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Influence of sexual orientation and age on disordered eating attitudes and behaviors in women

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Abstract

We evaluated the influence of age on the association between sexual orientation and disordered eating attitudes and behaviors in women. Heterosexual (n=47) and homosexual (n=45) women recruited from the community completed self-report questionnaires including the Body Esteem Scale, the Eating Disorders Inventory-2, the Reasons for Exercise Inventory, and the Self Esteem Scale. A multivariate analysis of variance of eating disorder variables revealed a main effect for sexual orientation on drive for thinness and exercise to control weight and a main effect for age on body mass index (BMI) and body dissatisfaction, but it did not reveal a significant interaction between sexual orientation and age. Sexual orientation may influence certain types of disordered eating attitudes and behaviors in women such as endorsing an extreme ideal of thinness. However, homosexual and heterosexual women reported more similarities than differences.

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... However, other studies have suggested that there are no significant differences between lesbian and heterosexual women in regard to eating disorder prevalence [53,74,131], nor for disordered eating behaviors and dieting behaviors [56,140,141,172]. Indeed, some studies appeared to find more similarities than differences between lesbian and heterosexual females regarding rates of disordered eating behaviors [125,172]. ...
... While some research suggests that lesbian adults may not be protected from eating pathology or body dissatisfaction [14,126], other researchers have argued that, on average, adult and adolescent lesbians appear to be at less risk for eating disorders [143,151]. Some findings suggested that they also report less engagement in disordered eating behaviors, including weight control methods such as dietary restriction and purging, dieting, and bingeing [99,125,134,151,162]. Additionally, some researchers found that in comparison to heterosexual and bisexual women, adult lesbians were more likely to report engaging in healthy eating behaviors and physical activity [159]. ...
... However, it should be noted some research findings suggested no significant differences between lesbian and heterosexual women in body dissatisfaction, attitudes regarding weight and appearance, awareness of cultural standards of attractiveness, drive for thinness, likelihood of having a higher BMI, and body esteem concerning weight and physical appearance [15,139,140,150,172]. And, other investigators found no apparent differences in the path from internalization of the thin ideal to disordered eating behaviors [125,172]. Some researchers have found that lesbians actually experienced lower body dissatisfaction and more body satisfaction, as further evidenced by their increased likelihood to have weighed significantly more and had a higher ideal weight reported greater body esteem concerning sexual attractiveness and were more satisfied with their weight and physical appearance (assuming "normal" BMI), expressed less concern regarding their weight and physical appearance, were less concerned with attempting to look like women in the media, and had a lower drive for thinness than adult and adolescent heterosexual females, which in turn reduced their likelihood of developing clinical eating disorders [3,4,6,56,67,78,99,104,125,134,140,151,162]. ...
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Background According to past research, lesbian, gay, bisexual, and transgender (LGBT) individuals experience a higher prevalence of psychopathology, which is attributable to the increased stress (i.e., stigma and prejudice) that they experience, as detailed by the minority stress model (MSM). Main This current literature review examined the empirical literature regarding the rates and types of, and risk factors for eating disorders and disordered eating behaviors in LGBT adults and adolescents, in addition to each individual subgroup (i.e., lesbians, gay males, bisexuals, transgender and gender-nonconforming individuals). Conclusion LGBT adults and adolescents experience greater incidence of eating disorders and disordered eating behaviors than their heterosexual and cisgender counterparts. Additionally, gay, bisexual, and transgender adults and adolescents were all at increased risk for eating disorders and disordered eating behaviors. Mixed results were found for lesbian adults and adolescents. Results are discussed within the framework of the MSM.
... Many studies have supported these theories and found that lesbians have more positive body image and a larger ideal body size than heterosexual women [12][13][14][15][16][17], and problematic eating attitudes and eating disorder symptoms have been observed to be less prevalent in lesbians than in heterosexual women in some studies [16,18,19]. More specifically, lesbians have generally been found to restrict their food intake less than heterosexual women [20,21]. However, not all studies have found this, for example Matthews-Ewals et al. [22] found that lesbian women were more likely than heterosexual women to report dieting for weight loss. ...
... Indeed, several studies have observed no significant differences between the disordered eating attitudes and behaviors of these two groups [6,[24][25][26][27]. Other studies have found that lesbian and heterosexual women tend to have similar levels of bulimic behaviors [20,21], body dissatisfaction and body image [6,24,25,28] and eating disorders [2,3]. Beren et al. [29] found similar levels of body dissatisfaction and psychosocial distress in women of both sexual orientations, and concluded that belonging to the lesbian community does not seem to be protective against body dissatisfaction. ...
... To address differences between types of disordered eating, we extracted data from the different subscales of the disordered eating measure. Five studies used the Eating Attitudes Test-26 [6,18,19,27,45], one used the full Eating Attitudes Test [21], five used the Eating Disorder Inventory [20,21,24,25,35], one used the Eating Disorder Inventory-2 [15], two used the Eating Disorder Inventory-Symptom Checklist [24,25], one used the Eating Disorder Examination Questionnaire [46] and one used the Bulimic Investigatory Test-Edinburgh [17]. The remaining studies provided self-reported answers to individual questions that did not comprise a validated questionnaire [14, 22, 28, 36-38, 47, 48]. ...
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Purpose Homosexuality is a clear risk factor for disordered eating in men; however, for women, research has yielded contradictory results. We conducted a meta-analysis to examine the association between sexual orientation and disordered eating in women. Methods PRISMA guidelines were used. Studies comparing disordered eating between lesbians and heterosexual women were identified using PsycNet database and Google Scholar. Twenty-one studies met inclusion criteria. Overall disordered eating, restricting, binging and purging were examined for heterosexual, lesbian, bisexual and ‘mostly heterosexual’ women. Results Whereas there was no significant difference in overall disordered eating between lesbians and heterosexual women, lesbians reported restricting less and binging more than heterosexual women. Bisexual women were more likely than lesbian women to restrict food intake and purge, and more likely than heterosexual women to have overall disordered eating and restrict food intake. “Mostly heterosexual” women were more likely than heterosexual women to restrict food intake, binge and purge. Conclusions Women of different sexual orientations show distinct patterns of disordered eating. Bisexual and “mostly heterosexual” women appear to be particularly at risk. Stress resulting from binegativity and rigid views of sexuality in a dichotomous society, rather than sexual orientation itself, may be associated with disordered eating in women. Findings should be viewed with caution because there were few studies with bisexual and “mostly heterosexual” women. This study elucidates the nature of the association between disordered eating and sexual orientation. Findings provide a possible explanation for previous inconsistencies, since opposing trends for different behaviors cancel each other out. Level of evidence Level I, systematic review and meta-analysis.
... A second part of this systematic review was focused on ED symptoms and eating behaviours. The search individuated 38 papers Austin et al., 2013;Bankoff et al., 2016;Bayer et al., 2017;Beren et al., 1996;Bergeron & Senn, 1998;Brand et al., 1992;Cella et al., 2010;Cella et al., 2013;Davids & Green, 2011;Diemer et al., 2015;French et al., 1996;Gettelman & Thompson, 1993;Hadland et al., 2014;Herzog et al., 1992;Katz-Wise et al., 2015;Lakkis et al., 1999;Legenbauer et al., 2009;Maloch et al., 2013;Mason & Lewis, 2015;Matthews-Ewald et al., 2014;Meyer et al., 2001;Moore & Keel, 2003;Mor et al., 2015;Nelson et al., 2011;Owens, Hughes, & Owens-Nicholson, 2003;Peplau et al., 2008;Polimeni et al., 2009;Schneider et al., 1995;Share & Mintz, 2002;Shearer et al., 2015;Siever, 1994;Striegel-Moore et al., 1990;Strong et al., 2000;VanKim et al., 2016;Watson et al., 2017;Wichstrom, 2006;Yean et al., 2013;Zullig et al., 2017) with relevant heterogeneity in the assessment of the symptoms, scales employed (e.g., Eating Disorders Inventory, Eating Attitudes Test-26, Sociocultural Attitudes Towards Appearance Questionnaires, and Youth Risk Behavioural Surveillance System Survey), and inclusion criteria. ...
... Regarding body perception, only Bankoff et al. (2016) did not find any differences between samples, using the Eating Attitudes Test-26 scale in order to investigate dieting and body shape concerns. Instead, Brand et al. (1992), Herzog et al. (1992), Lakkis et al. (1999), and Moore and Keel (2003), who used the Eating Disorders Inventory scale, and Zullig et al. (2017), who used a different composed scale, found more "drive for thinness" thoughts in heterosexual women than in lesbian or bisexual women. Also, considering body satisfaction, literature showed only one paper (Hadland et al., 2014) suggesting a protective role of being a lesbian or bisexual woman. ...
... Also, considering body satisfaction, literature showed only one paper (Hadland et al., 2014) suggesting a protective role of being a lesbian or bisexual woman. Conversely, a greater body satisfaction than heterosexual women was found in SM women by Bergeron andSenn (1998), French et al. (1996), Gettelman and Thompson (1993), Herzog et al. (1992), Lakkis et al. (1999), Moore and Keel (2003), Mor et al. (2015), Owens et al. (2003), Peplau et al. (2008), Polimeni et al. (2009), Schneider et al. (1995, Siever (1994), and Strong et al. (2000). Other studies did not show any significant difference as regards sexual orientation (Beren et al., 1996;Cella et al., 2010Cella et al., , 2013Davids & Green, 2011;Legenbauer et al., 2009; Nelson et al., 2011;Striegel-Moore et al., 1990;VanKim et al., 2016;Yean et al., 2013). ...
Article
Background Although the literature consistently shows increased levels of psychological distress in the gay population, less evidence—and with contrasting findings—is available with regard to lesbian women. The aim of the present study is to review the literature in the eating disorders (EDs) field in order to provide further data on the frequency of EDs symptoms in sexual minority women. Method A systematic review of the studies identified by electronic database search (PubMed, Ovid, ScienceDirect, and Google Scholar) up to August 2017. Results Fourty‐five studies were found, conducted on 372,256 women. Only 7 studies investigated patients with lifetime diagnosis of ED. As for the symptomatology of EDs, 39 studies were found, which presented huge differences in the scales used for the assessment (e.g., Eating Disorders Inventory and Eating Attitudes Test‐26). Conclusions A higher number of diagnoses of EDs were found in sexual minority women, with a symptomatology characterized by higher occurrence of binge eating and purging, as well as lower body dissatisfaction and drive for thinness, compared with heterosexual peers.
... Olivardia et al. [68] Men Non heterosexuality as risk factor for EDs Beren et al. [69] Men French et al. [70] Men Carlat et al. [71] Men Russell and Keel [72] Men Yelland and Tiggemann [73] Men Hospers and Jansen [74] Men Feldman and Meyer [75] Men Feldman et al. [76] Men Heinberg et al. [77] Men Brown and Keel [67] Men Matthews et al. [78] Men/women Matthews-ewald et al. [79] Men/women Heffernan et al. [80] Women Lack of association Moore et al. [81] Women Share and Mintz [82] Women Non heterosexuality protective for good body image Owens et al. [83] Women Moore and Keel [81] Women Non heterosexuality as risk factor for body uneasiness Duggan et al. [84] Men Conner et al. [85] Men/women Kaminski et al. [86] Men Morgan and Arcelus [87] Men Carper et al. [88] Men Blashill [89] Men Wiseman and Moradi [90] Men Dakanalis et al. [91] Men Koh and Ross [92] Women Higher risk in bisexual than lesbian Austin et al. [93] Men/women Non heterosexuality as risk factor for purging behaviors men not for women Legenbauer et al. [94] Men/women Non heterosexuality as risk factor for men; Lack of association for women Cella et al. [95] Men/women Austin et al. [96] Men/women Non heterosexuality as risk factor for purging behaviors Brewster et al. [97] Women Bisexuality as a risk factor for EDs Meyer et al. [98] Men/women Gender role and EDs Hepp and Milos [99] Men/women Duggan et al. [78] Men Hepp et al. [100] Women Cella et al. [101] Men/women Diemer et al. [102] Men/women Matthews-ewald et al. [79] Men/women Vocks et al. [103] Men/women Higher eating psychopathology in transgender Ålgars et al. [104] Men/women Bandini et al. [105] Men/women Fisher et al. [106] Men/women EDs, Eating disorders. ...
