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The cultural contribution to psychopathology may become more salient in situations of social change, but it remains difficult to distinguish individual agency among wider social and economic transitions, such as ‘modernization’ or simply ‘culture change’, which carry the potential for recourse to new patterns. Eating disorders, a biosocial pattern once identified exclusively with European societies, do occur among South Asian women including those living in the West. This seems not just a simple appropriation of contemporary Western ideals of female morphology — the ‘fear of fatness’ — but a reassertion of an instrumental strategy of self-renunciation in situations of experienced constraint.