Eating Disorders in LGBTQ+ Individuals

Girl on bench considering ED treatment

The stigma and prejudice that LGBTQ+ individuals experience can severely impact their mental health and well-being. This is seen in the unfortunately high rate of LGBTQ+ individuals being diagnosed with mental illness and eating disorder.

The Minority Stress Model (MSM) is often referred to when considering the impact of stigma on LGBTQ+ individuals. It posits that they “experience unique distal stressors, such as stigma and discrimination, and proximal stressors, such as internalized homophobia or transphobia and concealment of sexual or gender identity, which in turn lead to increased risk for the development of physical and mental health issues [1].”

A recent study considered how these factors impact eating disorder beliefs and behaviors in the specific minorities of adults and adolescents that identify as lesbian, gay, bisexual, or transgender.

Lesbian Populations

Of all sexual minorities, the rates of eating disorders among lesbians are the least consistent [1]. One study found that 34.7% of lesbians surveyed had been diagnosed with an eating disorder. An additional 66.7% had significant clinical risk factors for eating disorders [1].

Compared to heterosexual men and women, adult and adolescent lesbians had “significantly higher incidences of disordered eating behaviors [1].” Additionally, 82% of lesbian adults base their self-worth on their weight, and “adult lesbians had lower self-esteem and greater feelings of ineffectiveness, interpersonal distrust, and difficulties identifying their emotions than heterosexual women did [1].”

Gay Populations

Many studies have found gay men more likely to suffer from a clinical eating disorder than heterosexual men [1]. Additionally, “gay adults reported more frequent dieting and greater dietary restraint, more binge eating, less control over their eating behaviors, more purging, and more exercise than heterosexual men [1].”

Gay men have also been found more likely to exercise with the intention of losing weight, fasting, bingeing, purging, using diet pills, or restrictive eating [1]. These individuals also report greater body dissatisfaction.

Further, “discrepancy between current body shape and the body shape they believed they should have to attract a partner was significantly greater than their current body shape and ideal body shape. This discrepancy is associated with greater eating, shape, and weight concerns, suggesting that beliefs of partner body image preferences contribute to disordered eating behaviors in gay adults [1].”

Bisexual Populations

Girl in the LGBTQ+ community who struggles with eating disorderThis population has been studied much less than lesbian and gay populations. However, there is evidence to support increased disordered eating behaviors, particularly binge eating and purging, in bisexual individuals [1].

In fact, some studies have found higher rates of eating pathology in bisexual individuals. Studies also indicate that, unlike their heterosexual peers, bisexual adolescents fasting, purging, and diet pill behaviors do not show improvement over time [1].

Bisexual individuals have been found to have greater body dissatisfaction, and bisexual adolescent males were more likely to view themselves as “overweight” or “obese” despite having an “average” BMI [1].

Transgender and Gender Non-Conforming Populations in the LGBTQ+ and Eating Disorder

Individuals who identify as transgender, particularly transgender youth, have disordered eating rates higher than those of their cisgender counterparts [1]. One study found that 70% of the transgender and gender non-conforming adult participants reported dissatisfaction in their eating patterns, and 67.2% reported basing their self-worth on their weight status [1].”

Body dissatisfaction is a common issue among individuals that identify as transgender or gender non-conforming, particularly if there is a greater discrepancy between their external appearance and internal identity. These individuals have also been found to experience a great drive for thinness than their cisgender counterparts.

Varying Risk Factors for LGBTQ+ members for Eating Disorder

The study examined numerous risk factors related to the development of eating disorders among LGBTQ+ individuals, categorizing them based on risk factors related to sexual orientation, relationship dynamics, mental health, demographics, gender attitudes, intrapsychic functioning, and body image.

Truly, the list of risk factors is extensive, providing evidence that the unique experience of LGBTQ+ individuals can do a great deal to impact their mental health functioning and make them vulnerable to disordered eating.

Each individual LGBTQ+ minority has varying risk factors that may relate to their sexual or gender identity. I would encourage anyone interested to read this article in-full to gain a comprehensive understanding of these factors. Considering this is crucial to treating those in the LGBTQ+ community.


Resources:

[1] Parker, L. L., Harriger, J. A. (2020). Eating disorders and disordered eating behaviors in the LGBT population: a review of the literature. Journal of Eating Disorders, 8:51.


About the Author:

Image of Margot Rittenhouse.Margot Rittenhouse, MS, PLPC, NCC is a therapist who is passionate about providing mental health support to all in need and has worked with clients with substance abuse issues, eating disorders, domestic violence victims, and offenders, and severely mentally ill youth.

As a freelance writer for Eating Disorder Hope and Addiction Hope and a mentor with MentorConnect, Margot is a passionate eating disorder advocate, committed to de-stigmatizing these illnesses while showing support for those struggling through mentoring, writing, and volunteering. Margot has a Master’s of Science in Clinical Mental Health Counseling from Johns Hopkins University.


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 November 13, 2020, on EatingDisorderHope.com
Reviewed & Approved on November 13, 2020, by Jacquelyn Ekern MS, LPC

About Baxter Ekern

Baxter is the Vice President of Ekern Enterprises, Inc. He is responsible for the operations of Eating Disorder Hope and ensuring that the website is functioning smoothly.