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EATING DISORDERS, BODY DISSATISFACTION, AND SELF-ESTEEM AMONG SOUTH KOREAN WOMEN.

Historically, Korean women considered extra weight to be an indicator of higher status and better health (Jung & Lee, 2006; H.-R. Lee, Lee, Choi, Kim, & Han, 2014). Further, people in East Asian countries, unlike those from Western countries, have in the past thought that being thin represents poverty and unhealthiness (Jung & Forbes, 2007). Today, however, because of the Western influence on Asian cultures, Asian women value thinness; therefore, the prevalence of eating disorders has increased among Asian women. Despite this shift, there are not yet as many studies on eating disorders or eating difficulties in East Asian countries, like South Korea, as there are in the Western world. Western cultures generally associate thinness with healthy eating and exercise, and link extra weight with laziness or a lack of motivation (J. S. Lee, Lee, & Rho, 2012). As documented by Y.-S. Lim and colleagues (2015), in the past few decades the ideal female body in the Western world has become thinner and smaller. The conception of feminine beauty has steadily and progressively shifted toward images of overly thin models. Further, media platforms such as television and fashion magazines further perpetuate the Western ideal body to other cultures, including that of South Korea (Anschutz, Engels, & Van Strien, 2008; Matera, Nerini, & Stefanile, 2013).

In short, many South Korean women deal with a negative body image, like many women in the United States, with whom Korean women's body image situation has been compared (Y.-S. Lim et al., 2015). The perception that thin bodies are desirable leads to an exaggerated ideal, largely promoted by the media and celebrities. Although South Korean women tend to have a lower body mass index (BMI) compared to North American women, they nevertheless perceive themselves as overweight (H.-R. Lee et al., 2014). Nearly all the researchers I cite in the present paper discuss Westernization and how Western cultures have influenced Korean women's self-perception through mass media. It is important to acknowledge that an "ideal" female body is defined differently across different cultures, although in many Asian cultures, especially South Korea, people appear to be influenced more by Western celebrity culture than are others (Eisenberg, Nicklett, Roeder, & Kirz, 2011; Kempa & Jones Thomas, 2000).

Most people tend to assume that Korean women do not struggle with body image issues, but this is a fundamental misconception, because many Korean women are obsessed with dieting and attaining thinness, as are many high-status Western women (Jung & Hwang, 2016). Furthermore, South Korea has the highest rate of plastic surgery procedures among all Asian countries, and most of these are fat-reduction procedures that are meant to make the individuals who undergo these procedures look like glamorous Western celebrities (Jung & Forbes, 2007). The images of both Western and Korean women on television or the covers of magazines in South Korea tend to be touched up or photoshopped; consequently, women who compare themselves to these models are more dissatisfied with their bodies and experience more severe depression than do those who do not make these comparisons (Jung & Lee, 2006; H.-R. Lee et al., 2014).

On average, South Korean women are closer to what is assessed by the medical profession as their ideal BMI compared to Western women (H. Lim et al., 2014); thus, there is a misconception that South Korean women are less likely than their Western counterparts to develop eating disorders or eating difficulties. However, compared to North American women, South Korean women perceive a greater difference between their actual and ideal weight (Jung, Forbes, & Lee, 2009). Furthermore, in South Korea 14.8% of adolescent girls and 10.5% of adolescent boys have eating disorders (G. Lee, Ha, Vann, & Choi, 2009). Therefore, in this paper I discussed how body dissatisfaction and poor self-esteem can contribute to the development of eating disorders, harmful dieting behaviors, and negative body image among South Korean women.

Literature Review

The Roots of Body Dissatisfaction in South Korea

For over 500 years, during the Joseon period, South Korean people's social, political, and family lives were based on Confucian values. In a Confucian society, women are expected to be passive and submissive to men, and girls are submissive to boys in all aspects of life (Jung et al., 2009). In addition, there is more focus on an individual's duty toward others, whereas people in Western society place value on individuality and independence. As per collectivism, which is prominent in South Korea (Jung & Hwang, 2016), people are largely perceived as a group and not as independent individuals with freedom of choice, values, or expressions. Therefore, South Korean people might internalize their negative feelings because expressing individual concerns is not generally acceptable in a collectivist society. As a result, it is perhaps not possible to establish whether before the late 20th century South Korean women had issues with their body weight and image.

