Acculturation and eating disorders: a systematic review

Abstract

Purpose Acculturation, or the dual process of cultural change that takes place due to the interaction between two or more cultural identities, may contribute to the susceptibility of developing an eating disorder (ED). We conducted a systematic review exploring the relationship between acculturation-related constructs and ED pathology. Methods We searched the PsychINFO and Pubmed/Medline databases up to December 2022. Inclusion criteria were: (1) having a measure of acculturation or related constructs; (2) having a measure of ED symptoms; and (3) experiencing cultural change to a different culture with Western ideals. 22 articles were included in the review. Outcome data were synthesized by narrative synthesis. Results There was variability in the definition and measure of acculturation in the literature. Overall, acculturation, culture change, acculturative stress, and intergenerational conflict were associated with ED behavioral and/or cognitive symptoms. However, the nature of the specific associations differed depending on the specific acculturation constructs and ED cognitions and behaviors measured. Furthermore, cultural factors (e.g., in-group vs. out-group preferences, generational status, ethnic group, gender) impacted the relationship between acculturation and ED pathology. Discussion Overall, this review highlights the need for more precise definitions of the different domains of acculturation and a more nuanced understanding of the specific relationship between various acculturation domains and specific ED cognitions and behaviors. Most of the studies were conducted in undergraduate women and in Hispanic/Latino samples, limiting generalizability of results. Level of evidence Level V, Opinions of respected authorities, based on descriptive studies, narrative reviews, clinical experience, or reports of expert committees.

Weight-related eating among Latino college students.

“…These studies have focused on diet (e.g., consumption of fast food), and it might be that acculturation interplays with diet content differently than with eating patterns. Additionally, health research among minorities is plagued by discrepant operational definitions of acculturation (Schwartz et al, 2010; Song et al, 2023). Many studies have used singular definitions, such as English-language use, to assume acculturation despite the multifaceted nature of acculturation and enculturation.…”

“…The results provide support for the research of variables similar to acculturation but are perhaps less overarching. The nature of the relationships between acculturation and eating-disorder symptoms depends upon the specific acculturation-related constructs of interest (Song et al, 2023). Acculturative stress and internalization of mainstream Western ideals, for instance, are related to eating and body image in Latino college students (e.g., Warren & Rios, 2013).…”

“…For example, although acculturation appears to have no relationship with bulimic symptoms and compensatory behaviors, there is conflicting evidence for a relationship between acculturation and disinhibition, overeating, or food addiction; this research, however, has mostly studied Latina college students. (Song et al, 2023). Knowledge about acculturation, enculturation, and eating is far from robust-and is almost nonexistent for Latino college students.…”

“…Only one study investigated enculturation in Latino college students and found no relationship with body image (Warren & Rios, 2013). Song et al’s (2023) reviewed of acculturation and eating-disorders research highlights the inconsistent nature of recent findings. For example, although acculturation appears to have no relationship with bulimic symptoms and compensatory behaviors, there is conflicting evidence for a relationship between acculturation and disinhibition, overeating, or food addiction; this research, however, has mostly studied Latina college students.…”