Rodgers Rachel R, Beccia Ariel L, Schaefer Lauren M, Hazzard Vivienne M, Burke Natasha L
APPEAR, Department of Applied Psychology, Northeastern University, Boston, USA; Department of Psychiatric Emergency & Acute Care, Lapeyronie Hospital, CHRU Montpellier, France; Unité de Recherche Clinique et d'Innovation, Hôpital du Cotentin, Cherbourg, France.
Division of Adolescent and Young Adult Medicine, Boston Children's Hospital, Boston, MA 02115, USA; Department of Pediatrics, Harvard Medical School, Boston, MA 02115, USA.
Clin Psychol Rev. 2025 Apr;117:102554. doi: 10.1016/j.cpr.2025.102554. Epub 2025 Feb 14.
Individuals with intersecting marginalized identities experience body image and eating pathology at disproportionately high rates. To date, research in this area has been limited by an absence of overarching and guiding frameworks to support hypothesis-driven research and interpretation of the findings. This constitutes an important barrier to the development of theoretically grounded intervention strategies. In this article, we review theoretical frameworks relevant to the investigation of body image and eating pathology among marginalized individuals using an intersectional lens and considering how processes of both risk and resilience unfold at multiple levels. We describe factors at the macrosystem (e.g., structural racism, capitalism, patriarchy), exosystem (e.g., food environment, social media, mass media), and microsystem (e.g., family, peers) levels. At the macrosystem level, we review critical race theories and those illuminating the role of systems that maintain power, privilege, and oppression, which describe how systemic discriminatory practices have led to marginalized individuals being neglected in efforts to conceptualize, identify, prevent, and treat body image and eating pathology. At the exosystem level, marginalized individuals experience heightened socioeconomic stressors and associated lack of access to resources that may impact body image and eating pathology. Furthermore, sociocultural theories focus on how visible marginalized identities are discriminated against, while white appearance ideals are upheld. At the micosystem level, we review sociocultural and minority stress theories that account for how interpersonal agents may perpetuate oppressive discourses and how marginalized individuals may experience negative interpersonal experiences that impact body image and eating pathology. We provide a comprehensive theoretical framework to guide future research on the distribution and determinants of inequities in body image and eating pathology among marginalized populations.
具有交叉边缘化身份的个体经历身体意象和饮食问题的比例极高。迄今为止，该领域的研究因缺乏支持假设驱动研究及研究结果解读的总体指导框架而受到限制。这构成了理论基础扎实的干预策略发展的一个重要障碍。在本文中，我们使用交叉视角来审视与边缘化个体身体意象和饮食问题调查相关的理论框架，并思考风险和复原力过程如何在多个层面展开。我们描述宏观系统（例如，结构性种族主义、资本主义、父权制）、外部系统（例如，食物环境、社交媒体、大众媒体）和微观系统（例如，家庭、同龄人）层面的因素。在宏观系统层面，我们回顾批判种族理论以及那些阐明维持权力、特权和压迫的系统作用的理论，这些理论描述了系统性歧视做法如何导致在概念化、识别、预防和治疗身体意象和饮食问题的努力中忽视了边缘化个体。在外部系统层面，边缘化个体经历更高的社会经济压力源以及随之而来的获取可能影响身体意象和饮食问题的资源的机会缺乏。此外，社会文化理论关注可见的边缘化身份如何受到歧视，而白人的外貌理想却得到维护。在微观系统层面，我们回顾社会文化和少数群体压力理论，这些理论解释了人际因素如何延续压迫性话语，以及边缘化个体如何经历影响身体意象和饮食问题的负面人际体验。我们提供一个全面的理论框架，以指导未来关于边缘化人群身体意象和饮食问题不平等现象的分布及决定因素的研究。