... Olivardia et al. [68] Men Non heterosexuality as risk factor for EDs Beren et al. [69] Men French et al. [70] Men Carlat et al. [71] Men Russell and Keel [72] Men Yelland and Tiggemann [73] Men Hospers and Jansen [74] Men Feldman and Meyer [75] Men Feldman et al. [76] Men Heinberg et al. [77] Men Brown and Keel [67] Men Matthews et al. [78] Men/women Matthews-ewald et al. [79] Men/women Heffernan et al. [80] Women Lack of association Moore et al. [81] Women Share and Mintz [82] Women Non heterosexuality protective for good body image Owens et al. [83] Women Moore and Keel [81] Women Non heterosexuality as risk factor for body uneasiness Duggan et al. [84] Men Conner et al. [85] Men/women Kaminski et al. [86] Men Morgan and Arcelus [87] Men Carper et al. [88] Men Blashill [89] Men Wiseman and Moradi [90] Men Dakanalis et al. [91] Men Koh and Ross [92] Women Higher risk in bisexual than lesbian Austin et al. [93] Men/women Non heterosexuality as risk factor for purging behaviors men not for women Legenbauer et al. [94] Men/women Non heterosexuality as risk factor for men; Lack of association for women Cella et al. [95] Men/women Austin et al. [96] Men/women Non heterosexuality as risk factor for purging behaviors Brewster et al. [97] Women Bisexuality as a risk factor for EDs Meyer et al. [98] Men/women Gender role and EDs Hepp and Milos [99] Men/women Duggan et al. [78] Men Hepp et al. [100] Women Cella et al. [101] Men/women Diemer et al. [102] Men/women Matthews-ewald et al. [79] Men/women Vocks et al. [103] Men/women Higher eating psychopathology in transgender Ålgars et al. [104] Men/women Bandini et al. [105] Men/women Fisher et al. [106] Men/women EDs, Eating disorders. ...
... Less evidence has been found in women [79,81,82,93]. Some studies reported that lesbian sexual orientation is predictive of positive body image and fewer negative attitudes toward eating and weight [80,83,110]. ...
Article
Introduction The relationships between Eating Disorders (EDs) and sexuality are complex, and of interest for researchers and clinicians. Objective To identify psychopathological and clinical factors associated with restoration of regular menses and sexual function in EDs patients. Aims To evaluate the role of sexuality as a moderator of the recovery process after an individual Cognitive Behavioural Therapy (CBT). Methods 39 Anorexia Nervosa (AN) and 40 Bulimia Nervosa (BN) female patients were evaluated by means of a face-to-face interview, self-reported questionnaires, including Eating Disorder Examination Questionnaire and Female Sexual Function Index, and blood sample for hormonal levels and biomarkers. The assessments were repeated at baseline, at one year follow up, and at three years follow up. Results After CBT, both AN and BN patients showed a significant improvement of sexual functioning, which was associated with a reduction of core psychopathology. AN patients who recovered regular menses demonstrated a better improvement across time of psychopathological and clinical features, and were more likely to maintain these improvements at follow up. Recovery of regular menses and improvement of sexuality at the end of CBT were associated with a higher probability to have a full recovery at three years follow up. Conclusions These results challenge a concept of recovery in EDs exclusively based on weight restoration or behavioral changes. An assessment including sexual functioning and core psychopathology might identify the residual pathological conditions, and it is able to provide information regarding the long term recovery process.
... Olivardia et al. [68] Men Non heterosexuality as risk factor for EDs Beren et al. [69] Men French et al. [70] Men Carlat et al. [71] Men Russell and Keel [72] Men Yelland and Tiggemann [73] Men Hospers and Jansen [74] Men Feldman and Meyer [75] Men Feldman et al. [76] Men Heinberg et al. [77] Men Brown and Keel [67] Men Matthews et al. [78] Men/women Matthews-ewald et al. [79] Men/women Heffernan et al. [80] Women Lack of association Moore et al. [81] Women Share and Mintz [82] Women Non heterosexuality protective for good body image Owens et al. [83] Women Moore and Keel [81] Women Non heterosexuality as risk factor for body uneasiness Duggan et al. [84] Men Conner et al. [85] Men/women Kaminski et al. [86] Men Morgan and Arcelus [87] Men Carper et al. [88] Men Blashill [89] Men Wiseman and Moradi [90] Men Dakanalis et al. [91] Men Koh and Ross [92] Women Higher risk in bisexual than lesbian Austin et al. [93] Men/women Non heterosexuality as risk factor for purging behaviors men not for women Legenbauer et al. [94] Men/women Non heterosexuality as risk factor for men; Lack of association for women Cella et al. [95] Men/women Austin et al. [96] Men/women Non heterosexuality as risk factor for purging behaviors Brewster et al. [97] Women Bisexuality as a risk factor for EDs Meyer et al. [98] Men/women Gender role and EDs Hepp and Milos [99] Men/women Duggan et al. [78] Men Hepp et al. [100] Women Cella et al. [101] Men/women Diemer et al. [102] Men/women Matthews-ewald et al. [79] Men/women Vocks et al. [103] Men/women Higher eating psychopathology in transgender Ålgars et al. [104] Men/women Bandini et al. [105] Men/women Fisher et al. [106] Men/women EDs, Eating disorders. ...
... Olivardia et al. [68] Men Non heterosexuality as risk factor for EDs Beren et al. [69] Men French et al. [70] Men Carlat et al. [71] Men Russell and Keel [72] Men Yelland and Tiggemann [73] Men Hospers and Jansen [74] Men Feldman and Meyer [75] Men Feldman et al. [76] Men Heinberg et al. [77] Men Brown and Keel [67] Men Matthews et al. [78] Men/women Matthews-ewald et al. [79] Men/women Heffernan et al. [80] Women Lack of association Moore et al. [81] Women Share and Mintz [82] Women Non heterosexuality protective for good body image Owens et al. [83] Women Moore and Keel [81] Women Non heterosexuality as risk factor for body uneasiness Duggan et al. [84] Men Conner et al. [85] Men/women Kaminski et al. [86] Men Morgan and Arcelus [87] Men Carper et al. [88] Men Blashill [89] Men Wiseman and Moradi [90] Men Dakanalis et al. [91] Men Koh and Ross [92] Women Higher risk in bisexual than lesbian Austin et al. [93] Men/women Non heterosexuality as risk factor for purging behaviors men not for women Legenbauer et al. [94] Men/women Non heterosexuality as risk factor for men; Lack of association for women Cella et al. [95] Men/women Austin et al. [96] Men/women Non heterosexuality as risk factor for purging behaviors Brewster et al. [97] Women Bisexuality as a risk factor for EDs Meyer et al. [98] Men/women Gender role and EDs Hepp and Milos [99] Men/women Duggan et al. [78] Men Hepp et al. [100] Women Cella et al. [101] Men/women Diemer et al. [102] Men/women Matthews-ewald et al. [79] Men/women Vocks et al. [103] Men/women Higher eating psychopathology in transgender Ålgars et al. [104] Men/women Bandini et al. [105] Men/women Fisher et al. [106] Men/women EDs, Eating disorders. ...
... Less evidence has been found in women [79,81,82,93]. Some studies reported that lesbian sexual orientation is predictive of positive body image and fewer negative attitudes toward eating and weight [80,83,110]. ...
Article
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The scientific community appears to be less interested in sexuality of eating disorders (EDs) as compared to other psychiatric or medical comorbidities. However, a clear association between sexual problems and ED psychopathology was reported from different perspectives. The overarching goal of this systematic review was to evaluate the general approach of the scientific literature toward the topic of sexuality and EDs. In particular, four different categories of research have been individuated, encompassing the role of puberty, and sexual abuse in the pathogenesis of the disorders, sexual dysfunctions, and the association between sexual orientation and EDs psychopathology. Timing of puberty with its hormonal consequences and the changes in the way persons perceive their own body represent a crucial period of life for the onset of the disorder. Sexual abuse, and especially childhood sexual abuse are well-recognized risk factors for the development of ED, determining a worse long-term outcome. Recent research overcome the approach that considers sexual activity of EDs patients, in terms of hypersexuality and dangerous sexual behaviors, considering the sexuality of EDs persons in terms of sexual desire, satisfaction, orgasm and pain. Results from this line of research are promising, and describe a clear relationship between sexual dysfunction and the core psychopathological features of EDs, such as body image disturbances. Finally, the analysis of the literature showed an association between sexual orientation and gender dysphoria with EDs psychopathology and pathological eating behaviors, confirming the validity of research developing new models of maintaining factors of EDs related to the topic of self-identity.
... Research has shown that women show constant weight increases across the life span, up to age 65, at which point weight may decrease (Webster & Tiggemann, 2003;Williamson, 1993;Wilson & Morley, 2003). Overall, middle-aged women (e.g., 50 -64 years) and elderly women (e.g., 65-74 years) tend to have higher average BMI than young women (e.g., 17-30 years) (Allaz, Bernstein, Rouget, Arichard, & Morabia, 1998;McKinley, 1999;Moore & Keel, 2003;Tiggemann & Lynch, 2001). ...
... A somewhat surprising exception to this tendency for younger women to express greater eating disorder symptomatology was our finding that middle-aged women reported the least body satisfaction (Allaz et al., 1998;Heatherton & Burnett, 1994;Mangweth-Matzek et al., 2006;Moore & Keel, 2003;Stevens & Tiggemann, 1998;Tiggemann & Lynch, 2001;Tiggemann & Stevens, 1999). Our finding supports the assertion that the social pressure to be thin extends to middle-aged women as well as young women (Allaz et al., 1998;Heatherton & Burnett, 1994). ...
... A major strength was the large sample size and broad age range and ethnic variation that permitted valid statistical comparisons across the various categories of these variables. To date, many studies have used considerably small samples to examine age and ethnic differences between only one or two groups (e.g., Demarest & Allen, 2000;Moore & Keel, 2003). ...
Article
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Ethnic and age differences in body mass index (BMI), body shame, and eating disorder symptomatology were investigated in a representative, nonclinical sample (N = 601) of women from the Province of Alberta. Women reported ethnicity (White, Hispanic, Aboriginal, Asian), age, height, and weight (used to calculate BMI), and items measuring body shame and eating disorder symptomatology. Strong ethnic differences were observed. Aboriginal women reported significantly higher BMI than Hispanic and Asian women. Hispanic women reported higher body shame than White women. Hispanic women also reported more bulimic behaviour than White, Aboriginal, and Asian women. White women reported lower body satisfaction than Asian and Aboriginal women. Aboriginal women reported the highest body satisfaction. Bulimic behaviour was lowest in older women (65+ years) compared with other age groups. Body satisfaction was greatest in older women (65+ years). These study findings have important implications for theory, research, and practise, as our society continues to place an inordinate value on thinness and beauty as ideals for women and girls. (PsycINFO Database Record (c) 2012 APA, all rights reserved)
... Patterns are less clear for how sexual orientation relates to body satisfaction among women. Existing research typically observed no differences or only small differences between lesbian and heterosexual women in their levels of body dissatisfaction (He et al., 2020;Moore & Keel, 2003;Moreno-Dominguez et al., 2019;Morrison et al., 2004). In the Morrison et al. (2004) meta-analysis, lesbian women reported slightly higher body satisfaction overall (d = 0.12), and when controlling for BMI (d = 0.22). ...
... These differences for men may reflect the influence of sexual minority stress from being part of a marginalized group and/or sociocultural pressures from media, friends, family, partners, and within the sexual minority male community (Meyer, 1995;Tylka & Andorka, 2012). Also consistent with previous research (Moore & Keel, 2003;Moreno-Dominguez et al., 2019;Morrison et al., 2004;Frederick, Lever, & Peplau, 2007;Peplau et al., 2009), almost all differences among lesbian, bisexual, and heterosexual women were small and/or not statistically significant. These findings indicate relatively similar levels of body image concerns among lesbian, bisexual, and heterosexual women, but do not necessarily indicate that the factors contributing to these overall levels of body image are identical across the groups. ...
