), 499–504.Google Scholar
  15. Franko, D. L., & George, J. B. E. (2009). Overweight, eating behaviors and body image in ethnically diverse youth. American Psychological Association, 97–112.Google Scholar
  16. Furnham, A., & Adam-Saib, S. (2001). Abnormal eating attitudes and behaviours and perceived parental control: A study of white British and British-Asian school girls. Social Psychiatry Epidemiology, 36, 462–470.CrossRefGoogle Scholar
  17. Hallett, K. (2015). Intersectionality and serious mental illness—A case study and recommendations for practice. Women & Therapy, 38(1–2), 156–174.CrossRefGoogle Scholar
  18. Harper, B., & Tiggemann, M. (2008). The effect of thin ideal media images on women’s self-objectification, mood, and body image. Sex Roles, 58(9–10), 649–657.CrossRefGoogle Scholar
  19. Herr, R. S. (2014). Reclaiming third world feminism: Or why transnational feminism needs third world feminism. Meridians: Feminism, Race, Transnationalism, 12(1), 1–30.CrossRefGoogle Scholar
  20. Islam, F., Khanlou, N., & Tamim, H. (2014). South Asian populations in Canada: Migration and mental health. BMC Psychiatry, 14(1), 154.CrossRefGoogle Scholar
  21. Iyer, D. S., & Haslam, N. (2003). Body image and eating disturbance among South Asian-American women: The role of racial teasing. International Journal of Eating Disorders, 34, 142–147.CrossRefGoogle Scholar
  22. Jennings, P. S., Forbes, D., McDermott, B., Juniper, S., & Hulse, G. (2005). Acculturation and eating disorders in Asian and Caucasian Australian adolescent girls. Psychiatry and Clinical Neurosciences, 59(1), 56–61.CrossRefGoogle Scholar
  23. Katzman, M. A., & Lee, S. (1997). Beyond body image: The integration of feminist and transactional theories in the understanding of self starvation. International Journal of Eating Disorders, 22, 385–394.CrossRefGoogle Scholar
  24. Khanlou, N., & Hajdukowski-Ahmed, M. (1999). Adolescent self-concept and mental health promotion in a cross-cultural context. In Women’s voices in health promotion (pp. 138–151). Toronto, ON, Canada: Canadian’s Scholars Press.Google Scholar
  25. LaMarre, A., Rice, C., & Bear, M. (2015). Unrecoverable? Prescriptions and possibilities for eating disorder recovery. In Women’s mental health (pp. 145–160). Springer International Publishing.Google Scholar
  26. Link, B. G., Struening, E. L., Neese-Todd, S., Asmussen, S., & Phelan, J. C. (2001). Stigma as a barrier to recovery: The consequences of stigma for the self-esteem of people with mental illnesses. Psychiatric Services, 52(12).Google Scholar
  27. Ma, J. L. (2007). Journey of acculturation: Developing a therapeutic alliance with Chinese adolescents suffering from eating disorders in Shenzhen, China. Journal of Family Therapy, 29(4), 389–402.CrossRefGoogle Scholar
  28. Martinez-Gonzalez, M., Gual, P., Lahortiga, F., Alonso, Y., Irala-Estevez, J., & Cervera, S. (2003). Parental factors, mass media influences, and the onset of eating disorders in a prospective population-based cohort. Pediatrics, 111(2), 315–320.CrossRefGoogle Scholar
  29. McCourt, J., & Waller, G. (1996). The influence of sociocultural factors on the eating psychopathology of Asian women in British society. European Eating Disorders Review, 4(2), 73–83.CrossRefGoogle Scholar
  30. McKnight Investigators. (2003). Risk factors of eating disorders in adolescent girls: Results of the McKnight longitudinal risk factor study. The American Journal of Psychiatry, 160(2), 248–254.CrossRefGoogle Scholar
  31. Mirza, H. S. (2009). Chapter 14: Postcolonial subjects, black feminism, and the intersectionality of race and gender in higher education. Counterpoints, 369, 233–248.Google Scholar
  32. Mishra, R. K. (2013). Postcolonial feminism: Looking into within-beyond-to difference. International Journal of English and Literature, 4(4), 129–134.Google Scholar
  33. Mohanty, S. P. (1993). The epistemic status of cultural identity: On “beloved” and the postcolonial condition. Cultural Critique, 24, 41–80.CrossRefGoogle Scholar
