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LGBTQIA+ and Disordered Eating

Given that it is the month of June, and Dublin Pride is this weekend - I wanted to do a special edition blog. However, I didn’t feel like I could do it justice myself, so I wanted to bring in an expert. Welcome, Michelle Carrol. Michelle has an abundance of knowledge in the area of disordered eating and body image - so much so she is doing a PhD in Clinical Psychology in that exact area. I hope you enjoy the read and take lots from it! 




Members of the LGBTQIA+ community are more likely to be affected by eating disorders than their Joe Rogan-listening, straight, cisgender counterparts. Let’s discuss why, and what we can do to minimise this risk…


What is disordered eating?

Researchers have defined disordered eating as “unhealthy eating behaviours”, that don’t meet the criteria for a clinical eating disorder (Reba-Harrelson et al., 2013). Disordered eating involves an unhealthy relationship with food, and it exists on a spectrum, which can be seen below:

Note: Just because you have disordered eating doesn’t mean you have a clinical eating disorder. But, if you are concerned that you do, please check the Bodywhys website for further information (https://www.bodywhys.ie/).


What causes disordered eating?

There are lots of causes of disordered eating, and they include:

  • Genetics/biology – some people are more likely to have DE, for example those who identify as female.

  • Body image issues – societal beauty standards, pressure to “look a certain way”, body dissatisfaction

  • Dieting or a history of dieting

  • Stress

  • Depression/anxiety


LGBTQIA+ & Disordered Eating Risk

Members of the LGBT community are at risk of disordered eating, as they face many unique pressures and risk factors. 

This is typically explained in research using the minority stress model (MSM). The minority stress model posits that LGBT populations experience unique stressors and pressures that cisgender, heteronormative individuals do not. 


Examples of these stressors include:

  • Internalised homophobia/transphobia

  • Hiding your sexual or gender identity

  • Verbal or physical abuse from others about your gender or sexual identity

  • Discrimination (Parker and Harriger, 2020)


All of these stressors increase the risk of damage to an individual’s mental health, leading to depression, anxiety and risk of mental illness such as an eating disorder (https://jeatdisord.biomedcentral.com/articles/10.1186/s40337-020-00327-y).


Of course, the minority stress model is only one of the factors that influence DE risk amongst the LGBT community – but it is important to highlight the impact of being a minority on an individual’s relationship with food, as research suggests that eating disorders and disordered eating behaviours are more common in LGBT individuals compared to heterosexual and cisgender individuals. 


Here are some horrifying statistics to keep you up at night:

  • Research estimates 54% of LGBT adolescents receive an ED diagnosis within their lifetime

  • An additional 21% estimate they had an ED at some point in their life (The Trevor Project)

  • One study found that over 50% of LGBT youth experience weight-based discrimination and bullying from their family and peers (Himmelstein et al., 2019)


Not LGBTQ+ “Enough”

There are also many pressures that come from within the LGBTQ+ community – because it’s not enough to be “queer” anymore, it’s about being queer the “right” way, and LGBTQ+ individuals face a whole checkbox list of how they should look and move through the world. Obviously, this is a huge yikes for our relationship with food and our bodies.


Here are four delightful themes that popped up when researchers asked LGBTQ+ people about their experiences with appearance pressure and body image issues:


  1. You are the Captain stereotype now.  Many queer individuals feel a pressure to conform to a new ideal, be that the “gay ideal” or “woman”, with a specific look. It’s still a beauty standard, just with a pride flag slapped on it. You thought coming out meant escaping societal boxes? Think again! Many LGBTQ+ people feel pressured to fit into new ones. Gay men, for instance, are supposed to be lean, muscular, and tan, all the time. If you’re not serving GQ cover realness at brunch whilst quoting Drag Race are you even gay?

  2. Intersectionality. Sexuality and gender identity don’t just get a say in appearance pressures – race and ethnicity also play a role. This results in another layer of beauty standards to keep up with and juggle like some deranged circus clown.