However, from the 1980s to the 2000s, women's roles in society changed dramatically as South Korea became more democratic and women more liberal and independent. Women have also become more outspoken, confrontational, and "unfeminine" (Jung et al., 2009). This social change is a vital contributor to South Korean women's body dissatisfaction and psychological changes. After the Korean War ended in 1953, South Korean women were exposed to more aspects of the Western concept of the ideal woman through media platforms, and one consequence of this was the adoption of unhealthy eating practices (Jung & Hwang, 2016). Of the 13 Asian countries that belong to the Organisation for Economic Co-operation and Development, South Korean people are the most concerned with what they eat, and this justifies the sensitivity that South Korean women have expressed regarding body image (Jung & Lee, 2006; H.-R. Lee et al., 2014).

Theoretical Framework

Sociocultural and feminist theories are two theoretical approaches that are central to the understanding of body dissatisfaction. Sociocultural theory concerns the social and cultural variables that cause body dissatisfaction, instead of viewing individual psychopathology as the cause (Jung et al., 2009). According to this approach, the main source of social influences is the unrealistically thin body perpetuated by Western stereotypes. Family, friends, and the media may put consistent pressure on individuals, making this idealistic body seem attainable and causing psychological distress for individuals who cannot achieve this. In feminist theory, similar to sociocultural theory, the media's contribution toward idealizing a thinner body is acknowledged. Feminist theorists believe that the spreading of depictions of unrealistic appearances is a means to perpetuate gender inequality (Jung et al., 2009).

Sociocultural Theory

According to sociocultural theory, the more another culture is exposed to the Western world through the media, the more the people in that culture will experience body dissatisfaction, which is a risk factor for eating disorders (J. Lee & Lee, 2016). South Korean women have developed an unrealistic body image and a version of an ideal self that is affected not only by the women whom they see on television shows and in commercials, but also by images of women in magazines, resulting in poor self-esteem, body dissatisfaction, and social anxiety. Women often believe magazine suggestions on quick fixes to improve one's appearance (J. Lee & Lee, 2016). In most of these fashion and lifestyle magazines the Western body shape presented as being ideal is glorified, and vulnerable women use these images as cues for forming their own body ideal (J. Lee & Lee, 2016). Writers of articles in lifestyle magazines also tend toward portraying stereotyped gender roles where men are the providers and women act as caregivers, a concept that goes against aspects of feminist theory (Chen-Yu, Hong, & Seock, 2010; Jung & Lee, 2006). J. Lee (2012) found a positive correlation between such magazine articles and television advertisements and body dissatisfaction.

Feminist Theory

According to feminist theory, women from cultures where feminine status and roles have changed rapidly are more likely to have body dissatisfaction owing to the influences of foreign cultures (Jung et al., 2009). The same applies to women who are continually exposed to strong patriarchal traditions, because they tend to embrace unrealistic perceptions of an ideal body (Jung et al., 2009). It could be that the appearance of the idealized female body is a vehicle for oppression (Jung & Forbes, 2007). These cultural characteristics fit South Korea in forming the historical roots of body dissatisfaction in this country.

Body Image

Jung and Forbes (2007) measured body shape perception using the modified Stunkard Figure Rating Scale (Stunkard, Sorensen, & Schulsinger, 1983), which consists of seven images of silhouettes of boys and girls, each corresponding to an increase in shape, from very thin (silhouette 1) to obese (silhouette 7). Participants identify the figure that best represents their body shape (current body) and the body that they would like to have (desired or ideal body). Body dissatisfaction is estimated by the current minus the ideal body shape, with values ranging from -8 to 8. Positive scores indicate that the participant is dissatisfied about being heavier than his or her ideal, negative scores indicate that the participant is dissatisfied with being lighter than his or her ideal, and a score of zero indicates satisfaction with one's body shape. The results obtained by Jung and Forbes showed that the Korean sample had a lower BMI but greater body dissatisfaction than did the U.S. and Chinese samples.

