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An autoethnography: examining the association between maladaptive eating behaviors and the identity of a female Chinese international student
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An autoethnography: examining the association between maladaptive eating behaviors and the identity of a female Chinese international student
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Content
An Autoethnography: Examining the Association Between Maladaptive Eating Behaviors and
the Identity of A Female Chinese International Student
by
Krislynn Bi
A Thesis Presented to the
FACULTY OF USC ROSSIER SCHOOL OF EDUCATION
UNIVERSITY OF SOUTHERN CALIFORNIA
In Partial Fulfillment of the
Requirements for the Degree
MASTER OF EDUCATIONAL COUNSELING
May 2023
Copyright [2023] Krislynn Bi
MALADAPTIVE EATING BEHAVIORS AND IDENTITY
ii
Table of Contents
List of Figures ……………………………………………………………………………………iv
Abstract…………………………………………………………………………….……………...v
Chapter 1: Introduction ……………………………………………………….…………………..1
Research Questions and Methodology……………………………………….……………3
Theoretical Framework ……………………………………………………………….…..4
Purpose of the Study………………………………………………………………………5
Organization ………………………………………………………………………………7
Definition of Terms .………………………………………………………………………8
Chapter 2: Literature Review………………………………………………………….…………..9
A General Examination of Eating Disorders …..…………………………………………9
An Examination of Eating Disorders Among U.S. University Students………………...14
A General Examination: Various Perspectives Contribute to Eating Disorders or
Maladaptive Eating Behavior Among Female University Students …………………….18
An Examination on Chinese International Students Identities and Related Psychosocial
Stress that Lead to Eating Disturbances …………………………………………………22
How Can Institutions Address and Cope With the Problems of Disordered Eating? ..….29
Feminist Approach……………………………………………………………………….33
Chapter 3: Autoethnography
Method …………………………………………………………………………………..39
Research Question.………………………………………………………………………40
Participants ….……………………….…………………………………………………..40
Data Collection ………………………………………………………………………….41
MALADAPTIVE EATING BEHAVIORS AND IDENTITY
iii
Data Analysis ……………………………………………………………………………42
Quality Control of Data Collection ……………………………………………………...44
Limitations of the Study …………………………………………………………………44
Delimitations ………………………………………………………………...…………..45
Ethical Considerations ……………………….………………………………………….46
Chapter 4…………………………………………………………………………………………48
Self-Reflection…………………………………………………………………...………49
Historical Data Analysis………………………………………………………..………..56
Chapter 5: Analysis and Implications……………………………...………………….…………68
Theoretical Framework: Feminist Identity Development Model………………..………71
Discussion and Recommendations………………………………………………………74
Chapter 6: Epilogue……………………………………………………………………………...77
References ……………………………………………………………………………………….79
MALADAPTIVE EATING BEHAVIORS AND IDENTITY
iv
List of Figures
Figure 1.1 Pie Chart of Influential Factors………………………………………………49
Figure 2.1 Bar Graph of the Domains of My Diet Related Behaviors…………………..57
Figure 3.1 Pie Chart of Memo Records…………………..…………………..………….59
Figure 3.2 Example of Diet Record…………………..…………………..……………...60
Figure 3.3 Example of Diet Record…………………..…………………..……………...60
Figure 4.1 Pie Chart of Social Media Posts…………………..………………………….62
Figure 5.1 Pie Chart of Weight Loss Products……………..……………………………64
Figure 5.2 Example of Shopping Record……………..…………………………………64
Figure 5.3 Example of Shopping Record ……………..………………………………...65
MALADAPTIVE EATING BEHAVIORS AND IDENTITY
v
Abstract
This autoethnography article is mainly focused on the author, the only investigator and
participant of this research study, experiences of maladaptive eating behaviors during her
adolescence. The research’s data collection and analysis are based on the author's self-reflection
and historical data relating to the development and consequences of the author's extreme
eagerness toward weight loss. The study's findings are interpreted by the feminist identity
development model while also pinpointing the author's identity as a female Chinese international
student. The study wishes to highlight university and university counselors' attention to the
female Chinese international student population and the prevention of mental disturbances
among this vulnerable student population. From examining and reflecting upon the author’s
personal encounter, this study demonstrates how influential factors could shape someone’s
behaviors from the cultural, societal and psychological perspectives. According to the author’s
perception and comprehension of her adolescence, there are eight recommendations, intervening
and preventing psychosocial and physical harm for female Chinese international student
population, for university and university counselors.
MALADAPTIVE EATING BEHAVIORS AND IDENTITY
1
Chapter 1: Introduction
Societally impacted maladaptive eating behavior or eating disorders, as commonly
referred to, continues to silently impact college students. In most instances, college students
impacted by maladaptive eating behavior serves as an impediment to personal well-being
including finding fulfillment in the college going experience (Wei et al., 2007). As such, public
discourse and discussion among educators and student service providers specifically is necessary
to heighten the awareness and cognition towards this vulnerable student population. Societally
impacted maladaptive eating behavior are serious psychological issues that affect individuals’
academic performances, daily routines, and social connection. Incidents with any level of
severity in daily life may trigger unhealthy eating habits, being incapable of completing
coursework, unable to handle a constructive relationship, stress from missing deadlines, being
teased by peers, being discriminated against at school, etc. (Hazard et al., 2020). Eating disorders
comprise anorexia nervosa, bulimia nervosa, binge-eating disorder, and other eating disorders
(APA, 2015). Relevant to exploring the experiences of individuals impacted by societally
impacted maladaptive eating behavior, researchers may want to conduct a sufficient amount of
studies on the initiation and stimulation of eating disorders so the public could be well informed
and be prepared to avoid those triggering variables of eating problems. Being constructively
acknowledged also enhances an individual's ability to strengthen their self-recognition, self-
awareness and self-control to prevent or overcome eating disorders. Therefore, exploring
disordered eating habits among university students within the minority population can be a
noteworthy societal and educational approach . 9% of the U.S. population or 28.8 million
Americans will encounter an eating disorder in their life, and approximately 26% of people with
eating disorders attempt to commit suicide (Eating Disorder Statistic, n.d.). Besides opioid
MALADAPTIVE EATING BEHAVIORS AND IDENTITY
2
overdose, eating disorders have the highest mortality rate among all of the mental illnesses
(Eating Disorder Statistic, n.d.). The existence of eating disorders and its consequences may be
inevitable in modern day society due to media influences, gender biases, popularity of slimness,
male dominant aesthetic, etc. (Polivy & Herman, 2002). Individuals still can be at risk without
fully fitting the conditions for an eating disorders diagnosis; for instance, people who check
calories frequently, calculate daily intakes repetitively or exercises excessively shall also be
considered at risk individuals (Bardick et al., 2004). This study aims to highlight the magnitude
of bringing up society’s attention and recognition of negative eating habits among the female
Chinese international student population and their psychological health. More importantly, this
study aims to guide greater discussion towards understanding and comprehension of factors that
contribute to maladaptive eating behaviors as a response to social influences within the female
Chinese international student group.
As a girl raised in a traditional and male-dominant family, I grew up in an environment
where women weren’t treated with equality. One major influence from my family and my culture
is that my way of thinking has been suppressed and dominated by the male members in the
family. I have been educated, most of the time, with the life goal of being a qualified housewife
and the concept that women shouldn’t put too much effort into their academic career. I grew up
with a lack of self-development, and my mindset shifted to a state of compliance toward the men
in our family, which inevitably led to my negative eating behaviors, because my male peers and
male family members always proclaimed their preferences and fondness for a perfect female
body figure or the characteristic of skinniness. Once I grew up, I started my academic career in
the United States, and I had also begun my first romantic relationship while studying abroad. The
disordered eating related behaviors that later evolved in my life had resulted in disturbance in my
MALADAPTIVE EATING BEHAVIORS AND IDENTITY
3
academic career, inability to balance between regular meal routine and nutrition intake,
incapability to manage my social life, and more importantly, the inconsistency of my emotions.
These are the main factors that shaped the purpose of this research. I wish to expand and
elaborate upon my personal experience with different kinds of disordered eating to inform the
readers and the public about how maladaptive eating behaviors may be developed or triggered,
and the negative consequences individuals might get from maladaptive eating behavior or eating
disorders. I wish this research to highlight the severity of eating disorders or negative eating
behaviors and the societal and cultural influences that could lead to eating disorders. The identity
of a female Chinese international student implies a lot of characteristics and due to the
combination of being a female, a student of color and an international student hints at the
obstacles of academic achievement and personal development that this student may undergo. The
multiple intersectionalities that are embedded inside a female Chinese international student may
develop emotional disturbances that lead to eating disorders and possible negative eating
behaviors. Emotional disturbances that a female Chinese international student could endure may
be generated by social norms, new environment, gender inequality, and conservative cultural
values. The research addresses the issues of maladaptive eating behavior among female Chinese
international students because this student population’s susceptible mental states and possible
setbacks in their identity development are oftentimes overlooked by U.S. society and
postsecondary institutions.
Research Questions and Methodology
The central research questions that will guide this study are as follow:
- What are the sociocultural factors that engender a female Chinese international student’s
maladaptive eating behavior response?
MALADAPTIVE EATING BEHAVIORS AND IDENTITY
4
- How can institutions effectively support female Chinese international students that are
experiencing the impacts of maladaptive eating behaviors as influenced by society
according to the different stages in the feminist identity theory?
This research utilizes an autoethnography methodology. The research examines me, the
main researcher as the primary participant, as an overview of the mental state of a female
Chinese international student while experiencing eating disturbances. This autoethnography
contains internal and historical data collection that are associated with the sociocultural, societal,
environmental and psychological elements that shaped my eating behaviors. The data analysis
part obtains a narrative inquiry approach.
Theoretical Framework
The overall data analysis is grounded in the feminist identity approach (Downing &
Roush, 1985). The feminist identity approach contains five stages of women’s identity
development: stage 1 for passive acceptance, stage 2 for revelation, stage 3 for embeddedness-
emanation, stage 4 for synthesis and stage 5 for active commitment (Downing & Roush, 1985).
Most of self-reflection, self-perception and other internal data related with disordered eating
behaviors is framed with the stage 1, passive acceptance. Passive acceptance refers to the
concept of perceiving male as the superior role and traditional values as advantageous (Downing
& Roush, 1985). The stage of revelation indicates how female individuals start to question their
identity and roles while also perceiving men as negative (Downing & Roush, 1985).
Embeddedness-emanation indicates how women start to reach for sisterhood or similar women
like them and a development of cautiousness toward interaction with men (Downing & Roush,
1985). The fourth stage of synthesis stands for women transcending the traditional female
identities and embracing personal values (Downing & Roush, 1985). The fifth stage is the stage
MALADAPTIVE EATING BEHAVIORS AND IDENTITY
5
to transform the newly consolidated identity into meaningful action of plan (Downing & Roush,
1985).
Purpose of the Study
The purpose of this study, as mentioned earlier, is to bring greater awareness to the
educational community members, especially college counselors, and strengthen their
consciousness toward students experiencing maladaptive eating behaviors as influenced by
society. The first preferred approach for college counselors to cope with these mental illnesses is
to prevent the disorders from happening in the first place. Professional strategies for prevention
will be included in the later part of the literature review and at the concluding portion of the
discussion. Generally, school counselors shall be encouraged to pay attention toward students’
daily behaviors and perceive their academic performances’ and any changes. According to
students’ unusual behaviors, school counselors could then determine the possible reasons for the
situation. This research study highlights the importance of counselors to take psychological
issues into consideration as they interact with their students. This study indicates how
psychological problems are closely connected to students’ academic performances and, more
importantly, how students’ identities are interrelated with their vulnerability to disordered eating.
Early intervention of maladaptive eating behavior are significantly essential toward individuals’
time of recovery, increases the chances of staying free from the symptoms or reduces the
symptoms to the greatest extent (Jones & Brown, n.d.). As indicated by Jones and Brown, eating
disorders’ prevention can be processed through online programs or in-person sessions. Many
colleges and universities have acknowledged students with sexual harassment courses as an
enrollment requirement, and readers of this study may contemplate upon whether or not a
school’s educational system should also embrace and establish mandatory online courses
MALADAPTIVE EATING BEHAVIORS AND IDENTITY
6
informing students of how societal influences can impact their eating behaviors. Online
programs may also provide proper resources and mental health services’ information for
students. Adolescents might strive through various psychological disorders. Anorexia nervosa, a
commonly seen eating disorder, is the third most common mental disease among adolescents
(Jones & Brown, n.d.). This fact implies how crucial it is for school faculty members to raise
their attention toward the adolescent students population among mental diseases. As an
autoethnography research study, the study conducts a comprehensive view toward the
intersectionalities of being a female student, a student of color and an international Asian
student. Being a young female student has a 12 times higher chance of premature mortality rate
from eating disorders than other populations (Jones & Brown, n.d.). If symptoms aren’t well
treated or even recognized, chronic conditions will get more severe, and treatments could get less
responsive and productive (Jones & Brown, n.d.). The study also wants to pinpoint the fact that
obtaining a negative eating habit or being diagnosed with eating disorders’ symptoms aren’t a
conscious choice for individuals (Jones & Brown, n.d.). Eating disorders or maladaptive eating
behaviors could mostly be originated from social development issues or environmental effects.
For instance, adapting to a new cultural norm or struggling with peer pressure may lead to eating
disorders or maladaptive eating behaviors. This study likes to alert college institutions to the
importance of having a screening action plan among students, and screening isn’t for diagnosing,
but as a strategy of minimizing the impacts of societal forces towards maladaptive eating
behaviors. Demonstrated by Jones and Brown, screening of eating disorders helps to identify
individuals who are chronically exposed to or experiencing eating disorders (n.d.). With an
essential screening program, college advisors should also learn where and how to forward
students with maladaptive eating behaviors to an eating disorder specialist or professional.
MALADAPTIVE EATING BEHAVIORS AND IDENTITY
7
Eating disorders screening are vital among middle and high schools, colleges and universities,
and pediatrics and primary care (Jones & Brown, n.d.). To conclude the main purpose of this
study, workers in the field of education and mental wellness should recognize the possible
psychosocial factors that generate negative eating behaviors and recognize their obligations to
offer impacted students the appropriate resources, services and helplines that students may need.
