Eating Disorders Bigger Challenges for the LGBTQ Community

During this time of the year, families and friends gather together to celebrate a plethora of holidays. And, in doing so, food may be a central figure in these get togethers.

However, for those who are eating disordered, such as individuals with bulimia, anorexia, binge/purge eating, among others, the season may be one that presents discomfort, anxiety and possibly a need to withdraw.

In the LGBTQ community, incidents of eating disorders are far higher than those among the straight sector.

National Eating Disorders Association's (NEDA) reports that 42 percent of men who have eating disorders are gay, and gay and bisexual men are seven times more likely to binge, and 12 times more likely to purge than heterosexual men.

In addition, the LGBTQ community has been impacted by the rise of trends such as extremely healthy and clean eating, which can lead to orthorexia, as well as an obsession with fitness and compulsive exercising, she said.

Myra Hendley, primary therapist at Eating Recovery Center, The Carolinas, added more to the healthcare risk narrative. When asked if the demographic of those with eating disorders and who identify as LGBTQ, if there was more evidence that it affects females more than males, she shared, "More often than not, I see women who present in treatment for an eating disorder and report they are a sexual minority. The Journal of College Counseling published an article in 2013 identifying that sexual minority women report higher levels of eating concerns, trauma, anxiety and depression. However, when I treat a male with an eating disorder, I would venture to say they almost always mention gender or sexuality confusion." She added that NEDA also reported that in the U.S., 20 million women and 10 million men will suffer from an eating disorder. These numbers reflect only those who are open to reporting their illness and have a clinically significant illness. "I imagine LGBT males underreport their illness in order to maintain a physical stereotype and generally ask for help less than women in the US culture."

When asked if there was any evidence that there is a higher number in those 15-25, as opposed to those in the 25-35, 35-50, 50-65, 65 and older groups, she added, "Eating disorders present in all ages. As a whole, more and more older people present with eating disorders than commonly suspected. Research is available for this topic, but in the demographic of those with eating disorders who identify as LGBT, there is less reviewed evidence about age prevalence. NEDA reports body dissatisfaction in lesbian women presents as early as age 12, LBGTQ youth are at a higher risk for binge eating and purging and in ages 18-19 there is more evidence of bulimia symptoms than in older populations. When treating patients who identify as LGBTQ, the greater part of my practice has been with ages 15-25 as opposed to those in the 25-35, 35-50, 50-65, 65 and older. I would add that generally eating disorders are presenting in treatment in that age range in general, not just in the LGBT population."

Hendley asserted that the leading cause among the LGBT community is three-fold. "First, many patients who have an eating disorder have experienced trauma and are likely to hide events in their past that lead to the genetically-predisposed onset of an eating disorder. The second is family of origin influence. If a person is part of a non-supportive system, they are likely to develop mal-adaptive coping skills to deal with anxiety and depression that can manifest as an eating disorder. Lastly, weight stigma in society coupled with temperament predisposition often results in an eating disorder." She added, "If one is able to think of an eating disorder symbolically, they will gain insight to why the LGBTQ population presents for eating disorder treatment. Simply put, an anorexic patient may hide their self or who they are and then resort to restricting their food and shrinking away to nothing, oppressed in society. Likewise, a bulimic patient or a binge eating disorder patient may seek to fill the void of social acceptance and begin their novelty seeking track that leads to a cycle of binging and purging."

Also, gay male image can result in thinking one is too thin or too heavy. Hendley said, "Body image and self-image are often highly important for gay males as they play into their susceptibility to developing an eating disorder. These also affect their day-to-day life and social interaction with others, whether they are too heavy or too thin." She also shared, that the lack of cultural sensitivity to LGBTQ individuals "permeates" America in general, despite the recent political and social progress, "never mind the physical stereotypes assigned to them."

She asked a patient in her practice about eating disorders in the LGBTQ community and they responded, "I think that gay men have it tough because they have a lot of pressure to be thin." Hendley is in agreement and "unfortunately" thinks this is perpetuated in media and society. She added, "NEDA reports that gay men are disproportionately identified as having poor body image to other populations." Gay men represent only five percent of the population, but [NEDA stated that] 42 percent of those men have eating disorders. "One can only assume this shocking statistic supports the assumption that body dissatisfaction is highly prevalent and socially noticed in the gay male community leading to eating disorder behaviors to change dissatisfaction," she concluded.

For more information or to speak to a Masters-level clinician, call the ERC at 877-789-5758, email [email protected] or visit eatingrecoverycenter.com.