Minority Stress in Sexual Minorities with Disordered Eating and Body Dissatisfaction

· by · in body dissatisfaction, body image, bullying, diversity, harassment, healthcare, mental health, primary care, Queer community, sexual minorities, social media, weight stigma. ·

by Wesley R. Barnhart, M.A., Ph.D. Candidate in Clinical Psychology, Bowling Green State University, and CEED Summer Research Fellow 2023

Sexual minorities, including gay, lesbian, bisexual, and Queer people (a reclaimed term used by members of the community to represent people of non-heterosexual lived experiences),1 often report higher rates of disordered eating (e.g., excessive restriction of calories) and dissatisfaction with their body shape and weight than straight people.2-4 Why might sexual minorities experience higher rates of disordered eating and body dissatisfaction?

Looking at their social experiences, we know that sexual minorities experience a range of stressors related to their sexuality which are often made worse by people in their environment.5-6 Minority stressors include verbal and physical harassment based on sexual orientation, hiding or withholding one’s sexual orientation from others, and negative thoughts and feelings about oneself based on being a sexual minority.5-6 For example, sexual minority adolescents often experience bullying based on their sexual orientation by peers in the school setting.7 Straight adolescents typically do not have to deal with bullying related to their sexuality. Outside of school, sexual minorities may also experience similar harassment in the home and in their relationships, communities, and work.

Sexual minorities also experience pressures to conceal or hide their sexual minority status to be seen as heterosexual.5-6 Some sexual minorities may conceal their sexual orientation to keep themselves safe. Others may hide their sexual orientation to help them succeed. Over time, these experiences of harassment and concealing one’s sexual orientation can lead to negative thoughts and feelings about oneself based on being a sexual minority.  

Also known as internalized heterosexism, negative attitudes and beliefs about oneself based on being a sexual minority can lead to more minority stress by creating a deep sense of isolation and self-loathing.5-6 Think about it: if you strongly dislike yourself because of your sexual orientation, something you cannot change, you may want to “run away” from these thoughts and feelings or avoid them altogether. These negative thoughts and feelings can be a major barrier to learning that being a sexual minority is not a character flaw or something to be ashamed of but rather an important aspect of one’s overall identity to be honored and celebrated.

Minority stressors come in many forms and at any age, making it difficult, and sometimes impossible, for sexual minorities to find space to exist authentically. For these reasons, it is no surprise that minority stress has been associated with many negative psychological health outcomes,8 including disordered eating and body dissatisfaction.9-10

Minority stress may reinforce disordered eating in sexual minorities as a tool to help them fit in. Of course, pressures to maintain unrealistic thin and muscular body image ideals are felt by all people. People with bodies outside of these ideals are often targets of harassment, which contributes to negative thoughts and feelings about their shape and weight and is related to numerous unhealthy dietary and physical activity behaviors.11 Sexual minorities may engage in disordered eating as a way to try to reach thin and muscular body image ideals and blend in with some settings. Put another way, sexual minorities may be motivated to engage in disordered eating and maintain body image ideals to reduce the potential for harassment based on their sexual orientation. Hiding or withholding one’s sexual orientation from others may also be related to disordered eating and body dissatisfaction in sexual minorities.9-10

Concealing their sexual orientation can result in sexual minorities losing connections with people in the Queer community—supportive connections that can help them understand what it means to be a sexual minority. Specifically, having connections within the Queer community can provide them with the opportunity to realize that Queer people also come in all shapes and sizes. If you cannot see yourself represented or have no relationships with people like you, you may look to find representation in the media where sexual minorities often maintain unrealistic body image standards. This is a problem because there is a significant disconnect between what bodies look like in the media and what they look like in real life.12-13

Research also suggests that negative thoughts and feelings about oneself based on being a sexual minority are also related to disordered eating and body dissatisfaction.9-10 Specifically, holding negative thoughts and feelings about oneself based on being a sexual minority contributes to poor psychological well-being, which further increases the risk for disordered eating and body dissatisfaction.

In sum, medical and mental health providers as well as researchers are well-positioned to address the impact of minority stress in the treatment of disordered eating and body dissatisfaction in sexual minorities. In doing so, it is important to pay attention to factors that are outside of their client’s control. For instance, it is not possible to change the opinions of others such as those that hold homophobic attitudes and beliefs about sexual minorities. It is possible to help sexual minority clients cope with these relationships and set up healthy boundaries to manage their exposure to hurtful individuals. It is also important to understand that sexual minorities do not all look or think the same or have the same background, including where they are with awareness and acceptance of their sexual minority status.14 As such, careful attention should be paid to developing treatment protocols that are sensitive to these numerous lived experiences to help address the needs of all sexual minorities with disordered eating and body dissatisfaction.

References

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  3. He, J., Sun, S., Lin, Z., & Fan, X. (2020). Body dissatisfaction and sexual orientations: A quantitative synthesis of 30 years research findings. Clinical Psychology Review, 81, 101896. https://doi.org/10.1016/j.cpr.2020.101896
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  9. Miller, J. M., & Luk, J. W. (2019). A Systematic Review of Sexual Orientation Disparities in Disordered Eating and Weight-Related Behaviors among Adolescents and Young Adults: Toward a Developmental Model. Adolescent Research Review, 4(2), 187–208. https://doi.org/10.1007/s40894-018-0079-2
  10. 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. https://doi.org/10.1186/s40337-020-00327-y
  11. Zhu, X., Smith, R. A., & Buteau, E. (2022). A meta-analysis of weight stigma and health behaviors. Stigma and Health, 7(1), 1–13. https://doi.org/10.1037/sah0000352
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  13. Labre, M. P., & Walsh-Childers, K. (2003). Friendly advice? Beauty messages in web sites of teen magazines. Mass Communication and Society, 6, 379-396. https://doi.org/10.1207/S15327825MCS0604_3
  14. Morrison, T. G., Katz, J. W., Mirzaei, Y., & Zare, S. (2020). Body image and eating disorders among sexual and gender minority populations. In E. D. Rothblum (Ed.), The Oxford handbook of sexual and gender minority mental health (pp. 73–85). Oxford University Press. https://doi.org/10.1093/oxfordhb/9780190067991.013.8