Organization
The organization of the study is divided into five chapters: chapter one for Introduction,
chapter two for literature review, chapter three for research methodology, chapter four for
presentation of data and chapter five for discussion, implications and conclusion. Chapter one,
the introduction, contains background information for maladaptive eating behaviors, theoretical
framework of the research analysis, research questions and methodology, purpose of this
research study, life experiences of disordered eating based on the researcher’s personal
involvement and observation, organization of the study, and terminology. Chapter two, the
review of related literature to the topic of maladaptive eating behaviors, encompasses four
branches: an general examination of maladaptive eating behaviors, an examination of eating
disorders or maladaptive eating behaviors among U.S. university students, a general examination
of eating disorders/eating disturbances among female university students, an examination on
Chinese international students identities and related psychosocial stress that lead to eating
disturbances and an exploration on how can institutions address and cope with the problems of
eating disorders. Chapter three explains the method of autoethnography, participant, the data
collection, data analysis, quality control of data collection, limitation and delimitation of the
study and ethical considerations. Chapter four is the presentation of the data. Chapter five
MALADAPTIVE EATING BEHAVIORS AND IDENTITY
8
contains the restatement of the research purpose, research questions and data analysis, and it
connects the research findings with future research/implications and concluding thoughts.
Definition of Terms
Anorexia Nervosa: “Due to the severe fear of being overweight, individuals maintain a
status of underweight through starvation or too much exercise” (APA, 2015).
Bulimia Nervosa: “People with bulimia may secretly binge — eating large amounts of food
with a loss of control over the eating — and then purge, trying to get rid of the extra
calories in an unhealthy way” (Mayo Clinic Staff, 2018).
Binge-Eating: “People with the BED-syndrome have binge eating episodes as do
subjects with bulimia nervosa, but unlike the latter they do not engage in compensatory
behaviors” (Dingemans, et al., 2002).
Acculturation: “Acculturation is the dual process of cultural and psychological change
that takes place as a result of contact between two or more cultural groups and their
individual members” (Berry, 2015).
Maladaptive Perfectionism: “Maladaptive Perfectionism is characterized by the setting of
inflexible and/or unattainably high standards, the inability to take pleasure in one’s
performance and uncertainty or anxiety about one’s capability” (Enns, et al., 2002).
Autoethnography: “Autoethnography is a research method of self-reflection, and it
explores the researcher's personal experience, thereby interpreting this autobiographical
story in a cultural, political, and social context” (Cooper & Lilyea, 2022).
MALADAPTIVE EATING BEHAVIORS AND IDENTITY
9
Chapter 2: Literature Review
An General Examination of Eating Disorders
Introduction of Eating Disorders
Defined by the American Psychiatric Association (2015), eating disorders are long-
standing mental illnesses that disturb patients’ psychological and physical health. These chronic
eating behaviors tend to lead individuals to a deficiency of nutrients absorption (APA, 2015).
According to the American Psychiatric Association (2015), eating disorders comprise of
anorexia nervosa, bulimia nervosa, binge-eating disorder, and other eating disorders . Anorexia
nervosa, bulimia nervosa and binge-eating disorder are the three principal and most common
seen disorders in the field of eating disorders (APA, 2015). American Psychiatric Association
(2015) states that patients with anorexia nervosa are suffering from fat phobia, having difficulties
with gaining weight, and being incapable of maintaining a standard body weight for healthy
growth. They tend to perceive themselves as having a negative overweight body image even
when they seem slim to others. Their strict discipline over their body images dominates their
self-esteem. According to the APA (2015), women and girls are 10 times more likely to have
anorexia nervosa than men and boys. Individuals diagnosed with bulimia nervosa have a
repetition of binge eating behaviors, recurrent purging behaviors, and severe uneasiness of body
weight. 80% of bulimia nervosa patients are female (APA, 2015). Binge-eating disorder patients
don’t undergo purging behaviors, but their main disturbed eating habit is an unusually large
amount of food consumption, often unseen by others. It’s crucial to pinpoint that individuals with
binge-eating behaviors could be categorized in any body size. Data reveals that 0.8% of men and
1.6% of women experience binge-eating every year in the United States (APA, 2015).
MALADAPTIVE EATING BEHAVIORS AND IDENTITY
10
Vulnerable Populations with Eating Disorders
In the article “Which Population is Most Likely to Have an Eating Disorder", Samantha
Bothwell identified populations that are vulnerable to eating disorders. According to Bothwell
(2021), the LGBT community, women, girls, bullying victims, and athletes are at more risk for
having disturbed eating habits than the other groups. As indicated by the National Eating
Disorders Association, gay and bisexual boys account for 42% of males who have been
diagnosed with eating disorders, and generally, the ratio of females to males among people with
eating disorders are 3 to 1 (Bothwell, 2021). According to Bothwell (2015), 60% of eating
disorder patients vocalize that being bullied contributes to their eating disturbances. Within the
athlete population, 33% of males and 62% of females have struggled with eating disorders
(Bothwell, 2021). In summary, the elevated risks of eating disorders among these minority
groups seem to support the concept that social identity and personal development has an
inevitable impact on related symptoms of eating disorders.
Social Identity Influences
Social perspectives and community pressures have to be scrutinized to explore the
vulnerability of these populations with eating disorders or maladaptive eating behaviors.
Negative eating habits can be used by individuals from minority groups as a harmful behavior to
cope with anxiety, past traumatic experiences, and stress (Bothwell, 2021). As indicated by
Bothwell (2021), commonly seen beauty standards are influential variables that endanger girls
and women while the idea of being muscular also places pressure on males. In spite of that,
perfection of body image is avoidable; weight bias has been an ubiquitous instrument for judging
and discriminating among individuals (Bothwell, 2021). To sum up, in terms of disordered eating
behaviors, psychological and social factors are always interconnected; race, historical
MALADAPTIVE EATING BEHAVIORS AND IDENTITY
11
backgrounds, past experiences, cultural values, sexual orientation, income status, and so on are
variables that sway individuals to have negative or positive attitudes about eating.
Polivy and Herman (2002) surveyed and posited to explain the causes of disordered
eating. They posit that one main sociocultural factor is the obsession with thinness, which
prevails in cultures where food is substantial. In contrast, referring to what Polivy and Herman
(2002) have demonstrated, where food is scarce, the ideal body figure tends to be plump. It is
significant to determine the underlying intention of a culture or society always attempting to
achieve dispensable things that are difficult to achieve. Correspondingly, cultures with daily
media usage are at higher risk of eating disorders due to media influences, a powerful
propaganda tool for promoting slimness and perfection of appearance. The idealization of a
perfect body figure and the derogation of weight gaining or being fat are more prevailing among
females than males (Striegel-Moore 1993, 1997, as cited in Polivy & Herman, 2002). Peer
pressures also contribute to eating disorders. During adolescence, teenagers share values they
have acquired and unconsciously assimilate attitudes from each other, along with the fact that
media content ought to be persuasive in their age. As a matter of fact, media figures’ slimness
has been one of the social norms among teenage girls, and anyone who doesn’t fit within the
social norm might withstand teasing or judgment. One that meets the social norm standard shall
get praise or encouragement. Within the American female population, Black people’s custom, to
some extent, intercept their likelihood of getting eating disorders because Black males favor
heavier women, whereas other studies have shown that the norm of slimness have exhibited
among Black population’s subculture (Greenberg & Laporte, 1996, as cited in Polivy & Herman,
2002). Family and friends’ influences mostly betide among patients with anorexia nervosa.
Anorexia nervosa patients often get compliments and admiration from their family and friends
MALADAPTIVE EATING BEHAVIORS AND IDENTITY
12
due to the discipline needed to attain the patients’ weight and slimness in spite of the fact that
these praises don’t ignite the eating disorders (Branch & Eurman, 1980, as cited in Polivy &
Herman, 2002). Family intervention is pivotal for an effective treatment among eating disorder
patients, whereas many studies have revealed that family members deny and negate patients'
emotional needs. Some cases have shown that mothers could have a paramount impact on
daughters’ pathology by directly criticizing their daughters’ weight and affirming their
daughters’ lack of attractiveness (Hill & Franklin, 1998; Pike & Rodin, 1991, as cited in Pivolty
& Herman, 2002). Eating disorders, by chance, happen to be coping strategies of individuals’
stress and emotion management, such as controlling anxiety, relieving stress, handling with low
self-esteem, etc. (Raffi et al, 2000, as cited in Polivy & Herman, 2002).
Consequences of Eating Disorders
The following section is an acknowledgment of the pathologic and psychological
problems caused by eating disorders and maladaptive eating behaviors. With anorexia nervosa,
patients could be symptomized with slow heart rate, low blood pressure, reduction of bone
density, loss in muscles, intense dehydration, fatigue, hair loss, dry skin, and downy hair growth
all over the body (NEDA, 2005). According to the National Eating Disorder Association (2005),
the repetition of binge-purge behavior can result in irregular heartbeats, possible heart failure and
death, dehydration, gastric rupture from binge-eating span, inflammation of esophagus, rotting
tooth, irregular defecation, ulcers in the digestive system and pancreatitis. For binge-eating
disorder patients, the National Eating Disorder Association (2005) illustrates the following
medical consequences: high blood pressures, high cholesterol levels, heart disease, type II
diabetes mellitus and gallbladder disease. Mixed research has illustrated how particular types of
eating disorders (ED) or ED relating symptoms could lead to emotional affliction or
MALADAPTIVE EATING BEHAVIORS AND IDENTITY
13
psychological issues. For instance, referring to Folope et al. (2012), 73% of the ED patients
endure with anxiety and 50% of them suffer from depression. Overweight individuals often
encounter the sense of stress, anxiety, low self-esteem, and physical discomfort compared to the
normal weight population, and more notably, a negative self-evaluation is pervasive among ED
individuals (Folope et al., 2012). Concretely for binge-eating patients, they are regularly
associated with mood, anxiety, personality and substance-use disorder (Folope et al., 2012).
The following content seeks to explore how ED symptoms could alter ED individuals’
attachment styles in a romantic relationship and develop varying coping behaviors with family
members. Female patients with bulimic symptoms have reported their maladaptive eating
behaviors are negatively impacting their relationships with men, and female individuals’
negative self-evaluation has led to a greater tendency to reject passionate relationships and
sexual self-esteem while endorsing dependent and possessive relationship styles (Raciti &
Hendrick, 1992). Individuals with both anorexics and bulimics embrace a high percentage of
preoccupied attachment style in a relationship (Friedberg & Lyddon, 1996, as cited in Raciti &
Hendrick, 1992). Ward et al. (2000b, as cited in Troisi, Massaroni & Cuzzolaro, 2005) found that
their eating disorder patients possess the characteristics of insecure attachment styles,
overwhelming care seeking and compulsive self-reliance. Similar findings, as stated by Troisi,
Massaroni & Cuzzolaro, are “anorexic patients have an avoidant/dismissive attachment style,
whereas the bulimic patients have an angry/preoccupied style” (2005, p. X).
Relevant to family dynamics, parents whose children at the age range from 18-22 and
diagnosed with eating disorders had continuingly felt more frustration and helplessness in their
incapability to support their daughters from recovering compared to those parents whose children
are younger because they were able to stay home and help in their children’s treatment (Gilbert,
MALADAPTIVE EATING BEHAVIORS AND IDENTITY
14
Shaw & Notar, 2000). The perception of being unable to cope and support due to the burden of
eating disorders undermine parents’ coping strategies and develop their emotional distress
(Hillege, Beale & McMaster, 2005). According to Gilbert, Shaw & Notar, many mothers
reported a decline in leisure time and unable to maintain their routine (2000). Family members of
eating disorder patients reported a concern toward the financial expenditure for the treatment and
a sense of exclusion from society (Hillege, Beale & McMaster, 2005). It’s interesting to note
that sometimes overcoming eating disorders can bring family members together as an unity
although other times if the coping process doesn't go well family dynamics could eventually
lead to disintegration (Hillege, Beale & McMaster, 2005). Further, patients may also experience
inconsiderate comments from their friends or family members that elevate their intense anxiety
toward body shapes, which may further lead to parental anxiety (Hillege, Beale & McMaster,
2005).
An Examination of Eating Disorders Among U.S. University Students
According to Lipson & Sonneville (2017), eating disorders occur at a high rate of 11%-
17% of female students and 4% of male students within college campuses in the United States.
This portion of the literature assessment will first determine how eating disorders affect U.S.
students from their intention and orientation of monitoring weight. Secondly, the content will be
specifically focusing on binge-eating behaviors among college students and address how the
sense of insecurity toward food supplements may lead to eating disorders. Furthermore, the
following content comprises the symptoms of eating disorders among U.S. university students
and the significance that school counselors display in terms of eating disorders.
MALADAPTIVE EATING BEHAVIORS AND IDENTITY
15
Symptoms of Eating Disorders Among University Students U.S.
Symptoms of eating disorders among university students can be shown in multiple
perspectives: students’ age, degree-level, self-identified gender, sexual orientation, first-
generation status, racial groups, academic status, and weight status (Lipson & Sonneville, 2017).
According to Lipson and Sonneville (2017), the vulnerable population for eating disorders are
transgender students and younger age students while at the same time, older male students are
more endangered with binge-eating disorder. Male students living off campus possess an
inclination in objective binge eating, losing their sense to control their eating, while female
athlete students have a sign of increasingly usage of compensatory behaviors, such as purposely
vomitting one time and more, takes water pills, or exercises excessively in order to maintain their
weight (Lipson & Sonneville, 2017). Female undergraduate students are at higher risks of ED
than female graduate students (Lipson & Sonneville, 2017). Moreover, male students with
minoritized sexual orientations are shown to possess inclining eating disorders symptoms
(Lipson & Sonneville, 2017). Ultimately, it’s important to note that those that experience
maladaptive eating behaviors can come from diverse backgrounds with certain historically
marginalized populations seemingly more vulnerable.
Weight-Management and Eating Disorders
The article “Relationships Between Patterns of Weight-Related Self-monitoring and
Eating Disorder Symptomology Among Undergraduate and Graduate Students” illustrates
diverse behaviors of weight-related self-monitoring among graduate and undergraduate students
in the United States and how these behaviors correlate with eating disorders (Hahn et al., 2020).
Their study utilized a research assessment entitled the Eating Disorder Examination
Questionnaire in which a score of 4 or higher indicated eating disorders traits. The participants
MALADAPTIVE EATING BEHAVIORS AND IDENTITY
16
were categorized by gender, and afterward, the participants were clustered into three or four
contrasting, latent classes in terms of levels of weight related self-monitoring (WRSM) (Hahn et
al., 2020). The research data reveals that female participants who are highly likely to participate
in all kinds of weighted related self-monitoring behaviors are 13.64 times higher in being
diagnosed with eating disorders than those who are classified as rare or have no engagement in
weight related self-monitoring behaviors. For both male and female participants, highly engaging
in all kinds of WRSM activities elevates chances of getting eating disorders compared to
students who don’t engage in any WRSM activities. The article also pinpointed that across the
U.S. university, students regularly use a combination of WRSM movements while gender
differences differentiate their courses of action. It is vital to mention that students who have high
WRSM involvement tend to possess higher BMI (body mass index), and high BMI students are
more eager at losing weight, which could initialize an eating disturbance behavior by
intensifying students’ self-weighing behavior, calories counting behavior, etc,. WRSM
engagement might also increase individuals’ negative emotions, higher stress level, mood shift,
and sense of guiltiness that advance the symptoms of eating disorders (Hahn et al., 2017).