Article
We examined how gender, body mass, race, age, and sexual orientation were linked to appearance evaluation, overweight preoccupation, and body image-related quality of life among 11,620 adults recruited via Mechanical Turk. Men were less likely than women to report low appearance evaluation, high overweight preoccupation, negative effects of body image on their quality of life, being on a weight-loss diet, and trying to lose weight with crash diets/fasting. Racial differences were generally small, but greater appearance evaluation was reported by Black men versus other groups and Black women versus White women. Across all measures, gay and bisexual men reported poorer body image than heterosexual men, with only small effect sizes observed for sexual orientation differences among women. Body mass, but not age, was strongly associated with body image. The prevalence of poor body image highlights the need for interventions. On the positive side, half of men and women reported high appearance evaluation. Examination of this group could identify factors promoting positive body image.
... Research examining the cognitive-affective component of body image disturbance has revealed a significantly lower drive for a thinner body (drive for thinness) in homosexual women (HOW) than in heterosexual women (HEW) (25)(26)(27)(28)(29), although some studies have reported similar levels (30,31). To date, no study has investigated the association between sexual orientation and drive for leanness, i.e., the preference for a thin and welltoned body with as little body fat as possible (32). ...
... Concerning the cognitive-affective body image component, the higher degree of drive for thinness in HEW compared to HOW is in line with most previous research [e.g., (26)(27)(28)(29)]. Authors such as Moreno-Domínguez et al. (39) and Swami and Tovée (38) reported significant differences in women's BMI depending on sexual orientation, which they discussed as a potential reason for the variability in the cognitive-affective body image. ...
Article
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Body image disturbance is a core symptom of eating disorders (EDs) and body dysmorphic disorder (BDD). There is first evidence that females’ body image differs depending on sexual orientation, with heterosexual women (HEW) appearing to show more body image disturbance symptoms than homosexual women (HOW). Such disparities might be moderated by everyday discrimination experiences and involvement with the lesbian community. However, to date, there has been no comprehensive assessment of a broad range of body image facets such as drive for thinness, leanness, and muscularity; body avoidance; body checking and body dissatisfaction; and ED and BDD pathology as well as moderating factors. Moreover, studies have often neglected bisexual women (BIW). A total of N = 617 women (n = 180 HOW, n = 322 HEW, n = 115 BIW) completed an online survey assessing the various facets of body image, ED and BDD pathology, discrimination experiences, and involvement with the lesbian community. Significant group differences were found regarding drive for leanness and thinness, body checking, investment behavior, and body ideal (all p<.05). BIW showed significantly more body checking than HOW. Compared to HEW, HOW reported a significantly lower drive for leanness and thinness as well as compared to HEW and BIW less investment behavior. HOW preferred a body ideal with significantly more body fat than did HEW (all p<.05). In contrast, no differences emerged in body dissatisfaction, drive for muscularity, body-related avoidance, ED and BDD pathology, and body image disturbance (all p>.05). In all groups, discrimination experiences were positively related to ED and BDD pathology and to body image disturbance (all p < .05); however, discrimination was significantly correlated with more body image facets in HEW than in HOW or BIW. Involvement with the lesbian community was positively correlated with a larger ideal body size in HOW (p < .05) and negatively correlated with drive for muscularity in BIW (p < .05). Despite the group differences in several body image facets, we found no consistent evidence of increased vulnerability to body image disturbance or associated pathology depending on sexual orientation. However, in HEW, discrimination experience might pose a risk factor for the development of body image–related pathology and single facets of body image disturbance.
... Early research in this area appeared to indicate that lesbian (vs. heterosexual) women possess certain protective factors against disordered eating (e.g., increased body esteem, lower drive for thinness, decreased internalization of cultural standards; Heffernan, 1994;Moore & Keel, 2003;Share & Mintz, 2002). Other findings have failed to reveal differences between heterosexual and lesbian women in terms of actual disordered eating behaviors and psychosocial variables related to disordered eating (e.g., Feldman & Meyer, 2007). ...
... In an effort to better understand mechanisms underlying disordered eating among SSA women, another more immediate next step might involve examination of empirically supported risk factors, including negative attitudes regarding obesity (specifically, implicit biases) and internalized heterosexism, in a single model. In addition, given that disordered eating and body dissatisfaction differ across the lifespan (Moore & Keel, 2003) and that examining age as a variable of interest was beyond the scope of this particular study, future longitudinal research could inform our understanding of age, sexual orientation, and disordered eating. ...
Article
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Objective: We aimed to expand the scant research on disordered eating in women identifying same-sex sexual attractions. Method: We used multiple linear regressions to explore potential mechanisms driving disordered eating-both explicit and implicit weight bias and heterosexism-in a cross-sectional, online-recruited community sample of women (N = 437). Participants endorsed a range of sexual attractions from exclusively opposite-sex (21.1%) to exclusively same-sex (19.5%) attraction. Results: Findings revealed no associations between sexual attraction and disordered eating. Awareness of sociocultural norms valuing thinness accounted for disordered eating for all women, regardless of sexual attraction, and was influenced by attitudes regarding weight. Among women endorsing same-sex attractions, self-reported internalized heterosexism influenced disordered eating. Discussion: Findings contradict long-held beliefs that same-sex attracted women are protected from disordered eating. They emphasize a universal risk, for all women, of sociocultural norms valuing thinness, as well as the risk of internalized heterosexism among same-sex attracted women.
... The association between sexual orientation and eating pathology is specific in that it cannot be attributed to a link between sexual orientation and general psychopathology (Russell & Keel, 2002). The association is unique to men in that similar associations have not been found consistently in women (Moore & Keel, 2003). One explanation for the association in men is that BG men may feel pressure to obtain a lean physique to attract a male partner, as men place greater emphasis on physical appearance when selecting mates (Siever, 1994). ...
... These studies have provided evidence that the association between sexual orientation and eating pathology is not simply an artifact of treatment seeking. Community-based research shows that homosexuality has been consistently associated with factors that increase risk for eating disorders such as drive for thinness Siever, 1994), and body dissatisfaction (Beren, et al., 1996;Silberstein, et al., 1989) in men but not women (Beren, et al., 1996;Brand, Rothblum, & Solomon, 1992;Moore & Keel, 2003). Research in women indicates that homosexuality in females seems to be neither a risk nor a protective factor for eating disorder development (Morrison, Morrison, & Sager, 2004). ...
Article
Sexual orientation has emerged as a consistent and specific risk factor for eating pathology in men, with bisexual and gay (BG) men having higher rates of eating pathology than heterosexual men. One theoretical explanation for this association posits that BG men may feel pressure to obtain a lean physique to attract a male partner, leaving them vulnerable to disordered eating. However, the related implication that being in a relationship should serve as a protective factor against eating pathology in BG men has not yet been examined. The current study utilized a community-based sample of BG (n=42) and heterosexual men (n=536) to examine whether relationship status and relationship satisfaction moderate the effect of sexual orientation on disordered eating in men. Single BG men had increased disordered eating compared to single heterosexual men, while no differences were found for BG and heterosexual men in relationships. Among men in relationships, satisfaction with that relationship was not related to disordered eating; instead dissatisfaction with friendships and, to a greater degree, work predict disordered eating for BG, but not heterosexual men, in relationships. Results imply that being in a relationship is a protective factor for disordered in BG men. Among men in relationships, satisfaction with friends and work are additional protective factors.
... Some authors support a model where lesbianism might be seen as a protective factor against disordered eating attitudes. Other studies, conversely, have found no major differences between hetero-and homosexual women concerning body dissatisfaction [11,12], with regard to the presence of dysfunctional eating attitudes and behaviors [11][12][13][14] or in rates of eating disorders [15]. A detailed description of the relationship between sexual orientation and eating problems, in males and females, was published elsewhere [see 10,16]. ...
... In accordance with previous studies comparing homosexuals and heterosexuals of both sexes [10], heterosexual men scored lower than all other groups on each of the measures under study. No differences between lesbian and heterosexual women were found [10,13,14,47] so homosexual orientation seems to be associated with greater body dissatisfaction and abnormal eating behaviors in men but not in women. Transsexuals, instead, displayed higher degrees of abnormal eating attitudes and behaviors. ...
Article
The primary aim of this study was to investigate the relationship between gender role orientation and eating disorder attitudes and behaviors and body dissatisfaction in a sample of homosexuals, heterosexuals, and transsexuals. We screened 132 homosexuals, 178 heterosexuals (both male and female), and 15 MtF transsexuals by means of an ad hoc socio-demographic schedule; the Eating Disorders Inventory-2 and Symptom Checklist; the Body Uneasiness Test and the Bem Sex Role Inventory. Differences between homosexual, heterosexual, and transsexual participants emerged, but those data seem to be best explained by the constructs of femininity and masculinity than by the biological gender. The empirical evidence of a positive correlation between femininity and eating problems, and the negative correlation between masculinity and eating problems, is full of implications. Eating disorders appear to be diseases of femininity; masculinity seems to be a protective factor, independently by the biological gender.
... ), tuttavia altri studi riportano un rischio paragonabile al resto della popolazione femminile(Feldman e Meyer 2007; Altieri ________________________________________________________________________________________ 444 Share e Mintz 2002;Strong et al. 2000) ed altri ancora sembrano suggerire come nelle donne l'orientamento omosessuale possa rappresentare addirittura un fattore protettivo per lo sviluppo di DA(Conner et al. 2004;Moore e Keel 2003; Strong et al. 2000).Sono diversi i motivi a cui può essere ricondotta la scarsa coerenza dei risultati nelle donne SM.In primo luogo, tale variabilità può essere dovuta ad uno dei principali limiti che emerge dagli studi presenti in letteratura sui DA nella popolazione LGBTQI+, rap-presentato dal largo utilizzo di misure dicotomiche nella valutazione dell'identità di genere e dell'orientamento sessuale, con lo scopo di rilevare le differenze tra eterosessuali-omosessuali e tra maschi-femmine, imponendo una visione binaria che esclude tutte le altre possibili sfumature identitarie e non consentendo, pertanto, di rilevare in maniera sistematica le differenze esistenti per ciascuna di esse (Matera et al. 2019; Pistella et al. 2019). La letteratura indica come l'orientamento sessuale e l'identità di genere non siano costrutti dicotomici, ma possano essere sperimentati dimensionalmente lungo un continuum che delinea, rispettivamente, una maggiore o minore attrazione erotica e/o affettiva e una maggiore o minore identificazione nei confronti del proprio sesso o del sesso opposto (Diamond e Butterworth 2008; Kaestle 2019; Savin-Williams 2014, 2016; Vrangalova e Savin-Williams 2012).Tuttavia, soprattutto negli studi meno recenti, le donne lesbiche sono state spesso incluse all'interno del sottogruppo "gay" o della popolazione eterosessuale generale, presupponendo pertanto un'omogeneità all'interno della comunitàLGBTQ+ intesa come categoria monolitica, oppure escludendole totalmente da essa al fine di indagare una maschio-centrica "comunità gay" rispetto alla quale le donne lesbiche e bisessuali sono state spesso rese invisibili(Matthews-Ewald et al. 2014;Meneguzzo et al. 2018). ...
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In the existing literature, most studies on Eating Disorders (EDs) have involved predominantly heterosexual women. This is due to the high prevalence of this disorder in the female population and to the difficulty in recruiting sufficiently large and diversified samples encompassing the plurality of the identity components potentially involved. The purpose of this paper is to highlight the complexity of EDs' clinical picture in both etiopathogenetic and intersectional terms, considering the multiplicity and specificity of the subjects with EDs or at high risk of developing it. A literature review on the prevalence of EDs in the LGBTQI + population is presented here. Particular attention has been paid to the peculiarities of each of the subjectivities of which each letter that makes up the acronym is an expression, highlighting some methodological issues that have limited data availability needed to accurately inform clinical work and treatment.
