People who suffer from eating disorders live in a state of constant paradox. They know the calorie count of food, but don’t eat. They look into mirrors without accurately seeing what’s there. They understand that they’re sick—often with precise insight—and yet lack control over the disorder that runs their lives.

Perhaps the most troubling paradox of eating disorders, however, is how LGBTQ people are a highly vulnerable population that lack a coherent dialogue on its causes, effects, and methods of healing. In order to help people who suffer from eating disorders, it’s essential to de-stigmatize and re-contextualize the conversation through a healing-centric and body-positive lens. This framework is necessary for eating disorder-affected people and their loved ones to understand and heal.

Who Do Eating Disorders Affect?

As the National Eating Disorder Association (NEDA) states, “LGBTQ+ people face unique challenges that may put them at greater risk of developing an eating disorder. Research shows that, beginning as early as 12, gay, lesbian, and bisexual teens may be at higher risk of binge-eating and purging than heterosexual peers.” Contributing factors to eating disorders are diverse. Fear of rejection, trauma, conditional acceptance from loved ones, and the internalization of negative societal messages are a few examples. In truth, the discussion on eating disorders in the LGBTQ community exists on a spectrum as vast as sexuality itself.

For instance, 42% of men who have eating disorders are gay men. Gay and bisexual men are seven times more likely to binge, and 12 times more likely to purge than straight men. A range of behaviors and mentalities exist within these parameters. Some over-exercise and under-eat. Some want more muscle, and some want less. Some display tendencies of all of the above.

eating disorder

For lesbian and bisexual women, that panorama of behaviors is equally expansive. Studies show that lesbian women are less likely to constrict their diet (as anorexics do), but may be more likely binge eat. Bisexual women are are at higher risk of an eating disorder than straight women. Contrary to stereotypes, women who suffer from eating disorders are not necessarily white, upper to middle class, or concerned about their appearance. They come in a range of backgrounds, ethnicities, and sexual orientations.

In a nutshell, there are no hard and fast rules about eating disorders in the LGBTQ community. You can be anorexic, bulimic, or a combination of the two. You can be halfway out of the closet, or fully embrace your sexuality. You can be in denial that you have a problem, or aware and actively seeking help.

How Do Eating Disorders Affect LGBTQ People?

Eating disorders within the LGBTQ population occupy a spectrum both vast and nuanced. Providing a lens that is wide enough, and acute enough, to make room for eating disorders requires a certain mindfulness.

Zach Rawlings is a professional counselor who works in New York City at one of the country’s largest eating disorder hospitals. He writes about how the pressure to have a “perfect” body in the gay community can lead to a negative relationship with one’s body. “Competition is expected in the dating world,” he says. But “gay men are creating a culture in which they are competing in every relationship they have. When someone has a history of rejection (like being called faggot on the playground, getting crammed into lockers, being mercilessly ridiculed for more feminine interests, etc.) he might work tirelessly to achieve acceptance through his new life…You feel extra pressure to get your body to meet some pretty unrealistic expectations.”

Rawlings notes that eating disorder-afflited LGBTQ people often experience dual and sometimes conflicting pressures from the gay community and broader society. Gay men who were shunned by straight peers find themselves compensating by adopting the same masculine persona that rejected them. They then face the further challenge of fitting that persona into the gay community.

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Lesbian and bisexual women also face challenges. Research suggests eating disorders are likely to stem from deeper feelings of anxiety or depression over being LGBTQ. For instance, a study shows that women who are questioning their sexual identity are more likely to suffer from eating disorders. Societal messages over body image could also contribute, although research is still greatly lacking in this area.

One important note: eating disorders almost invariably stem from these deeper places of struggling with social stigma, depression, or even trauma. They are not, as popular culture suggests, the product of superficial concerns over body image. Indeed, some studies suggest that people who suffer from eating disorders have higher levels of intelligence than the rest of the population. The eating disorder-afflicted are often smart and self aware. They may understand their disease with astounding, almost clinical clarity, but are unable to stop their destructive behavior.

And make no mistake: eating disorders are destructive. Mortality rates for anorexia nervosa are 4.0 percent, 3.9 percent for bulimia nervosa, and 5.2 percent for eating disorder not otherwise specified. In severe cases, an eating disorder can permanently damage the body. Beyond physical health concerns, sufferers of an eating disorder often experience alienation, depression, and other negative social repercussions as a result of living with their disease.

Curing an Eating Disorder Through Awareness, Community, and Support

Rawlings strives to heal eating disorders by reframing them in a body-positive context. Eating disorders, he says, can be understood as the body’s way of expressing an internalized pain. The source of that pain will vary from person to person. But the bottom line remains: making room for that bodily expression is the first step to healing. As Rawlings says: “Pain is written in and on the body. It doesn’t matter if the body is muscular, chiseled, soft, malnourished, or broken, each body speaks a message—it’s up to you to figure out what yours is saying.”

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The process of hearing the body’s story takes time and courage. But it’s an empowering first step. “When a gay man works tirelessly to perfect his physique, his body is often communicating desperation to fit in,” says Rawlings. “When he plasters himself half-naked on social media, he’s usually shouting his need for approval and affirmation.” People suffering from eating disorders can ask themselves: what is my body trying to say? The answer usually goes beyond food, exercise, or other image-conscious factors. It usually enters the territory of finding out who you are: your background, your history, what makes you distinctly and indelibly you. Addressing these facets are not a panacea for an eating disorder, but they are a powerful way to begin healing.

Getting Help for an Eating Disorder

Every person has a unique relationship to their bodies. And every human body has a story. When eating disorders take a hold of that narrative, it’s a sign that some fundamental pain can no longer stay on the sidelines. It’s demanding recognition in the same way that a starved child will scream until it’s fed.

That’s why it’s essential for people who suffer from an eating disorder to engage with it in a supportive environment. Knowing statistics on mortality rates may temporarily shock a person into ceasing harmful behavior. Understanding suffering can help alleviate some of the pain, and connecting to a larger community can very well save a life. But these actions, while useful, won’t necessarily cut to the root of the disease.

Seeking professional help is highly recommended for people who suffer from eating disorders, and it’s crucially important that you feel safe discussing all the nuances and pain points in your life and story as a queer person. Lighthouse is proud to offer resources that meet these needs. Click here if you’d like to connect to an LGBTQ affirming therapist.

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