Binge-Eating Disorder Among University Students
Binge-eating disorder (BED) is a typical kind of eating disorder in the school community,
and college students encompass great chances of struggling from binge-eating. According to
Solly et al., (2021), 2.4 % of the 3659 students being surveyed had a positive screen of binge-
eating disorder, and it occurs more among female students. The results display a clear association
between alcohol use and BED. The score of the Alcohol Use Disorders Identification Test
(AUDIT) may also designate binge-drinking behaviors among students, and due to this critical
assumption, further studies should be conducted between other binge-related movements and
MALADAPTIVE EATING BEHAVIORS AND IDENTITY
17
binge-eating disorder patients. One crucial factor is most of the participants with BED have been
previously treated with other mental illnesses. Students with BED disclosed their high level
stress intake, depressive symptoms, and low self-esteem, which shows the high likelihood of
post-traumatic stress disorder and attention deficit/hyperactivity disorder (Solly et al., 2021). The
presence of BED is more prevailing among students who have encountered traumatic events
compared to those who have never been exposed to traumatic occurrences. More notably,
according to the research, only few individuals have ever received effective support and
treatments for their BED, which could be associated with limited acknowledgement and
insufficient recognition regarding BED. More advantageous and convenient access for specific
support of BED should be established and well-informed to students.
Food Insecurity
The increase of food insecurity aligns with negative educational outcomes, attention
problems, serious psychosocial growth, and decline in graduation rate (Christensen et al., 2021).
A study by Christensen et al (2021) illustrates how food insecurity is particularly associated with
specific eating disorders among university students. Out of the 579 respondents in their study,
47.6% of the individuals who reported food insecurity screened positive for eating disorders
compared to 31.1% of the individuals with no food insecurity (Christensen et al., 2021). The data
displays students with food insecurity tend to possess greater ED-related symptoms, a more
regular objective binge-eating episode, and more frequent fast food ingestion. While on the
contrary, there was no correlation discovered between food insecurity and purging behavior or
imoderate exercises (Christensen et al., 2021).
MALADAPTIVE EATING BEHAVIORS AND IDENTITY
18
A General Examination: Various Perspectives Contribute to Eating Disorders or
Maladaptive Eating Behavior Among Female University Students
Perfectionism and Eating Disorders
As a means to explore the influences that can lead to maladaptive eating behaviors, the
concept of perfectionism must be explored. Specifically, in this portion of the literature review, I
examine body and weight related perfectionism as considered in relation to the social identities
that individuals might possess and display. According to Bouguettaya et al. (2018), participants
presented a body-focused perfectionism within their personal identity and social identity. Their
study conducted interviews and analysis from 10 female university students who have or had
been diagnosed with an eating disorder (Bouguettaya et al., 2018). Personal identity of
perfectionism for the participants, as reported, developed through their family members,
particularly their mothers (Bouguttaya et al., 2018). Their drive to be perfect was meant to be a
perfect woman. Bouguttaya et al. (2018) stated that an image of a perfect woman is usually
defined with strength, self-control and capability. Besides, this fact seems to be supported in the
previous research review portion that illustrates stress management and eating disorders. It is
commonly seen that individuals withstand stress or anxiety toward reaching for their potential or
capability. With this analysis, researchers could associate eating disorders with a sense of
accomplishment among female university students. For example, a participant Kimmy, from the
study by Bouguttaya et al. (2018), stated that when she was diagnosed with eating disorders, she
wished that she could be an anorexic because an anorexic displays a strong self-control
characteristic, and she wasn't able to achieve that “strength.” Kimmy perceived not being able to
be diagnosed with Anorexia as a lack of self-control and a negative personality trait
(Bouguettaya et al., 2018). One similarity that the participants shared was that all of them
MALADAPTIVE EATING BEHAVIORS AND IDENTITY
19
perceive and value others’ feedback as their standard of being perfect (Bouguettaya et al., 2018).
In summary, perfectionism is one sort of social identity problem that intrinsically pulls female
students into an unhealthy diet trait that “help” them to conform with the social norm.
Perfectionism, to some extent, also creates a perception for individuals that they are being fitted
into the society with a perfect figure that others observe. Moreover, female adolescents often
engage in peer conversation that involves weight losing topics and compliments toward dieting
habits (Bouguettaya et al., 2018). This “fat talk” is prevalent among female students. As such,
participants stated that feedback from the others, regardless of positive or negative, contributes to
their eating disturbances because it helps them align with the group norm (Bouguettaya et al.,
2018). Ruggiero et al. (2008) conducted a research examination on 35 female university
students’ stress and eating disorders. Their findings indicate that, clinically, the perfectionism
attitude and self esteem develop a stressful state for individuals while this mental state could
drive individuals toward dieting thoughts and dissatisfaction of individuals’ body figures
(Ruggiero et al., 2008). In the bargain, within a stressful situation, individuals are more likely to
develop an eagerness to lose weight due to a sense of insecurity (Ruggiero et al., 2008). To
conclude, perfectionism is a typical type of characteristic that is embedded in female
populations, and particularly, the body-focused perfectionism prevails among the female
university students by offering them more security toward not being excluded from the social
norm. Female university students’ perception toward perfectionism is supposed to be a
misunderstanding or a biased cultural value that portrays a woman maintaining a slim body
shape or perfectionism in other areas as a positive figure of femininity.
MALADAPTIVE EATING BEHAVIORS AND IDENTITY
20
Weight Status
One identity-relating variable that is influential for female university students at getting
maladaptive eating behaviors is individuals’ body figure: being overweight or maintaining a
healthy weight. Referring to the article “Overweight and obesity are associated with increased
eating disorder correlates and general psychopathology in university women with eating
disorder,” Balantekin et al. (2021) illustrate how individuals with an overweight body image
possess an elevated risk of eating disorders diagnosis. The article conducted a research design
among 690 women from 28 U.S. universities, and all of the participants have been shown
positive for an ED screen (excluding anorexia nervosa) (Balantekin et al., 2021). The study result
indicates that compared to individuals with healthy weight, overweight individuals are 24% more
likely at exhibiting eating disorders, and moreover, an incline of weight demonstrates a greater
risk of diagnosing ED (Lipson & Sonneville, 2017, as cited in Balantekin et al., 2021). If
assuming that body weight and level of concern toward body shape are positively correlated,
then the more concern toward body figures could also indicate an elevated risk of exhibiting
eating disorders according to the result from above research.
Cultural and Ethical Differences in the Perception of Body Images
Maladaptive eating behaviors victims could vary among race and ethnicity. Different
cultures encompass and portray distinctive values, which means different cultures comprise
diverse perspectives toward ideal figures of women. According to previous research, white
women were identified with greater preferences of being slim compared to Black women and
Latinas (Gordon et al., 2010). Gordon et al. (2010) conducted research among 276 female
undergraduate participants to examine the association between eating disorders and women
within diverse racial groups. The study’s result illustrated that Latina and white women chose a
MALADAPTIVE EATING BEHAVIORS AND IDENTITY
21
significantly skinnier body image than Black women participants (Gordon et al., 2010). In
addition, Latina women and white women also reported a greater level of body dissatisfaction
compared to Black women; however, the study also predicted that Black women and Latino
women have an elevated risk of eating disorders due to acculturation(Gordon et al., 2010). Last
but not least, the result implies that U.S. mainstream cultural values have a great association with
maladaptive eating behaviors and in fact have a dynamic influence on increasing individuals’, in
the United States, risk of exhibiting eating disorders.
Sexual orientation
Sexual orientation is an instrumental variable for eating disorders diagnosis or
maladaptive eating behaviors. Simone et al. (2019) published a research article examining
individuals from the LGBTQ community and their sexual minority identity’s association with
eating disorders. Their study included 13,906 participants from Minnesota who engaged in the
College Student Health Survey from 2015-2018 (Simone et al. 2019). Previous research
demonstrated that “eating disorders and ED behaviors are more prevalent among LGBTQ+
individuals relative to heterosexual individuals,” stated by Simone et al. (2019). The result of the
study has brought to light that female LGBTQ participants experience higher chances of EDs
comparing to heterosexual participants, and furthermore, lesbian, bi-sexual and unsure sexual
orientation female participants self-disclosed with an inclining association with anorexia nervosa
and more of those bisexual cisgender female participants self-reported with bulimia nervosa
(Simone et al., 2019). Connecting with previous exploration of emotional distress and social
influences for minority populations, researchers might want to highlight eating disorders’ greater
chances of occurrence among individuals who come from minority groups. Hazard et al.(2020)
also addressed how sexual orientation is associated with eating disorder with a sampling of 178
MALADAPTIVE EATING BEHAVIORS AND IDENTITY
22
university students from the U.S. While pinpointing the reason why, bisexual individuals’
encounter a greater risk of maladaptive eating behaviors compared to the heterosexual population
and other homosexual populations. Hazard et al. (2020) have detected that bisexual individuals
experience discrimination within the LGBTQ+ community and the individuals’ denial of bi-
sexual identity. Hazard et al. (2020) indicated that bisexual and lesbian female students have
greater encounters with eating disorders or related symptoms. These results, again, could sustain
and validate previous research findings of the association between emotional distress/ social
influences and eating disorders. As an overall consensus of the literature, female Chinese
international students are more vulnerable to disordered eating behaviors or eating disorders
compared to the general population.
An Examination on Chinese International Students Identities and Related Psychosocial
Stress that Lead to Eating Disturbances
Implying from the above literature review analysis, there are numerous identifiable
social and cultural causes of stress that engender maladaptive eating behaviors among
individuals; related stress could be developed by self-identified identity, sexual orientation,
acculturation, social norms, etc,. Despite copious amounts of research that have been conducted
among eating disorders and the accordingly vulnerable populations, there is limited research
findings exploring the association between the identity of female Chinese international students
and maladaptive eating behaviors. It is crucial to emphasize that the existing research of
maladaptive eating behaviors that specifically focuses on the population of female Chinese
international students is exceptionally rare. Throughout the above reading reviews, many of these
studies pinpoint how stress and psychological issues could lead to maladaptive eating behaviors.
For instance, the idealization of slimness could generate female individuals’ dissatisfaction and
MALADAPTIVE EATING BEHAVIORS AND IDENTITY
23
emotional distress toward their body figures, which eventually lead to disordered eating
behaviors (Polivy & Herman, 2002). The idealization of slimness originates from the biased but
prevailed social expectation on the identity of females. With a psychosocial approach, the
following will unveil U.S. female Chinese international students’ potential causes of exhibiting
maladaptive eating behaviors in a psychological extent or stress-related context. Further, due to
the limitation of scholarly articles exploring Chinese international students and eating disorders
specifically, the subsequent section of this literature review aim to associate Chinese
international students with maladaptive eating behaviors by illustrating multiple sources of stress
and other psychological problems that Chinese international students could encounter in their
academic career in the United States and then link them with the effect of psychological issues
towards maladaptive eating behaviors.
As a general examination, there are plenty of research sources about the contributing
factors that lead to psychological issues that international students encounter. These contributors
often consist of acculturation, perfectionism, academic stress, and cultural norm. Heng (2019)
highlighted that Chinese international students struggle through academic, personal and social
life with the sense of isolation, anomie and heightened stress (Chen & Bennett, 2012; Yan &
Berliner, 2009). Chinese international students reported feeling challenged at navigating the new
culture (Moores & Popadiuk, 2011, as cited in Heng, 2019), while they also have to undertake
the suppression of discrimination from the local community and domestic peers (Heng, 2017;
Guo & Guo, 2017, as cited in Heng, 2019). In the article “Report of a Mental Health Survey
Among Chinese International Students at Yale University,” Han et al. (2012) conducted a
research among 130 Chinese international students at Yale with a finding of 45% with
depression symptoms and 29% with anxiety symptoms. Individuals’ self-evaluation of current
MALADAPTIVE EATING BEHAVIORS AND IDENTITY
24
health status, relationship with advisor, exercise routine, and internet usage duration are
associated with the depression and anxiety symptoms while factors such as religion, sex and time
spent on reading are specifically correlated with anxiety symptoms (Han et al., 2012).
Acculturative Stress
As stated by Wei et al. (2007), international students’ depression is associated with the
maladaptive perfectionism and acculturative stress; the research result demonstrates a positive
correlation between depression and acculturative stress and supported the expected positive
association between depression and maladaptive perfectionism. Chinese international students
tend not to cope well with their acculturative stress because acculturative stress implies personal
failures in their perception, and they might feel ashamed by self-disclosing the tension (Wei et
al., 2007). Wei et al. (2007) indicated a value of emotional self-control in the Chinese culture,
and this sort of emotional suppression could lead individuals toward depression, specifically in a
case involving discrimination or other external factors that individuals are incapable of
comprehending and assimilating. Ye (2006) analyzed the acculturative stress among Chinese
international students with four divisions: perceived discrimination, perceived hatred, fear and
negative feelings caused by change. Ye (2006) indicated that international students with older
age, longer period of living experience in the United States., more satisfied interpersonal support
networks, and greater amount of informational and emotional support from online ethnic social
groups experiences less acculturative stress. With better support provided for international
students as they experience adapting a new cultural norm, the less psychological vulnerability
they would suffer, and lastly, the less likely they would develop negative eating behaviors.
Davis & Katzman (1999) examined 197 Chinese international students (93 females and
104 males). They asserted that increased acculturation for the female participants are positively
MALADAPTIVE EATING BEHAVIORS AND IDENTITY
25
correlated with symptoms of bulimia, drive for thinness, interoceptive awareness, maturity fears
and Eating Disorder Inventory scores (Davis & Katzman, 1999). Root (1990, as cited in Davis &
Katzman, 1999) demonstrated that immigrants may over-emphasize real or imagined deficits,
which means that women may pay much of their attention on altering and perfecting their
appearance. Indicated by the content analyzed in the previous portion of this literature review, it
is likely that perfectionism of appearance, including body image, directly elevates the risk of
disordered eating behaviors.
Maladaptive Perfectionism
Chinese international students may face obstacles such as language barrier, new
environment, and new cultural norms. For those with maladaptive perfectionism, these variables
elevate their difficulties in maintaining the same academic performance they possessed in China,
and in addition, these individuals tend to focus on their negative performances and perceive these
as their personal failures, which upraise their risk in depression (Hewitt et al., 1996, as cited in
Wei et al., 2007). Accordingly, within the Chinese international students population, those who
have been staying in United States for a long period of time aim to achieve higher academic
performance than those who have been in United States for a shorter period of time, and due to
this fact, the length of time individuals have stayed in United States positively aligns with the
level maladaptive perfectionism and risk of depression (Wei et al., 2007).
