LGBTQ

LGBTQ Youth & Eating Disorders - River Centre Clinic

Why Are Eating Disorders More Common in the LGBTQ Community?

Eating disorders have long been a problem in the United States. These disorders have been part of the psychiatric literature for many years. In recent decades, psychiatrists and other healthcare professionals have allocated more time and resources towards the study, treatment and prevention of these disorders. Recent studies are attempting to explain a particular pattern of eating disorders in U.S. society. Researchers have found that more than half of young LGBTQ people between the ages of 13 and 24 have been diagnosed with an eating disorder.

Both the National Eating Disorder Association (NEDA),  and The Trevor Project, (LGBTQ suicide prevention organization) state that the report is based on online surveys of 1,034 young people. Among the 46 percent of LGBTQ youth who were surveyed and had never been diagnosed with an eating disorder, 54 percent reported that they at some point suspected they suffered from an undiagnosed eating disorder. Out of all the survey’s respondents, 75 percent said they had either been diagnosed with an eating disorder or suspected they had one at some point in their life. This research displays the need for additional studies in this area.

The most common disordered eating behavior from the survey was skipping meals and eating very little food in general. Not surprisingly, anorexia nervosa was the most prevalent eating disorder. The data also displayed a correlation between young LGBTQ individuals with eating disorders and suicide. Out of the individuals who had been diagnosed with bulimia, a shocking 96 percent had considered suicide. On a similar note, 66 percent of survey respondents who had stated that they had considered suicide already had been diagnosed with an eating disorder.

An earlier study in 2007 had explored at the prevalence of eating disorders in lesbian, gay and bisexual men and women. Part of the research examined associations between participation in the LGBTQ community and eating disorder prevalence in gay and bisexual men. The research was not clear as to why there was a high prevalence of eating disorders among gay and bisexual men. Researchers in this study found that gay and bisexual men had a significantly higher incidence of eating disorders when compared to heterosexual men.

Studies in 2007 were the first to assess DSM diagnostic categories, gay and bisexual men had a significantly higher prevalence of lifetime full syndrome bulimia, subclinical bulimia, and any subclinical eating disorder. At the time, gay men are thought to only represent 5 percent of the total male population in the United States. Yet, for males who have been diagnosed with an eating disorder, 42 percent of them identify as gay. For people who identified as gay, lesbian, bisexual or mostly heterosexual, they possessed binge eating, purging and laxative abuse rates that were much higher than their heterosexual peers. Data shows that for LGBTQ youth, as early as age 12, they are at a higher risk of engaging in disordered eating behavior.

So why is there a higher occurrence of eating disorders in the LGBTQ community?

Some researchers argue that because of stress from living as a minority, unhealthy eating habits are more common in the LGBTQ community. Eating behaviors such as binge eating and anorexia nervosa are symptoms of the general social stress that LGBTQ individuals experience as minorities. Thankfully, new studies and technology are making it easier to understand the physical impulses that surround unhealthy eating behaviors. Also, a broader acceptance of LGBTQ people in American culture should hopefully lower this statistic. The election of the first openly gay governor in Colorado shows that U.S. society is changing.

However, there are still unique stressors that people in the LGBTQ community are forced to face every day. These stressors create higher levels of anxiety and depression. This, in turn, can encourage unhealthy coping mechanisms that creates eating disorders and/or substance abuse. Some of the stressors that may encourage the development of eating disorders include:

  • Internalizing negative messages.
  • Living in fear from being harassed which can develop into PTSD.
  • Stress from discrimination.
  • Living as a runaway and/or experiencing homelessness.

Healthcare professionals who have direct experience with diagnosing and treating eating disorders can help people successfully recover from an eating disorder infliction. For additional information or questions about bulimia and anorexia, please contact the staff at River Centre Clinic (RCC). Their Eating Disorders Programs provide a full range of treatment options for both adolescents and adults. Their facility is located Northwest Ohio in the town of Sylvania, OH.

Follow on Twitter:  @River_Centre

LGBTQ, Eating Disorders, Anorexia Nervosa
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LGBTQ+ and Advice to Eating Disorder Treatment Providers

Guest contributor:  Lee R.

When asked to write this blog post, I turned immediately to my good friend Google to look up some statistics and check out the latest research. What I found, or what I did not find, was revealing, albeit not entirely surprising to me. Google Scholar turned up 1,360 results for the search “LGBT eating disorder” in the last 10 years, whereas simply “eating disorder” racked up over 59,000 hits for the same time period.

It is not clear whether or not the LGBTQ+ (Lesbian, Gay, Bisexual, Transgender, Queer/Questioning, etc.) community is underrepresented in eating disorder research, but it certainly is not prominent, appearing in only 2.3% of the research references. But that should not be interpreted as meaning that the disease does not impact the LGBTQ+ community. In fact, it’s quite the opposite.

