Associations between Financial Strain, Eating Disorders, Body Appreciation, and Intuitive Exercise Among Black Americans

Background/Rationale:

Contrary to common perceptions of eating disorders (EDs) as occurring among wealthy individuals, lower socioeconomic status (SES) is linked to EDs (Burke et al., 2023). A disproportionately large number of Black Americans live below the poverty line (US Census Bureau, 2025), which places them at greater risk of financial strain (FS). Black individuals have similar incidence rates of EDs compared to their white counterparts (Cheng et al., 2019), though rates for Black populations may be underestimated due to bias in measurements (Kelly et al., 2012) and stereotypes in diagnosing (Gordon et al., 2002). Within-race gender comparisons reveal that for Black women, a drive for thinness is central to EDs while Black men experience greater excessive exercising behaviors (Yeboah et al., 2024).

Lower body appreciation predicts more frequent eating and body image disturbances (Linardon et al., 2022). Additionally, poor body appreciation is linked to increased depression (Ramseyer Winter et al., 2019). Greater body appreciation is correlated with intuitive exercise (Ramsey, 2018), a construct which measures non-disordered intent to engage in exercise (Reel et al., 2016).

Much of the literature on EDs in Black people involves only female participants. Research on the associations between EDs and FS is underdeveloped, as is literature on body appreciation and intuitive exercise in Black populations. The current study addresses these gaps by examining associations between FS and EDs, body appreciation, and intuitive exercise among Black men and women.

Methods/Methodology

Secondary data analysis was conducted using a cross-sectional survey of Black men and women in the United States (N=473). Study participants had to be at least 35 years old and have a Body Mass Index (BMI) of at least 25 to meet inclusion criteria.

The independent variable, SES, was measured using the Financial Strain Index (FSI; Hamby et al., 2011). A lower score indicates greater FS.

Dependent variables were ED symptoms, measured by the Eating Disorder Examination Questionnaire-13 (EDEQ-13; LevAri et al., 2020) which includes five subscales (Restricted Eating, Body Dissatisfaction, Shape and Weight Over-Evaluation, Binging, and Purging); body appreciation, measured with the Body Appreciation Scale-2 (BAS-2; Tylka & Wood-Barcalow, 2015); and intuitive exercise, measured with the Intuitive Exercise Scale (IEXS; Reel et al., 2016) which includes four subscales (Emotional Exercise, Body Trust, Mindful Exercise, and Exercise Rigidity).

Covariates were included in each multivariate linear regression model and included age, binary sex, and education level.

Results

FS significantly predicted overall EDEQ-13 score (B = -.20, p < .001), and shape and weight over-evaluation (B = -.17, p < .001), body dissatisfaction (B = -.23, p < .001), and binging (B = -.19, p < .001) subscales. FS significantly predicted body appreciation (B = .28, p < .001) and exercise rigidity (B = -.14, p = .01).

Conclusion

Black Americans facing FS are at higher risk of EDs, less likely to appreciate their bodies, and more likely to practice exercise rigidity. These are underdiscussed consequences of FS that social workers should know to improve the recognition of ED, body, and exercise disturbances.