In the past, eating disorders have stereotypically been seen as a disorder that primarily affects “cisgendered, heterosexual, middle-upper class white females” [1]. Not only is this narrative incorrect, but it has systematically created errors in the way eating disorders are diagnosed, prevented, and treated for people in the LGBTQIA2S+ community.
Eating disorders affect people of all genders, ages, sexual orientations, ethnicities, and body types. However, some groups are more at risk than others. Research suggests that eating disorders and disorder eating behaviours are disproportionately high in the LGBTQIA2S+ (Lesbian, Gay, Bisexual, Transgender, Questioning, Intersex, Asexual and Two-Spirit) community [2]. According to the Trevor Project National Survey (an LGBTQIA2S+ suicide prevention organization), LGBTQIA2s+ folxs are 50% more likely to develop an eating disorder or die by suicide than their heterosexual and cisgender peers [3].
Keep reading to learn more about the prevalence of eating disorders in the LGBTQIA2S+ community. We will also discuss risks factors, prevention strategies, and how you can support this community as an ally.
Prefer to listen? Tune in to the HealED podcast with Marie-Pier Pitre-D’Iorio (The Balanced Practice founder). On episode 159, Marie-Pier is joined by Quinn Haisley to talk about the intersections of eating disorders and the LGBTQQIA2S+ community. Listen here)
Knowing the statistics relating to eating disorders in the LGBTQIA2S+ community can help us bring attention to those who are currently being underserved. By raising awareness of current gaps in care, we can advocate for a better and more inclusive future of support for LGBTQIA2S+ folks.
Here are some statistics from current research relating to the prevalence of eating disorders in the LGBTQIA2S+ community [4]:
As indicated by the numbers above, we can see that people in the LGBTQIA2S+ community are at a disproportionately high risk of developing an eating disorder. In addition to this, LGBTQIA2S+ youth who have been diagnosed with an eating disorder are nearly four times more likely to attempt suicide [3].
The intersectionalities of gender identity, sexual orientation, and race play a role in the risk of developing an eating disorder as well. LGBTQIA2S+ youth who are Indigenous or Multiracial have the highest rates of being diagnosed with an eating disorder (12% and 10% respectively) [3].
These statistics clearly demonstrate that the idea of eating disorders being most common among “cisgendered, heterosexual, middle-upper class white females” is VASTLY incorrect. But why is there such a high occurrence of eating disorders in the LGBTQIA2S+ community?
There are many risk factors at play in the development of an eating disorder. It is thought that the unique stressors that LGBTQIA2S+ folks face in their day-to-day lives increase their risk of developing mental illnesses, like anxiety and depression.
To deal with these increased levels of anxiety and depression, folks may engage in disordered eating behaviours as a way to cope. Studies have also shown a higher rate of substance abuse as a way to cope [5].
Some of the stressors that may contribute to the development of eating disorders in LGBTQIA2S+ people include [3,5,6]:
In addition to the above, LGBTQIA2S+ folks also experience disordered eating and body dysmorphia at higher rates than their peers.
It is reported that over half of LGBTQIA2S+ youth report experiencing weight-based discrimination from family members or peers [4]. This form of discrimination leads to increased instances of binge eating, dieting, and other unhealthy behaviors in order to control their weight. This type of weight-based discrimination also increases stress, unhealthy physical activity patterns, and impacts sleep hygiene.
Similar to their heterosexual and cisgender peers, LGBTQIA2S+ youth also experience external pressure relating to appearance ideals. These societal pressures can come from sources such as social media, traditional media, LGBTQIA2S+-specific media, and dating apps [4].
Overall, the discrimination LGBTQIA2S+ folks experience in their day-to-day lives greatly impacts their overall mental health. External and internal pressures to meet societal “appearance ideals” then make people more susceptible to developing an unhealthy relationship with food and their body.
With everything that we’ve discussed so far, we’d like to take a second to acknowledge something.
Just because someone has a specific sexual orientation or gender identity, does NOT guarantee they will develop an eating disorder. However, we can identify that there is an elevated risk. This means it is important that health professionals, and others working with the LGBTQIA2S+ community, are aware of the signs and symptoms of eating disorders.
When it comes to eating disorders, the best prevention is early detection! When disordered eating is identified, ensuring people have access to safe and inclusive care is crucial to their recovery process. (For warning signs, read this blog)
If disordered eating is identified, a multidisciplinary approach (including a medical doctor, registered dietitian, mental health professional, and support persons) has been found to be the most effective treatment plan [1]. Due to the relationship between eating disorders and suicide in LGBTQIA2S+ youth, it is imperative that youth receive treatment as soon as disorder eating behaviors are identified [3]. This can mean that treatment starts prior to receiving an official diagnosis.
Remember, you don’t need a diagnosis of an eating disorder in order to be worthy of receiving care. You always have a right to heal, and there is never a bad time to reach out for support.
At The Balanced Practice, we aim to provide inclusive and affirming care to those who struggle with eating disorders/disordered eating. Combining our lived experience with the best clinical guidelines, we are here to guide you through recovery.
Let’s connect. Book a connection call today!
In addition to the unique risk factors listed above, LGBTQIA2S+ folks also experience many challenges in accessing treatment and support. Common barriers experienced by LGBTQIA2S+ folks often relate to gaps in the following areas [6]:
Inclusive treatment programs that incorporate up-to-date knowledge, respect, empathy and understanding are imperative to the successful treatment of eating disorders. Here at The Balanced Practice, we ensure that we are able to create a safe and welcoming space for everyone! We have many team members who are part of the LGBTQ2IA2S+ community. We are also gender-affirming and continue to invest in our own learning and education. Our overarching goal is to provide safe and inclusive spaces for all of our clients.
Community connectedness has also been found to decrease the risk of developing an eating disorder. This suggest that being actively involved in the LGBTQIA2S+ community may also help to prevent eating disorders. To read more about the role of communities in eating disorder treatment, read our blog post on the topic here!
Even if you don’t belong to the LGBTQIA2S+ community, there are ways you can support this community as an ally. Here are some ways you can help support the treatment and prevention of eating disorders for LGBTQIA2S+ folks:
As an ally, it is also important to practice cultural humility.
Cultural humility is a lifelong process of self-reflection and self-exploration combined with a willingness to learn from others [2]. When it comes to learning more about the LGBTQIA2S+ community, it is important to recognize that you can increase your knowledge and understanding through self-education. Self-education helps to prevent the tokenization of people (which can lead to stress and burnout for them). Books, blogs, podcasts, and other queer media are all great ways to educate yourself on LGBTQIA2S+ issues.
Eating disorders impact folks in marginalized communities at a higher degree, such as the LGBTQIA2S+ community. We all have a role to play. By reducing stress for community members, raising awareness of the issues at hand, and increasing access to culturally competent care, we can reduce the risk of both eating disorders and suicide for LGBTQIA2S+ people.
Written By: Olivia Kuhlmann, RD, MPH, CDE
Reviewed By: Marie-Pier Pitre D’Iorio, RD, B.Sc. Psychology
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