The Trevor Project and NEDA (National Eating Disorder Association) came together in 2018 to research the prevalence of eating disorders in LGBTQ+ youth1 and the results were staggering. About 54% of the sample had been diagnosed with an eating disorder, and an additional 21% suspected they had an eating disorder due to disordered eating habits. In another study2, it was found that nearly 16% of transgender college students had been diagnosed with an eating disorder in the past year, as opposed to approximately 2.5% of their straight, cisgender counterparts.

Though the research on LGBTQ+ eating disorders is scarce, what does exist speaks volumes. Eating disorders run rampant through this community, yet it is rarely spoken about in the LGBTQ+ community itself, and even less frequently in the mainstream eating disorder treatment community. Where there is currently silence, there needs to grow a discussion on how LGBTQ+ eating disorders develop and progress, how they present, and the best treatment modalities to help sufferers receive the best care possible.

That is not to say that mainstream providers cannot appropriately serve the LGBTQ+ community. However, if providers were educated specifically on how eating disorders impact the LGBTQ+ community, there may be an even greater success rate for recovery. As a start, here are 5 things I, and a few others in the community, wish treatment providers were more aware of:

  1. Gender dysphoria exists and can make it difficult for a person to live in their own body. Gender dysphoria is the feeling of distress that occurs when someone’s gender does not match the one they were assigned at birth. It can often focus on specific parts of the body that society reads as one sex or another. It can result in restriction of food, compensatory behaviors, or binge eating. Providers need to be aware of gender dysphoria, because of the added complications to recovery. Poor body image or body dysmorphia is not the only physical hurdles in those who experience gender dysphoria. Additionally, gender dysphoria is not necessarily due to poor body image, though one may trigger the other.
  2. Internalized homophobia is also a thing that exists. Internalized homophobia refers to the prejudices that members of the LGBTQ+ community turn inward after seeing and hearing the prejudices in society. This can lead to negative views and even shame of their own sexuality. This shame and negativity can then lead to further flawed thinking and disordered eating habits.
  3. Language is important. Using my pronouns is not just a suggestion. While I’ll probably present it as a timid request and tell you “it’s fine” when you mess them up, my pronouns are actually very important to me. They help me feel more at peace with who I am, especially in such a tumultuous time as the beginning stages of eating disorder recovery. By using the correct pronouns for me, you not only convey that you respect who I am, you also help me build trust and rapport. Additionally, using gender-neutral language is imperative. People of all genders can have eating disorders, using female-centric language is outdated. Help everyone feel at home by neutralizing your language.
  4. Do not assume we are just confused. I identify as a queer non-binary person. I am not confused about who I love or what gender I am; I am completely confident in both aspects. And it is quite possible your clients will be too. When they do come out to you, know that this means they trust you. Do not insist that it’s “a phase” or that it’s due to their eating disorder. In fact, it’s likely the other way around: eating disorders often develop and progress due to minority stress, internalized homophobia, and gender dysphoria. If your client is in the beginning stages of exploring their gender and/or sexuality, do not diminish their journey by crediting the eating disorder.
  5. Having culturally sensitive resources available to us is so important. Whether it’s an LGBTQ+ process group, a therapist who is a member of the LGBTQ+ community, or even something as simple as gender-inclusive bathrooms, having resources readily available to us helps us feel included and heard. Knowing that a treatment team is culturally competent can be a great relief for LGBTQ+ people who may otherwise have felt like they needed to keep their identity a secret.

This list is by no means extensive; it really is just a beginning. Every client is unique, and the best way to get to know what they want you to know is to open an honest conversation with them.

I have found in my experience that the staff at the River Centre Clinic is willing to have those honest conversations with their patients. When I first arrived at RCC in 2014, I was unsure if I wanted to come out as genderqueer. I began by talking about it with several of the other patients who then encouraged me to tell the staff. Once I did come out to everyone, the support I received from the staff and my peers did not waver. The staff was willing to learn more about my identity and use the pronouns I chose. Even when I returned in 2016, they remembered my identity and treated me with the same respect and compassion with which they treated everyone else. I believe that the acceptance I received was a vital component in making my recovery as strong as it is today.

Follow us on Twitter:  @River_Centre

 

1 – National Eating Disorder Association. (2018). Eating Disorders Among LGBTQ Youth [Press release]. Retrieved from https://www.nationaleatingdisorders.org/sites/default/files/nedaw18/NEDA -Trevor Project 2018 Survey – Full Results.pdf

2 – Diemer, E. W., Grant, J. D., Munn-Chernoff, M. A., Patterson, D., & Duncan, A. E. (2015). Gender identity, sexual orientation, and eating-related pathology in a national sample of college students. Journal of Adolescent Health, 57(2), 144-149.

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