... Furthermore, Yean et al. (2013) found SMW (n = 86) did not differ from heterosexual women (n = 361) in a lifetime prevalence of EDs. Moreover, Moore and Keel (2003) also found no differences between heterosexual women (n = 47) and SMW (n = 45) when investigating bulimic symptomology. However, the majority of these studies focused on comparing heterosexual women with all SMW subgroups, overlooking the distinct analysis of bi + women. ...
... The presumption of immunity is not unanimous; some studies report that women experience body image issues and practice problematic body management strategies regardless of sexual orientation (Feldman & Meyer, 2007;Moore & Keel, 2003). Other researchers argue that behaviours coded as eating disorder symptoms are actually more common for queer women than they are for women with a cisgender and heterosexual identity (Austin et al., 2013;Koh & Ross, 2006;Wichstrom, 2006). ...
Article
In this study we examine how discourses of obesity and eating disorders reinforce cissexist and heteronormative body standards. Sixteen queer women in Canada produced autobiographical micro-documentaries over the course of two workshops. We identified three major themes across these films: bodily control, bodies as sites of metamorphosis, and celebration of bodies. Such films can be memorable, cultivate empathy, disrupt misunderstanding of queer bodies, and inform medical practice. Our analysis suggests that research and policy on ‘disordered’ bodies must better account for how people negotiate discourses around body shape and size, how shaming is internalised, how regulation can function as resistance, and how variant bodies can be embraced, desired, and celebrated. Community-grounded, arts-based research points to new ways of gathering and producing knowledge.
... Some studies suggest that lesbian orientation would be a protective factor against these disorders [12], being associated with lower body dissatisfaction [16,17] and more positive attitudes towards food and weight [18]. Other studies, however, did not find large variations in ED symptoms [13,19,20] or body dissatisfaction [21,22] among women according to sexual orientation. Finally, there are studies that even consider that minority sexual orientation, far from being a factor of protection, can come to represent an added risk in women. ...
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Background Men tend to give more importance than women to physical aspects when selecting a partner; thus, the internalization of beauty standards and the ideal of thinness may be greater in populations attracted to men, placing them at a higher risk of eating disorders. Methods In a sample (n = 398) of heterosexual and gay men and women, we evaluated the drive for thinness, body dissatisfaction, and bulimic symptomatology. Using ANCOVAs, we analyzed the differences in symptoms score according to sex, sexual orientation and relational status including body mass index (BMI) as covariate; we also evaluated the mediating role of drive for thinness in the relationship between sexual orientation and body dissatisfaction. Results We found an increased drive for thinness and body dissatisfaction in men-attracted compared with women-attracted participants; also, body dissatisfaction was greater in women than in men. Heterosexual women presented higher bulimia scores than lesbian women. Gay men open to relationships presented higher drive for thinness and body dissatisfaction scores than those not-open to relationships. Finally, differences in body dissatisfaction between gay and heterosexual men were fully explained by drive for thinness, while, in the case of women, drive for thinness only partially explained these differences. Conclusions Attraction to men seems to be a risk factor for EDs in the case of gay men and heterosexual women. In addition, in the case of heterosexual women, other factors independent of the desire to attract men seem to be important.
... In addition, gay men are more likely than heterosexual men to feel judged based on their appearance, think often about how they look, engage in appearance-based social comparison, and feel pressure from the media to be attractive (Frederick & Essayli, 2016). In contrast, findings for women have been less consistent, with some studies finding small differences in body image across sexual orientation groups, and others finding no differences Frederick et al., 2020;Henn, Taube, Vocks, & Hartmann, 2019;Moore & Keel, 2003;Moreno-Domínguez, Raposo, & Elipe, 2019;Morrison et al., 2004;Peplau et al., 2009). ...
Article
Objectification theory and the tripartite influence model provide useful frameworks for understanding the body image experiences of men and women. However, there is little systematic investigation of how sexual orientation moderates the links between these constructs and body image satisfaction. It has been hypothesized, for example, that the associations of surveillance (i.e., monitoring of one’s appearance due to objectification by others) would be strongest for groups targeted by the male gaze (e.g., gay men, lesbian women, and bisexual men and women). Here we proposed an integrated sociocultural model and examined these pathways in multigroup structural equation models in a national sample of heterosexual, bisexual, and lesbian women (ns = 5395; 598; 213, respectively), and heterosexual, bisexual, and gay men (4869; 194; and 194, respectively) aged 18–65 years. Sexual orientation moderated some of these pathways. The most consistent pattern was that appearance pressures were internalized to a greater extent among bisexual participants. The pathways to poorer body image were generally similar among heterosexual and gay/lesbian men and women. These findings highlight the importance of examining sexual orientation-specific influences on body image across diverse groups, as well as the commonalities in the experiences of men and women across sexual orientations.
... These patterns are consistent with most of the existing evidence that recognizes the heterogeneity of DEBs. On the one hand, there is a low rate of restrictive behaviors among LBW (Matthews-Ewald et al., 2014;Morrison et al., 2004) or there are no differences associated with sexual orientation (Laska et al., 2015;Moore & Keel, 2003;Morrison et al., 2004;Yean et al., 2013). On the other, with exceptions (Matthews-Ewald et al., 2014), LBW have a higher prevalence of behaviors re-lated to bulimia nervosa such as use of weight loss pills, self-inducted vomiting and purging (Austin et al., 2009;Laska et al., 2015). ...
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Introduction In high-income countries, sexual minorities are at a higher risk for disordered eating behaviors. It is not known whether these findings can be extrapolated to Mexico. Objective Determine whether there are any differences in disordered eating behaviors among Mexican youth according to sexual orientation and analyze the potential role of experiences of violence and discrimination as mediators of these differences. Method Data from a representative sample of Mexican youth (12 to 29 years old, n = 27,876) were analyzed. Three groups were identified: young people who were not in love (NIL), who were in love with people of the opposite sex (ILOS), or in love with people of the same sex (ILSS). Restrictive behaviors, secret eating, and self-induced vomiting were identified through a scale created for the survey. Results ILSS men had a higher risk of restrictive thoughts and behaviors (B = .31), secret eating (OR = 2.21), and self-induced vomiting (OR = 3.65) than ILOS youth. Among women, there was only a difference in self-induced vomiting (RM = 2.49). In both sexes, being a young ILSS had an indirect effect on restrictive behaviors through its association with experiences of violence, discrimination at school, and sexual violence. Discussion and conclusion . Mexican sexual minority men are at a higher risk of disordered eating behaviors, whereas sexual minority women are at a higher risk of purging. Part of the differences in restrictive behaviors were explained by the increased risk for experiences of prejudice faced by sexual minority youth.
... Researchers seem to confirm this notion; they suggest that, despite comparable levels of awareness of sociocultural norms pertain ing to appearance, individuals differ in the extent to which they internalize said norms. For example, studies show that gay men may be more likely than their heterosexual coun terparts to be influenced by sociocultural factors (Gigi, Bachner-Melman, & Lev-Ari, 2016), while lesbian women may be less likely to internalize sociocultural beauty norms, such as the thin ideal, when compared to heterosexual women (Huxley, Halliwell, & Clarke 2015;Moore & Keel, 2003). (However, some studies detect no difference between lesbian and straight women [e.g., Koff, Lucas, Migliorini, & Grossmith, 2010;Legenbauer et al., 2009].) ...
Chapter
This chapter reviews current literature pertaining to body image and pathogenic eating practices among sexual and gender minority populations. The authors begin by detailing three dominant theoretical frameworks that have been used to particularize why some sexual and gender minority persons are at risk of body dissatisfaction and disordered eating—the minority stress model, sociocultural theory, and objectification theory—as well as the pantheoretical model of dehumanization. Then, to highlight dominant trends in the literature, the authors summarize narrative and meta-analytic reviews on body image and eating disorders that target gay men, lesbian women, bisexual persons, and trans persons. The authors conclude by detailing obstacles that prevent researchers from better grasping the corporeal psychology of sexual and gender minority persons. These obstacles include (1) inconsistent and ambiguous operationalizing of constructs such as the “gay community”—constructs that are often invoked to explain why sexual and gender minority persons are at risk;(2) reliance on outdated measures of sexual orientation;(3) the elision of bisexual persons in body image scholarship;(4) the limited attention that is paid to the variability existing within sexual and gender minoritized groups;(5) the absence of research focusing on the dynamics of intersectionality as they pertain to the body; and (6) the lack of studies conducted outside of the United States.
... In addition, the possibility of interaction between sexual orientation and age has only received very limited research attention. In this regard, Moore and Keel (2003) reported that both sexual orientation and age were related to women's body dissatisfaction, but their interaction was not. ...
Article
Previous research studies on the relationship between body dissatisfaction and sexual orientation in men and women showed inconsistent results. To better understand this body of research, we conducted a quantitative synthesis based on a three-level random-effects meta-analytic model. In total, we analyzed 229 effect sizes from 75 primary studies published between 1986 and 2019. Results showed that sexual minority men had a higher level of body dissatisfaction than heterosexual men (57 studies, 128 effect sizes), with a small to medium effect size (d = 0.34; 95% CI: 0.28, 0.39). Other comparisons—bisexual men vs. gay men (6 studies, 9 effect sizes), sexual minority women vs. heterosexual women (36 studies, 85 effect sizes), and bisexual women vs. lesbian women (6 studies, 7 effect sizes)—showed smaller and statistically insignificant differences. Moderator analyses revealed that the inconsistency in previous studies comparing sexual minority men and heterosexual men could be partially explained by specific study features, including publication year, survey method, participants’ age, participants’ BMI, and measures used to assess body dissatisfaction. The inconsistent findings in comparing sexual minority women and heterosexual women could be partially explained by the different survey methods used in previous studies. Explanations and implications are discussed.
... In a large sample of LGB participants, the lifetime prevalence of eating disorders was 8.8% for gay and bisexual men, with another 15.5% reporting a subthreshold eating disorder [58]. Despite the long-standing belief that lesbians are protected from disordered eating, evidence suggests that lesbians and bisexual women develop eating disorders at rates similar to heterosexual women [49]. In fact, Davids and Green [9] reported higher rates of disordered eating in bisexual than in heterosexual men and women. ...
Article
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Drawing on objectification theory, we investigated associations among age, gender-typed traits (masculinity, femininity), community involvement (gay and lesbian sample), and body objectification (body surveillance and body shame) in gay men, lesbians, and heterosexual men and women. Our sample included 390 participants from university and community settings. A total of 82 gay men, 62 lesbians, 82 heterosexual men, and 164 heterosexual women, M age = 23.06 years (range 18–62), completed a measure to assess body surveillance and body shame and masculinity and femininity. Additionally, the lesbian and gay participants completed an assessment to measure LGBT community involvement. Controlling for age, results were significant for the femininity × masculinity interaction on body surveillance for gay men and lesbians, and masculine gender-typed traits for heterosexual women. Masculinity also was a significant predictor of body shame for lesbians. LGBT community involvement was non-significant for both gay men and lesbians. Our findings are consistent with objectification theory and highlight the importance of examining the complexities of gender (e.g., interaction between masculinity and femininity) and sexual orientation when body objectification is investigated.
... Some studies estimate that approximately 8%-9% of lesbian women and 11 % of bisexual women report a lifetime eating disorder Mason, Lewis, & Heron, 2017), and found that lesbian women are at similar or increased risk for eating disorders and disordered eating compared to heterosexual women, especially during adolescence Bankoff, Marks, Swenson, & Pantalone, 2016;Feldman & Meyer, 2010;Frisell, Lichtenstein, Rahman, & Langstrom, 2010;Hadland, Austin, Goodenow, & Calzo, 2014). Other studies report conflicting https://doi.org/10.1016/j.bodyim.2019.11.006 1740-1445/Published by Elsevier Ltd. results, some indicating no significant differences in eating disorder diagnoses (Feldman & Meyer, 2007) or symptoms (Moore & Keel, 2003;Share & Mintz, 2002) in lesbian/bisexual women compared to heterosexual women, while another found that lesbian/bisexual women had higher levels of disordered eating compared to heterosexual women (Wichstrom, 2006). ...
