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Learn more about the results we get at Within

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Eating disorder treatment programs for LGBTQIA+ people

Clinicians and researchers have long been aware of the occurrence of eating disorders, but studies on the subject have typically focused on the experiences of young, white women. More recently, eating disorder research has expanded to other impacted populations, leading to a broader understanding of how these conditions impact different people.

One group that's historically gone underreported in eating disorder research is the LGBTQIA+ community. However, recent and ongoing research on the experiences of gay and bisexual men, lesbian and bisexual women, transgender individuals, intersex individuals, and others in the community have shown that they experience high rates of eating disorders.

This new research has brought increased awareness about the needs of LGBTQIA+ people with eating disorders, and the need for the development of treatment approaches that can better serve these populations.

Like non-LGBTQIA+ people, individuals in this community often benefit from a multidisciplinary treatment plan that includes individual and group psychotherapy, nutritional counseling, and medical monitoring. However, the delivery of interventions may need to be adjusted to best meet the particular needs of LGBTQIA+ patients.

Learn about the LGBTQIA+ groups we offer at Within Health.

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Last updated on 
October 11, 2023
October 11, 2023
LGBTQIA+ couple
In this article

Understanding eating disorders in the LGBTQIA+ population

LGBTQIA+ stands for lesbian, gay, bisexual, transgender, queer or questioning, intersex, asexual, and the plus represents other identities that are not clearly denoted in the acronym.

The gender identities and sexual orientations included in the LGBTQIA+ acronym are not an exhaustive list, and this community encompasses a wide variety of identities. While this population is very diverse, there are important shared experiences common to many LGBTQIA+ individuals. Although research on eating disorders in LGBTQIA+ communities was not initiated until fairly recently, existing studies have consistently shown that LGBTQIA+ people are more likely to develop eating disorder symptoms than their cisgender, heterosexual peers.1

Learn more about how Within helps LGBTQ eating disorder patients remotely.
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Part of this discrepancy has been attributed to the additional stress many LGBTQIA+ people feel from social stigma, prejudice, or discrimination directed at their sexual orientation, gender identity, and sex trait variations.1

Internalized homophobia or transphobia may cause additional stress that can contribute to disordered eating, along with related shame. Individuals who feel pressure to conceal their sexuality or gender identity experience even more challenges and stressors. LGBTQIA+ people also report experiencing more violent incidents and have higher rates of depression, which may also contribute to the development of an eating disorder.1

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LGBTQIA+ eating disorder stats & trends

While research into eating disorder prevalence in the LGBTQIA+ community was not conducted until fairly recently, some patterns are already starting to emerge from the results.

According to one study published in 2019:1,3,4

  • Weight-based self-worth was much higher in lesbian women (82%) than in gay men (63%)
  • 69.8% of transgender non-conforming adults reported dissatisfaction with eating patterns
  • Gay men had the lowest percentage of dissatisfaction with eating patterns, at 47.7%
  • 42% of men diagnosed with an eating disorder identify as gay or bisexual
  • Lesbian women experience binge eating at higher rates than heterosexual women

Collectively, lesbian, gay, and bisexual individuals, transgender individuals, and other members of the LGBTQIA+ community self-report a higher lifetime prevalence of eating disorders than their heterosexual peers, including anorexia nervosa (AN), bulimia nervosa (BN), and binge eating disorder (BED).5

Eating disorder risk factors for the LGBTQIA+ community

In addition to minority stress and the violence and discrimination that often accompanies it, individuals in the LGBTQIA+ community face additional risk factors for developing eating disorders.

Mental health conditions like depression and anxiety are also common among LGBTQIA+ people. Transgender individuals are at a particularly high risk for experiencing depressive symptoms. (6) Depression and anxiety often co-occur with eating disorders and may play a role in instigating or maintaining them.7

Transgender individuals may face additional internal and external pressures to conform to gendered body ideals,5 which can include the expectation for women to be thin, for men to be muscular, and for nonbinary people to have a curveless body. Attempting to conform to these gendered body ideals is a prevalent factor in the high rates of eating disorder development in transgender and nonbinary populations.1,5 

Additional risk factors for LGBTQIA+ people for eating disorders include:3

  • A low sense of belonging
  • Social stigma and discrimination 
  • More frequent bullying 
  • Rejection due to gender and/or sexual orientation
  • Childhood or adulthood trauma or violence

‍Treatment for LGBTQIA+ people with eating disorders

Eating disorders have a negative impact on everyone who experiences them, regardless of sexual orientation or gender identity. It is, therefore, crucially important to provide inclusive care programs that support and fully understand individual challenges experienced by LGBTQIA+ people with eating disorders.

An integrated approach to eating disorder treatment ensures that each patient’s unique needs and challenges are addressed, increasing the likelihood of healing. Patient-centered approaches to care can additionally help build the trust and rapport necessary to ensure LGBTQIA+ patients achieve better overall outcomes.

Different approaches may be used to support LGBTQIA+ patients with eating disorders depending on their needs and circumstances.

