Sexual attraction to men as a risk factor for eating disorders: the role of mating expectancies and drive for thinness

Muscularity-oriented attitudes and behaviors among college-aged women: The role of sexual orientation

While sexual minority (SM) status has been associated with poorer body image and greater eating pathology among men, findings are inconsistent among women. The lack of focus on muscularity-oriented attitudes and behaviors among SM women may contribute to these mixed findings; thus, we examined these constructs within a large sample of SM and heterosexual women. Our sample included 1511 cisgender women (n= 1213 heterosexual, n= 298 SM). Measurement invariance for the Muscularity-Oriented Eating Test (MOET) was assessed using alignment optimization prior to latent mean comparison. Differences in muscle dissatisfaction and APED misuse were assessed using appropriate generalized linear models. SM women exhibited significantly greater muscle dissatisfaction and muscularity-oriented eating pathology than heterosexual women. No significant differences in APED misuse were found. The present study is novel in its assessment of sexual orientation differences in muscularity-oriented eating pathology, APED misuse, and muscle dissatisfaction in women. By separately analyzing attitudinal and behavioral components of drive for muscularity in SM women vs. heterosexual women, we aim to aid in the understanding of levels of muscularity-oriented body image and eating pathology within these groups and highlight the importance of incorporating diverse measures of body-related attitudes and behaviors beyond those focusing on thinness.

Toward inclusivity: A systematic review of the conceptualization of sexual minority status and associated eating disorder outcomes across two decades

OBJECTIVE

Sexual minority (SM) groups (e.g., those who identify as lesbian, gay, bisexual, questioning, queer, asexual, or those who feel their sexual orientation identity cannot be captured with existing terminology [LGBQA+] and those who report same-sex or same-gender attraction and/or behavior) are at elevated risk for eating disorder (ED) symptoms and behaviors. However, the ways in which this risk varies across SM is less clear, and findings are not fully convergent. Evolution in the definition and assessment of SM status may contribute to this divergence. The aim of this study was to systematically review how sexual orientation and SM status have been assessed in the ED literature and how this may relate to patterns of associations between SM status and ED symptoms.

METHODS

A systematic review of the literature focused on ED symptoms and behaviors and SM groups was conducted, yielding 182 studies.

RESULTS

Five categories were created reflecting SM status assessment: identity only (n = 105), attraction only (n = 8), behavior only (n = 4), combinations of identity, behavior, or attraction (n = 58), and articles with unclear or insufficient information about SM status assessment (n = 7). SM status operationalizations varied across studies, with more inclusive assessments in more recent work. Findings revealed persistent conflicting patterns of disordered eating symptomatology for some SM groups. In addition, decisions to selectively combine SM participants in some studies, most often to increase power, decreased the specificity of their results in relation to differential risk and protective factors within specific LGBQA+ groups.

DISCUSSION

Findings highlight the importance of inclusive assessments of sexual orientation in the ED literature and research focused on underrepresented groups with intersecting identities. Identifying modifiable targets for intervention is a critical next step.

PUBLIC SIGNIFICANCE

Sexual minority (SM) groups have been identified as presenting elevated risk for eating disorder symptoms and behaviors. Our findings suggest that the level of risk is variable across SM groups and points to the need for multi-dimensional assessments of SM status, and increased focus on the function of disordered eating behaviors and different profiles that might emerge related to efforts to modify physical appearance or to regulate emotion.