Socioeconomic Factors and Body Image: A Systematized Review and Feminist Analysis

Background and Purpose: Body dissatisfaction is considered a normative discontent among women and is associated with numerous detrimental health consequences including eating disorders, depression, and poor sexual health outcomes. Body image disturbance and eating disorders have historically been characterized as most prevalent among wealthy women even though recent studies debunk this myth with estimates underscoring eating disorder prevalence across demographic groups. Social and cultural factors shape the affective and cognitive aspects of body image, but there has been insufficient examination of how socioeconomic status (SES) is conceptualized and operationalized in relation to body image, which is particularly important given body image is a crucial risk factor for eating disorders.

SES influences women’s food choices, physical activity, health care access, quality of education, and ability to invest in health and wellness resources, all of which may impact the way women think and feel about their bodies. A systematized literature review was conducted to better understand to what extent SES impacts negative body image and to promote a more social-justice-oriented approach to body image research, policy, and practice.

Methods: A systematized review was conducted to identify quantitative studies that reported a relationship between a body image measure and one or more socioeconomic indicators for women aged 18 or older. In consultation with a librarian, four databases (APA PsychInfo, Academic Search Complete, Psychology and Behavioral Sciences Collection, and SocIndex Full Text) were systematically scoped to gather studies written in English between January 2000 and February 2021. Only studies from Western, industrialized countries were included.

Results: The initial search yielded 926 articles. After a series of title, abstract, and full-text review stages, 26 studies met eligibility criteria. Samples included under-represented groups such as immigrant women, sexual minority women, and pregnant women, though most samples were predominately White and middle-aged. Studies were categorized into three groups: 1) studies reporting a positive association between body image and SES (n = 7), 2) studies reporting a negative association (n = 7), and 3) studies reporting a null effect. SES indicators included income, social class, occupation or employment status, wealth, and social mobility. Education was the most common SES indicator, but directionality varied across studies.

Conclusions and Implications: Overall, findings are mixed. It is likely that most women, regardless of SES, are influenced by objectification culture to think poorly about their bodies. However, studies largely lack an intersectional feminist perspective. Future research should explore how aspects of social identity and broader systemic factors interact with SES to affect body image. For example, studies might investigate whether race/ethnicity, gender identity, or disability status moderate the SES/body image relationship. Future research should also utilize population-based samples and incorporate SES measures at the individual, household, and neighborhood levels. Finally, interventions that prevent eating disorders and promote positive body image should be affordable, accessible, and start early in adolescence. Promoting body positivity in school-based programs, such as sex education and health promotion campaigns, can be cost-effective and support diverse young women’s healthy body image development.