Understanding the relationship between sexual harassment and eating disorder psychopathology: a systematic review and meta-analysis

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.