Gay and bisexual men may be at far higher risk for eating disorders

Gay and bisexual men may be at far higher risk for eating disorders than heterosexual men, according to a study conducted at Columbia University's Mailman School of Public Health.

In the first population-based study of its kind, the researchers found that gay and bisexual men have higher rates of eating disorders. The findings are reported in the April 2007 issue of International Journal of Eating Disorders.

Researchers Ilan H. Meyer, PhD, associate professor of clinical Sociomedical Sciences at the Mailman School of Public Health and principal investigator, and Matthew Feldman, PhD, of the National Development and Research Institutes and first author, surveyed 516 New York City residents; 126 were straight men and the rest were bisexual men and women.

According to the study results, more than 15 percent of gay or bisexual men had at some time suffered anorexia, bulimia or binge-eating disorder, or at least certain symptoms of those disorders -- a problem known as a subclinical eating disorder, compared with less than five percent of heterosexual men. In contrast, sexual orientation did not seem to influence the risk of eating disorder symptoms among women. Just below 10 percent of lesbian and bisexual women and eight percent of heterosexual women had ever reported having a subclinical eating disorder.

Despite the interest in the question of eating disorder in lesbians, gay men, and bisexuals, until now studies used measures of body dissatisfaction or symptoms of eating disorders, which may suggest the presence of an eating disorder, but does not assess diagnoses. This population-based study for the first time provides evidence of formal diagnoses based on established psychiatric criteria.

"It is not clear why gay men have high rates of eating disorders," says Dr. Meyer. "One theory is that the values and norms in the gay men's community promote a body-centered focus and high expectations about physical appearance, so that, similar to what has been theorized about heterosexual women, they may feel pressure to maintain an ideal body image."

To assess this theory, the investigators studied whether gay and bisexual men with greater connection and affiliation with the gay community are more likely to have eating disorders than those who are not affiliated with the gay community. Despite slightly elevated eating disorders among men who were active in gay recreational groups, men who said they felt closely connected to the gay community and who participated in a range of gay and bisexual organizations did not have higher rates of eating disorders than men who were not as closely affiliated with the community.

"Even gay and bisexual men who participate in gay gyms, where body-focus and community values regarding attractiveness would be heightened, did not have higher rates of eating disorders than those gay and bisexual men who participated in non-gay gyms or who did not participate in a gym at all," observes Dr. Meyer. "This suggests that factors other than values and norms in the gay community are related to the higher rates of eating disorder among these men."

As for the findings in women, the researchers reported no differences in rates of eating disorders between lesbian/bisexual women and heterosexual women, suggesting that lesbian/bisexual women are not protected from eating disorders as some previous researchers have suggested. Also, rates of eating disorders of lesbian/bisexual women did not differ significantly from gay/bisexual men. "This shows that there needs to be greater awareness of these problems among gay and bisexual men and women alike, as well as specific interventions to address the issues in this population," the researchers conclude.