On May 14th, 2025, Megan Soun, MTS, ACSW, therapist and the Community Program Manager at Yellow Chair Collective, presented "Unpacking the Asian American Experience: Cultural Considerations in Body Image and Disordered Eating".
Defining Asian American
The term Asian American encompasses a vast and diverse population, with individuals tracing their roots to more than 20 countries across Asia. Clinically, it is crucial to avoid monolithic assumptions and instead recognize that Asian American identity is shaped by a complex interplay of cultural expectations, narratives, and experiences. Many clients are navigating not only what it means to be Asian in America, but also what it means to be American while honoring their Asian heritage. It is essential to approach each client with cultural humility, allowing them to define their own identity and lived experience, rather than relying on preconceived notions of what being Asian American "should" mean.
How Does Culture Affect Eating Disorders?
Increased pressure for thinness
Asian Americans often navigate dual cultural pressures around appearance, particularly when thinness is idealized in both Asian countries and in the U.S. The ideal female body weight in some Asian countries is significantly lower than in the U.S., with “ideal” BMIs falling into ranges considered underweight by American medical standards. In cultures where appearance is closely tied to perceived character, discipline, and moral value, the stakes around body image can feel especially high.
In many Asian cultures, comments about weight and eating are common and socially accepted, particularly among family members or elders. Statements like “you’ve gained weight” are often used as greetings or observations, but they can be upsetting, especially for individuals struggling with disordered eating. Compounding this is a cultural landscape where the devotion to thinness is rarely challenged. In the U.S., body neutrality and body positivity movements offer some counternarratives, but many Asian societies lack widely held alternative perspectives. As a result, Asian Americans may internalize a sense of inadequacy and feel caught between conflicting cultural standards, with little validation or reprieve from either side.
Collectivist values in Asian cultures
To fully understand the cultural risk factors that impact Asian American clients with eating disorders, it is essential to consider the role of collectivism. In collectivist cultures, identity is grounded in group belonging and interdependence. A person’s sense of self is often shaped by how they are perceived by others, and their actions, including how they look, can be seen as reflections of their family or broader community. This dynamic can increase body image concerns, as individuals may feel pressure not just to meet personal standards, but to uphold the expectation of the group.
With this, it becomes more socially acceptable for family members or peers to comment on a person's body or eating habits. These comments are normalized due to more fluid interpersonal boundaries and a collective sense of accountability. Social comparison is also common, with individuals frequently being measured against siblings, peers, or cultural ideals. While collectivism can be a risk factor for disordered eating, it can also be a protective factor, especially through strong family bonds and community-based support systems that, when engaged thoughtfully, can play a vital role in healing.
Acculturative and race-based stress
Asian Americans face unique psychological stressors that stem not only from navigating cultural differences, but from racial inequality as well. Acculturative stress refers to the challenges of adapting to a dominant culture, while race-based traumatic stress (or racial trauma) stems from experiences of discrimination, stereotyping, and exclusion. For many Asian Americans, these stressors are compounded as cultural differences are often treated as less than. Examples include being mocked for traditional foods, accents, or names, or being made to feel othered in social and academic settings.
These experiences are both painful and clinically relevant. Research shows that both acculturative stress and racial trauma are predictors of disordered eating among Asian American populations. Additionally, beauty ideals rooted in Western norms (thin, toned, tall, and white) further marginalize Asian American individuals, whose natural body types and features often fall outside these standards. Many Asian American women report higher levels of body dissatisfaction, feeling that their bodies are simultaneously too small for the Western ideal and not small enough for the Asian ideal. Facial features are also a source of distress, sometimes leading to the use of makeup or cosmetic surgery to appear “less Asian.” The sense that no standard is fully attainable may contribute to disordered eating as a means of coping with or gaining perceived control over these layered and contradictory pressures.
Objectification of Asian women
The objectification of Asian women is a significant and often overlooked risk factor for disordered eating, occurring at the intersection of racism and sexism. Objectification refers to the reduction of a person to a physical or sexual object. For Asian women, this is shaped by long-standing, harmful stereotypes perpetuated in Western media, most notably, the “dragon lady” (hypersexual, aggressive) and the “lotus blossom” (dainty, passive, submissive). Both define Asian women by their desirability and subservience.
These portrayals contribute to pressures to remain small, not only physically, but in presence and power. Research has shown that disordered eating behaviors are positively correlated with racialized gender microaggressions, including experiences of fetishization and expectations of submission. For Asian American women, disordered eating can become a way to navigate or resist the dehumanizing impact of objectification.
Clinical presentation of eating disorders in Asian American clients
Disordered eating and body image concerns among Asian American clients may present differently from those seen in white populations, and standard clinical measures may not capture the nuances of their experience. Many of the screening tools and diagnostic criteria used in eating disorder assessment were developed primarily for white populations, which can lead to missed diagnoses in Asian American clients.