Cultural Values
The traditional cultural value of mental illness in China also stands for a significant role
in this study. Chinese people tend to refer to mental problems as “nerves” or headaches (Han et
al, 2021), and in general, the role of psychologists or therapists aren’t well-acknowledged in
most of the communities in China. Therefore, as an assumption, Chinese international students
MALADAPTIVE EATING BEHAVIORS AND IDENTITY
26
might experience psychological illness while considering it as a physical illness. Ignorance or
lack of awareness of the importance and severity of mental health may escalate Chinese
international students’ vulnerability to depression and other psychological issues. Then, the
symptoms of depression and other psychological issues may heighten Chinese international
students' risk of eating disorders. Academic stress could also be a predominant factor for Chinese
international students’ development in depression and anxiety because the traditional Chinese
culture values academic success to a great extent (Han et al, 2021). Awareness and
acknowledgment toward mental illness that are regularly occurring at school communities,
including eating disorders, are exceedingly crucial in preventing negative mental well being.
More importantly, school faculty and advisors should be obligated to inform their students of the
prospective mental distress that students could get, and advisors shall concentrate more on those
students who come from cultures that embrace values that have a greater chance at generating
psychological illnesses. In a holistic view of eating disorders and maladaptive eating behaviors,
guiding Chinese international students to cognize the seriousness of maladaptive eating
behaviors is also inevitable for pursuing a healthier school community.
Influences from Family Background
Cheng & Merrick examined a case study with a 24 years old female Chinese international
student named Cheng-Yin (2017). As the researchers illustrated, “Throughout treatment, Cheng-
Yin recalled her fear of going home from school, not knowing whether she would be criticized or
yelled at by her father” (Cheng & Merrick, 2017, p. X). Cheng-Yin mentioned she would feel
odd when her father acted nice to her, and she also disclosed that her mother had been physically
abused by her father (Cheng & Merrick, 2017). The above information revealed Cheng-Yin’s
male dominant cultural background and family background. According to Cheng & Merrick
MALADAPTIVE EATING BEHAVIORS AND IDENTITY
27
(2017), Cheng-Yin never had the option to reject food from her parents, and due to the fact, she
perceived herself as overweight when she entered middle school. As Cheng-Yin attended
college, her symptoms of negative eating habits started to emerge: counting calories, restricting
eating, and exercising excessively (Cheng & Merrick, 2017). As a psychological outcome,
Cheng-Yin began ruminating on negative ideas and self-criticism while also withstanding the
sense of helplessness and frustration (Cheng & Merrick, 2017). Concluding Cheng-Yin’s eating
disorder experience, the potential and leading factors are presumably her male-dominant family
background that may implicitly guide her to devalue women’s capabilities other than maintaining
a perfect outlook.
How Do Psychological Issues Lead to Eating Disorders
According to Cattanach and Rodin (1988), coping stress, separation stress, sexual
conflicts, changes in lifestyles, emotional distress, and difficult interpersonal interactions lead to
individuals’ disturbing eating behaviors, mostly bulimia eating disorder. Coping is a behavior
generally known for adapting to a new environment internally. While coping behaviors exist
with daily changes, individuals might go through mood shiftment, behavior changes and health
problems (Stone & Neale, 1984, as cited in Cattanach & Rodin, 1988). Patients with bulimia
eating disorders have reported with greater amount of life changes comparing to individuals with
no bulimia diagnosis, and investigations have revealed the fact that active and effective coping
strategies are greatly reducing stressors, which also decreases the risk of eating disorders
(Cattanach & Rodin, 1988). Separation from a particular partner, sexual conflicts, life style’s
changes, a poor relationship, and issues with femininity have been found influential toward the
origination of bulimia eating disorder (Lacey et al., 1986, as cited in Cattanach & Rodin, 1988).
Chinese international students possess great chances of life changes as they study abroad in the
MALADAPTIVE EATING BEHAVIORS AND IDENTITY
28
United States and try to acculturate with domestic society, and their capability to adapt and cope
with new changes and environment are significant in terms of preventing negative eating habits.
Changes for Chinese international students could vary: changes in food culture, change in
socialization, change of environment, separation from loved family members or romantic
partners, coping stress with homestay or American peers, etc,. Additionally, as discussed in the
above literature review sections, maladaptive eating behaviors could be managed as a way to
handle emotional distress, and from this fact, Chinese international students could be assumed to
have greater possibility of exhibiting eating disorders symptoms. Cattanach and Rodin (1988)
also indicated that female individuals with dieting habits may develop bulimia symptoms if they
lack coping strategies with their personal difficulties. Female Chinese international students who
experience difficulties in their academic development or personal life changes due to
acculturation in the United States may be susceptible to bulimia.
Personal concerns and perfectionism toward weight have been repetitively proved with a
significant correlation with eating disorders (Keel & Forney, 2003). The exceedingly prevailing
concept of a perfect body of image has been negatively impacting individuals’ mental status and
encompassed within individuals’ personality traits. Maladaptive perfectionism has been shown
with the greatest relevance with eating disorders (Keel & Forney, 2003). Maladaptive
perfectionism can lead to a negative psychological state of being anxious and terrified for
making mistakes, not being socially accepted, negative self-evaluations, and incapable of
achieving idealistic goals (Keel & Forney, 2003). Strive for perfectionism will initiate negative
emotionality and distress for weight achievement, and these personality traits are greatly
influenced by social environment (Keel & Forney, 2003). Additionally, peer selection exerts
social influences on bulimic symptoms (Keel & Forney, 2003). By relating these factors to
MALADAPTIVE EATING BEHAVIORS AND IDENTITY
29
Chinese international students, their original cultural norms and adaptive perfectionism should be
inclusively cognized by researchers. As generally perceived, Chinese culture has a large number
of male-dominant families, as indicated by the case studies above, and in this situation, female
individuals are assumed to act according to the male’s aesthetic of female: being slim while
“bootylicious”. This sort of culture may largely increase female individuals’ risks of getting
disordered eating behaviors.
This study, in conclusion, orients to designate the association between diverse
perspectives of identity of female Chinese international students and eating disorders. This study
aims to investigate this association directly and explicitly with an autoethnography. By
illustrating how divergent factors of an identity evolve maladaptive eating behaviors,
professional educators, researchers and academic counselors could reframe their mode of
thinking and cognition toward this specific population of female Chinese international students,
and furthermore, develop sufficient coping strategies for maladaptive eating behavior related
problems.
How Can Institutions Address and Cope With the Problems of Maladaptive Eating
Behaviors?
As highlighted above, maladaptive eating behaviors may result in severe chronic mental
health and physical health problems. As such, it is imperative that institutions offer students
sufficient resources and programs to prevent eating disturbances or to recover from the eating
disorders.
Early Intervention
MALADAPTIVE EATING BEHAVIORS AND IDENTITY
30
According to “College Hope: Eating Disorder Treatment Resources for College and
University Campuses” (n.d.), there is a college response program, created by Screening for
Mental Health, for early detection, prevention, and treatment for treatable mental illnesses, which
includes eating disorders or maladaptive eating behaviors. This program offers students the
services of self-screening, depression detection, unlimited online screening, help-seeking
strategies, and immediate referrals of the results to school advisors and school’s mental health
center (College Hope: Eating Disorder Treatment Resources for College and University
Campuses, n.d.). “College Hope: Eating Disorder Treatment Resources for College and
University Campuses” (n.d.) provides some examples on how multiple colleges cope with eating
disorders. For example, Dartmouth College offers students a program called Thriving Together
Wellness Peer Support that mainly focuses on early intervention and prevention of eating
disorders (College Hope: Eating Disorder Treatment Resources for College and University
Campuses, n.d.). Further, Texas Christian University offers the Body Project and the annual Feed
Your Body and Soul Week. The Body Project is for students to express their body image
concerns and celebrate body positivity. The annual Feed Your Body and Soul Week holds
informative events on intuitive eating and body image (College Hope: Eating Disorder Treatment
Resources for College and University Campuses, n.d.). George Washington University
established an on-campus community for eating disorders advocacy (College Hope: Eating
Disorder Treatment Resources for College and University Campuses, n.d.). Yager and O’dea
(2008) designated multiple intervention strategies that institutions could set up for eating
disorders: media literacy intervention, incorporation of health promotion activities to build self-
esteem, and computer-based interventions. The media literacy intervention from health education
programs promote a critical evaluation of media content, which helps to diminish the
MALADAPTIVE EATING BEHAVIORS AND IDENTITY
31
internalization of ideal body figures online and biased cultural norms toward thinness (Shaw &
Waller, 1995, as cited in Yager & O’dea, 2008). Evaluation of media content is able to develop a
dissonance toward media literacy, thereby weakens individuals’ internalization of thinness;
moreover, the dissonance against media content on ideal body figures have been found
successfully in altering female college students’ behavior in terms of maladaptive eating
behaviors (Becker et al., 2005; Stice et al., 2000, as cited in Yager & O’dea, 2008). Incorporation
of health promotion activities stands for a self-esteem approach and a promotion of self-efficacy
toward eating disorders among adolescents and children (Yager & O’dea, 2008).
Treatment and Recovery
Brown University has a peer and mentors workshop for individuals with eating disorders
to share their experiences and feelings (College Hope: Eating Disorder Treatment Resources for
College and University Campuses, n.d.). Indicated by the “Eating Disorder Recovery & Meals in
a College Cafeteria” (n.d.), when individuals encounter an assortment of stress, sudden life
changes, and new pressures, their maintenance of recovery will be challenged. This may imply
the effort that institutions should make on programs that assure students are perpetuating their
treatment and recovery. “Eating Disorder Recovery & Meals in a College Cafeteria” (n.d.) listed
steps for students’ recovery: plan ahead, make time to shop, have a backup plan of potential
obstacles for recovery and aim for progress instead of perfection. It will be ideal and practical if
institutions websites for student wellness can provide a list of long term plans for recovery from
mental health specialists among the eating disorders. Computer-based interventions have been
essential for individuals’ recovery and the treatment among varieties of mental health disorders,
including obesity prevention (Selmi et al., 1990, as cited in Yager & O’dea, 2008). Yager &
O’dea (2008) also demonstrated that online resources, such as support groups, have been found
MALADAPTIVE EATING BEHAVIORS AND IDENTITY
32
beneficial for the recovery process of eating disorders. Additionally, institutions may want to
consider collaborating with hospitals or eating disorder centers for keeping up with students’
recovery or detecting susceptible students. For example, why Choose UCLA Health for Eating
Disorder Treatment” (n.d.) has an AYAM Eating Disorders Program that cooperates with the
Inpatient Eating Disorders Program at the Resnick Neuropsychiatric Hospital.
How Can a College Counselor Help?
School counselors have a vital role in examining students’ perceptions of weight, body
figure, and attitudes toward food in terms of the early emergence of eating disorders symptoms.
According to Bardick et al. (2004), the first step of school counselors to prevent or intervene
with eating disorders at school is identifying at-risk students. For instance, some earlier stage
behaviors that could later trigger eating disorders could be intaking great amount of “healthy” or
low calorie food and energy bars, rejecting food, counting calories, skipping meals, etc, (Bardick
et al., 2004). Other identifying factors could be students regularly reading diet related magazines
or books, self-weighing multiple times per day, and unrestrained exercise plans (Bardick et al.,
2004). Recognizing psychological factors as well could help counselors to locate potential eating
disorders students. Early intervention, such as declaring various kinds of support and expressing
caring to the students, would certainly be beneficial for students with ED (Bardick et al., 2004).
Counselors should cognize that most of the students with ED tend to deny the existence of their
mental disorders and are capable of giving professional guidance. Questionnaires and self-report
surveys within the school community also contribute greatly in divulging any presences of eating
disorders (Bardick et al., 2004). Some coping strategies from the psychotherapy treatments for
eating disorders could be sufficiently utilized for school counselors attempting to support and
guide their students. As reported by Wilson, Grilo & Vitousek (2007), psychotherapy treatments
MALADAPTIVE EATING BEHAVIORS AND IDENTITY
33
for eating disorders alter with variety. For anorexia nervosa, the most comprehensively
researched therapy strategy is the family therapy and additionally, the most frequently applied
individual therapy is the cognitive behavior strategy. Cognitive behavioral therapy and
interpersonal psychotherapy are recounted as treatments for bulimia nervosa. Data reveals that
cognitive behavior therapy has a 30%-50% reduction of binge-purge behaviors in all the
examinations (Wilson, Grilo & Vitousek, 2007). Furthermore, cognitive behavior therapy,
interpersonal therapy, and dialectical behavior therapy have displayed efficacy in treating binge-
eating disorder. Dialectical behavior therapy has resulted in a 56% of remittance for patients who
have received treatment after 6 months (Telch, Agras & Linehan, 2001, as cited in Wilson, Grilo
& Vitousek, 2007).
Feminist Approach
Theoretical Framework
This research study is elucidated through the feminist identity approach. In the article
“From Passive Acceptance to to Active Commitment: A Model of Feminist Identity
Development for Women,” Downing and Roush (1985) mention the different stages of
development women will go through: first stage of passive acceptance, second stage of
revelation, third stage of embeddedness-emanation, fourth stage of synthesis and fifth stage of
active commitment. The first stage of passive acceptance is that women deny the discrimination
and oppression they have faced from individual, institutional and cultural values (Downing &
Roush, 1985). In this stage, the traditional role of female is accepted, and female individuals tend
not to avoid elements that may strike their sense of equilibrium (Downing & Roush, 1985).
Cultural values and male-dominant cultures have shown to be one of the reasons that women feel
oppressed, and these emotional disturbances of suppression may lead to conditions relative to
MALADAPTIVE EATING BEHAVIORS AND IDENTITY
34
eating disorders (Cheng & Merrick, 2017). Female individuals may feel helpless or not be aware
of their disadvantages. In this stage of passive acceptance, women are not likely to possess the
consciousness of fighting against the traditional views of women (Downing & Roush, 1985).
This kind of situation may predict that women will struggle through ego depletion, and this may
incline the risk of getting eating disorders. Another concept that is grounded in stage one and
related to maladaptive eating behaviors could be the perfectionism toward slimness. Society has
certain standards of physical attractiveness upon women (Jones, 2021). Many societal norms
favor women to be slim or fit and tend to inflict standards of beautiness upon women (Jones,
2021). Women may get eating disorders or related unhealthy behaviors from the stress of
attempting to have a perfect body figure (Bouguttaya et al., 2018). As traditional concepts of
women’s role diminished, women may accept more alternative and comprehensive perspectives
toward their identities (Downing & Roush, 1985). Stage two of revelation is the consciousness-
rising stage, in which women start to realize the discrimination they have withstanded and
prepare to change their frame (Downing & Roush, 1985). Assuming the second stage refers to
the awakening of women’s self-cognition, the process of obtaining self-cognition or self-
awareness may guide them to focus more and more on their own advantages, beliefs, preferences
and pursuits. The rise of self-awareness and self-identification could lead women to get rid of the
chains of acquiring a perfect body shape and reduce the incidence rate of maladaptive eating
behaviors. It is necessary to scrutinize if self-identification may develop female individuals’
strength and capability at expanding their freedom at pursuing other attainable variables in the
community. Stage three of embeddedness-emanation accounts for strengthening individuals’ new
identities and forming connections with similar female individuals (Downing & Roush, 1985).
