Eating Disorders and Gay Men… Is this a Stereotype? (November 2013)
The other month I wrote about how eating disorders are growing in the male community. I thought writing about how gay men are affected by eating disorders would be helpful since I see many gay teens and men. Often times expressing their sexuality via body dissatisfaction is their first step via eating disorder is the first way the client feels comfortable communicating that they are gay.
Some studies show that between 20% and 42% of eating disordered males are gay or bisexual. Did you know that 6% of our general male population is gay? There appears to be an unbalanced representation in the male eating disorder population. Furthermore, more than 15% of gay and bisexual men are struggling or have struggled with a body image issue or an eating disorder. It is certain that we are hearing more in research in and the media about men with eating disorders, but this population certainly deserves more attention in the research arena.
In the male gay community when looking at the majority of magazines and billboards the pictures that we see are photos (often times airbrushed) or an increasingly unattainable ideal. In many of my sessions when I was reading the various research articles that I have used as resources for this article I would ask my gay male clients how it makes them feel when they see these pictures? A very similar response of (from my single gay males) feeling competitive needing to look “perfect” cut, with lean ripped abs, defined chest muscles, arms and to be ready at any time to meet somebody. They also feel like living in a gay community that they are on display, having to look fit, sculpted. These clients would feel like they need to eat what they perceive is “perfect” or compulsively exercise to achieve the look that they desire.
In a study by Hospers and Jansen (2005) it was revealed that eating disorder behaviors evolved by body dissatisfaction. For gay males’ body dissatisfaction was influenced by their gay peers more strongly than for straight men. Men who are 30-40 years of age have a stronger increase of developing an eating disorder (particularly thinness, and dieting but not for bulimia) if they are single when trying to find a partner. Another area to take into consideration is the clients past. Often time’s trauma has an impact if they have an eating disorder. A study by Feldman and Meyer (2007) revealed that 53% of those men who shared that they are bisexual and 31% who disclosed that they are gay have a history of childhood sexual abuse. This study also showed a connection between childhood sexual abuse and the development of eating disorders with gay and bisexual males. It is important as a nutrition therapist to keep in mind if the client has an abuse history, since a body image issue may come up.
There are six primary stages that gay men go through when they come out to themselves and to others according to Vivienne Cass (1979). Briefly the gay male’s identity first begins with confusion, and then moves to identity comparison, tolerance, acceptance, pride, with the hope of identity synthesis. It is important to know where the eating disordered client minority is as this will be helpful for the practitioner when beginning to work with the client.
Lastly, for a client to share any of this information it is important for him to establish a relationship with him. He needs to know that he is in a safe non-judgmental environment and that you work as a team with whomever else he is seeing. If he doesn’t have a team, then as a nutrition therapist I for example will find the right people to help him. It is also important to remember that the work with this client may not always entail body image work, as it could be helping him with his feeling about being gay. Regardless he must feel confident with the environment that he is seeking treatment in.
References:
1. Anderson, A.E. (1999). Eating Disorder in Gay Males. Psychiatric Annals, 29, 206-212.
2. Brown, T.A., Keel, P.K. (2012). The Impact of Relationships on the Association Between Sexual Orientation and Disordered Eating in Men. International Journal of Eating Disorders, (45), 6, 792-799.
3. Carlat, D.J., Carmargo, C.A., & Herzog, D.B., (1997). Eating Disorders in Males: A report of 135 patients. American Journal of Psychiatry, 154 (8), 1127-1132.
4. Cass, V.C. (1979). Homosexuality Identity Formation: A theoretical model. Journal of Homosexualty, 4, 219-235.
5. Duncan, D. (2007). Out of the Closet into the Gym: Gay men and Body Image in Melbourne, Australia. The Journal of Men’s Studies, 15 (5), 331-346.
6. Feldman, M.B., & Meyer, I.H. (2007). Eating Disorders in Diverse Lesbian, Gay and Bisexual populations. International Journal of Eating Disorders, 40(3), 218-226.
7. Hospers, H.J., & Jansen, A. (2005). Why Homosexuality is a Risk Factor for Eating Disorders in Males. Journal of Social and Clinical Psychology, 24 (8), 1188-1201.
8. Seidman, S.N., & Rieder, R.O. (1994). A Review of Sexual Behavior in the United States. American Journal of Psychiatry, 151, 330-341.