Article
This study provided the first test of whether sexual orientation (categorized as heterosexual vs. sexual minority) is associated with baseline eating disorder risk factors and symptoms, moderated the intervention effects of variants of the dissonance-based Body Project, or moderated the relation of baseline risk factors to future change in eating disorder symptoms. A total of 680 women with body image concerns were randomized to clinician-or peer-led Body Project groups, the eBody Project, or educational video control and completed assessment of eating disorder risk factors and symptoms at pretest, posttest, and at six-, 12-, 24-, and 36-month follow-up. Results indicated that sexual minority women had significantly higher negative affect and impaired psychosocial functioning at baseline, but did not differ on other eating disorder risk factors or symptoms. We found no evidence that sexual orientation moderates the effects of the Body Project on risk factor or symptom change over follow-up or the relation of baseline risk factors to future change in eating disorder symptoms. Overall, sexual minority and heterosexual women differ on two, less specific eating disorder-related risk factors at baseline, but did not differ in response to different versions of the Body Project or the relations of risk factors to future symptom change.
... Research examining the cognitive-affective component of body image disturbance has revealed a significantly lower drive for a thinner body (drive for thinness) in homosexual women (HOW) than in heterosexual women (HEW) (25)(26)(27)(28)(29), although some studies have reported similar levels (30,31). To date, no study has investigated the association between sexual orientation and drive for leanness, i.e., the preference for a thin and welltoned body with as little body fat as possible (32). ...
Article
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Body image disturbance is a core symptom of eating disorders (EDs) and body dysmorphic disorder (BDD). There is first evidence that females’ body image differs depending on sexual orientation, with heterosexual women (HEW) appearing to show more body image disturbance symptoms than homosexual women (HOW). Such disparities might be moderated by everyday discrimination experiences and involvement with the lesbian community. However, to date, there has been no comprehensive assessment of a broad range of body image facets such as drive for thinness, leanness, and muscularity; body avoidance; body checking and body dissatisfaction; and ED and BDD pathology as well as moderating factors. Moreover, studies have often neglected bisexual women (BIW). A total of N = 617 women (n = 180 HOW, n = 322 HEW, n = 115 BIW) completed an online survey assessing the various facets of body image, ED and BDD pathology, discrimination experiences, and involvement with the lesbian community. Significant group differences were found regarding drive for leanness and thinness, body checking, investment behavior, and body ideal (all p<.05). BIW showed significantly more body checking than HOW. Compared to HEW, HOW reported a significantly lower drive for leanness and thinness as well as compared to HEW and BIW less investment behavior. HOW preferred a body ideal with significantly more body fat than did HEW (all p<.05). In contrast, no differences emerged in body dissatisfaction, drive for muscularity, body-related avoidance, ED and BDD pathology, and body image disturbance (all p>.05). In all groups, discrimination experiences were positively related to ED and BDD pathology and to body image disturbance (all p < .05); however, discrimination was significantly correlated with more body image facets in HEW than in HOW or BIW. Involvement with the lesbian community was positively correlated with a larger ideal body size in HOW (p < .05) and negatively correlated with drive for muscularity in BIW (p < .05). Despite the group differences in several body image facets, we found no consistent evidence of increased vulnerability to body image disturbance or associated pathology depending on sexual orientation. However, in HEW, discrimination experience might pose a risk factor for the development of body image–related pathology and single facets of body image disturbance.
... [65], Erol vd. [15], Şengül ve Hekimoğlu [66], Moore ve Keek [67], Siyez ve Uzbaş [42], Ünalan vd. [34], Tekyaprak [63] ve Uskun ve Şabaplı [59]'nın çalışmalarından farklı olarak anlamlı olmadığı (p>0.05) ...
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Bu çalışmada Bitlis Eren Üniversitesi’nde öğrenim gören 294 üniversite öğrencisinin yeme davranışı bozukluğuna yatkınlıklarının belirlenmesi amaçlanmıştır. Öğrencilere cinsiyet, yaş, vücut ağırlığı ve boy uzunluğu bilgileri sorulup, Savaşır ve Erol (1989) tarafından Türkçeye uyarlanan 40 soruluk Yeme Tutum Testi (YTT-40) uygulanmıştır. YTT-40’ın değerlendirme ölçeğine göre; “≥30” puan alan kişiler “yeme davranışı bozukluğuna yatkın” şeklinde nitelendirilmiştir. Elde edilen veriler IBM SPSS 20® programında, sıklık ve Pearson ki-kare testleriyle değerlendirilmiştir. Kız öğrencilerin % 11.9’unun (n=21), erkek öğrencilerin %14.9’unun (n=18) YTT-40 puanı ≥30 olarak tespit edilmiştir. YTT-40 puanlarına göre; zayıf öğrencilerin %7.8’inin (n=3), normal öğrencilerin %13.6’sının (n=31) ve şişmanlık öncesi (pre-obez) öğrencilerin %15.5’inin (n=5) yeme davranışı bozukluğuna yatkın oldukları belirlenmiştir. Öğrencilerin yaş aralıklarına göre YTT-40 puanları değerlendirildiğinde; 17-23 yaş aralığındaki öğrencilerden %13.8’inin (n=38) ve 24-29 yaş aralığındaki öğrencilerden ise %4.3’ünün (n=1) yeme davranışı bozukluğuna yatkın oldukları görülmüştür. Öğrencilerin ortalama YTT-40 puanları 18.14±9.95 olarak bulunurken; %13.3’ünün (n=39) yeme davranışı bozukluğuna yatkın olduğu belirlenmiştir. Ancak, öğrencilerin cinsiyetleri, BKİ değerleri ve yaş aralıkları ile YTT-40 puanları arasındaki farkın anlamlı olmadığı (p>0.05) ortaya çıkmıştır.
... There is evidence to suggest that ethnic/racial background/identity may shape how girls and women relate to ideals of hegemonic femininity, with women of color embracing a "thicker" body ideal and a more fluid, flexible approach to thinking about the female body that does not hinge upon the achievement of a cultural body ideal (Parker et al. 1995;Wood-Barcalow et al. 2010). Similarly, there is some work to suggest that sexual orientation may shape how women relate to the hegemonic ideal, with lesbian women less focused upon the thin ideal than heterosexual women (Moore and Keel 2003). The present work also was limited in that it did not include the perspectives of the owner or the coaches at the box, but rather, relied upon member accounts to gain an understanding of participant-owner and participantcoach interactions. ...
Article
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The purpose of this interpretive study was to explore how women’s participation in the sport of CrossFit sets a context for the development of their body images—including their thoughts and feelings about the body and their lived experiences of embodiment—as well as their perceptions of culturally constructed ideals of beauty and gender. Analyses were informed by feminist cultural studies. In-depth, face-to-face interviews were conducted with 16 women who regularly participate in CrossFit. Data were analyzed using constant comparison processes. Findings illuminate how women experienced the culture of a male-owned, co-ed, CrossFit gym and how their immersion and participation in that gym culture gave rise to varied bodily experiences and practices, including body/appearance ideals, bodily appraisals, appetites and diets, physical fitness ideologies, appearance management routines, perspectives on gender, and identity development. Participant narratives revealed diverse lived realities across accounts as well as some evidence of contradiction or ambivalence within individual accounts. Implications for professionals who work in the body image area (e.g., nutritionists, counselors/therapists, sports psychologists), for the apparel and merchandising industry, for the sport of CrossFit, and for future work in the area are discussed.
... Some cross-sectional evidence indicates that lesbian and bisexual women have elevated eating disorder risk as compared with heterosexual women (Hadland et al., 2014;Moore & Keel, 2003). ...
... From an overall perspective, the body of research on LGBQ women and disordered eating depicts mixed results. A small number of early studies suggest that lesbians experience lower rates of body dissatisfaction and eating disorders compared to heterosexual women [21][22][23], with other studies finding no differences between these two groups of women [11,18,[24][25][26]. A small number of recent studies suggest that LGBQ females, similar to LGBQ males, may be at an increased risk for eating disorders and disordered eating during adolescent development and emerging adulthood [27][28][29][30]. ...
Article
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Purpose: To investigate the relationship between selected disordered eating behaviors and self-reported sexual minority status (gay/lesbian, bisexual, and unsure) among a representative sample of high school adolescents. Methods: The 2013 Centers for Disease Control and Prevention (CDC)-sponsored Connecticut Youth Risk Behavior Survey was utilized (N = 2242). Unadjusted and adjusted logistic regression analyses, separated by gender, examined sexual minority adolescents (gay/lesbian, bisexual, and unsure) and selected eating behaviors. Analyses adjusted for race, age, cigarette use, binge drinking, organized school activity participation, body mass index (BMI), and depression. Results: Gay males were significantly more likely to report exercising or eating less to lose weight in the unadjusted models (p < 0.05) and fasting, vomiting, and taking diet pills in both adjusted (p < 0.05) and unadjusted models (p < 0.01) when compared to the referent heterosexual males. Bisexual females were significantly more likely to report fasting, vomiting, and taking diet pills in the unadjusted model (p < 0.05) when compared to the referent heterosexual females and significantly less likely to report exercising or eating less to lose weight in the adjusted models (p < 0.05). Conclusions: Although additional studies are needed owing to small sample sizes, preliminary findings support previous research suggesting that high school-aged sexual minority youth subgroups are a priority target population for increased efforts to prevent disordered eating.
... With regards to age, sexual orientation, and disordered eating, a study by Moore and Keel (2003) found that age did not influence sexual orientation and eating disorder symptoms. They did find a main effect for age, however, as older women were more dissatisfied with their bodies and more likely to use exercise as a method of weight control. ...
Article
Women are often socialized to adhere to an ideal of thinness, although recent research has shown that sexual orientation and religious beliefs may moderate body dissatisfaction and disordered eating symptoms. The present study examined the effects of religious and sexual orientations on memory for weight-related stimuli. The main research question was whether sexual and religious orientations would affect the recall of pictures, whether they are weight-related, neutral, or intrusions. Young college women (aged 18-30), of different sexual and religious orientations, participated in an incidental memory test consisting of weight-related and neutral pictures shown on a computer screen. Participants were also asked to complete a series of questionnaires and scales. Results indicated that religious, heterosexual participants recalled more intrusions than non-religious, heterosexual participants. Furthermore, religious orientation affected the number of weight-related intrusions recalled.
... Smoking initiation among adolescent girls is associated with body image and weight gain concerns, 53 although several studies report that lesbians are less likely to be concerned with weight and body image than heterosexual women. 54,55 We are aware of one study on smoking and weight among lesbian adults, which showed smoking was unassociated with BMI. 56 However, in our study overweight/obesity was inversely correlated with smoking (r = À0.35, ...
Article
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Purpose: Syndemics, or the co-occurrence and interaction of health problems, have been examined extensively among young men who have sex with men, but their existence remain unexamined, to our knowledge, among sexual-minority (i.e., lesbian, gay, and bisexual) women. Thus, we investigated if syndemics were present among young sexual-minority women, and if sexual-orientation discrimination was an independent variable of syndemic production. Methods: A total of 467 sexual-minority women between the ages of 18 and 24 completed a cross-sectional online survey regarding their substance use, mental health, sexual behaviors, height, weight, and experiences of discrimination. We used structural equation modeling to investigate the presence of syndemics and their relationship to sexual-orientation discrimination. Results: Heavy episodic drinking, marijuana use, ecstasy use, hallucinogen use, depressive symptoms, multiple sexual partners, and history of sexually transmitted infections (STIs) comprised syndemics in this population (chi-square=24.989, P=.201; comparative fit index [CFI]=0.946; root mean square error of approximation [RMSEA]=0.023). Sexual-orientation discrimination is significantly and positively associated with the latent syndemic variable (unstandardized coefficient=0.095, P<.05), and this model fit the data well (chi-square=33.558, P=.059; CFI=0.914; RMSEA=0.029). The reverse causal model showed syndemics is not an independent variable of sexual-orientation discrimination (unstandardized coefficient=0.602, P>.05). Conclusions: Syndemics appear to be present and associated with sexual-orientation discrimination among young sexual-minority women. Interventions aimed at reducing discrimination or increasing healthy coping may help reduce substance use, depressive symptoms, and sexual risk behaviors in this population.
