Reconsidering the status of anorexia nervosa as a western culture-bound syndrome

Based on Ritenbaugh's 1982 definition, this essay reconsiders the status of anorexia nervosa as a Western culture-bound syndrome (CBS). It argues that anorexia nervosa, in its culturally reconstructed fat phobic form, is no longer bound to specific Western localities. Instead, it may be conceived as being grounded in the transnational culture of 'modernity', characterized by an internationalised socio-economic stratum now found in many rapidly urbanising parts of the world, and composed of increased affluence, as well as the globalization of fat phobia and diffusion of biomedical technology. Although the treatment implication of Ritenbaugh's CBS concept may appear to be misplaced from the clinician's pragmatic perspective, its salience for clarifying the interaction of individual and cultural concerns in self-starvation, as well as for fostering a needed self-scrutiny in psychiatry, is affirmed. A critique of the dialectical relationship between culture and psychopathology is then put forward. This addresses the apparently conflicting role of anorexia nervosa in enacting as well as combating the cultural pursuit of thinness, and ends by highlighting the inadvertent influence of the biomedical establishment in propagating the condition with measures intended, ironically, for preventing it.