Shin and Shin (2008) conducted a study involving 413 South Asian children in Grades 5 and 6 to determine the prevalence of eating disorders among South Asian adolescents and whether the concept of body image develops early in life. Among the children, 56 were obese and 51 were overweight. The results showed that the obese children had significantly lower body satisfaction than the overweight and normal-weight children did.

In a related longitudinal study Jung et al. (2009) asked twelve 15-year-old East Asian middle-school children to respond to a series of tests regarding their sense of their body size, the kind of body that they desired, and the body size that they thought was desirable in the eyes of their parents and peers. Jung et al. conducted their study to determine the influences of parental upbringing, peers, and the media on the development of body image, and whether these influences lead to eating disorders later in life. Their results confirmed that adolescent girls in East Asia face psychological stressors concerning their appearance and are concerned about their mothers' and peers' comments about their body shape. Over 75% of the sampled children wanted to achieve a body size that was desirable to their mothers and peers, and 50% wanted to achieve a body size like those of entertainers and other media personalities. All these factors were found to contribute to the development of eating disorders.

Body image and eating disorders among college students. Scholars have investigated the prevalence of eating disorders among college students, who are considered the most vulnerable group regarding body image (Jung & Forbes, 2007). Ko and Cohen (1998) examined the effects of Westernization on body dissatisfaction among Korean American women and native Korean women. Native Koreans were found to have more disordered eating attitudes than Korean Americans did; furthermore, concerning the effects of media images on women and their connections to body dissatisfaction, greater importance was placed on how the viewer watches television shows or advertisements, rather than the amount they watch. If the viewer compares (vs. does not compare) herself to the women in the advertisements, then she is more likely to be dissatisfied with her body (Ryu & Contento, 2011).

Jung and Lee (2006) reported that 77.9% of the 201 undergraduates at a university in Seoul, who were their Asian participants, were underweight and only 0.6% were above the weight range that is considered to be normal by the medical profession, whereas 64.4% of the North American sample of 205 undergraduate women at a mid-Atlantic university in USA were in the normal weight range. In his study, J. Lee (2012) selected 42 female college students who were taking courses in communication as participants. The significance of J. Lee's study is that the results helped determine the correlation between eating disturbances and body image dissatisfaction according to media exposure and supposed reality among female students. Jung et al. (2009) obtained results supporting feminist theory by revealing that nearly half (48.7%) of the 272 girls aged from 12 to 15 years who were their participants were dissatisfied with their bodies.

Han (2003) found that exposure to images of thin women in the media influenced ordinary Korean women to make drastic changes to their eating behaviors in order to achieve a body shape consistent with those in the media. Han measured upward comparison by asking participants to click through nine different advertisements featuring female models on a computer and rate their agreement with the following statements: "I wish I had slimmer arms and legs just like the models in the advertisements," "I want to have a body like the models in the advertisements," and "I wish I were as thin as the models in the advertisements."

Body image among children and adolescents. Children begin to comprehend the concept of weight and body image at a very early age (e.g., thinness schema; Shin & Shin, 2008). According to Jung and Hwang (2016), unhealthy eating behaviors and body dissatisfaction can originate in childhood; therefore, research into the psychological well-being of children is crucial for understanding the persistence of eating disorders into adulthood.

When Jung et al. (2009) conducted a study with Korean school children to determine levels of body dissatisfaction among adolescents, they established that adolescents are more concerned with their body appearance and size than is any other age group, such as young children. Specifically, the girls wanted to have a slender body shape. In addition, Jung et al. compared their findings against those of studies conducted among adolescents in Western cultures and found a significant relationship between the eating habits of Asian and Western adolescent girls and the goal of sustaining a perceived healthy and attractive body weight. If these findings about the relationship are correct, then the notion that South Korean women have a smaller chance than have women in Western cultures of developing an eating disorder is incorrect and misleading.

Shin and Shin (2008) examined the links between obesity, body dissatisfaction, self-esteem, and depressive symptoms in Korean elementary school children. They found that obesity was strongly linked to body dissatisfaction because of the idealized concept of beauty that people in Korean society have adopted.

