Eating disorders do not discriminate – they impact many individuals with various intersectional identities, including those with LGBTQ+ identities. In fact, research has indicated that eating disorders disproportionately impact some segments of the LGBTQ+ community. 
Research suggests that LGBTQ+ identified people face unique stressors and challenges that likely put them at risk for developing eating disorders. According to the National Eating Disorders Association, these potential risk factors include: 
- Fear of rejection or experience of rejections by friends, family, and co-workers
- Internalized negative messages/beliefs about oneself due to sexual orientation, non-normative gender expressions, or transgender identity
- Experiences of violence and post-traumatic stress disorder (PTSD), which research shows sharply increases vulnerability to disordered eating
- Discrimination due to one’s sexual orientation and/or gender identity
- Being a victim of bullying due to one’s sexual orientation and/or gender identity
- Discordance between one’s biological sex and gender identity
Inability to meet body image ideals within some LGBTQ+ cultural contexts
The following are common myths about eating disorders in the LGBTQ+ population, followed by facts supported by current research (important note: eating disorder research in LGBTQ+ populations is sparse, much more research is needed in order to further explore disordered eating in the LGBTQ+ population).
Myth: Eating disorders are most prevalent in White women. Fact: Black and Latina LGBs have at least as high a prevalence of disordered eating as White LGBs. 
Myth: Lesbian women care less about their appearance than heterosexual women, and this serves as a protective factor against developing eating disorders. Fact: It is important to note that research is limited and conflicting on eating disorders among lesbian and bisexual women. While some research indicates that lesbian women experience less body dissatisfaction overall, other research suggests that lesbian women are more likely to compare their bodies to their female partner’s body and place more emphasis on their weight as a means of self-worth. [2, 3, 4]
Myth: Gay men are more likely to have an eating disorder than lesbian women. Fact: While it is true that disordered eating disproportionately affects the gay male population — as gay males are thought to only represent 5% of the total male population but among males who have eating disorders, 42% identify as gay — and that gay and bisexual men had a significantly higher prevalence of eating disorders when compared with heterosexual men (specifically, lifetime full syndrome bulimia, subclinical bulimia, and any subclinical eating disorder), gay men are not more likely to have an eating disorder when compared to lesbian women. In fact, when compared to gay men and transgender and non-conforming adults, lesbian women have the highest frequency of eating disorders. [1, 3]
Myth: Eating disorders are encouraged in gay communities. Fact: A sense of connectedness to the gay community was related to fewer current eating disorders, which suggests that feeling connected to the gay community may have a protective effect against disordered eating. 
Other statistics regarding eating disorders in the LGBTQ+ community include: 
- Transgender individuals experience disordered eating at rates significantly higher than cisgender individuals.
- In one study, gay and bisexual boys reported being significantly more likely to have fasted, vomited, or taken laxatives or diet pills to control their weight in the last 30 days. Gay males were 7 times more likely to report binging and 12 times more likely to report purging than heterosexual males.
- Females identified as lesbian, bisexual, or mostly heterosexual were about twice as likely to report binge-eating at least once per month in the last year.
- Elevated rates of binge-eating and purging by vomiting or laxative abuse was found for both males and females who identified as gay, lesbian, bisexual, or “mostly heterosexual” in comparison to their heterosexual peers.
Barriers to eating disorder treatment
LGBTQ+ people face unique treatment barriers, including difficulty finding eating disorder specialists (therapists, dietitians, physicians, and so on) who are knowledgeable about LGBTQ+ experiences and issues. LGBTQ+ people may also lack social support from family and friends as LGBTQ+ community supports can be sparse, leaving many LGBTQ+ people isolated.
Additionally, even when LGBTQ+ people who do have access to supports, such as LGBTQ+ youth drop-in centers, gay-straight alliances, LGBTQ+ community centers, and LGBTQ+ healthcare resources, these supports may not be trained in recognizing and/or treating eating disorders.
Therefore, it is important that mental and healthcare providers build cultural competency, including understanding LGBTQ+ experiences and issues, and for LGBTQ+ allies to build their awareness of eating disorders. 
1. National Eating Disorders Association. Learn: Identity & Eating Disorders – Eating Disorders in LGBTQ+ Populations. Retrieved from https://www.nationaleatingdisorders.org/learn/general-information/lgbtq on June 16, 2020.
2. Koh AS, Ross LK. Mental health issues: a comparison of lesbian, bisexual and heterosexual women. J Homosex. 2006;51(1):33-57. doi:10.1300/J082v51n01_03
3. Bell K, Rieger E, Hirsch JK. Eating Disorder Symptoms and Proneness in gay Men, lesbian Women, and Transgender and Non-conforming Adults: Comparative Levels and a Proposed Mediational Model [published correction appears in Front Psychol. 2019 Jul 10;10:1540]. Front Psychol. 2019;9:2692. Published 2019 Jan 8. doi:10.3389/fpsyg.2018.02692
4. National Eating Disorders Association. Learn: Statistics and Research on Eating Disorders. Retrieved from: https://www.nationaleatingdisorders.org/statistics-research-eating-disorders on June 16, 2020.
About the Author:
Chelsea Fielder-Jenks is a Licensed Professional Counselor in private practice in Austin, Texas. Chelsea works with individuals, families, and groups primarily from a Cognitive Behavioral Therapy (CBT) and Dialectical Behavior Therapy (DBT) framework.
She has extensive experience working with adolescents, families, and adults who struggle with eating, substance use, and various co-occurring mental health disorders. You can learn more about Chelsea and her private practice at ThriveCounselingAustin.com.
The opinions and views of our guest contributors are shared to provide a broad perspective on eating disorders. These are not necessarily the views of Eating Disorder Hope, but an effort to offer a discussion of various issues by different concerned individuals.
We at Eating Disorder Hope understand that eating disorders result from a combination of environmental and genetic factors. If you or a loved one are suffering from an eating disorder, please know that there is hope for you, and seek immediate professional help.
Published June 30, 2020, on EatingDisorderHope.com
Reviewed & Approved on June 30, 2020, by Jacquelyn Ekern MS, LPC