... Overall, research on LGBQ women and DES has demonstrated mixed findings. For example, a few early studies found that lesbians experience lower rates of body dissatisfaction and DES than heterosexual women (Guille & Chrisler, 1999;Siever, 1994), while others found no differences between the two groups (e.g., Beren et al., 1996;Feldman & Meyer, 2007;Heffernan, 1996;Moore & Keel, 2003;Share & Mintz, 2002). More recently, a number of studies suggest that LGBQ females, like LGBQ males, may be at increased risk for ED behaviors and/or unhealthy weight control practices during adolescence and young adulthood (e.g., Austin et al., 2009;Hadland, Austin, Goodenow, & Calzo, 2014;Robin et al., 2002;Wichstrøm, 2006). ...
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Research shows that gay and bisexual males are at increased risk for disordered eating symptoms (DES); however, studies examining DES amongst lesbians and bisexual women have produced mixed findings. Furthermore, few studies have included questioning or "unsure" individuals. This study examined DES symptoms in adolescents and young adults across self-reported sexual attraction and behavior. Participants were recruited from ten primary care sites in Pennsylvania and administered the Behavioral Health Screen (BHS) - a web-based screening tool that assesses psychiatric symptoms and risk behaviors - during a routine visit. As expected, males who were attracted to other males exhibited significantly higher disordered eating scores than those only attracted to members of the opposite sex. Males who engaged in sexual activities with other males also exhibited significantly higher scores than those who only engaged in sexual activities with females. Amongst females, there were no significant differences in DES scores between females who were only attracted to females and those only attracted to males. Those who reported being attracted to both sexes, however, had significantly higher scores, on average, than those only attracted to one sex. More surprisingly, females who were unsure of who they were attracted to reported the highest DES scores of all. These findings are contrary to previous assumptions that same-sex attraction plays a protective role against eating pathology in females. Females who are unsure or attracted to both sexes may actually be at increased risk for developing DES. Copyright © 2015 Elsevier Ltd. All rights reserved.
... Interestingly, identifying as a SM woman does not appear to increase the risk for disordered eating behaviors. The largely non-significant findings detected among SM women in this study are consistent with some previous research (Feldman & Meyer, 2007;Moore & Keel, 2003;Share & Mintz, 2002), but not with other research (Heffernan, 1994). It is possible that results are due to the co-morbidity of such variables as depression and disordered eating ...
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This study compared the risk of a) clinically diagnosed eating disorders, and b) disordered eating behaviors, separately among three groups of United States college students, controlling for known covariates. These groups included college students self-identifying as: 1) gay/lesbian; 2) bisexual; and, 3) unsure, with self-identified heterosexuals as the reference. Data from the American College Health Association's National College Health Assessment II (2008–2009) were utilized (N = 110,412). Adjusted logistic regression analyses, stratified by self-reported gender, examined the effect of self-identified sexual identity on clinical eating disorder diagnosis and disordered eating behaviors. Covariates included self-reported binge drinking (past 2 weeks), stress (last 12 months), smoking (past 30 days), depression (past 12 months), fraternity/sorority membership, college athletics participations, and race. Additional logistic regression sub-analyses examined sexual minorities only, with gay/lesbian as the referent. Gay, unsure, or bisexual men were at significantly increased odds to report both clinical eating disorders and disordered eating behaviors when compared to heterosexual men in both the unadjusted and adjusted models (p < .002). All sexual minority men and women were significantly more likely to report dieting to lose weight compared to heterosexual men and women (p < .002). Targeted disordered eating and eating disorder prevention efforts are needed for those who are sexual minorities, particularly for sexual minority men.
... A consistent finding in Western countries is that homosexual men are more vulnerable to eating disorders than heterosexual men. Amongst homosexual males eating disorders and disordered eating attitudes are significantly more prevalent than amongst heterosexual men (Andersen, 1999;Brand, Rothblum, & Solomon, 1992;Harvey & Robin-son, 2003;Lakkis, Ricciardelli, & Williams, 1999;Moore & Keel, 2002;Strong, Williamson, Netemeyer, & Geer, 2000;Williamson & Hartley, 1998;Yelland & Tiggemann, 2003, but see Boroughs & Thompson, 2002). In addition there is a typical overrepresentation of homosexual males in clinical eating disorder samples: an average of 20% (Andersen, 1999) to 42% (Russell & Keel, 2002) of males with eating disorders are homosexual. ...
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There is a typical overrepresentation of homosexual males in clinical eating disor- der samples. The present study investigated the role of gender role orientation, peer pressure, self-esteem, and body dissatisfaction in relation to eating disorder symp- toms among a sample of homosexual men and a sample of heterosexual men. The results show that most variables were highly interrelated. However, using multivariate regression analyses it was found that body dissatisfaction, and not self-esteem, was the dominant predictor of eating disorder symptoms. For both het- erosexual and homosexual men, a higher level of body dissatisfaction was related to higher Body Mass Index (BMI), more peer pressure, and lower masculinity scores. In addition, an interaction of sexual orientation and peer pressure was found: the rela- tionship between peer pressure and body dissatisfaction was substantially more pro- nounced among homosexual men. Finally, associations between eating disorder symptoms on the one hand and sexual orientation, gender role orientation and peer pressure on the other hand, became non-significant when taking body dissatisfac- tion into account. The results show the central role of body dissatisfaction in the rela- tionship between homosexuality and eating disorder symptoms, as well as the contribution of peer pressure. Directions for future research are discussed.
... In contrast to the findings for gay men, it has previously been argued that lesbians have a lower risk of developing an eating disorder or negative body image as they are not focused on the slender ideal to the extent that heterosexual women are (Moore & Keel, 2003). Data from another study collected from lesbian and heterosexual women revealed a lesbian sexual orientation to be predictive of a positive body image and fewer negative attitudes towards eating and weight (Owens, Hughes, & Owens-Nicholson, 2002). ...
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This study assesses whether characteristics of one's own body image influences preferences of attractiveness in a partner. The role of gender and sexual orientation is also considered. Heterosexual women (n=67), lesbian women (n=73), heterosexual men (n=61) and gay men (n=82) participated in an internet survey assessing attitudes towards the body and preferences of attractiveness in a partner. Men in particular were found to prefer attractive partners, regardless of sexual orientation. Weight/shape dissatisfaction was found to be a negative predictor for heterosexual men and women. For gay men, preferences were better explained by internalization and weight/shape dissatisfaction. No such associations were found in the lesbian group. Levels of weight/shape dissatisfaction and internalization of socio-cultural slenderness ideals influence expectations of thinness and attractiveness in a partner with this effect being modified by gender and sexual orientation.
... There has been no research to date on the impact of body weight on the frequency or quality of relationships among lesbians. Yet this would be an interesting area to investigate, since studies have found lesbians to be feel more satisfied with their bodies, diet less, and score lower on measures related to eating disorders than heterosexual women (Bergeron and Senn 1998;Gettelman and Thompson 1993;Herzog et al. 1992;Moore and Keel 2003;Owens et al. 2003;Share and Mintz 2002;Schneider et al. 1995;Siever 1994). This is despite the fact that some studies have found lesbians to weigh more than heterosexual women (e.g., Boehmer et al. 2007;Guille and Chrisler 1999;Herzog et al. 1992;Owens et al. 2003), even when compared with their heterosexual sisters (Rothblum and Factor 2001). ...
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Although research and scholarship on weight-based stigma have increased substantially in recent years, the disproportionate degree of bias experienced by fat women has received considerably less attention. This paper reviews the literature on the weight-based stigma experienced by women in North America in multiple domains, including employment, education settings, romantic relationships, health care and mental health treatment, and portrayals in the media. We also explore the research examining the intersection of gender and ethnicity related to weight stigma. Across numerous settings, fat women fare worse than thinner women and worse than men, whether the men are fat or thin. Women experience multiple deleterious outcomes as a result of weight bias that have a significant impact on health, quality of life, and socioeconomic outcomes. Because of this gender disparity, we argue that feminist scholars need to devote as much attention to the lived experiences of fat women as they have to the “fear of fat” experienced by thin women. KeywordsFat women–Feminism and weight–Weight-based stigma–Weight bias–Women and weight
... They also held more stereotypically masculine personality traits and attitudes. Among young women, BMI is one of the strongest predictors of a drive for thinness (e.g.Davis et al., 1997;Moore & Keel, 2003). However, in the present study we did not find a linear or a curvilinear association between respondentsÕ drive for muscularity and BMI. ...
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The female drive for thinness [DT] and the male drive for muscularity [DM] reflect the pursuit of two culturally explicit, gender-specific, body shape ideals. While a large body of research has confirmed a set of personality vulnerability traits related to DT in women, little is known about the personality correlates of DM. We hypothesised that a similar psychological profile would characterize both. We assessed a sample of young men on measures of neuroticism, perfectionism, narcissism, and appearance and fitness orientation, and used multiple regression procedures to determine the utility of each in predicting DM. Our hypothesis was strongly supported; results indicated that all the traits except narcissism were significantly and simultaneously related to DM, together accounting for 40% of the variance. Given the strong links among DM, steroid use, and excessive weight training, we can infer that these psychological characteristics also increase the risk of potentially risky and unhealthy behaviours in young men as they do in young women.
... These evidences support a model where lesbianism might be seen as a protective factor against disordered eating attitudes. Other studies, conversely, have found no major differences between hetero-and homosexual women concerning body dissatisfaction (Beren et al., 1996; Striegel-Moore et al., 1990), with regard to the presence of dysfunctional eating attitudes and behaviors (Streigel-Moore et al., 1990; Beren et al., 1996; Share & Mintz, 2002; Moore & Keel, 2003) or in rates of eating disorders (French et al., 1996). For example, Heffernan (1996) reported that lesbians were not significantly different from heterosexual women in attitudes concerning body weight and appearance or dieting. ...
... 1,4-10 Sexual orientation demonstrates a specific association with eating pathology that is independent of risk for general psychopathology. 1 The association is unique to men in that similar associations have not been found consistently in women. 11 Taken together, these findings suggest that there is something about sexual orientation that increases risk for eating pathology above risk for other forms of psychopathology in men. One explanation is that BG men may feel pressure to obtain a lean physique to attract a male partner, as men emphasize physical appearance when selecting mates. ...
Article
Robust evidence supports that bisexual and gay (BG) men have increased eating pathology compared to heterosexual men. BG men may be at greater risk due to pressure to attract a male partner; however, the related implication that relationships serve as protective factors for BG men remains untested. BG (n = 42) and heterosexual men (n = 536) completed surveys to determine whether relationship status and satisfaction moderate sexual orientation's effect on disordered eating. Single BG men had increased restrictive disordered eating compared to single heterosexual men, while few differences were found between BG and heterosexual men in relationships. Relationship satisfaction was not related to restrictive disordered eating; however, low relationship satisfaction was associated with increased bulimic symptomatology in BG men compared to heterosexual men. Being in a relationship, independent of whether or not the relationship is satisfying, may be a protective factor for restrictive disordered eating in BG men.
... The sample of homosexual females showed lower body dissatisfaction than heterosexuals (24). Other studies have found no major differences between heteroand homosexual women, with regard to the presence of dysfunctional eating attitudes and behaviours (25)(26)(27). ...