Discussion

The Link Between Body Dissatisfaction and Eating Disorders

According to the literature I have cited above, the body dissatisfaction phenomenon has led to a drastic rise in eating disorders among South Korean women, ostensibly to attain the thin body promoted by Western celebrities and media as the ideal in terms of beauty. It can, therefore, be argued that South Korean women seek to be thin in order to fit into a foreign presentation of the glamourous thin model. These attempts to adopt a false presentation of the ideal BMI can have only negative consequences (Jung & Lee, 2006).

The onset of body dissatisfaction in early adolescence. Jung et al. (2009) found that body dissatisfaction can start in early adolescence. In particular, Korean girls compared to boys reported experiencing body dissatisfaction as well as a variety of eating disorders. The authors also noted a link between body dissatisfaction in childhood and adolescence.

Overemphasizing physical appearance leads to body dissatisfaction. Jung and Lee (2006) investigated the effect of placing cognitive importance on one's appearance on lower self-esteem and increased body dissatisfaction. They concluded that South Korean women consider appearance more important than North American women do, and that South Korean women were more satisfied with their current weight because there was less of a difference between their current and ideal BMI. However, just because South Korean women were closer to their ideal weight than their North American counterparts were does not mean they were satisfied with their bodies.

The effects of modeling on body dissatisfaction. People tend to compare themselves to those who look better or are perceived to look better in terms of appearance and who have a better lifestyle (Jung & Forbes, 2007). Han (2003) found that exposure to images of thinness contributed to upward comparison and led participants to perceive thinness as more representative than it is. According to Shin and Shin (2008), body dissatisfaction is influenced by biological, psychological, and sociocultural factors, and in a collectivist (vs. individualist) society, the influence is even greater. People follow what society considers normal; therefore, when Westernization heavily influences societal norms, South Korean women view Western ideals as their norm. Then, society is separated into who is "in" and who is "out," which might increase negative comments from family and peers when fatness is perceived as abnormal (Jung & Lee, 2006). These comments can strongly affect people's thinking. However, in a collectivist society, women should have few body dissatisfaction compensation behaviors or internalized behaviors, such as unhealthy dieting, because such acts are focused on the individual. Nonetheless, as South Korea becomes more Westernized, the effects of comments from social peers are becoming more problematic (Jung & Lee, 2006). This is evident as there has been more expression of comments about body dissatisfaction from young people in South Korea (Jung et al., 2009).

Clinical Implications

Disordered eating is a serious psychiatric problem with an etiology that requires further investigation. In conducting this literature review my aim was to show the need for effective treatment of, and prevention plans for eating disorders. Exploring the changes that come along with body dissatisfaction, low self-esteem, and depression reveals a unique pattern of eating disorders that can be prevented from early age, when children start developing a sense of body image (Pallan, Hiam, Duda, & Adab, 2011). Specifically, I recommend using transdiagnostic theory (Fairburn, Cooper, & Shafran, 2003) as an approach to understanding psychological disorders outside the conceptual structure provided by the notion of diagnosis, because there are several risk factors that contribute to an increased incidence of bulimia nervosa and anorexia nervosa (Bearman, Stice, & Chase, 2003; Stice, Rohde, Shaw, & Marti, 2012).

Limitations

In general, it is difficult to conduct a body dissatisfaction study across diverse cultures. A control for body size is crucial for research (Jung et al., 2009). Furthermore, body dissatisfaction is a subjective state that is not monofactorial, and studies with only one reported measure should not be used to generalize across the entire South Korean population. Even when studies are focused on one culture there are still limitations because obtaining a sample that accurately represents the entire population is nearly impossible. In addition, height and weight measurements were all self-reported in the reviewed studies; therefore, the BMI or weight ranges might have been inaccurate.

Similarly, all the studies I reviewed involved translation, which carries the potential for introducing errors. Even though all the questions and statements were reviewed by bilingual scholars, there is no way to know whether the two translations mean the same thing in both cultures, especially when bias is considered. For example, there is no term in Korean for "others." In studies addressing the role of social media, different age groups and communities could be exposed to varying levels of Western media.