Stage four of synthesis is where women begin to develop an authentic and positive identity of
MALADAPTIVE EATING BEHAVIORS AND IDENTITY
35
feminist while stage five refers to the consolidation of their new feminist identity and take into
progressive and essential action plans (Downing & Roush, 1985). Before connecting these last
three stages with maladaptive eating behaviors, readers of this research study may want to be
mindful of the societal elements that may generate maladaptive eating behaviors’ conditions and
the psychosocial variables that contribute to the fact that the female population is a vulnerable
group toward eating disorders compared to the male population. The development of women’s
consciousness is their way to be freed from the traditional women roles (Downing & Roush,
1985). The last three stages are a progressive pathway for women to defend themselves from
what they have suffered, including the high risk of getting maladaptive eating behaviors. Women
with increased self-awareness may be capable of reaching their potential in other domains, such
as careers related achievements, education related goals or varied life orientations. This model of
feminist development may diminish women’s attentiveness on being skinny or bootylicious and
guide them to explore more of themselves internally. The multiple stages of this feminist identity
development are the compelling instruments to interpret my experiences of maladaptive eating
disorders.
Incorporating Feminist Identity Development Model Stages to Therapy
Many of the social variables that contribute to maladaptive eating symptoms are directly
related to the gender identity of being female. The existence of feminist theory is to gain equal
rights and justice for the female population, and in this case, eating disorders are inequalities
many female individuals encounter. In the article “An Integrated Feminist Approach to
Disordered Eating Intervention in a University Campus Outpatient Setting,” Carolan et al. (2010)
MALADAPTIVE EATING BEHAVIORS AND IDENTITY
36
demonstrated that female individuals remain the dominant group of eating disorders patients, and
meanwhile, between 4-9% of female college students meet the criterion of anorexia nervosa and
bulimia nervosa (Boskind-White, 2000, as cited in Carolan et al., 2010). The association between
female individuals and eating disorders pinpoints the ascendant cultural values of body images
and its influences on the female population’s self-esteem (Carolan et al., 2010). The study
coordinated a case study on a girl named Karly, who was 21 years old and a junior college
student who self-reported a long period of dieting and binge eating behaviors (Carolan et al.,
2010). Karly’s purging behavior occurs nearly every day along with a sense of compunction, and
her dietary behaviors are reinforced by her father’s compliments about her weight loss (Carolan
et al., 2010). Carolan et al. (2010) concluded that female individuals’ counseling practices of
maladaptive eating behaviors should comprehend and incorporate feminist theory principles.
Karly’s counseling team guided her through a process of self-awareness among the thoughts that
Karly had possessed and how those biased concepts dominate her perception toward herself and
her negative eating behaviors (Carolan et al., 2010). According to Carolan et al. (2010), Karly’s
father viewed crying as a weakness which developed Karly’s resistance to crying; nevertheless,
Karly reported a decline in her purging frequency after she had cried in one of her counseling
sessions (Carolan et al., 2010). Feminist therapy approaches focus on patients’ cultural, social
and political context while therapists are capable of guiding individuals to reframe some
detrimental perspectives that could have provoked their mental illnesses (Feminist Therapy,
2015). Inferencing from the case study of Karly, Karly’s disturbed eating behaviors could have
been predominantly driven and escalated by her male-dominated family background, which also
could be the reason that her father’s viewpoints had been so authoritative to her. Her resistance
MALADAPTIVE EATING BEHAVIORS AND IDENTITY
37
to cry, which her father perceived as a weakness, could somehow corroborate previous literature
analyses on the connection between emotion management and eating disorders.
Erchull et al. (2009) used snowball sampling to recruit 217 participants, and the
participants were instructed to complete the Feminist Identity Composite (FIC) defined by the
feminist identity development model. The participants were divided into four groups: younger
feminists, younger non-feminists, older feminists and older non-feminists (Erchull, et al., 2009).
Illustrated by Erchull et al. (2009), younger female participants who are not feminist score high
for passive-acceptance, and young feminists score the highest for the revelation. Downing and
Roush model of feminist identity development (1985) was proved to be consistent with the
research result that women’s aging process aligns with women’s experiences from vexation to
active commitment (Erchull, et al., 2009). Nevertheless, researchers theorized that young women
nowadays are likely to start in the synthesis stage rather than in passive acceptance according to
their measurement (Erchull, et al., 2009).
Feminist therapy often incorporates the concept of feminist identity development model
into feminist therapy and refers to the stages according to their clients’ status (McNamara &
Rickard, 1989). For instance, a feminist therapy with a client in stage 1 of the model, passive-
acceptance, therapists tend to self-disclose and share the common experiences as a female
individual, and usually clients in the stage of passive-acceptance tend to seek help for feeling
happier instead of figuring out the origin of their difficulties (McNamara & Rickard, 1989). The
self-disclosure of similar challenges as a female form the therapist would lead the clients to self-
reflect upon their own experiences, and the clients may start to wonder if their situations are
rather embedded in a cultural quandary that women usually face rather than an individual issue
(McNamara & Rickard, 1989). According to McNamara and Rickard (1989), clients in stage
MALADAPTIVE EATING BEHAVIORS AND IDENTITY
38
two, revelation, are accessible to be mobilized, and clients in the stage of revelation are at a
quintessential point for self-identification and self-awareness, which allows them to move toward
the later stages of the feminist identity development model (McNamara & Rickard, 1989).
Therapists may perceive a sense of competition and agitation from clients in the early stage of
embeddedness-emanation, but the “emanation” occurs as clients start viewing male through an
individual approach rather than a confrontational community (McNamara & Rickard, 1989).
During a therapy with clients in this stage of embeddedness-emanation, therapists shepherd the
clients to integrate and split up the attributions of their difficulties by developing self-
responsibility (McNamara & Rickard, 1989). For example, therapists guide clients with eating
disorders to realize the fact that women struggle through weight perfectionism because women
are more critical to their appearances although women’s standards of themselves are usually
higher than what men actually yearn for from women (McNamara & Rickard, 1989). In the stage
of synthesis, some clients will flounder by the inconsistency between their personal beliefs and
the feminist values, and the therapist will need to guide the clients to perceive themselves as
being more authentic instead of being backsliding in their identity development progress
(McNamara & Rickard, 1989). Stage 5, the active commitment, could evolve unexpectedly for
clients after stage 4, but in some cases, some clients might still strive from questioning the
“correct” feminist movements to commit, which still refers to the struggle from stage 4
(McNamara & Rickard, 1989). Therefore, therapists are responsible here for leading clients to
release the burden of an externally defined “feminist” and start to act upon her authentic self
(McNamara & Rickard, 1989).
MALADAPTIVE EATING BEHAVIORS AND IDENTITY
39
Chapter 3: Autoethnography
Method
As a female Chinese international student with approximately three years experience of
maladaptive eating behaviors, I choose autoethnography to explore and analyze societal, cultural
and psychological association between maladaptive eating behaviors and the identity of a female
Chinese international student in a U.S. four-year university. During my three years as an
undergraduate student, I had been experiencing regular routines of purging after meals and
bulimic habits after purging. Even though I have never got the opportunity to meet a professional
doctor to diagnose my condition, my previous eating habits exactly apply to the symptoms of
multiple maladaptive eating behaviors from my own acknowledgment and research. Moreover,
maladaptive eating behaviors could either be diagnosed as eating disorders or be the predominant
stimulation of eating disorders. Autoethnography is a unique qualitative research method that
may contain multiple traditional approaches such as narrative research, autobiography,
ethnography, and art-based research (Cooper & Lilyea, 2022). Autoethnography is a process of
examining, exploring and reflecting on an individual's personal experiences from distinctive
perspectives. In this research paper, I am conducting an autoethnography upon my personal
experience of maladaptive eating during my undergraduate time at a university of California
school. Relevant to the research topic, the inclusive perspectives are from my previous romantic
relationship and attachment styles, friendship, international students’ acculturation, peer
pressure, perfectionism, cultural norm and academic achievement. My personal experiences are
the primary data sources in this research study. I hope to explore the conscious and non-
conscious sentiment and struggles that I had encountered by utilizing the perspectives listed
above. From this process of self-reflection and self-analysis, I wish to highlight the importance
MALADAPTIVE EATING BEHAVIORS AND IDENTITY
40
of self-authorship, self-efficacy and self-recognition among psychosocial influences among
individuals’ experiences. More importantly, I aim to pinpoint the severity of ignorance and lack
of acknowledgement toward maladaptive eating behaviors and college advisors’ unawareness
toward vulnerable student populations of maladaptive eating behaviors. I wish to vocalize for
female Chinese international students’ susceptibilities of their academic development and
personal growth. Moreover, I would be delighted to guide readers to have more consciousness
and comprehension toward the emotional and life-related disturbance that a female Chinese
international student could endure.
Research Question
My research questions below will reflect upon my study’s orientation and eventually
direct the research conclusion and implication at the final portion of this research paper.
- What are the sociocultural factors that engender a female Chinese international student’s
maladaptive eating behavior response?
- How can institutions effectively support female Chinese international students that are
experiencing the impacts of maladaptive eating behaviors as influenced by society
according to the different stages in the feminist identity theory?
Participants
I am the main character for examination and data collection, whereas I am not the only
character being involved in this research study. My mother and my best friend Amy are the
subordinate participants answering several research questions, mostly for the purpose of quality
control. The autoethnography also accommodates four relationships of mine: former romantic
relationship, friendship, family relationship and college advisor-students connection. While most
of the participants remain inactive, my mother and my best friend Amy are invited to answer
MALADAPTIVE EATING BEHAVIORS AND IDENTITY
41
several research questions in order to validate the quality control of the data collection. The
romantic relationship stands as my first love experience, and the analysis contains my unhealthy
commitment style, which is exceedingly noteworthy at pinpointing the origin and inevitable
continuation of my maladaptive eating behaviors. Friendship refers to individuals who have been
supportive for my rehabilitation or negatively triggered my eating disturbances. Family
relationships mainly regard my motherhood, fatherhood and family culture. My undergraduate
college advisor who had been unsupportive toward my personal growth and academic
development also plays a role in this autoethnography. From reflecting upon my counseling
experience with my previous college advisor, the paper pinpoints how colleges should heighten
their awareness of female Chinese international students’ mental disturbances and negative
eating behaviors that are caused by societal pressures.
Data Collection
The autoethnography is dominantly based on my personal experiences as the primary
sources. The data collection process involves historical data, such as memo records, social media
posts, and shopping records, and reflection among lists of triggering factors during my
maladaptive eating duration. According to this autoethnography study, I incorporate a
combination of personal experiences and internal perspectives toward the experiences. There is a
brief and necessary summary that demonstrates a holistic view of my personal experiences, from
different approaches, as a storytelling process, which is defined as an internal data collection.
Comments from my former relationship or words said by my family members or friends through
reminiscence are included for this internal data collection. Another internal data source is my
perception towards maladaptive eating habits and other peoples’ expression toward my
maladaptive eating behaviors. Referring to other individuals’ expressions, I am going to focus on
MALADAPTIVE EATING BEHAVIORS AND IDENTITY
42
my perceptions toward my family members, close friends and former partner’s attitudes and
reactions toward my maladaptive eating behaviors. Memo records to keep track of my weight,
social media posts, media influencers that I had followed, shopping records are encompassed for
the historical data collection process. Another external source is the ineffective interaction
between me and my undergraduate academic advisor. Lastly, my current state relating to
maladaptive eating behaviors is also examined and recorded as an internal data source.
Data Analysis
The data analysis contains a narrative inquiry. One of my narrative inquiries focuses on
analyzing my memories from diverse perspectives chronologically. The major events that linked
with my maladaptive eating are listed in order and being emphasized with their influences
toward my maladaptive eating behaviors’ symptoms. The memories refer to my personal
encounters with romantic relationships, emotional management, family coping behaviors,
friendship engagement and school advisor’s lack of involvement toward my academic obstacles
and interests. The narrative portion additionally includes some positive turning points or times
that the maladaptive eating had exaggerated or ceased. I analyze how internally and externally I
have been affected by these turning points or critical incidents. The narrative part of this
autoethnography embraces a large amount of self-reflection while this self-reflecting process
conducts a lot of external influences that shift my characteristics, which incline or decline my
maladaptive eating habits in diverse approaches. Significant concepts from the literature review
content are incorporated into the data analysis process; maladaptive perfectionism, feminist
approach, acculturation, stress management, cultural values of body image, and family
background are the applicable terms, from the literature review, to examine and elaborate among
the data. It is also significant to analyze the data with the theoretical framework for this research
MALADAPTIVE EATING BEHAVIORS AND IDENTITY
43
topic. As mentioned in the last section of the literature review, the conceptual framework
approach of this research is the feminist identity approach (Downing & Roush, 1985). The
feminist identity approach embraces five stages for women’s identity development (Downing &
Roush, 1985), and the interpretation of my experiences is based on these theoretical stages. Most
of the self-reflection about experiencing maladaptive eating behaviors are analyzed through the
first stage, passive acceptance, of the feminist identity model (Downing & Roush, 1985). The
concept of passive acceptance refers to a state of women not being aware of the cultural
prejudice, male dominant culture and individual denial that she is withstanding (Downing &
Roush, 1985). This concept aligns with the psychological impact from lack of family connection
and unhealthy romantic relationship that I illustrate later in this research study. The stage 2 of
revelation has an association with my rehabilitation of the frequent purging and bulimic
behaviors. According to the concept of revelation, my data analysis demonstrates the beginning
stage of me shifting from a woman of serious spiritual dependency on others to a woman with
mindfulness and self-consciousness. The third stage of embeddedness-emanation explains the
middle stage of me recovering from the crisis I had encountered that initiated my maladaptive
eating behaviors. The fourth stage of synthesis could appropriately delineate my current stage of
identity development, in which now I have recovered from maladaptive eating symptoms and
staying free from mental disturbances. The fifth stage of active commitment is a stage that
reflects this research paper: me sharing my vulnerability and challenges as a meaningful action
plan. This is the stage to transform the newly consolidated identity into meaningful action of plan
(Downing & Roush, 1985). In the data analysis portion, the feminist identity approach stages are
incorporated as a profound elucidation of the societal influences that had shaped the way I was
during different periods.