Additionally, body dissatisfaction in Asian Americans often includes dissatisfaction with specific traits, examples being facial features or skin tone. These are areas less emphasized in traditional assessments focused primarily on body size and weight. Clinicians must take a culturally informed approach to evaluation, asking about how race, culture, and identity intersect with body image concerns, and being cautious not to rely solely on traditional assessment indicators.
Model Minority Myth
The model minority myth paints Asian Americans as high-achieving, hardworking, obedient, and emotionally restrained—often positioning them as the “ideal” minority in comparison to other racial and ethnic groups. One of its most damaging consequences is the pressure it places on Asian Americans to succeed without visible struggle. As a result, individuals may feel they must suppress emotional distress or avoid seeking help, fearing they will fall short of expectations.
This is reflected in research showing that Asian Americans are the least likely racial group in the U.S. to access mental health services (SAMHSA). The myth contributes to underdiagnosis, delayed intervention, and internalized shame around needing support.
Mental health stigma
Stigma surrounding mental health remains a significant barrier to care in many Asian cultures, where psychological struggles are often viewed as a sign of personal weakness or a failure of willpower.
There is often deep concern about how mental health challenges might impact the family’s social reputation or create a financial burden, leading individuals to suffer in silence. This stigma contributes to underreporting of symptoms and a reluctance to engage in care, even when support is desperately needed.
Lack of Asian representation in eating disorder treatment
Asian American often face a lack of representation in the areas of mental health, eating disorders, and body image advocacy, both in media and in clinical settings. When clients rarely see people who look like them being validated or treated for these concerns, it can contribute to the belief that eating disorders are not something “people like me” experience, or that help is only for those who are visibly or severely ill.
In clinical spaces, limited representation can also mean that Asian American clients must explain their cultural values, family dynamics, and experiences of racialized stress to providers who may not fully understand or ask the right questions. This can further alienate clients, reinforce feelings of shame or invisibility, and discourage them from engaging in or continuing care.
Asian American eating disorder treatment recommendations
Psychoeducation to address eating disorder stigma
Many Asian American clients may internalize their eating disorder as a personal failure, experiencing guilt, shame, or a sense of being a burden to their families. Psychoeducation is a critical first step in treatment, helping clients understand that eating disorders are not moral failings but complex mental health conditions influenced by biological, psychological, and sociocultural factors. It can be especially validating to explore how patriarchy, white supremacy, and cultural expectations shape body image and eating behaviors, reframing the struggle as a systemic issue rather than solely an individual one.
It is also important to include family members in psychoeducation. Helping them understand the nature of eating disorders and how their beliefs or comments may impact recovery can reduce shame, build empathy, and create a more supportive environment.
Reclaiming Asian American identity
Asian American clients often grow up navigating conflicting messages about who they are and who they’re supposed to be, creating a painful sense that being American and Asian cannot coexist. As clinicians, we must hold space for our clients to define their identities on their own terms. That starts with asking—not assuming—how culture and identity are showing up in their lives and in treatment. If a client expresses interest in reconnecting with their heritage, we can support that exploration by learning more about Asian American history, family traditions, and community narratives—affirming that reclaiming identity can be a meaningful and healing part of recovery.
Culturally-attuned boundary setting
For many Asian American clients, setting boundaries, especially with family, can feel deeply uncomfortable, even when it’s necessary for mental health and recovery. This discomfort is not due to a lack of assertiveness or people-pleasing tendencies, but rather reflects internalized cultural values rooted in collectivism. In the United States, boundary setting is often framed as essential to self-care, but for Asian Americans, this approach can evoke feelings of shame, guilt, or fear of disrupting familial dynamics.
Clinicians should take time to explore how clients feel about boundary setting, validate why it may be difficult, and gently uncover competing desires—such as the wish to speak up versus the desire to maintain peace. There are options to set internal or external boundaries with internal strategies such as visualization and relaxation techniques, breathwork, or progressive muscle relaxation to help reduce reactivity and foster as well as expressing the emotional impact and making a specific, respectful request. Framing boundaries as a way to preserve relationships, as opposed to rejecting them can help clients reimagine this practice as a path to deeper connection, rather than disconnection.
Available Assessments for Eating Disorders in Asian Americans
There are various assessments that can help in identifying and treating Asian Americans. Here are a few:
- Social Attitudinal familial and environmental acculturative stress scale (SAFE)
- Self-Construal Scale
- Subtle and Blatant Racism Scale for Asian Americans (SABR-AA)
- Gendered Racial Microaggression Scale for Asian American Women (GRMSAAW)
Resources:
Flawless: Lessons in Looks and Culture from the K-Beauty Capital by Elise Hu
SAMHSA: Racial/Ethnic Differences in Mental Health Service Use among Adults
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