Future Research

My findings in this review paper support the cognitive behavioral model of eating disorders among Korean women. A key pathway in this model, specifically bulimic behavior, is the link between overconcern with weight and shape and the adoption of binge eating and purging (Jung, & Lee, 2006). Body dissatisfaction contributes to dietary restraints, lower self-esteem, and heightened social anxiety among Korean women, who have developed a distorted sense of body image based on Westernization and the influence of the media.

Rather than focusing on body dissatisfaction alone, future researchers should also examine other mediating factors, such as low self-esteem, depression, and childhood conflicts. Durkin, Paxton, and Sorbello (2007) argued that although body dissatisfaction is a significant contributor to most eating disorders, it is a rather narrow concept and cannot be used conclusively to understand the prevalence of disordered eating within any group.

Similarly, future researchers should focus on different dimensions of the concept of body dissatisfaction, such as socioeconomic status, developmental challenges, and negative life events, which can all impact on how women express their sense of body image (Smeets, Jansen, & Roefs, 2011). Last, previous studies have been mainly focused on bulimia nervosa and anorexia nervosa; however, there is a need for more investigation into incidences of binge-eating disorder and how body dissatisfaction, which is a major risk factor for obesity, leads to this disorder.

References

Anschutz, D. J., Engels, R. C. M. E., & Van Strien, T. (2008). Susceptibility for thin ideal media and eating styles. Body Image, 5, 70-79. https://doi.org/cf9pdr

Bearman, S. K., Stice, E., & Chase, A. (2003). Evaluation of an intervention targeting both depressive and bulimic pathology: A randomized prevention trial. Behavior Therapy, 34, 277-293. https://doi.org/ckc4fs

Chen-Yu, J. H., Hong, K.-H., & Seock, Y.-K. (2010). Adolescents' clothing motives and store selection criteria: A comparison between South Korea and the United States. Journal of Fashion Marketing and Management: An International Journal, 14, 127-144. https://doi.org/ds8qrt

Durkin, S. J., Paxton, S. J., & Sorbello, M. (2007). An integrative model of the impact of exposure to idealized female images on adolescent girls' body satisfaction. Journal of Applied Social Psychology, 37, 1092-1117. https://doi.org/ffswj8

Eisenberg, D., Nicklett, E. J., Roeder, K., & Kirz, N. E. (2011). Eating disorder symptoms among college students: Prevalence, persistence, correlates, and treatment-seeking. Journal of American College Health, 59, 700-707. https://doi.org/dhc5ns

Fairburn, C. G., Cooper, Z., & Shafran, R. (2003). Cognitive behaviour therapy for eating disorders: A "transdiagnostic" theory and treatment. Behaviour Research and Therapy, 41, 509-528. https://doi.org/cdjcss

Han, M. (2003). Body image dissatisfaction and eating disturbance among Korean college female students: Relationships to media exposure, upward comparison, and perceived reality. Communication Studies, 54, 65-78. https://doi.org/f8d

Jung, J., & Forbes, G. B. (2007). Body dissatisfaction and disordered eating among college women in China, South Korea, and the United States: Contrasting predictions from sociocultural and feminist theories. Psychology of Women Quarterly, 31, 381-393. https://doi.org/f8j

Jung, J., Forbes, G. B., & Lee, Y.-J. (2009). Body dissatisfaction and disordered eating among early adolescents from Korean and the US. Sex Roles, 61, 42-54. https://doi.org/fpsbm2

Jung, J., & Hwang, C. S. (2016). Associations between attitudes toward cosmetic surgery, celebrity worship, and body image among South Korean and US female college students. Fashion and Textiles, 3, 17. https://doi.org/cjj4

Jung, J., & Lee, S.-H. (2006). Cross-cultural comparisons of appearance self-schema, body image, self-esteem, and dieting behavior between Korean and U.S. women. Family and Consumer Sciences Research Journal, 34, 350-365. https://doi.org/fp7tcv

Kempa, M. L., & Jones Thomas, A. (2000). Culturally sensitive assessment and treatment of eating disorders. Eating Disorders, 8, 17-30. https://doi.org/dzj89z