  3. Community spaces: LGBTQ+ spaces can be a sanctuary… or a runway. Some people find acceptance and body positivity in queer circles. Others find... a toned, curated, Instagram-ready nightmare where everyone’s pretending they don’t judge you for having a normal human body. Cheers to “inclusivity” and “accepting yourself as you are”.


This is really important to be mindful of – especially because body dissatisfaction and body image pressures/issues are one of the biggest drivers of eating disorder risk (Sharpe et al., 2018).


What can we do?

It’s not enough to plaster a rainbow sticker on your relationship with food issues and say “every body is beautiful”. Here’s how to support yourself and your relationship with food.


Stop equating body size to health

You cannot tell someone’s health, happiness, or worth by looking at their body, or their plate. Many LGBTQ+ individuals grow up receiving messages that their bodies need to be “fixed” to be accepted. That toxic thinking often shows up in disordered eating… and shifting away from making appearance a key measure of your worth as a person is a great start.


Diversify your social media feed

We can’t say “representation matters” and expect to like our bodies if our feeds are only full of Instagram-perfect fitness models. So much nutrition advice assumes everyone is cisgender, straight, and already feels safe in their body. It can be helpful to diversify the accounts that you follow on social media – and follow people of all shapes, sizes, races and gender expression. 


Watch out for community-specific pressures

Certain LGBTQ+ subcultures can push appearance standards (e.g., “Twink,” “Bear,” “Femme,” etc.) and this can come with eating behaviours that aren’t always healthy. Fitting in can sometimes come with a side of restriction, bingeing, or over-exercising. Before you decide to diet or change your appearance, it can be helpful to ask yourself – am I doing this to feel enough? Will changing my body really make me feel more worthy?


Know the warning signs of disordered eating

Watch out for when your relationship with food may have taken a turn for the unhealthy. Look out for things like food guilt, obsessing about macro/calorie counts or scale weight, binge eating and strict rules around eating. 


Conclusion

Members of the LGBT community are at higher risk of disordered eating behaviours (thanks society!) compared to their heterosexual, cisgender counterparts. It is important that you are aware of some of the pressures and challenges you face in building a positive relationship with food and your body, and do your best to support yourself in overcoming them.


I know I personally got s much from that blog, so I'm sure you did too. Thank you so much to Michelle for putting it together! If disordered eating or body image is an area you struggle with yourself or would like to learn more about, make sure you are following Michelle on Instagram @michellecarroll1 where she puts out a plethroa of content in the area!


Resources:


References

  • Himmelstein MS, Puhl RM, Watson RJ. Weight-based victimization, eating behaviors, and weight-related health in sexual and gender minority adolescents. Appetite. 2019;141. https://doi.org/10.1016/j.appet.2019.104321.

  • Parker, L.L., Harriger, J.A. Eating disorders and disordered eating behaviors in the LGBT population: a review of the literature. J Eat Disord 8, 51 (2020). https://doi.org/10.1186/s40337-020-00327-y

  • Reba-Harrelson L, Van Holle A, Hamer RM. Patterns and Prevalence of Disordered Eating and Weight Control Behaviors in Women Ages 25-45. Eat Weight Disord. 2013;14:190-198.

  • Sharpe H, Griffiths S, Choo TH, Eisenberg ME, Mitchison D, Wall M, Neumark-Sztainer D. The relative importance of dissatisfaction, overvaluation and preoccupation with weight and shape for predicting onset of disordered eating behaviors and depressive symptoms over 15 years. Int J Eat Disord. 2018 Oct;51(10):1168-1175. doi: 10.1002/eat.22936.

  • The Trevor Project, National Eating Disorders Association, & Reasons Eating Disorder Center (2018). Eating Disorders Among LGBTQ Youth: A 2018 National Assessment. Retrieved from https://www.nationaleatingdisorders.org/sites/default/files/nedaw18/NEDA%20-Trevor%20Project%202018%20Survey%20-%20Full%20Results.pdf.


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