Understanding the relationship between sexual harassment and eating disorder psychopathology: A systematic review and meta‐analysis

Abstract

Objective The experience of sexual harassment (SH) may exacerbate the drive toward an ideal and often unattainable physical appearance, creating the foundation of unhealthy eating, and greater shape and weight concerns. This systematic review aimed to synthesize evidence on the relationship between SH and eating disorder psychopathology, as well as mediating and moderating factors that contribute to this relationship. Method Six key databases were searched from inception to August 2020; including CINAHL, PsycInfo, PubMed, Medline, Scopus, and Web of Science. Results Overall, 15 studies meeting inclusion criteria were found, with 14 reporting a statistically significant relationship between SH and eating disorder psychopathology. A meta‐analysis with 12 cross‐sectional studies confirmed a small but significant effect for this concurrent association. Moderators of this relationship included gender, posttraumatic stress, and anxiety. No studies in this review conducted true mediation. Discussion Conclusions about causal and mediating relationship between SH and eating disorder psychopathology are constrained by the preponderance of cross‐sectional design (14 of the 15 studies). Therefore, it is recommended that future studies focus on the use of longitudinal design, and also on adolescent populations, where first experiences of SH are usually reported, and which is also the peak age of onset for eating disorders.

Longitudinal relationship between experience of sexual harassment and 2-year body image and weight outcomes in adolescence: mediation through self-objectification and psychological distress

“…Consistent support for concurrent associations between sexual harassment and broad disordered eating pathology were identified, with self-surveillance/self-objectification, psychological distress and body shame all suggested to act as mediators on this relationship [see supplementary file, 5,[8][9]. The current study extended this research by investigating whether this relationship and its mediators are also found between sexual harassment and weight outcomes, and weight/shape concern in adolescents.…”

“…Finding no direct relationship between sexual harassment and future weight outcomes and weight/shape concern was inconsistent with previous research, which may be due to the longitudinal nature of the current paper and/or due to adolescence being a time of marked psychosocial development. Previous research has consistently found support that sexual harassment has a direct relationship with disordered eating pathology [ 9 ]. However, no study as far as we are aware to date had examined causal relationships in a longitudinal sample that also controls for baseline measures.…”

“…Experiences of sexual harassment have become common within society thus increasing the impact of their consequences [12]. Research consistently supports the concept that sexual harassment is directly associated with disordered eating pathology and that self-objectification and psychological distress have a concurrent role in this relationship [9]. However, no study to date has specifically investigated the contributing relationship of sexual harassment on weight outcomes, and weight/shape concern in adolescent population, nor potential mediators of this relationship.…”

“…Similarly, a cross-sectional paper found that sexual harassment was associated with higher levels of weight/shape concern regardless of gender in young adults [ 8 ]. A recent meta-analysis found sexual harassment was significantly associated with disordered eating pathology [ 9 ]. This review found only one longitudinal study, which was conducted on an early adolescent sample and found that sexual harassment was directly and indirectly related to global disordered eating pathology after 4 years, irrespective of gender [ 5 ].…”

“…In this context, women are socialised to view and treat themselves as an “object” and valued predominantly for their appearance, use or consumption by others [ 7 ]. Objectification theory has contributed to current understandings of the impact of sexual harassment on disordered eating pathology and body image concerns [ 7 ], with self-objectification, alongside psychological distress and body shame, found to be a significant mediator of the relationship between sexual harassment and disordered eating pathology [ 9 ]. This appearance-focused shift can result in striving towards unrealistic sociocultural appearance ideals (e.g.…”