Article
The primary aim of this study was to investigate the relationship between sexual orientation and disordered eating attitudes and behaviours in a sample of homosexuals and heterosexuals subject. We screened 110 homosexuals (85 males and 25 females) and 121 heterosexuals (85 males and 36 females) by means of: a) an ad hoc socio-demographic schedule; b) the Eating Disorders Inventory 2 (EDI 2); the Eating Disorders Inventory 2 - Symptom Checklist (EDI-SC); the Body Uneasiness Test (BUT). Male homosexuals obtained much higher scores than male heterosexuals on the EDI 2 Drive for thinness, Bulimia, Ineffectiveness, Interoceptive awareness, Impulse regulation scales and on all the BUT subscales. Similarly, with regard to eating behaviours, a significantly higher frequency in the use of strategies to compensate weight increase was observed. On all these scales the sample of homosexual males did not show any significant differences from the group of hetero- and homosexual women. The male homosexuals who claimed they were not in a stable relationship scored higher in all the variables considered. Our findings seem to suggest that homosexual orientation is associated with greater body dissatisfaction and abnormal eating behaviours in males, in particular among those who claimed they were not in a sentimental relationship.
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Amaç: Bu araştırmanın amacı, sağlık yüksekokulu öğrencilerinin yeme tutumları ile sağlıklı yaşam biçimi davranışları arasındaki ilişkiyi araştırmaktır. Gereç ve Yöntem: Kesitsel tipteki bu araştırma, Şubat-Mart 2008 tarihleri arasında, Erciyes Üniversitesi Sağlık Yüksekokulu, beslenme ve diyetetik (130), hemşirelik (103) ve ebelik (39) bölümlerinde öğrenim gören 272 öğrenci üzerinde yapılmıştır. Araştırma verileri; öğrencilerin demografik sosyo-kültürel özellikleri, beslenmeye ilişkin davranışlarını değerlendiren bir anket formu ile Yeme Tutum Testi (YTT) ve Sağlıklı Yaşam Biçimi Davranışları Ölçeği (SYBDÖ) kullanılarak, araştırmacı tarafından yüz yüze anket uygulanarak toplanmıştır. Verilerin analizinde; Ki kare testi, Mann-Whitney U testi, Kruskal Wallis testi, Pearson Korelasyon analizi ve Lojistik Regresyon analizi uygulandı. Bulgular: Öğrencilerin Yeme Tutum Testi puan ortalaması 20.9±9.3, SYBD puan ortalaması ise 127.8±17.5’dir. Öğrencilerin %14’ü YTT’den ≥30 puan almışlardır. Kız öğrencilerin olası yeme bozukluğu oranları erkek öğrencilere göre anlamlı düzeyde yüksek bulunmuştur. Öğrencilerin kaldıkları yere ve yerleşim yerine göre; YTT puan ortalamaları arasında anlamlı fark bulunmuştur (p<0.05).Normal kilolu olanların olası yeme bozukluğu oranları anlamlı düzeyde yüksek bulunmuştur. Uygulanan Pearson korelasyon analizi sonucunda; yeme tutumu testi toplam puanları arttıkça da sağlık sorumluluğu puanlarının da anlamlı düzeyde arttığı tespit edilmiştir (p<0.05). Sonuç ve öneriler: Kız öğrencilerde, normal kilolu öğrencilerde, yurtta kalan, ilçede yaşayan öğrencilerde olası yeme bozukluğu görülme oranı yüksektir. Üniversite öğrencileri hem yaşları gereği hem de psiko-sosyal ve ekonomik zorlanmalar nedeniyle yeme bozuklukları için bir risk grubunu oluşturmaktadır. Bu nedenle öğrencilere ve ailelerine yeme bozukluğu hakkında eğitim verilmesi, koruyucu önlemlerin alınmasını öneriyoruz
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Background: Sexual orientation is usually developed during the adolescence, which coincides with the eating disorders peak onset. This paper aims to explore existing literature to identify whether there is an association between sexual orientation and eating disorder-related eating behaviours (EDrEBs) in this age-group. Methods: This review was based on the PRISMA guidelines, covering the published articles between 1990 and 2021. A meta-analysis of the proportion of sexual orientation and the adjusted odds ratio (OR) with 95% confident intervals was reported. Results: Ten studies (412,601 participants) were included in this review. The results demonstrated adolescents identified as minority sexual orientation, particularly homosexual males were with higher OR of EDrEBs, as follows: Homosexual (binge eating: M = 7.20, F = 2.14; purging: M = 5.40, F = 2.41; diet pills use: M = 3.50, F = 2.59; dieting: M = 3.10, F = 1.75); Bisexual (binge eating: M = 4.60, F = 2.26; purging: M = 4.44, F = 2.37; diet pills use: M = 3.42, F = 2.30; dieting: M = 2.36, F = 1.86). Conclusions: Adolescents who were of a minority sexual orientation were more vulnerable to EDrEBs than their heterosexual peers. Healthcare professionals and sexual minority communities should be primed to facilitate earlier recognition and access to services in these vulnerable groups.
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Objective Epidemiological data support that sexual minorities (SM) report higher levels of eating pathology. Theories suggest these disparities exist due to stressors specific to belonging to a minority group; however, few studies have specifically explored differences between SM and heterosexual individuals in clinical eating disorder samples. Thus, the present study compared SM and heterosexual patients with eating disorders on demographic characteristics and eating disorder and psychological outcomes during day hospital treatment. Method Patients (N = 389) completed surveys of eating pathology, mood, anxiety, and skills use at treatment admission, 1‐month post‐admission, discharge, and 6‐month follow‐up. Overall, 19.8% of patients (n = 79) identified as SM, while 8.0% (n = 32) reported not identifying with any sexual orientation. SM were more likely to present across genders (17.7% of females, 24.2% of males, 33.3% of transgender patients, and 87.5% of nonbinary patients). Results SM patients were significantly more likely to endorse major depressive disorder, panic disorder, and self‐harm at admission than their heterosexual counterparts. Multilevel models demonstrated that across time, SM patients demonstrated greater eating pathology, emotion dysregulation, depressive symptoms, and anxiety symptoms. Significant interactions between sexual orientation and time were found for eating pathology and emotion dysregulation, such that although SM patients started treatment with higher scores, they improved at a faster rate compared to heterosexual patients. Discussion Consistent with minority stress theory, SM patients report greater overall eating disorder and comorbid symptoms. Importantly, results do not support that there appear to be significant disparities in treatment outcome for SM patients in this sample of day hospital patients.
Chapter
Gender incongruence, gender dysphoria, and many eating and weight disorders share a troubling body uneasiness. Gender nonconformities were considered to be diseases, in particular, mental disorders, till the last decades of the twentieth century. In this chapter the new DSM-5 diagnostic category gender dysphoria is discussed together with some recent changes in terminology and medical classifications concerning gender identity and sexual orientation.The rates of psychiatric disorders are higher among transgender patients attending specialized services than in cisgender people, with higher levels of body dissatisfaction and suicidal risk. Psychiatric morbidity tends to improve after gender confirmation treatments, often but not always. Therefore, an expert multi-disciplinary team including mental health professionals should manage the assessment and intervention procedures before and after hormone and surgical treatments. The risk of disordered eating and weight control behaviors is increased among sexual minorities, maybe more among MtF (male-to-female) transgenders and homosexual men. Transgender persons may develop unhealthy eating behaviors to accentuate the physical features of their gender identity. Stigma and violence exposure are significant risk factors, while social support is a significant protective factor. The effects of medical and surgical treatments of gender incongruence on eating and weight-related disorders are mostly unknown.
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Objective: In 2015, the Academy for Eating Disorders collaborated with international patient, advocacy, and parent organizations to craft the 'Nine Truths About Eating Disorders'. This document has been translated into over 30 languages and has been distributed globally to replace outdated and erroneous stereotypes about eating disorders with factual information. In this paper, we review the state of the science supporting the 'Nine Truths'. Methods: The literature supporting each of the 'Nine Truths' was reviewed, summarized and richly annotated. Results: Most of the 'Nine Truths' arise from well-established foundations in the scientific literature. Additional evidence is required to further substantiate some of the assertions in the document. Future investigations are needed in all areas to deepen our understanding of eating disorders, their causes and their treatments. Conclusions: The 'Nine Truths About Eating Disorders' is a guiding document to accelerate global dissemination of accurate and evidence-informed information about eating disorders. Copyright © 2017 John Wiley & Sons, Ltd and Eating Disorders Association.
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It remains unclear whether body dissatisfaction, a widely recognized predictor of eating-related pathologies and depressive symptomatology, is consistent across cohorts and time. This question is important to investigate because dominant theories propose that sociocultural influences, which may fluctuate, play an important role in the development of body dissatisfaction. Previous efforts for tracking body dissatisfaction across cohorts and time are limited by relying on data from a single institution or using assessments that lack psychometric support across genders. In this study, we utilized cross-temporal meta-analyses to examine changes in 2 dimensions of body dissatisfaction: thinness-oriented dissatisfaction as assessed with the Eating Disorder Inventory-Body Dissatisfaction subscale (data available across 31 years from 326 unique samples, n = 100,228 participants) and muscularity-oriented dissatisfaction as measured with the Drive for Muscularity Scale (data available across 14 years from 117 unique samples, n = 23,575 participants). Results revealed a significant interaction between year of study and gender in predicting thinness-oriented dissatisfaction: girls and women scored higher than boys and men consistently (ds = 0.51–1.17), although only girls’ and women’s scores decreased gradually across time (d = 0.49). Boys and men scored higher than girls and women on muscularity-oriented dissatisfaction (d = 1.72), with no significant changes across time. These patterns remained when controlling for age and geographic location. Overall, these findings highlight the importance of considering multiple dimensions of body dissatisfaction in research and offer evidence that sociocultural shifts in body acceptance and diversity may be countering thinness-related pressures for girls and women.
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Abstract Background: Lesbian, gay and bisexual (LGB) people may be at higher risk of mental disorders than heterosexual people. Method: We conducted a systematic review and meta-analysis of the prevalence of mental disorder, substance misuse, suicide, suicidal ideation and deliberate self harm in LGB people. We searched Medline, Embase, PsycInfo, Cinahl, the Cochrane Library Database, the Web of Knowledge, the Applied Social Sciences Index and Abstracts, the International Bibliography of the Social Sciences, Sociological Abstracts, the Campbell Collaboration and grey literature databases for articles published January 1966 to April 2005. We also used Google and Google Scholar and contacted authors where necessary. We searched all terms related to homosexual, lesbian and bisexual people and all terms related to mental disorders, suicide, and deliberate self harm. We included papers on population based studies which contained concurrent heterosexual comparison groups and valid definition of sexual orientation and mental health outcomes Results: Of 13706 papers identified, 476 were initially selected and 28 (25 studies) met inclusion criteria. Only one study met all our four quality criteria and seven met three of these criteria. Data was extracted on 214,344 heterosexual and 11,971 non heterosexual people. Meta-analyses revealed a two fold excess in suicide attempts in lesbian, gay and bisexual people [pooled risk ratio for lifetime risk 2.47 (CI 1.87, 3.28)]. The risk for depression and anxiety disorders (over a period of 12 months or a lifetime) on meta-analyses were at least 1.5 times higher in lesbian, gay and bisexual people (RR range 1.54-2.58) and alcohol and other substance dependence over 12 months was also 1.5 times higher (RR range 1.51-4.00). Results were similar in both sexes but meta analyses revealed that lesbian and bisexual women were particularly at risk of substance dependence (alcohol 12 months: RR 4.00, CI 2.85, 5.61; drug dependence: RR 3.50, CI 1.87, 6.53; any substance use disorder RR 3.42, CI 1.97-5.92), while lifetime prevalence of suicide attempt was especially high in gay and bisexual men (RR 4.28, CI 2.32, 7.88). Conclusions: LGB people are at higher risk of mental disorder, suicidal ideation, substance misuse, and deliberate self harm than heterosexual people.
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Objectification theory identifies the role of culture in women's risk for eating disorder symptomatology. Women's internalization of unrealistic beauty and cultural ideals of thinness may lead to "body shame" when they are not achieved and to the development of eating disorder symptomatology. Research applying objectification theory relative to sexual orientation has yielded mixed results. Some studies suggest that both lesbian and heterosexual women are affected by an objectifying culture and subsequently experience body shame and eating disorder symptomatology. Others suggest that because lesbian women reject traditional social norms, notably "heterosexual" standards of beauty and thinness, and, instead, accept their own bodies, lesbian sexual orientation may be a "protector" against eating disorder symptomatology. This commentary briefly reviews current research in this body of literature, taking into account how bisexual women, too, may be at-risk, and how gender atypicality (i.e., a butch/femme identity) might create a "gender role conflict" that puts both lesbian and bisexual women at-risk. This commentary fills a gap in the literature and resolves some inconsistencies.