MALADAPTIVE EATING BEHAVIORS AND IDENTITY
44
Quality Control of Data Collection
To enhance the quality of the data collection and data analysis, interviews are conducted
with family members and close friends who had accompanied or communicated with me during
my years with frequent purging and bulimic behaviors. For the purpose of quality control and
validation, two participants are engaged in the study to answer several questions through an
interview. The historical data that would be collected as a research source may also be utilized in
heightening the research’s quality and credibility.
Limitation of the Study
There are several limitations that have to be revealed in this research paper. The first
limitation is the limited boundaries I‘ve set for the data collection. Since consents are required
from characters who are featured in this research paper, many characters can’t be mentioned in
this research due to my incapability to reach out for them and ask for their consent. The
exploration of my experiences is not as comprehensive as it can be, for instance, I have to
eliminate the explicit peer pressure that influenced me during my undergraduate period. The
second limitation is the accuracy of my perception that I use as one of the internal data
collection. Unlike common quantitative and qualitative data, the self-reflection and memory of
this autoethnography can’t be manipulated or confirmed in terms of the data’s authenticity and
credibility. Additionally, since I have demonstrated that multiple dimensions impacted my
disordered eating behaviors, I can only assume the association between them instead of making a
firm conclusion because the study is limited to my personal apprehension. As the main
participant being analyzed and investigated on, I am not capable of representing other members
in the female Chinese international population, whereas I may assume other female Chinese
international students may possess the similar cultural influences or acculturative stress that I had
MALADAPTIVE EATING BEHAVIORS AND IDENTITY
45
withstanded. One of the limitations is that I am only addressing the perspectives and influences
that I consciously recognized as the contributors of my maladaptive eating experiences. The
implicit and undefined variables that had been impactful toward my eating habits may have been
limited in this research due to my unintentional unawareness. Unlike a case study or other
qualitative research, in the autoethnography, the connection I would find between the
participants/variables and my maladaptive eating behaviors is consciously presumed before the
study is being conducted. This thereby implies the possible biases that I might have set up in the
study.
Delimitation
For an autoethnography, the researcher is able to determine multiple boundaries of the
examination among herself, and in this study, I’ve set boundaries to comprehend my experiences
of disordered eating. I am able to collect and manipulate the data for usage of this
autoethnography, and I am the one to define participants’ roles and how they are featured in my
research. Due to the fact that most of the people involved in this study are inactive participants, I
have a larger space to alter their roles and behaviors. I am using self-collection data to verify and
underpin my self-perception rather than data or questionnaires from resources that I can’t
manipulate or select. Self-collection data includes my shopping lists, memo records, and media
platform records from 2018 to 2020. Moreover, the perspectives to explain my eating behaviors
are selected by my disposition instead of relying on participants’ answers or reactions. The
stimulation of my eating behaviors that is embedded in the sociocultural or psychosocial contexts
are determined by me, the researcher, rather than figuring out the possible triggering variables of
my conditions through interviewing or investigating others. There is merely a little content
MALADAPTIVE EATING BEHAVIORS AND IDENTITY
46
involving dependent variables in this study, referring to my mother and Amy’s interview for
quality control.
Ethical Considerations
Relevant to the ethical considerations, an autoethnography is required to protect the
researcher’s own privacy and confidentiality as the main participant (Guidelines For Conducting
Autoethnography Research, 2017). As the researcher and the main participant, I am obligated at
setting boundaries for self-disclosure and self-revelation. I am responsible for acknowledging
myself the inevitable consequences of revealing personal encountering information and the
irretrievable data retention in the universal network storage. I have to inform myself of the
information that I feel not comfortable at sharing and thereby not incorporating this information
in the autoethnography. For my mother and Amy, participants who don’t play a dominant role in
this autoethnography, have still been informed with their consent for privacy and confidentiality.
In order to protect my best friend’s identity, a pseudonym was selected for her participation in
my study. They are informed and guaranteed with the rights to know how they are portrayed and
how their words are literalized in the entire process of this research. The non-active participants
are also protected with their privacy and confidentiality (Guidelines For Conducting
Autoethnography Research, 2017). According to the Guidelines For Conducting
Autoethnography Research, they will be asked with their consents to be in this autoethnography,
and they are guaranteed with the rights to be informed how they are featured in the study (2017).
For all of the participants, none of the data that they state with an unwillingness to disclose will
be displayed in this research. Embarrassing content, intimate information, or legal implications
of the participants are not being disclosed without a firm and definite authorization from the
MALADAPTIVE EATING BEHAVIORS AND IDENTITY
47
participants. Participants who preferred anonymity are presented with a fake name, pronouns, or
terms that indicate their identities.
MALADAPTIVE EATING BEHAVIORS AND IDENTITY
48
Chapter 4
Grounded in autoethnography methodology, the data collection for this study will utilize
narrative reflection towards previous maladaptive eating behaviors along with a collection of
historical data related to my abnormal eating habits. The historical data that will be presented
will include my on-diet memo records, diet-related social media posts, and on-diet shopping
records. This chapter will center my journey in dealing with societal pressures leading to
maladaptive eating behavior. First, I will introduce and then elaborate on the influences that
implicitly stimulated my abnormal eating habits. The chapter will then highlight the historical
data related to my maladaptive eating habits. According to my personal experiences that
contributed to my maladaptive eating behaviors, this data collection portion constitutes
influential factors such as romantic relationships, cultural and societal determinants, stress and
emotion management, kindredship, interpersonal relationships and inadequate support from
university counselors. Before I illustrate these components in detail, figure 1.1 indicates a
division of factors that constructed my behaviors. Figure 1.1 and the percentage of each label are
based on my retrospection, and this pie chart only aims to visually clarify, in a simple manner,
the division of the contributors of my maladaptive eating. Because this is a qualitative research
study, any numbers are just a representation of me categorizing the variables. The distribution of
the numbers is to identify the significance each of the variables may have had on my experiences
as a Chinese female international student. Additionally, it must be noted that the labels of
academic stress, romantic relationships, family influences and peer pressure are interconnected.
As such, although I assign percentages to each area, it is simply a means to organize my own
thoughts to the level of impact each had on my maladaptive eating behavior. For reference in
viewing the chart, peer pressure refers to my interpersonal relationships. Social media content
MALADAPTIVE EATING BEHAVIORS AND IDENTITY
49
refers to the cultural and societal determinants. Family influences refer to the disquietude I got
from my kindredship. Furthermore, each particular links with the insalubrious regulations of my
negative emotions that lead to my maladaptive eating behaviors.
Self-Reflection
(figure 1.1 Demonstrates my subjective perception of the influential variables that contribute to
my maladjusted behaviors.)
Kindredship
My family’s influences upon my maladaptive eating behaviors have started since my
childhood. Those influences have eventually developed into imprints carried within my
personality. The major incidents that have shaped my perfectionism toward a slim body figure,
which weakens my self-consciousness as oneself and as a female are the incessant conflicts
between my parents, my grandfather’s educational concept, and my family’s extreme pursuit of
thinness.
For as long as I can remember, my parents had been quarreling about their marriage since
I was six years old, and my father had always been complaining about my mom not fulfilling her
responsibility as a housewife and taking care of my father’s daily life. From that point, I had
MALADAPTIVE EATING BEHAVIORS AND IDENTITY
50
internally embraced and misunderstood the role of a female and a wife. I assume this was the
initiation of the undermining of my self-awareness of my identity, which was due to my father’s
concept of marriage and gender roles. Additionally, my grandfather believes that girls don’t have
to attend universities, because he affirms the fact that the most decisive and valuable thing for a
woman is to marry a worthy guy at the age of twenty. My grandfather and father both share the
values of the traditional Chinese culture’s male-dominant societal structure. It is crucial for me to
pinpoint that I am not biased and do not hold any prejudice toward any kind of female role,
especially toward women being housewives as their vocation. I am just indicating how my
father’s perspectives toward women had formed a narrowed view of female’s identity
development in my cognition. The alignment between their male-dominant values and my
identity development, including the reasons of my maladaptive eating habits, are expatiated in
the next chapter.
Other than being constrained by my family’s values, I was also influenced by my
family’s excessive aim toward thinness. For instance, after my mother, my brother, and I moved
to the United States, my mother and my brother started their own diet routines and daily
exercises. They would go to the gym four times a week and they would count their calories
intake every single day. As far as I can recall, my brother always carries a smart weighing scale
that connects to his mobile app, and that app will tell him his weight and thirteen body
composition measurements. My brother and my mother have a low body mass index.
Nevertheless, my father isn’t as skinny as them, but he had plastic surgeries on fat reduction and
fat transfer years ago.
MALADAPTIVE EATING BEHAVIORS AND IDENTITY
51
Cultural and Societal Determinants
The cultural and societal determinants of my eating behaviors started when I was around
eleven years old. My family’s culture aligns with Chinese society. For example, when I was
eleven years old, my thighs were thicker than most of the girls my age, although I still maintain a
body mass index (BMI) lower than the standard BMI. When I was eleven years old, I moved to
the United States and entered a junior high that had a special classroom system for international
students. My classmates were all Chinese international students like me. My male classmates
often made fun of my look and body shape, and those boys loved to list girls from the most
beautiful to the ugliest. I was always marked as the ugliest girl of that class in the list. Because
the educational system for international students in that junior high school was a fixed classroom
teaching system, I had to endure the disdain of my appearances for the entire two years. Unlike a
domestic student, I didn’t know where to seek help, and I didn’t tell my mother because I didn’t
think there was anything she could do for me. My mother didn’t know English at that point, and I
was so terrified if my academic life would negatively impact my mom’s expectation of moving
to a new country.
Due to my novelty and enjoyment toward the fast food culture of the United States, I
gained more weight during my early adolescence. During my early adolescence, I went back to
China every summer break and winter break. Every time I went back home, I would hear my
aunt and grandmother judging my legs for being too thick. Nowadays, I can precisely reminisce
about the afternoon, when I heard my brother and my mom metaphoring my thighs as elephant
legs. They were speaking behind my back, and even till today, they still don’t know that I heard
their conversation.
MALADAPTIVE EATING BEHAVIORS AND IDENTITY
52
At the age of eleven, I started using smartphones and began regularly surfing the internet.
Although I moved to the United States, I remained a traditional and typical Chinese international
student’s hobbies, including surfing on Chinese media. Most of the Chinese media platforms
have been dominated by influencers or celebrities with very thin body figures and a Chinese
view of perfect appearance. I remember there were multiple times that I saw girls encountering
cyber-violence just because they posted their photos publicly on the internet, and the criticisms
were all about their bodies and appearances. The Internet had a great effect on my cognition
toward the standard of beauty and a satisfying weight. Because of all of these societal and
cultural influences, at the age of fifteen years old, I secretly went to a private plastic surgery
institution for botox injection on my face and lipodissolve injection on my thighs. Family,
cultural and societal influences had rooted the desirability toward slimness in my mind.
Romantic Relationships
Family, internet and life in junior high had enlarged my concern toward weights. As I
grew older I also began to experience the impact that my romantic relationships can have on my
self attitude towards my body and, ultimately, to my eating behaviors. Relating to my previous
romantic relationship, the most frequent and corresponding maladaptive eating behavior is
purging. My first romantic relationship took place in the late period of my adolescence, when I
graduated from high school and entered a university. My former boyfriend had frequent contact
with another girl who I perceived as slim, tall and beautiful. Therefore, starting from that period,
I began my weight loss progress. As we encountered the run-in period, like other couples after
the honeymoon phase, we had frequent altercations. I had doubted his love and questioned
myself if the relationship was weakened by my inadequacy of charm and beauty. Everytime
after a dispute between me and my former boyfriend, I purged. He behaved very anxious, angry
MALADAPTIVE EATING BEHAVIORS AND IDENTITY
53
and concerned when I purged, and his tension always led to my sense of achievement and
satisfaction of being cared for. I could still recall the first time he heard me purging, and he
drastically knocked at the restroom door. That was the first time in my life that I felt there was
actually someone who could be eagerly concerned about my behaviors and would not hesitate to
disclose his heedfulness and affection. My intense and ambivalent attachment to the relationship
could be associated with my parents’ divorce and my father’s insufficiency of accompanying me
during my childhood and early adolescence. My father had never been emotionally
understanding and paternal for me although he has always been financially supportive until
nowadays. This relationship had engendered my maladaptive eating behaviors from purging to
overeating. Each time I overate, I purged, too. Besides, I also started self-starvation to feel good
and more satisfied with myself, because during the relationship, I had a consistent uncertainty
toward my former boyfriend and the stability of our relationship.
Interpersonal Relationships
Interpersonal relationships refer to the influences I got from my classmates and friends.
Peer pressure’s impact upon my maladaptive eating behaviors started as I entered junior high. I
mentioned how boys make fun of girls’ appearance in a section above. Therefore, this section
highlights the peer pressure of perfectionism in body weight during my high school and
university years. During my high school years, there were a lot of Chinese international students,
which approximately accounted for 60% of students in my high school. Unfortunately, identical
with my junior high, my high school’s male Chinese international students weren’t stingy on
complimenting or judging female’s looks. A lot of female Chinese international students would
dress stylishly and strive for extreme skinniness relating to the Chinese perspective of beauty.
My best friend from high school incessantly criticized her weight and body shape, even though
MALADAPTIVE EATING BEHAVIORS AND IDENTITY
54
she weighed ten pounds less than me. As I entered the university, I had two female roommates,
and they were both Chinese international students. We have similar heights, around five feet four
inches, but both of them weighed around eighty-eight pounds. My weight loss progress was
definitely elevated by living with them. They only ate a tiny portion of food in every single meal,
and seeing that had caused me to consume less food due to the guilty feelings of eating too much
in front of them. Getting along with my roommates in undergraduate years had strengthened my
determination and effectiveness in self-starvation. I never mentioned my maladaptive eating
behaviors with my roommates because of the sense of shamefulness. I didn’t want them to
perceive what I strive for is something that they obtain in their genes. Selfishly, I envied their
talent of being a skinny person while I didn’t want them to know about my longing for their
inborn talent and their weights.
Inadequate support from University Counselors
Starting from my sophomore year, I started to affirm the feeling of getting inadequate
support from my four year university counselors. As undergraduate students, we all had
mandatory counseling sessions every quarter. I didn’t know what counselors are able to offer in
my entire university life, except that I knew they do help me schedule my courses for each
quarter. I didn’t realize that university counselors are eligible to communicate with students
about things other than courses. My undergraduate university site and counselors never
acknowledged that students could be experiencing bouts with eating disorders or related
behaviors and other potential mental health problems students might get from academic stress.
There were various sorts of pressure in my undergraduate years, such as the consistent conflicts
with my former boyfriend, academic development, and family’s oppression toward my potential
career. Academic development was about me choosing a major or double majors. Nevertheless,
MALADAPTIVE EATING BEHAVIORS AND IDENTITY
55
because I didn’t have too much energy and attention to put upon my academic plan, my
academic goal eventually became “just graduate.” My family members had always considered
my future career in our family business, which was why they all disagreed upon my decision of
applying to a master program. When I graduated with a bachelor degree, the male family
members persuaded me to marry someone from our hometown. I was so bewildered because I
didn’t know why they were always structuring my life for me without communicating with me.
