Understanding Body Dissatisfaction in Ethnic Minority Women:
Do We Have an Incomplete Picture?
By Marisol Perez, PhD, FAED
Body dissatisfaction and disordered eating occur across women of diverse racial and ethnic identities. With this understanding has come an increase in research within the past two decades. However, the majority of this research focuses on generalizing existing theoretical models and assessments to women of racial and ethnic identities. Although this is informative and it is important to know the generalizability and universality of our theoretical models, a limitation is that we do not know to what extent our models are missing common symptoms and risk factors specific to non-White individuals. In the United States, 40 percent of the population is non-White (U.S. Census, 2019). A prominent theoretical model is the Tripartite Model of disordered eating, a model developed based on studies with predominantly White girls and women. This model proposes that the internalization of appearance ideals predicts body dissatisfaction and disordered eating (Thompson et al., 1999). Appearance ideals are the physical features or characteristics considered attractive within a culture (Thompson et al., 1999). Internalization of appearance ideals is the extent to which an individual subscribes to a culture’s appearance ideal and engages in behaviors to attain the ideal (Thompson et al., 1999).
The literature describes two appearance ideals: the thin ideal and the muscular ideal. The thin ideal is when a feminine physique appearing slender with a small waist and low body fat is attractive in a culture (Thompson et al., 1999). A myriad of experimental studies, as well as longitudinal and intervention research, documents thin ideal internalization as an impactful and significant risk factor for body dissatisfaction and disordered eating behaviors. The muscular ideal is another appearance ideal documented in the literature, in which a slender, toned, and fit feminine physique is attractive in a culture (Gruber, 2007). Although there is less research on the muscular ideal relative to the thin ideal, what does exist demonstrates an association between muscular ideal internalization and the pursuit of unhealthy behaviors and disordered eating behaviors.
Research studies examining the thin and muscular ideals consist of predominantly White samples. There is a small amount of research that supports the existence of another ideal among racial and ethnic minority women. The hourglass ideal is when a curvy body shape with bigger breasts and hips/buttocks and an indented waist is attractive in a culture. In a qualitative study, 16 Black women described a shapely and curvaceous body image as the ideal for their culture (Kelch-Oliver & Ancis, 2011). Similarly, 27 Latina adolescents endorsed a slender but curvy body shape as the cultural appearance ideal (Romo, Mireles-Rios, & Hurtado, 2016). Another study with a diverse sample of women found that some subscribed to a thin ideal and some subscribed to an hourglass ideal, while others subscribed to both (Hunter et al., 2020).
Our research supports the existence of an hourglass appearance ideal and its association with body dissatisfaction and disordered eating. We conducted two studies: the first with 916 women of racial and ethnic minority identities, between the ages of 18 and 48 years old, recruited from the community; the second with 195 undergraduate women of diverse racial and ethnic minority identities. We assessed hourglass ideal internalization through a six-item self-report questionnaire featuring a score range of 1 to 5, with higher scores indicating more internalization. Interestingly, 88 percent of the entire sample reported some endorsement of hourglass ideal internalization. High levels of hourglass ideal internalization were reported by 23.2 percent of women with Asian American identities, 20.4 percent of women with Black identities, and 21.4 percent of women with Hispanic/Latinx identities. It’s important to note that hourglass ideal internalization was associated with body dissatisfaction and disordered eating behaviors. Across all racial/ethnic groups, women who endorsed more hourglass ideal internalization also reported more body dissatisfaction. Women who reported more hourglass ideal internalization also reported more impairment in daily functioning as a result of body shape and weight concerns. Further, those who reported endorsing the hourglass ideal with another ideal, such as the thin or muscular ideal, had higher body dissatisfaction and more severe disordered eating behaviors than those who reported just one ideal.
Do We Have an Incomplete Picture? The answer is yes. Collectively, studies with women and girls of racial and ethnic identities report a third appearance ideal absent in the body dissatisfaction and disordered eating literature. Similar to other appearance ideals, the hourglass ideal relates to body dissatisfaction and disordered eating behaviors among women of racial and ethnic minority identities. These findings have important implications. First, current theoretical models such as the Tripartite Model of disordered eating need refinement to include an hourglass ideal internalization to better represent women from diverse cultures. However, future research needs to examine the extent to which the type of appearance ideal internalization matters. It may be that the presence of an ideal, regardless of what it is, contributes to body dissatisfaction and the pursuit of unhealthy behaviors to attain the ideal. In that case, whether a woman endorses a thin versus a muscular versus an hourglass ideal becomes less relevant. Second, body acceptance interventions need to be adapted for women of racial and ethnic identities. In a study of clinicians treating Hispanic/Latinx women with eating disorders, all clinicians reported not using the body image modules from treatment manuals because they did not apply to their patients (Josephs et al., under review). Body acceptance interventions focus only on the thin ideal; adapting these interventions to apply to an hourglass ideal may be more efficacious. Third, research needs to examine the unhealthy behaviors common to both thin and hourglass ideal internalization and those unique to each ideal internalization. Body dissatisfaction and disordered eating measures require adaptation to incorporate the unhealthy behaviors pursued as a result of an hourglass ideal internalization. It is important to note that women of racial and ethnic identities can endorse thin and muscular ideals. Indeed, in our studies, there was evidence of all possible combinations: women who endorsed thin ideal internalization only, women who endorsed muscular ideal only, women who endorsed hourglass ideal only, women who endorsed all three, women who did not subscribe to any ideal, etc. Thus, our main point is that adding hourglass ideal internalization provides a more complete picture of the development of body dissatisfaction in women of racial and ethnic identities.
About the author:
Dr. Marisol Perez is an Associate Professor in the Department of Psychology at Arizona State University. Her research explores the genetic, biological, psychophysiological, cultural, and environmental underpinnings of body image and eating behavior in its development towards unhealthy lifestyles. The majority of her research focuses on individuals with racial and ethnic identities. Dr. Perez comes from a Cuban immigrant family. She was the first generation in her family to go to college and graduated with a bachelor’s degree from University of Miami in Florida. She obtained her master’s and doctoral degrees from Florida State University in clinical psychology.
Gruber, A. J. (2007). A More Muscular Female Body Ideal. In J. K. Thompson & G. Cafri (Eds.), The Muscular Ideal: Psychological, Social, and Medical Perspectives (p. 217-234). American Psychological Association. DOI: 10.1037/11581-011
Josephs, J., Perez, M., Trujillo, E., & Ramirez, A. L. (under review). Use of Cognitive Behavioral Therapy with Spanish-Speaking Clients Suffering from Eating Disorders.
Kelch-Oliver, K. & Ancis, J. R. (2011) Black Women’s Body Image: An Analysis of Culture-Specific Influences. Women & Therapy, 34(4), 345-358. DOI: 10.1080/02703149.2011.592065
Romo, L. F., Mireles-Rios, R., & Hurtado, A. (2016). Cultural, Media, and Peer Influences on Body Beauty Perceptions of Mexican American Adolescent Girls. Journal of Adolescent Research, 31(4), 474-501. DOI: 10.1177/0743558415594424
U.S. Census Bureau QuickFacts. (2019). Race and Hispanic Origin Survey. U.S. Census Bureau. https://www.census.gov/quickfacts/fact/table/US/PST045219