Disordered eating across COVID-19 in LGBTQ+ young adults

Abstract

Emerging evidence suggests that the COVID-19 pandemic is negatively affecting mental health, especially for sexual and gender minority populations. Relatively little is known about the impact of the pandemic on disordered eating behaviors (DEB) for these populations. The aim of this study is to understand changes in DEB across COVID-19 within an LGBTQ+ sample, with a particular focus on differences across sexual and gender identities, and the impact of social support on these outcomes. In a sample of 830 LGBTQ+ adults with a past year history of DEB, most, but not all, participants reported that the frequency of and urge to engage in each DEB increased a little bit or a lot during COVID-19. Contrary to research showing more severe psychopathology and DEB among gender minorities (GM) compared to sexual minorities (SM), changes in DEB severity since COVID-19 were not significantly different between SM and GM participants. There were a few small and significant relationships between changes in average DEB severity and characteristics of interpersonal relationships, average quality of home relationships, and living with someone not affirming of one's identity. Results highlight that COVID-19 may have exacerbated DEB for SGM young adults, that these changes were not different across sexual versus gender minorities, and that these changes are weakly but significantly related to minority stressors.

Impact of COVID-19 stress on the psychological health of sexual & gender minority individuals: A systematic review

“…The current review also found that Covid-19 stress among SGM individuals is associated with elevated risks of disordered eating behavior and increased perception of weight gain among them ( 33 ). Hart et al ( 49 ) noted that most of their study participants reported an increase in the urge and frequency of engaging in disordered eating behavior. Moreover, they found an association between disordered eating behavior and increased levels of psychological stress due to Covid-19 and the quality of relationships at home and non-acceptance of one's sexual identity by family members.…”

“…Out of the 16 studies, seven studies presented a comparative account across heterosexual and SGM respondents ( 5 , 8 , 39 , 32 , 33 , 44 , 46 ), while three more studies included heterosexual respondents although in very small percentages ( 6 , 7 , 49 ). The rest of the studies included only the SGM group for the investigation.…”

“…Additionally, the studies considered for the review include participants from across a wide range of race/ethnic groups. Eight studies were conducted on the US population ( 5 , 8 , 31 – 33 , 44 , 46 , 49 ), although the US population included in the studies was a heterogenous mix of Asian American, Latin American, African American, and multiracial origins along with White Americans. Two studies were conducted among the UK population ( 39 , 45 ), also a heterogeneous group of white individuals, mixed racial groups, and Asian individuals.…”

“…Some of the studies also studied variables like Loneliness, Rumination, and Quality of relationships in addition to the stress and psychological symptoms related to Covid-19. Additionally, Hart et al ( 49 ) and Tabler et al ( 33 ) measured eating disorder symptoms as well using the Eating Disorder Examination-Questionnaire ( 58 ) and Eating Disorder Examination—Questionnaire Short (EDE-QS) (12 items) ( 59 , 60 ) respectively. Akre et al ( 44 ) and Goodyear et al ( 50 ) measured problem drinking using the Patient-Reported Outcomes Measurement Information System (PROMIS) and substance use through a set of semi-structured questions.…”

“…All sixteen studies reported an elevated risk of depression and anxiety symptoms among sexual minority individuals. The heightened symptoms of depression and anxiety were also found to be associated with loneliness ( 5 , 39 ), symptoms of post-traumatic stress disorder, worries related to the Covid-19 severity and related grief ( 32 ), poor quality of relationships ( 49 ), suicidal thoughts ( 50 ), substance use and alcohol abuse ( 5 , 50 ), and disordered eating behavior ( 33 , 49 ). Higher levels of depression and anxiety are more often experienced by non-working, European SGM youths, who are more susceptible to feeling uncomfortable, isolated, and emotionally impacted by the pandemic ( 6 , 7 ) and among transgender or gender-diverse women who are full-time students ( 31 ).…”