Individuals with minoritized and intersecting identities in the prevention of body image and eating disorder pathology: Grounding theoretical frameworks of resilience and risk

Abstract

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.