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Eating Disorders in the LGBTQ+ Community

Eating Disorder Treatment in the LGBTQ+ Community 

Members of the LGBTQ+ community have an increased risk of developing an eating disorder compared to their straight and cisgender peers. Unfortunately, members of the community are also more likely to experience barriers to care than the general population, and without treatment eating disorders can have serious psychological consequences and lead to severe medical complications. Ensuring that your practice is a safe, identity-affirming place for LGBTQ+ patients is the first step in delivering high-quality care for this patient population.  

 

Risk Factors for the LGBTQ+ Community 

LGBTQ+ individuals experience greater levels of stress, discrimination, violence, bullying, social pressure to conform and higher levels of isolation compared to their straight and cisgender peers. These challenges make LGBTQ+ individuals more likely to experience mental health struggles, especially if their identity isn’t affirmed by their loved ones or they have experienced trauma. 

 

Lesbian and Bisexual Women 

Research is limited and conflicting on eating disorders among lesbian and bisexual women. While research indicates lesbian women experience less body dissatisfaction overall, research has also shown that there are no significant differences between heterosexual women and lesbians in the prevalence of any eating disorders.  

Lesbian, bisexual and mostly heterosexual females were about twice as likely to report binge eating at least once per month in the last year. Bisexual and questioning women in particular have been found to have higher rates of disordered eating compared to their lesbian and straight peers. 

Because of conflicting research, it is hard to determine the impact lesbian culture has on body image and whether they are more likely to reject heteronormative beauty ideals and accept diverse body types. 

 

Gay and Bisexual Men 

Men make up 15% of cases of anorexia nervosa, bulimia and binge-eating disorder, and up to 22% of young men turn to dangerous means to bulk up muscle with disordered eating behaviors. While men can suffer from an eating disorder, there still exists stigma and shame surrounding seeking treatment for an eating disorder. And when men do seek care, clinicians aren’t as quick to screen for eating disorders. Parents of teenage boys also might not as readily recognize eating disorder symptoms in boys, chalking things like significant weight loss and excessive exercise up to puberty. 

On top of being male, gay and bisexual men also face additional pressures both within and outside of the community to conform to certain body standards. Despite gay men only representing 5% of the total male population, among men who have eating disorders, 42% identify as gay.  

Gay men are seven times more likely to report bingeing and 12 times more likely to report bingeing than heterosexual men. Additionally, gay and bisexual boys report being significantly more likely to have fasted, vomited or taken laxatives or diet pills to control their weight in the last thirty days.  

The gay community is no different from broader society, with its own ideas of attractiveness and how that attractiveness is valued. Present in dating preferences and idealized body types, typically thin or muscular, gay and bisexual men may resort to eating disorder behaviors. Men with a desire for thinness may engage in restriction or bingeing and purging, while men with a desire for muscularity may excessively or compulsively exercise to boost their feelings of attractiveness and be validated in their community. 

 

Transgender People 

Transgender individuals may feel serious pressure from their family, friends or peers to “pass” (being perceived by people as the gender you identify as) in order to be validated. Passing may also be necessary for their own safety, as someone who does not pass may be identified as transgender and subsequently targeted for ridicule or discrimination, forcefully outed or become a victim of violence. 

As transgender individuals transition, they can also begin to internalize messaging about the idealized or stereotypical male or female body. Trans men may seek to have a more muscular build to conform to society’s expectation for men and masculinity, while trans women might desire a thin and delicate frame to conform to society’s expectation for women and femininity. 

Both of these factors can increase trans people’s risk of developing an eating disorder. About 16% of transgender individuals suffer from an eating disorder. Transgender individuals are also at a higher risk of suicidality, with 40% of transgender adults attempting suicide in their lifetime, compared to less than 5% of the general U.S. population. With suicide being a major cause of death for those with eating disorders, this makes transgender individuals with eating disorders particularly at-risk.  

 

Get Help for a Severe Eating Disorder 

If you or someone you care about is experiencing severe medical complications due to an eating disorder, ACUTE can help. Reach out to us today to learn more about medical intervention for severe and extreme eating disorders with our experts at ACUTE. With proper, identity-affirming and LGBTQ-competent care provided by experienced experts, we can help you restore your weight and regain your health. 

 

Related Articles 

 

Resources 

  • Burnette, C. B., Kwitowski, M. A., Trujillo, M. A., & Perrin, P. B. (2019). Body Appreciation in Lesbian, Bisexual, and Queer Women: Examining a Model of Social Support, Resilience, and Self-Esteem. Health Equity, 3(1), 238–245.  

  • FAQ: What is Passing? (2020, December 17). Teen Health Source. 

  • National Eating Disorders Association. (2012). Eating Disorders in LGBT (Gay/Lesbian/Bisexual/Transgender) Populations. https://www.nationaleatingdisorders.org/sites/default/files/ResourceHandouts/LGBTQ.pdf 

  • New survey on LGBTQ youth finds “concerning” disparities in suicide risk | NAMI: National Alliance on Mental Illness. (2021, May 19). National Alliance on Mental Illness. 

  • Young, R., & Paris, F. (2020, February 25). Gay Men More At Risk Of Eating Disorders, But Finding Community Can Be Hard | Here & Now. WBUR. 

 

    ACUTE Earns Prestigious Center of Excellence Designation from Anthem
    In 2018, the ACUTE Center for Eating Disorders & Severe Malnutrition at Denver Health was honored by Anthem Health as a Center of Excellence for Medical Treatment of Severe and Extreme Eating Disorders. ACUTE is the first medical unit ever to achieve this designation in the field of eating disorders. It comes after a rigorous review process.

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