Eating disorders are associated with substantial morbidity and
mortality;1 the World Health Organization (WHO) has designated
them a global priority area within adolescent mental health.2
Evidence that migration, urbanisation, acculturation and
modernisation elevate risk for eating disorders3,4 raises concern
about their contribution to the burden of disease in low-resource
populations. Ecological, historical and cross-national comparative
population data cumulatively support an association between
modern and/or Western social contexts and eating pathology,5,6
and suggest mechanisms by which cultural exposures increase risk.
Major theoretical models propose a central role for social norms –
established, in part, through the mass media – promoting ‘thin
ideals’ and appearance-based social comparison as aetiological
and maintaining mechanisms.