Weight Misperception and Unhealthy Weight Control Behaviors Among Sexual Minorities in the General Adolescent Population

Abstract

Purpose Gay, lesbian and bisexual youth may experience significant body dissatisfaction. We examined sexual orientation differences in self-perceived weight status and prevalence of potentially dangerous weight control behaviors in a representative sample of adolescents. Methods Data were obtained from 12,984 youth between 2003–2009 over four cycles of the Massachusetts Youth Risk Behavior Survey, a statewide survey of 9th–12th grade students. Self-perceived weight status and past-month unhealthy weight control behaviors (fasting >24 hours, using diet pills, and vomiting/using laxatives) were compared among gay/lesbian, bisexual, self-identified heterosexual youth with same-sex partners, unsure youth, and exclusively heterosexual youth using logistic regression, adjusting for age and race/ethnicity. Results Compared to exclusively heterosexual males, heterosexual males with prior same-sex partners and bisexual males were more likely to self-perceive as overweight despite being of healthy weight/underweight (respectively, adjusted odds ratio [AOR], 2.61; 95% confidence interval [CI], 1.68–4.05; and AOR, 2.56; 95% CI, 1.64–4.00). Compared to exclusively heterosexual females, lesbians and bisexual females were more likely to self-perceive as being of healthy weight/underweight despite being overweight/obese (respectively, AOR, 3.17; 95% CI, 1.15–8.71; and AOR, 2.00; 95% CI, 1.20–3.33). Unhealthy weight control behaviors were significantly more prevalent among sexual minority males (32.5%; AOR, 4.38; 95% CI, 3.38–5.67) and females (34.7%; AOR, 2.27; 95% CI, 1.85–2.78) when considered together relative to exclusively heterosexual males (9.7%) and females (18.8%). Conclusions One-third of sexual minority youth engage in hazardous weight control behaviors. Future research should investigate underlying mechanisms and determine whether clinicians should routinely screen for these behaviors.

Body image in transgender young people: Findings from a qualitative, community based study

“…Youth and young adults, in particular, may struggle given the salience of body image in adolescence and young adulthood, and the added health risks for sexual and gender minority (SGM) populations (de Vries et al, 2104;Hadland et al, 2014). Although evidence suggests transgender youth may face unique risks with regards to body image, little is understood about how transgender youth experience their bodies in adolescence and as they transition into adulthood.…”

“…Although recent research has examined weight and body image among lesbian, gay, and bisexual youth, with some likely being gender variant (Austin et al, 2009;Calzo, Corliss, Blood, Field, & Austin, 2013;Carper, Negy, & Tantleff-Dunn, 2010;Hadland, Austin, Goodenow, & Calzo, 2014), studies specifically regarding body image among only transgender adolescents and young adults are fairly limited. Knowledge about body image in a broader population of youth serves to guide research in this emerging area.…”

Internet Pornography Use, Body Ideals, and Sexual Self-Esteem in Norwegian Gay and Bisexual Men

“…However, there is also variation in body type ideals between and within different subgroups of the gay community, such as twinks (young and thin) or bears (large, hairy, and older) (Alvarez, 2009;Kaminski, A c c e p t e d M a n u s c r i p t 4 Chapman, Haynes, & Own, 2005). The desire to be more muscular and/or lean is not only associated with gay men having lower overall body satisfaction (Kaminski et al, 2005;Levesque & Vichesky, 2006;Peplau et al, 2009), but also with their being at higher risk for unhealthy weight control behaviors (Hadland, Austin, Goodenow, & Calzo, 2014) and eating problems (Wiseman & Moradi, 2010), compared to heterosexual men.…”

Gender Conformity and Use of Laxatives and Muscle-Building Products in Adolescents and Young Adults

“…11 Beyond gender differences in laxative and muscle-building product use, emerging epidemiologic data indicate disparities by sexual orientation identity (ie, heterosexual vs sexual minority [gay, lesbian, bisexual, mostly heterosexual]). [11][12][13][14] Sexual minority females, particularly those who identify as bisexual or mostly heterosexual, report higher levels of laxative use than their heterosexual peers, 14,15 a finding that runs counter to the popular misperception that sexual minority females are at lower risk for body dissatisfaction and eating disorders. Less is known about muscle-building product use among heterosexual and sexual minority females.…”

“…Among males, sexual orientation differences in muscle-building product use are less consistent. Sexual minority adolescent males are more prone to engage in behaviors related to weight restriction, such as purging, and expressing concerns regarding leanness, 12,13, 16 yet they also may be more likely to try steroids than their heterosexual peers. 9 Little research has examined the mechanisms contributing to gender and sexual orientation disparities in laxative abuse and muscle-building product use.…”