Ko, C., & Cohen, H. (1998). Intraethnic comparison of eating attitudes in native Koreans and Korean Americans using a Korean translation of the Eating Attitudes Test. The Journal of Nervous and Mental Disease, 186, 631-636. https://doi.org/dzwc9b

Lee, G., Ha, Y., Vann, J., & Choi, E. (2009). Weight perception and dieting behavior among Korean adolescents. The Journal of School Nursing, 25, 427-435. https://doi.org/dc6frg

Lee, H.-R., Lee, H. E., Choi, J., Kim, J. H., & Han, H. L. (2014). Social media use, body image, and psychological well-being: A cross-cultural comparison of Korea and the United States. Journal of Health Communication, 19, 1343-1358. https://doi.org/cjjj5

Lee, J. (2012). The relationship between appearance-related stress and internalizing problems in South Korean adolescent girls. Social Behavior and Personality: An international journal, 40, 903-918. https://doi.org/f3852s

Lee, J., & Lee, Y. (2016). The association of body image distortion with weight control behaviors, diet behaviors, physical activity, sadness, and suicidal ideation among Korean high school students: A cross-sectional study. BMC Public Health, 16, 39. https://doi.org/cjjj7

Lee, J. S., Lee, S. Y., & Rho, J. O. (2012). The effects of body weight status, perception of body shape and satisfaction of body shape on obesity stress, self-esteem among male and female middle school students [In Korean]. Korean Journal of Human Ecology, 21, 1223-1234. https://doi.org/cjj6

Lim, H., Lee, H.-J., Park, S., Kim, C.-I., Joh, H.-K., & Oh, S. W. (2014). Weight misperception and its association with dieting methods and eating behaviors in South Korean adolescents. Nutrition Research and Practice, 8, 213-219. https://doi.org/cjjj8

Lim, Y.-S., Park, N.-R., Jeon, S.-B., Jeong, S.-Y., Tserendejid, Z., & Park, H.-R. (2015). Analysis of weight control behaviors by body image perception among Korean women in different age groups: Using the 2010 Korea National Health and Nutrition Examination Survey Data. Korean Journal of Community Nutrition, 20, 141-150. https://doi.org/cjjj9

Matera, C., Nerini, A., & Stefanile, C. (2013). The role of peer influence on girls' body dissatisfaction and dieting. Revue Europeenne de Psychologie AppliqueelEuropean Review of Applied Psychology, 63, 67-74. https://doi.org/cjk7

Pallan, M. J., Hiam, L. C., Duda, J. L., & Adab, P. (2011). Body image, body dissatisfaction and weight status in south Asian children: A cross-sectional study. BMC Public Health, 11, 21. https://doi.org/cc38rv

Ryu, H. K., & Contento, I. R. (2011). A study on body image perception and eating disorders by birthplace and the length of residence in USA in Korean American college students. Korean Journal of Community Nutrition, 16, 113-125. https://doi.org/cjmc

Shin, N. Y., & Shin, M. S. (2008). Body dissatisfaction, self-esteem, and depression in obese Korean children. The Journal of Pediatrics, 152, 502-506. https://doi.org/dfm8b2

Smeets, E., Jansen, A., & Roefs, A. (2011). Bias for the (un)attractive self: On the role of attention in causing body (dis)satisfaction. Health Psychology, 30, 360-367. https://doi.org/dfjb7t

Stice, E., Rohde, P., Shaw, H., & Marti, C. N. (2012). Efficacy trial of a selective prevention program targeting both eating disorder symptoms and unhealthy weight gain among female college students. Journal of Consulting and Clinical Psychology, 80, 164-170. https://doi.org/d7qzc9 Stunkard, A., Sorensen, T., & Schulsinger, F. (1983). Use of the Danish Adoption Register for the study of obesity and thinness. Research Publications - Association for Research in Nervous and Mental Disease, 60, 115-120.

SOYOUNG KIM

Columbia University

Soyoung Kim, Department of Psychology, Columbia University.

Correspondence concerning this article should be addressed to Soyoung Kim, Department of Psychology, Columbia University, 151 W 113th Street # 1705, New York, NY 10025, USA. Email: sk3814@columbia.edu

https://doi.org/10.2224/sbp.6801
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