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Our study extended a modified version of objectification theory to a sample of sexual minority women in order to understand their experiences with body image and disordered eating concerns. Specifically, reported experiences of heterosexist discrimination and internalized heterosexism were integrated into the objectification theory framework. A total of 243 U.S. sexual minority women (primarily White and lesbian) participated in our online study. Results of a path analysis and tests of direct and indirect relations elucidated the important role of heterosexist experiences in sexual minority women’s eating disordered behaviors. Moreover, internalized sociocultural standards of beauty and internalized heterosexism were important predictors of sexual minority women’s body image concerns. Overall, our results supported the applicability of tenets of objectification theory to sexual minority women, with some important modifications. Our study demonstrates the importance of attending to stressors that uniquely affect sexual minority women, which arise from a sexist and heterosexist sociocultural context.
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Most disordered eating research has focused on White, heterosexual women. More empirical work is needed to better understand disordered eating among women of diverse backgrounds. Given evidence of disparities between heterosexual and sexual minority (i.e., non-heterosexual) women in other health behaviors (e.g., tobacco use) and outcomes (e.g., cardiovascular disease), it appears important to study disordered eating behaviors among sexual minority women. In this article, we review the extant literature on disordered eating behaviors in women across sexual orientations, with a focus on research examining potential mechanisms of disparities in disordered eating, including awareness and internalization of sociocultural norms.
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Queer women have not been adequately represented in the literature on eating disorders, and as such, ideas about eating disorders in queer women are often rooted in stereotypes. This article aims to synthesize the research on eating disorders in queer women, with an emphasis on existing shortcomings and necessary future directions. A critique of current literature and existing findings related to eating and body image problems in queer women are presented, followed by a discussion of the current disjuncture between cognitive behavioral therapy (CBT) treatment for eating disorders and culturally competent modifications of CBT for queer clients. Recommendations for the integration of feminist methods in research and practice are made, with the emphasis that improved understanding of sexually diverse women's experiences with eating disorders will create more accurate research findings, better treatment options for such clients, and a richer and more nuanced understanding of eating disorders in general.
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Our purpose was to investigate acculturation and eating disorders by examining the role of ethnic identity and by utilizing a bidimensional perspective toward two cultures. We predicted that orientation toward European American culture and lower ethnic identity would be positively associated with eating disorders. Participants were 188 Mexican American women recruited from the community (79 with eating disorders and 109 control women). The Structured Clinical Interview for DSM-IV-TR and Eating Disorder Examination were used to establish diagnoses. The Acculturation Rating Scale for Mexican Americans–II and the Multigroup Ethnic Identity Measure assessed Anglo orientation, Mexican orientation, and ethnic identity. Orientation toward Anglo American culture was significantly associated with eating disorders, whereas orientation toward Mexican culture and strength of ethnic identity were not associated with eating disorder status. Findings point to the role of Anglo cultural orientation in the development of eating disorders and underscore the need for future research to utilize bidimensional models.
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The development and validation of a new measure, the Eating Disorder Inventory (EDI) is described. The EDI is a 64 item, self-report, multiscale measure designed for the assessment of psychological and behavioral traits common in anorexia nervosa (AN) and bulimia. The EDI consists of eight sub-scales measuring: 1) Drive for Thinness, 2) Bulimia, 3) Body Dissatisfaction, 4) Ineffectiveness, 5) Perfectionism, 6) Interpersonal Distrust, 7) Interoceptive Awareness and 8) Maturity Fears. Reliability (internal consistency) is established for all subscales and several indices of validity are presented. First, AN patients (N = 113) are differentiated from female comparison (FC) subjects (N = 577) using a cross-validation procedure. Secondly, patient self-report subscale scores agree with clinician ratings of subscale traits. Thirdly, clinically recovered AN patients score similarly to FCs on all subscales. Finally, convergent and discriminate validity are established for subscales. The EDI was also administered to groups of normal weight bulimic women, obese, and normal weight but formerly obese women, as well as a male comparison group. Group differences are reported and the potential utility of the EDI is discussed.
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The development and validation of a new measure, the Eating Disorder Inventory (EDI) is described. The EDI is a 64 item, self-report, multiscale measure designed for the assessment of psychological and behavioral traits common in anorexia nervosa (AN) and bulimia. The EDI consists of eight sub-scales measuring: 1) Drive for Thinness, 2) Bulimia, 3) Body Dissatisfaction, 4) Ineffectiveness, 5) Perfectionism, 6) Interpersonal Distrust, 7) Interoceptive Awareness and 8) Maturity Fears. Reliability (internal consistency) is established for all subscales and several indices of validity are presented. First, AN patients (N = 113) are differentiated from female comparison (FC) subjects (N = 577) using a cross-validation procedure. Secondly, patient self-report subscale scores agree with clinician ratings of subscale traits. Thirdly, clinically recovered AN patients score similarly to FCs on all subscales. Finally, convergent and discriminate validity are established for subscales. The EDI was also administered to groups of normal weight bulimic women, obese, and normal weight but formerly obese women, as well as a male comparison group. Group differences are reported and the potential utility of the EDI is discussed.
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This study examined the relationship between sexual orientation and eating disorders inwomen using a non-clinical sample of 45 homosexual and 64 heterosexual women, Subjects completed two self-report inventories composed of questions regarding weight, body image satisfaction, eating attitudes, and eating behaviors. Homosexual women were significantly heavier than heterosexual women, desired a significantly heavier ideal weight, were less often concerned with weight and appearance, and had less drive for thinness. Homosexual women of normal weight were more satisfied with their bodies than heterosexual women. Homosexual women's greater body satisfaction and lower concern with weight and appearance may contribute to their lower rates of eating disorders.
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The relationships of body satisfaction, self-esteem, dieting, and exercise were studied in 92 men and women. Men and women did not differ in degree of body dissatisfaction as assessed by three different measures. However, on the direction of body dissatisfaction, men were as likely to want to be heavier as thinner, whereas virtually no women wished to be heavier. Although overall body esteem was correlated with self-esteem for both men and women, measures of weight dissatisfaction were not associated with self-esteem for women. The normative nature of weight dissatisfaction for women today may serve to buffer its effects on self-esteem. Women reported exercising for weight control more than men, and exercising for weight control was associated with disregulated eating.
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Whereas gay culture's presumed emphasis on physical appearance may potentiate body dissatisfaction, lesbian culture's seeming lack of emphasis on appearance may protect against body dissatisfaction. We examined body dissatisfaction, associated psychosocial variables, and affiliation with the gay and lesbian community. Self-report measures were administered to 257 subjects (69 lesbians, 72 heterosexual women, 58 gay men, and 58 heterosexual men). Compared with heterosexual men, gay men reported significantly more body dissatisfaction and more distress in many of the psychosocial areas related to body dissatisfaction. In contrast, lesbians and heterosexual women did not differ in these areas. Although affiliation with the gay community was associated with body dissatisfaction in gay men, affiliation with the lesbian community was unrelated to body dissatisfaction in lesbians. It seems that aspects of the gay community increase vulnerability to body dissatisfaction, yet the values of the lesbian community do not seem to be protective against body dissatisfaction.
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This study estimated rates of bulimia nervosa and binge eating, and assessed risk factors among 203 lesbians. Participants completed questionnaires containing measures addressing lifestyle, self-esteem, body esteem, attitudes about attractiveness, and disordered eating. The rate of bulimia nervosa among lesbians was similar to that of heterosexual women, but binge eating disorder was more frequent. Eating as negative affect regulation was a more significant predictor of binge eating than body dissatisfaction or dieting. Lesbians were not significantly different from heterosexual women in attitudes concerning weight and appearance, or dieting. Self-esteem was significantly related to body esteem, and actual-ideal weight discrepancy was associated with body dissatisfaction, suggesting that lesbians are not immune from the effects of not meeting societal ideals of thinness. Increased lesbian/gay involvement was associated with lower weight concern. Implications for models of risk for eating disorders, and understanding the experience of lesbians, are discussed.
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The hypothesis that homosexual orientation would be associated with higher rates of body dissatisfaction, dieting, and eating disordered behaviors in males, but lower rates in females, relative to those of heterosexual orientation, was examined. A population-based sample of 36,320 students in Grades 7 through 12 completed a health behavior survey that included questions on sexual orientation, body satisfaction, and weight control behaviors. A subset of heterosexual males (N = 212) and females (N = 182) were selected for comparison with the adolescents who self-identified as homosexual (N = 81 males and N = 38 females) or bisexual (N = 131 males and N = 144 females). Homosexual males were more likely to report a poor body image (27.8% vs. 12.0%), frequent dieting (8.9% vs. 5.5%), binge eating (25.0% vs. 10.6%), or purging behaviors (e.g., vomiting: 11.7% vs. 4.4%) compared with heterosexual males. Homosexual females were more likely than heterosexual females to report a positive body image (42.1% vs. 20.5%). However, they were not less likely to report frequent dieting (20.8% vs. 23.7%), binge eating (25.0% vs. 31.8%), or purging behaviors (e.g. vomiting: 19.4% vs. 12.1%). These results support the hypothesis that homosexual orientation is associated with greater body dissatisfaction and problem eating behaviors in males, but less body dissatisfaction in females. The possible role of sociocultural influences or gender identification on these relationships is discussed.
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The current study examined whether homosexuality is a specific risk factor for disordered eating in men. Men (64 heterosexual and 58 homosexual) completed the Beck Depression Inventory (BDI), the Rosenberg Self-Esteem Scale (RSE), the Masculinity and Femininity scales of the Bem Sex-Role Inventory (BSRI), the Bulimia Test-Revised (BULIT-R), the Eating Attitudes Test (EAT-26), and the Body Shape Questionnaire (BSQ). Homosexual men had more pathological scores on the BDI, RSE, BULIT-R, EAT-26, and BSQ. Additionally, homosexual men reported greater discomfort with sexual orientation. After controlling for differences in depression, self-esteem, and comfort with sexual orientation, sexual orientation continued to account for significant variance in BULIT-R, EAT-26, and BSQ scores. Future research may benefit from exploring aspects of homosexuality that may contribute specifically to risk for disordered eating in men.
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This paper examines diagnostic agreement between interview and questionnaire assessments of women participating in a long-term follow-up study of bulimia nervosa. Women (N = 162) completed follow-up evaluations comprising questionnaires and either face-to-face or telephone interviews. Consistent with previous research, rates of eating disorders were higher when assessed by questionnaire than when assessed by interview; however, rates of full bulimia nervosa were similar. Overall diagnostic agreement was adequate for eating disorders (kappa=.64) but poor for bulimia nervosa (kappa=.49), with greater agreement between questionnaires and telephone interviews (kappa's range: .67-.71) than between questionnaires and face-to-face interviews (kappa's range: .35-.58). Findings support the possibility that increased rates of eating pathology on questionnaire assessments may be due, in part, to increased candor when participants feel more anonymous. Questionnaire assessments may not be inferior to interview assessments; they may reveal different aspects of disordered eating.
Living into my body Looking queer: Body image and identity in lesbian, bisexual, gay, and transgender communities (pp. 5–15) The influence of sexual orientation on body dissatisfaction in adult men and women
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Barron, N. (1998). Living into my body. In D. Atkins (Ed.), Looking queer: Body image and identity in lesbian, bisexual, gay, and transgender communities (pp. 5–15). New York: Harrington Press. Beren, S.E., Hayden, H.A., Wilfley, D.E., & Grilo, C.M. (1996). The influence of sexual orientation on body dissatisfaction in adult men and women. International Journal of Eating Disorders, 20, 135–141.
  • Striegel-Moore
Looking queer: Body image and identity in lesbian, bisexual, gay, and transgender communities
  • Barron