They didn’t even know about my major in my undergraduate school, but they did want to know
if I was seeing someone who is qualified to marry. I had a confused view toward my future after
graduating from the bachelor program, and I also didn’t know that this was something I could or
should discuss with my university counselors. My family wanted me to go back to China and
work for the family business. I had nowhere to get support for my negative emotions, although I
have heard of the mental health services in our university. The reason I didn’t seek help there
was because some of my Chinese friends told me that California’s mental health clinics or
hospitals will confine me if they think I am hurting myself. I wasn’t really sure if my purging
behavior and self-starvation were self-harm behaviors. Furthermore, because of this concern of
confinement, I never told my counselors about my maladaptive eating behaviors.
Stress and Emotion Management
The inadequate support from my family and university counselors had implicitly formed
my adverse management toward stress. Purging and overeating were both strategies of
manipulating my emotions and pressure. These were my ways of regulating my anxiety and
grievance. The following portion, historical data analysis, provides a more detailed view toward
my maladaptive eating behaviors during the time period of 2018 to 2020.
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56
Historical Data Analysis
This section reveals how I came to organize historical data surrounding my maladaptive
eating behavior and body awareness challenges. I’ve organized my historical data through the
display of one bar graph and three pie-charts according to the data I have collected from my
previous diet-related behaviors between 2018 to 2020. Each graph/chart is being elaborated
based on their data calculation procedure and the exposition of what it represents. The numbers,
the data, conceptualize my mental activity among weight loss behaviors and may help readers to
comprehend the interconnection between my behaviors and sentiments.
Diet Related Behaviors
The major three domains of my diet related behaviors are my on-diet memo records, on-
diet social media posts and products shopping records relating to weight loss. The calculation
process of figure 2.1 was that I calculated the numbers of records, social media posts and weight
loss products I had bought online each month from 2018 to 2020. The total number of on-diet
memo records I had from 2018 is 226, and after I divided it by 12 (12 months), the average
number of memo records I took in each month of 2018 is around 18.83. The total times of social
media posts I had posted and the products for weight loss I had bought online in 2018 are 42 and
55. The average number of on-diet social media posts per month in 2018 is around 3.5, and the
average number of weight loss products I bought online in 2018 each month is around 4.58. The
total times of memo records I had taken, social media posts I had posted and the weight loss
products I had bought online in 2019 are 131, 25 and 53. The average number of memo records I
wrote, social media posts I posted and weight loss products I bought online in each month of
2019 are around 10.91, 1.42 and 4.42. The total counts of memo records I had taken, social
media posts I had posted and the weight loss products I had bought online in 2020 are 50, 23 and
MALADAPTIVE EATING BEHAVIORS AND IDENTITY
57
33. The average number of memo records I wrote, social media posts I posted and weight loss
products I bought online in each month of 2020 are around 4.17, 1.92 and 2.75.
The purpose of me taking on diet records in that period was due to the fact that I wanted
to keep track carefully of my diet routines, starvation behaviors and weight management. I
wanted to make sure the efficiency and effectiveness of my diet process. As I wrote down my
diet information, I felt more confident about the procedure and gained more faith in myself to
successfully lose weight. The on-diet social media posts refer to my social media behaviors of
posting photos that contain slim body figures, diet meals and weight posts. The analysis of these
behaviors would be interpreted in chapter five. Products shopping record for weight loss refers to
the amount of times I bought products that I had believed to support my weight loss action.
(figure 2.1)
MALADAPTIVE EATING BEHAVIORS AND IDENTITY
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Categories of On Diet Memo Records
Figure 3.1 aims to demonstrate the distribution of content sorts in my memo records from
2018 to 2020. There are four main categories based on my findings: purge, overeating, calories
counting and dietary meal plans. Purge refers to the amount of times that I recorded my self-
purging behavior. Overeating refers to the amount of time that I recorded for my overeating
behavior. Calories counting refers to the amount of time that I calculated the calories intake for a
particular day or meal. Dietary meal plans refer to the amount of time I detailed the diet plans for
a particular meal or day. The calculation process involved numerating the memo records and
dividing the content into these four categories from 2018 to 2020. The total number of times that
I had taken an on-diet memo records from 2018 to 2020 are 407 times. Then, I divided the total
amount of each category by 407 and got the percentages list in the figure 3.1. These numbers aim
to display the visualization of my eating behaviors, and these data may help readers of this paper
to understand the frequency relating to anxiety from the negative attitude toward weight loss
among my mental activities. Figure 3.2 and 3.3 are my diet memo records from 2019. These
figures are screenshots from a diet media platform that I previously used to keep track and record
updates on my weight loss progress. These screenshots include the goal of the weight loss plan,
maximum calories intake per day and a calories calculator. I also used this platform for counting
calories intake per meal.
I recorded down my purging behaviors sometimes due to the guiltiness of self-harming,
and recording this behavior was also a warning signal to myself for not repeating this behavior in
the future. Whenever I reviewed my records of purging behavior, I felt remorseful. Although
there were plenty of reasons for me self-purging, I still perceived myself as being irresponsible
toward my physical wellness. Because of incessant purging, I was diagnosed with chronic acid
MALADAPTIVE EATING BEHAVIORS AND IDENTITY
59
reflux. The overeating behavior was recorded because it was interconnected with my purging
behavior. When I ate too much, I felt regretful for gaining weight, then the only solution, from
my point of view, for the overeating behavior was to vomit out the food that I just consumed.
Recording the overeating frequency could make me remember the regularity of me not being
able to manipulate my course of actions. Records of calories courting and diet meal plans were
both to set goals for my daily food intake. Sometimes, the calorie counting recording was to
make myself feel bad about the overeating behavior and remind myself to consume less food the
following day. Occasionally, when I did what I thought was a great job in food restriction, I also
took notes on calories counting in order to get the sense of achievement.
(figure 3.1)
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60
(figure 3.2)
(figure 3.3)
MALADAPTIVE EATING BEHAVIORS AND IDENTITY
61
Divisions of On Diet Social Media Posts from 2018 to 2020
The social media I had posted during my diet period and food starvation period from
2018 to 2020 encompassed three classifications: body figure posts, weight posts and diet meal
posts. The total amount of social media posts relating to my diet behaviors between 2018 to 2020
are 90. There were a total of 18 body figure posts, 31 weight posts and 41 diet meal posts. I
divided each of these numbers by 90 and got the following percentages in figure 4.1.
Body figure posts refer to the posts showing my arms, legs or belly in order to let the
viewers know my “thinness.” This behavior occurred when I felt satisfied with my body shape
and weight after a period of food restriction. Diet meal posts were pictures containing food
products that apply for individuals who are on a diet. The frequency of posting diet meal posts
were relatively higher than posting body figures and weights. Most of the time, I would upload a
meal plan photo on a media platform to notify my friends and followers about my diet plan. This
course of action was associated with strengthening my faith in weight loss. The weight posts
were literally pictures of a weight scale with my weight on it. Every single time that I reached a
lower weight number, I preferred to “notify” others to feel pride and get in the mood of
attainment.
MALADAPTIVE EATING BEHAVIORS AND IDENTITY
62
(figure 4.1)
Categories of Weight Loss Products Bought Online from 2018 to 2020
Figure 5.1 is a pie chart containing seven criterias of products that I bought during 2018
to 2020 for weight loss. This autoethnography only displays the online shopping record because
in-person shopping records weren't available for retrospection and calculation. There were a total
of 141 diet or weight loss related items I had bought from 2018 to 2020. The online shopping
records illustrate that I bought 45 low-calorie snacks, 7 diet equipment, 23 packs of diet drinks, 5
packs of low-calorie noodles, 12 bottles of melatonins, 37 packs of diet enzymes and 12 bottles
of fat burning supplements. In order to get the following percentages in figure 5.1, I divided each
quantity of products by 141. Figure 5.2 and figure 5.3 are some weight loss products, mostly diet
enzymes from Japan, that I bought during the year of 2018. A shopping record of food scale is
included in figure 5.3.
Low-calorie snacks were mostly cookies made with konjac flour. Diet enzymes were
enzymes that help me defecate. Due to regular food restriction, I often encountered problems of
constipation, which could be solved by those enzymes. Additionally, some of the enzymes were
MALADAPTIVE EATING BEHAVIORS AND IDENTITY
63
labeled with the function of blocking the absorption of carbohydrates, oils and fats. Diet
equipment included jump rope, yoga ball, yoga met, large volume water bottle and hula hoop. I
rarely used this equipment because exercise wasn’t my thing. I bought them only because after I
had binge eating, I needed them to make me feel less culpable. I bought fat burning supplements
because they were described as tools to block the absorption of fat and upraise my metabolism.
Melatonin products were the most requisite product during my maladaptive eating behavior
period. Every time I started a new diet routine, I needed melatonin to fall asleep. My diet plans
took three years to end, because the diet plans were easily ended by my shortage in will power.
Therefore, everytime I started a new diet routine, my body couldn’t adapt quickly to food
deprivation and undernutrition. In this stage, the starvation would cause insomnia, which could
be lightly resolved by melatonin. Diet drinks I bought were mostly powders that mix with water
and turn into liquid (drinks). Those diet drinks are often called meal substitutes. Low-calories
noodles I bought were made with konjac flour. Noodles are traditionally the main course in my
hometown and family culture. Regular noodles are made with components that can easily raise
an individual's blood glucose and have higher calories than konjac products, which was why I
bought konjac noodles to feel less oppressed by the calories intake. These online shopping
records highlight my need for low daily calories intake because a nutritious or a standard meal
could beget pressure for me from preventing weight loss or even engendering weight gain.
MALADAPTIVE EATING BEHAVIORS AND IDENTITY
64
(figure 5.1)
(figure 5.2)
MALADAPTIVE EATING BEHAVIORS AND IDENTITY
65
(figure 5.3)
Making Meaning of the Experience
In summary, my maladaptive eating behaviors had formed my morbid fascination toward
weight loss and diet-related habits, and these are interconnected with my improper attitudes and
negative emotional responses toward weight loss.
Referring to my historical data, I have found the most recurring behavior of mine was
using memo records of my purging behaviors, overeating behaviors, diet-meal plans and calories
counting. The least habitual behavior was social media posts relating to my on-diet behaviors.
Due to this comparison, I realized the exhaustion caused by my internal strife. This internal strife
was caused by the underlying suppression from my culture, my family, the male-dominated
tradition, academic stress, peer pressure and romantic relationship. I tended to struggle within my
inner world by repeating the circulation of food-restriction, binge-eating, calories counting,
purge, meal-plan, and then food-restriction. Everytime after I had a few meals with food-
MALADAPTIVE EATING BEHAVIORS AND IDENTITY
66
restriction, I would start binge eating. Overeating was always like a retaliatory eating for me
after a few routines of self-starvation. Then, overeating led to purge because of my guiltiness,
which had a confrontation with my yearn for food, especially high calorie food. After purging, I
tended to feel more culpable because vomiting injures my esophagus, and additionally, I had a
huge addiction toward incessant purging. In some ways, purging released my stress by
preventing calories intake.
Because of my preference of striving for these eating disturbances on my own, I didn’t
have too much awareness of seeking help from others, particularly from my university
counselors or university health center. Nevertheless, there were a few times that I thought about
seeking a mental health counselor from our university's mental health center, and I also thought
about maybe I could discuss my personal issue with my university advisors because these
behaviors had largely influenced my academic concentration. The problem was that my
undergraduate university’s official website and counseling site didn’t have any perceptual
information about eating disorders or maladaptive eating behaviors. I didn’t know if there were
other students encountering these similar struggles as mine. I remembered that during my
counseling session with the university advisors, the advisors were always amiable but not that
concerning. As the counseling session began, they would greet me for a while by asking how my
school was, how my classes were, etc,. The starting of the conversation and process of the
conversation were kind of systemized. I am not criticizing a systemized counseling session, but I
just wish the counseling process could involve more conversation leading to my mental status or
necessity of mental health support. I was in an absolute state of needing help, but as a female
Chinese international student, I was too scared to explore other professions near me that could
support me mentally. As a female, I didn’t want others to think I was in an extreme state of
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67
losing weight because I didn’t want others to perceive my behaviors as an approach to attract
men or to conform to the mainstream male-dominated culture. Although I knew my maladaptive
eating patterns were partially caused by the male-dominated culture, I was too afraid of letting
others to cognize my mentality since there have always been more and more feminists in this
nation. I didn’t want to be criticized or judged by my gender and the female population. As a
Chinese person, I had no idea of how mental health sessions work in the United States. I failed to
keep a mental health counseling session appointment due to the risk of confinement. Moreover, I
didn’t ask my university counselors about my question of the possibility of being put in
confinement because I knew that university counselors are responsible for reporting students’
self-harming behaviors.
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68
Chapter 5: Analysis and Implications
My maladaptive eating behaviors could be divided into three stages: what shaped my
behaviors, why did I get addicted to these behaviors and what were the consequences of these
behaviors. This analysis portion is embedded within these three categories, and Chapter five
elaborates the three stages relating to the theoretical framework of feminist identity development
model. There would be a specific portion at the end of chapter five to analyze the association
between university counselors and my overall maladaptive eating experiences. Referring to the
self-reflection portion of chapter four, the cultural and societal determinants, kindredship,
interpersonal relationships and inadequate support from university counselors were the primary
causes of my maladaptive eating habits whereas romantic relationships and stress management
were more concurrent with the development of my addiction toward some maladjusted actions,
such as purging and self-starvation. The consequences of these eating behaviors are concretely
unfolded in the following sections.
The Formation of My Maladaptive Eating Behaviors
Cultural and societal determinants, kindredship, and interpersonal relationships weakened
my consciousness toward developing and focusing on my own identity. My family members’
judgment toward appearances and my junior high classmates’ emphasis on perfectionism of
women’s exterior had pushed me into an endless loop that I had to keep reaching for recognition
from others. The recognition had always been about how I look and how much I weighed. That
was stressful because as I entered my undergraduate university, the more people I got to know,
the more perceptual recognition I had to seek from them. I now realize that before I fully accept
and love myself, I will be drowned in this societal and cultural cage, which is mostly set for the
female population in China. Because of my intense concentration of weight growing up, I had
MALADAPTIVE EATING BEHAVIORS AND IDENTITY
69
never reflected among my own characteristics and identities. If I had realized the significance of
self-awareness, I would have spent more time reflecting and appreciating myself. As a child, a
teenager, and an adolescent, I rarely got any praise from my family and friends. Ironically, I also
rarely got any criticism for school performances from my family, but I do recall the criticism
toward my thighs and face shape, being too round, from my family members. Growing up, I
didn’t have any confidence in myself. The excessive emphasis on body shape and weight had
faded my intrinsic values away, which was why I only focused on starving myself, purging,
calories counting and other maladaptive eating behaviors.
