Anorexia and Sexual Orientation

A California psychotherapist recently emailed me about an anorexic client who was a lesbian. "Once she accepted that she was gay, her anorexia was no longer an issue," he wrote. The clinician then asked me whether there was any research on anorexia nervosa and sexual orientation.

The answer is yes, but the association is complex. Recent studies indicate that while male homosexuals have a greater risk of developing anorexia than their "straight" counterparts, lesbian populations show less incidence of the illness than heterosexual women.

Eating disorders specialist Barton J. Blinder cites research by Herzog indicating that male anorexic patients experience sexual isolation, sexual inactivity, and conflicted homosexuality¹. Herzog hypothesized that cultural pressure exerted by the gay community on homosexual men to be thin and attractive increases their risk for eating disorders². While gay men represent three to five percent of the total male population³, they account for 20 percent of eating disorders among men⁴.

According to an article appearing on Medscape, a study of 135 eating disordered men conducted by psychiatrist Daniel J. Carlat, M.D. at Anna Jacques Hospital in Newburyport, Massachusetts found that 46 percent had bulimia, and 42 percent of the bulimic men were either homosexual or bisexual⁵. Thirty men (22 percent) had anorexia, and of these, 58 percent were asexual, which was defined by the researchers as lacking all sexual interest for one year prior to the study⁶. The researchers are quoted in the article as follows: "Homosexuality can be seen as a risk factor which puts males in a subcultural system that places the same premium on appearance in men as the larger culture places on women."⁷.

However, the article also reports the observation of New York psychologist and eating disorders specialist Janet David, Ph.D. that the amount of research on this subject is small and should, therefore, be cautiously interpreted.

In contrast to male homosexuality, there is evidence that lesbianism may be a "protective factor" against developing an eating disorder⁸. Research by Siever indicates that pressure for thinness exerted by members of one's community, from greatest to least, is as follows: heterosexual females, gay males, lesbian females, and heterosexual males⁹. This theory, however, remains controversial¹⁰.

Nothing in this article is meant to suggest that anyone should consider changing his or her sexual orientation. Gregory M. Herek, Ph.D., of the University of California at Davis, provides an excellent overview of this subject. Herek notes that the American Psychological Association has condemned the practice of "reparative therapy" touted by religious groups and others as a method of promoting heterosexuality in homosexuals. He describes the methodological and ethical problems with studies purporting to demonstrate the success of this technique.

Go To Page: 1 2

Articles in this Topic    Discussions in this Topic