Individual psychotherapy
Group therapy
Telemedicine

Additional treatment considerations

Appropriately tailored approaches to treatment are essential for all individuals with eating disorders, but individualized care is especially for LGBTQIA+ individuals.3

Some LGBTQIA+ patients who have participated in treatment programs for eating disorders have reported feeling disappointed by their providers’ incompetence or ignorance of LGBTQIA+ experiences.9 Without proper training, many clinicians are ill-equipped to help these patients navigate the additional stressors they experience while navigating the world and treatment settings as LGBTQIA+ individuals. It is, therefore, essential to make sure that all providers involved in eating disorder care have appropriate training in working with LGBTQIA+ patient populations. 

Treatment programs for LGBTQIA+ people should also include elements relating to body acceptance, including the ways in which sexual orientation, gender identity, and intersex status can impact body image in unique ways for these populations.

Finding help at Within Health

At Within Health, we work to train all of our clinicians on the experiences and concerns of all people, including members of the LGBTQIA+ community. We are always working internally to raise awareness among our staff and be the best providers possible for all of our clients.

Our treatment program is entirely online, through our app and website, giving members of the LGBTQIA+ community access to specialized care when they may otherwise live far from in-person options for this type of treatment.

Our team of multidisciplinary experts develops treatment plans tailored to each patient's specific history and needs, helping to ensure anyone who uses our service is given the best tools possible to succeed.

If you or someone you love in the LGBTQIA+ community is struggling with an eating disorder, help them get connected to a gender-competent program or provider, like Within Health, who has experience working with sexual minority populations.

Disclaimer about "overeating": Within Health hesitatingly uses the word "overeating" because it is the term currently associated with this condition in society, however, we believe it inherently overlooks the various psychological aspects of this condition which are often interconnected with internalized diet culture, and a restrictive mindset about food. For the remainder of this piece, we will therefore be putting "overeating" in quotations to recognize that the diagnosis itself pathologizes behavior that is potentially hardwired and adaptive to a restrictive mindset.

Disclaimer about weight loss drugs: Within does not endorse the use of any weight loss drug or behavior and seeks to provide education on the insidious nature of diet culture. We understand the complex nature of disordered eating and eating disorders and strongly encourage anyone engaging in these behaviors to reach out for help as soon as possible. No statement should be taken as healthcare advice. All healthcare decisions should be made with your individual healthcare provider.

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.
  2. Meerwijk, E. L., & Sevelius, J. M. (2017). Transgender Population Size in the United States: a Meta-Regression of Population-Based Probability Samples. American Journal of Public Health, 107(2), e1–e8.
  3. Bell, K., Rieger, E., & Hirsch, J. K. (2019). Eating Disorder Symptoms and Proneness in Gay Men, Lesbian Women, and Transgender and Non-conforming Adults: Comparative Levels and a Proposed Mediational Model. Frontiers in Psychology, 9, 2692. 
  4. McClain, Z., & Peebles, R. (2016). Body Image and Eating Disorders Among Lesbian, Gay, Bisexual, and Transgender Youth. Pediatric Clinics of North America, 63(6), 1079–1090. 
  5. Nagata, J. M., Ganson, K. T., Austin, S. B. (2020). Emerging trends in eating disorders among sexual and gender minorities. Current Opinions in Psychiatry, 33(6), 562-567. 
  6. Su, D., Irwin, J. A., Fisher, C., Ramos, A., Kelley, M., Mendoza, D., & Coleman, J. D. (2016). Mental Health Disparities Within the LGBT Population: A Comparison Between Transgender and Nontransgender Individuals. Transgender Health, 1(1), 12–20. 
  7. Sander, J., Moessner, M., Bauer, S. (2021). Depression, Anxiety and Eating Disorder-Related Impairment: Moderators in Female Adolescents and Young Adults. International Journal of Environmental Research and Public Health, 8(5), 2779.
  8. Stoehr, J. R., & Jahromi, A. H., & Schechter, L. S. (2022). Telemedicine for Gender-Affirming Medical and Surgical Care: A Systematic Review and Call-to-Action. Transgender Health, 7, 2.
  9. Duffy, M. E., Henkel, K. E., & Earnshaw, V. A. (2016) Transgender Clients’ Experiences of Eating Disorder Treatment, Journal of LGBT Issues in Counseling, 10(3), 136-149.
  10. Warning Signs and Symptoms. (n.d.). National Eating Disorders Association. Accessed September 2023. 

FAQs

How can I support an LGBTQIA+ loved one who is struggling with an eating disorder?

Be supportive and compassionate. Listen to what they are going through without offering advice or insight, and realize even if you have experience with eating disorders, their experience may differ due to their gender identity or sexual identity. Encourage them to seek help through their physician, a therapist, or a higher level of care. Ensure whichever provider they seek out knows how to support LGBTQIA+ patients and their specific needs.

How can you tell if an LGBTQIA+ individual has an eating disorder?

Eating disorders do not discriminate, and signs of eating disorders among LGBTQIA+ individuals are similar to those among cisgender heterosexual populations.

Common signs of eating disorders may include but are not limited to:10

  • Fixation on weight and body image
  • Frequent fluctuations in weight
  • Avoiding activities and gatherings where food is served
  • Restricting certain foods or food groups entirely, or other forms of dietary restriction
  • Hiding or hoarding food

Where can you find help for an LGBTQIA+ loved one when you suspect they have an eating disorder?

Within Health offers comprehensive, gender-competent eating disorder programs to support LGBTQIA+ individuals. Contact our clinical care team to learn more about resources available in your area.

Further reading

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