My undergraduate university advisors didn’t offer me a sufficient amount of
opportunities to disclose my vulnerability among my eating habits. I am not trying to blame
neither my university advisors nor my university on my maladjusted experiences. I just need to
pinpoint the importance of institutions being aware and concerned of the possible psychological
issues among students, especially international students who don’t usually know where to seek
support. I want to emphasize the Chinese international student population because I perceive
most of my compatriots possess a self-stigma toward mental disturbances and mental disorders.
Studying abroad in the United States could offer Chinese international students, at least most of
them, an opportunity to correctly understand the variety of mental disorders and mental support
from professions. Nevertheless, this assumption could only be made if university and university
counselors have a proper knowledge and consideration of the prevalence and intervention of
mental diseases among their diverse student populations.
The Addiction Toward These Maladaptive Eating Behaviors
The compulsion of repeating those maladaptive behaviors are primarily due to my
previous romantic relationship and the negative management of my emotion and stress. As I
MALADAPTIVE EATING BEHAVIORS AND IDENTITY
70
have mentioned above in chapter four, I tended to purge everytime after I had a conflict with my
previous boyfriend because he would show an extreme concern that made me feel fulfilled with
love. This fulfillment is one part of my eagerness to be recognized by individuals around me.
There is no doubt that my persistence in weight loss was to earn a sense of security in the
relationship because I assumed that having a nearly perfect appearance would maintain the
equilibrium and strengthen my partner’s affection for me in my relationship. These were all
related to my acquisition of recognition due to my self-distrust and incertitude toward others’
affection. From purging, I could feel that love, which I couldn’t completely perceive without any
extreme behavior. This was significant toward my addiction to these maladjusted behaviors.
My stress management comprised self-starvation, binge eating and purging. These
behaviors could resolve eighty percent of my negative emotion normally, which was why I could
not quit them for almost three years. During my undergraduate years, there wasn’t anywhere I
could seek treatments of my maladaptive actions although these actions had helped me withstand
a lot of stress from school, family and self-doubt. It was more like a vicious cycle where I got
pleasured by these unhealthy behaviors, and then I didn’t have any other approaches to solve my
stress. I also wasn’t fully sure if I could get rid of these habits and if I could be prepared to
manage my negative emotions without these habits. Therefore, I got more and more reliance on
these habits.
The Consequences of Maladaptive Eating Behaviors
The consequences of maladaptive eating behaviors are divided into the changes in
mentality and changes in my physical wellness. Due to the unconsciousness toward the inequity
among genders from my culture and society, my psychological and physical well being had been
harmed sequentially.
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71
As mentioned above, I had psychologically suffered from the addiction toward binge
eating and purging. Even if I tried to stop the self-starvation from the severe thirst of weight loss,
the overeating and purging behaviors wouldn’t cease due to my delicate volition and the amount
of stress from school work and family issues.
Physically, due to frequent purging from my undergraduate period, I have been
experiencing acid reflux every time I got full from a meal. I have been diagnosed with chronic
acid reflux with chronic gastritis.
Theoretical Framework: Feminist Identity Development Model
While my experiences could be embedded and interpreted within the feminist identity
development model, it is important to pinpoint that my experiences didn’t follow the order of the
stages completely. I have discovered that I could enter a later stage in the model before having a
prior stage while some stages could coexist at the same time for me.
Stage 1: Passive Acceptance I bought into the idea that I had to look perfect
to please the male gaze.
Stage 2: Revelation My consciousness of the negative
consequences from maladaptive eating
behaviors and personal values arised.
Stage 3: Embeddedness-Emanation I started to enjoy being accompanied by
female friends, particularly who shared
similar characteristics and experiences with
me.
Stage 4: Synthesis I began to view people, whether male or
female, as a unique unit instead of an
individual from a superior or minority
population.
Stage 5: Active Commitment My first but only active commitment of the
feminist identity development is writing this
autoethnography while vocalizing my
MALADAPTIVE EATING BEHAVIORS AND IDENTITY
72
experiences due to the gender oppression and
stereotypes from my culture, my family and
the patriarchal society.
(Table 1)
Stage I: Passive Acceptance
According to Downing and Roush (1985), the first stage of the feminist identity
development model is the stage of passive acceptance, in which female individuals are either
unaware or deny the existence of the discrepancy among genders. Reflecting through my
maladaptive eating behaviors from 2018 to 2020, I was in the stage of passive acceptance in
most of the months, which is why I would continually act on those maladjusted actions. I didn’t
realize the sources that had been leading me toward my mentality of that time. I perceived the
male-dominated culture and its values that suppressing my identity development as a superior
structure above my real self, and I interpreted this inequity, female trying to look perfect enough
to reach men’s preference of women, as an advantageous approach for me to be accepted in this
culture. The stage of passive acceptance and my reflection upon myself in this stage have
highlighted the significance of the approachability and receptivity toward alternative
conceptualizations of one’s identity.
Stage II: Revelation
The second stage, revelation, refers to individuals’ period of conscious-raising and
realization of discrimination against the female population (Downing & Roush, 1985).
Revelation is a stage of readiness for female individuals to change her frame of reference
(Downing & Roush, 1985). 2020 was the year I started to consciously realize the consequences
of my maladaptive eating behaviors, and it was also the time I broke up with my previous
romantic partner. The detachment from that relationship had somehow supported me to terminate
MALADAPTIVE EATING BEHAVIORS AND IDENTITY
73
the purging habit because there was no more need of attaining my partner’s affection and
concern toward me. As I cognized this fact, my reflection upon my culture and family started
gradually. I assumed the termination of my romantic relationship had enlightened me to face the
challenges of my female identity in my culture and my family.
Stage III: Embeddedness-Emanation
I didn’t fully enter the stage of embeddedness-emanation since this stage could be
divided into two parts: embeddedness and emanation. Downing and Roush (1985) referred to
embeddedness as the female individual’s phase of finding sisterhood and connecting with similar
women while emanation is demonstrated as beginning to accept divergent viewpoints. During
the late 2020, I did reach for close connections with some female friends who had similar
experiences with me. I resonate with the phase of sisterhood connection because sisterhood
supported me to withstand the stress from society and the termination of my previous romantic
relationship. 2020 was the year that the pandemic started, and I stayed home with my roommates
for almost half a year. We had a lot of conversations about our personal encounters, and those
conversations were powerful, which led me to feel more confident about my exterior and inner
self. Essentially, my encounter with embeddedness and the stage of revelation coexisted in 2020.
My emotional support from sisterhood and realization of the disequilibrium among genders were
interconnected. I couldn’t recall which of them came first. I don’t think any of my experiences
match with the phase of emanation because until nowadays, I possess an extreme need of being
accompanied by female friends, especially those who share similar characteristics with me.
Stage IV: Synthesis
I prefer to position my current self in the stage of synthesis. Synthesis is demonstrated as
a stage where female individuals perceive man as an individual instead of an individual from a
MALADAPTIVE EATING BEHAVIORS AND IDENTITY
74
superior population and adapt a flexible frame of mind in this society (Downing & Roush, 1985).
Corresponding to Downing and Roush’s (1985) indication of synthesis, where female individuals
are able to exceed traditional sex roles and make voluntary choices according to personal values,
I currently possess the appropriate strength of making my career and academic choices. I am no
more bothered by the significance of marriage and motherhood that are the foreground in my
culture and my family. Because of realizing that I possess a great amount of alternative
opportunities, my attention on perfecting my appearance and losing weight have been limited. I
conceive that there are more things I should strive for instead of getting my exterior to be
recognized by the male-dominated culture.
Stage V: Active Commitment
Active Commitment is a stage where newly consolidated identity turns to meaningful
actions (Downing & Roush, 1985). I didn’t have the opportunity and willingness to participate in
any action for social changes among gender inequity yet. Nevertheless, I believe this
autoethnography paper is the first step of me entering the stage of active commitment.
Discussion and Recommendations
The purpose of this study is to bring to greater light the experience of a female Chinese
International student challenged by maladaptive eating behaviors. Through the autoethnographic
methodology of this study, I’ve come to a greater understanding of myself and the possible
supports that would have benefited me in my time of need. The following are my concluding
remarks responding to the research questions that have guided this study.
Support From the University
MALADAPTIVE EATING BEHAVIORS AND IDENTITY
75
- How can institutions effectively support female Chinese international students that are
experiencing the impacts of maladaptive eating behaviors as influenced by society
according to the different stages in the feminist identity theory?
I have indicated a lot of content on how university and university counselors should
develop a mental health intervention and prevention system for the vulnerable student
population. This portion, I address and highlight the momentousness of university and university
counselors to raise the concern toward the female population relating to the feminist identity
development stages.
As female students enter the university, they enter a new environmental context that
could be metaphored as a small-scale society. University could be a place where women
gradually develop their identity because generally this is when women possess more
independence. Due to the diversity of schoolmates and school faculty members, women could
enhance their alternative viewpoints toward other populations and themselves. Therefore,
university counselors could utilize the feminist identity development model as a reference of
female students' growth and potential dilemmas at the university. Being acknowledged with the
possible stages of female students’ growth, counselors could predict or foresee a female student’s
psychological status according to what the female student has indicated in their counseling
session.
As a female Chinese international student, my perceived dilemma from studying abroad,
leaving my familiar environment and academic stress were beyond my expectation of
undergraduate life. University counselors and a proper acknowledgment toward mental
disturbances and mental disorders in an appropriate timing would have nurtured my identity
development. Grounded in the findings of this study, here are several recommendations for
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76
institutions to provide greater supports to female Chinese International students who may be
experiencing maladaptive eating behaviors:
1. Destigmatize maladaptive responses to societal pressures among female university
students and Chinese international students.
2. Support and guide female Chinese international students by reframing their mindset
perceiving other populations.
3. Provide a proportionate amount of online or in-person resources and acknowledgement
lessons among mental disorders and mental disturbances.
4. Be aware of the potential discomfiture among the vulnerable student populations,
especially among female Chinese international students.
5. Be prepared for any legal psychological prevention and intervention for female Chinese
international students according to their concern.
6. Consider any potential circumstances that might involve school bullying.
7. Without violating students’ privacy, try to be acquainted with the impacts from traumatic
experiences in romantic relationships among university students.
8. Establish female international student support groups or communities.
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77
Chapter 6: Epilogue
The work of this project has been a tremendous learning experience. I close reflecting on
this experience centering the central question guiding this study.
Lessons Learned
- What are the sociocultural factors that engender a female Chinese international student’s
maladaptive eating behavior response?
The language of feminist identity development model has provided me an outlet for
expressing my experience. In utilizing this platform of an autoethnography, I have been able to
self-reflect on my experience with maladaptive eating behavior. I have acknowledged myself
with the importance of self-consciousness, which is embedded within every unique individual’s
inner self and possessed values. I have cognized the negative consequences of not
comprehending societal and cultural influences and being framed by mainstream beauty-
appreciation. As I am more educated, I get to know more about my potentiality and my power as
a female Chinese international student. When I communicate with girls who share similar
characteristics, concerns and ethical backgrounds with me, I am capable of offering more
professional and practical advice so they make less detours.
More importantly, if I find myself catching up on some previous maladaptive eating
habits nowadays, I know the best way to cease the disturbance instead of letting it turn into a
vicious circle. Because of this experience, I get more interested in the mental health criteria and
offering counseling support for vulnerable student populations. I have gained a greater fortitude
to withdraw from any instant thought relating to the persuasion of perfectionism in appearance
and body shape. I have become more disposed to seek support from school faculty members and
MALADAPTIVE EATING BEHAVIORS AND IDENTITY
78
mental health experts because I know what could happen if I struggle to puzzle out the
disturbance solitarily.
Referring to my current master’s program in educational counseling, I have learned some
prospective needs of students in undergraduate and graduate schools. First of all, I perceive the
counseling process as the most crucial step for offering support to students in a frail state of
mental wellness. I untrusted my undergraduate university and undergraduate school advisors,
which leads to the duration of three years of me enduring the maladaptive eating behaviors.
University counselors have a better opportunity to approach and communicate with students
compared to the mental health centers. Counselors should value each counseling session as the
only chance to discern students’ characteristics and possible demands. Counselors should clarify
their intention of the counseling session as a space for students to self-disclose and should not
barely pinpoint the noteworthiness of psychological wellness.
As a conclusion of my adolescents with the maladaptive eating behaviors, I have properly
rescued myself from the negative impacts surrounding my childhood and teenage. During my
adolescence, the question of “what can I be without being perfectly skinny and pretty?” had
stimulated my motivation to self-starve, to purge, and to lose weight. The answer to this question
was always “nothing.” I doubted myself so pathetically that I believed nobody would be
interested in my inner self and my mindfulness if my appearance isn’t attractive and approbatory
at the first point. As I turned twenty-one years old, I began to realize that there have always been
a lot of different answers for that question. From being more educated, knowing more female
friends who had similar experiences with me, reading more books, becoming more independent
and acquiring more self-awareness, I am capable of seeing my potential. I have gained the
freedom of answering this question and the power of seeing a broader view of possibilities.
MALADAPTIVE EATING BEHAVIORS AND IDENTITY
79
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Abstract (if available)
Abstract
This autoethnography article is mainly focused on the author, the only investigator and participant of this research study, experiences of maladaptive eating behaviors during her adolescence. The research's data collection and analysis are based on the author's self-reflection and historical data relating to the development and consequences of the author's extreme eagerness toward weight loss. The study's findings are interpreted by the feminist identity development model while also pinpointing the author's identity as a female Chinese international student. The study wishes to highlight university and university counselors' attention to the female Chinese international student population and the prevention of mental disturbances among this vulnerable student population. From examining and reflecting upon the author's personal encounter, this study demonstrates how influential factors could shape someone's behaviors from the cultural, societal and psychological perspectives. According to the author's perception and comprehension of her adolescence, there are eight recommendations, intervening and preventing psychosocial and physical harm for female Chinese international student population, for university and university counselors.
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Bi, Krislynn
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Core Title
An autoethnography: examining the association between maladaptive eating behaviors and the identity of a female Chinese international student
School
Rossier School of Education
Degree
Master of Education
Degree Program
Educational Counseling
Degree Conferral Date
2023-05
Publication Date
04/04/2023
Defense Date
04/04/2023
Publisher
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Tag
acculturation,anorexia,autoethnography,binge-eating,bulimia nervosa,maladaptive perfectionism,OAI-PMH Harvest
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Ocampo, Atheneus (
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krislynn@usc.edu,krislynnbi99@gmail.com
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Tags
acculturation
anorexia
autoethnography
binge-eating
bulimia nervosa
maladaptive perfectionism