  34. Mumford, D. B., Whitehouse, A. M., & Platts, M. (1991). Sociocultural correlates of disorders among Asian schoolgirls in Bradford. The British Journal of Psychiatry, 158, 222–228.CrossRefGoogle Scholar
  35. Musaiger, A. O., Al-Mannai, M., Tayyem, R., Al-Lalla, O., Ali, E. Y., Kalam, F., … Chirane, M. (2013). Risk of disordered eating attitudes among adolescents in seven Arab countries by gender and obesity: A cross-cultural study. Appetite, 60, 162–167.CrossRefGoogle Scholar
  36. Mustafa, N. (2013). Conspiracy of silence: Cultural dissonance as a risk factor for the development of eating disorders in second generation South Asian women (Doctoral dissertation, University of Ontario Institute of Technology).Google Scholar
  37. Mustafa, N., Zaidi, A. U., & Weaver, R. R. (2016). Conspiracy of silence: Cultural conflict as a risk factor for the development of eating disorders among second-generation Canadian South Asian women. South Asian Diaspora, 1–17.Google Scholar
  38. National Eating Disorder Information Centre. (2011). Understanding statistics on eating disorders. Retrieved from
  39. Nielsen, K. M., & Dewhurst, A. M. (2010). Chapter 12: Feminist crisis counselling. In L. Ross (Ed.), Feminist counselling: Theory, issues, and practice. Toronto, ON, Canada: Women’s Press.Google Scholar
  40. Pallan, M. J., Hiam, L. C., Duda, J. L., & Ada, P. (2011). Body image, body dissatisfaction and weight status in South Asian children: a cross sectional study. BMC Public Health, 11, 21. Retrieved from:
  41. Portes, A., & Rumbaut, R. (2005). Introduction: The second generation and the children of immigrants longitudinal study. Ethnic and Racial Studies, 28(6), 983–999.CrossRefGoogle Scholar
  42. Seng, J. S., Lopez, W. D., Sperlich, M., Hamama, L., & Meldrum, C. D. R. (2012). Marginalized identities, discrimination burden, and mental health: Empirical exploration of an interpersonal-level approach to modeling intersectionality. Social Science & Medicine, 75(12), 2437–2445.CrossRefGoogle Scholar
  43. Smink, F. R., Van Hoeken, D., & Hoek, H. W. (2012). Epidemiology of eating disorders: Incidence, prevalence and mortality rates. Current Psychiatry Reports, 14(4), 406–414.CrossRefGoogle Scholar
  44. Spivak, G. C. (1985). Three women’s texts and a critique of imperialism. Critical Inquiry, 12(1), 243–261.CrossRefGoogle Scholar
  45. Statistics Canada. (2015). Immigration and ethnocultural diversity in Canada. Retrieved from
  46. Statistics Canada. (2007). The South Asian Community in Canada. Retrieved from
  47. Tomiyama, A. J., & Mann, T. (2008). Cultural factors in collegiate eating disorder pathology: When family culture clashed with individual culture. Journal of American College Health, 57(3), 309–313.CrossRefGoogle Scholar
  48. Treasure, J., Claudino, A. M., & Zucker, N. (2010). Eating disorders. Lancet, 375, 583–549.CrossRefGoogle Scholar
  49. Vogel, D. L., Wade, N. G., & Haake, S. (2006). Measuring the self-stigma associated with seeking psychological help. Journal of Counseling Psychology, 53(3), 325–337.CrossRefGoogle Scholar
  50. Vogel, D. L., Wade, N. G., & Hackler, A. H. (2007). Perceived public stigma and the willingness to seek counseling: The mediating roles of self-stigma and attitudes toward counseling. Journal of Counseling Psychology, 54(1), 40–50.CrossRefGoogle Scholar
  51. Wardle, J., Haase, A. M., & Steptoe, A. (2006). Body image and weight control in young adults: International comparisons in university students from 22 countries. International Journal of Obesity, 30, 644–651.CrossRefGoogle Scholar
  52. Weedon, C. (2007). Postcolonial feminist criticism. In G. Plain & S. Sellers (Eds.), A history of feminist literary criticism (pp. 282–300). New York, NY: Cambridge University Press.CrossRefGoogle Scholar

Copyright information

© Springer International Publishing AG 2018

Authors and Affiliations

  1. 1.Office of Women’s Health Research Chair in Mental Health, Faculty of HealthYork UniversityTorontoCanada
  2. 2.Faculty of HealthYork UniversityTorontoCanada
  3. 3.Branch Policy and Process AdministratorArbor Memorial Inc.TorontoCanada

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