Sexual orientation and prevalence of body dissatisfaction and eating disordered behaviors: A population-based study of adolescents

Objective: The hypothesis that homosexual orientation would be associated with higher rates of body dissatisfaction, dieting, and eating disordered behaviors in males, but lower rates in females, relative to those of heterosexual orientation, was examined. Methods: A population-based sample of 36,320 students in Grades 7 through 12 completed a health behavior survey that included questions on sexual orientation, body satisfaction, and weight control behaviors. A subset of heterosexual males (N = 212) and females (N = 182) were selected for comparison with the adolescents who self-identified as homosexual (N = 81 males and N = 38 females) or bisexual (N = 131 males and N = 144 females). Results: Homosexual males were more likely to report a poor body image (27.8% vs. 12.0%), frequent dieting (8.9% vs. 5.5%), binge eating (25.0% vs. 10.6%), or purging behaviors (e.g., vomiting: 11.7% vs. 4.4%) compared with heterosexual males. Homosexual females were more likely than heterosexual females to report a positive body image (42.1% vs. 20.5%). However, they were not less likely to report frequent dieting (20.8% vs. 23.7%), binge eating (25.0% vs. 31.8%), or purging behaviors (e.g. vomiting: 19.4% vs. 12.1%). Discussion: These results support the hypothesis that homosexual orientation is associated with greater body dissatisfaction and problem eating behaviors in males, but less body dissatisfaction in females. The possible role of sociocultural influences or gender identification on these relationships is discussed.