Beyond a stereotype: recognizing the true scope of eating disorders
When people picture someone with an eating disorder, a thin, teenage girl with anorexia nervosa often comes to mind. This stereotype obscures the reality: eating disorders affect people of all genders, ages, and sexual orientations, including many within the LGBTQIA+ community. Emerging research shows that LGBTQIA+ individuals may be disproportionately affected, with unique risk factors that can shape how these disorders develop and persist.
What the evidence says about risk in LGBTQIA+ communities
Multiple studies have found higher rates of eating disorders, disordered eating behaviors, and body image concerns among LGBTQIA+ individuals compared with their heterosexual and cisgender peers. The risks are not uniform, and they vary by gender identity, sexual orientation, race/ethnicity, and other identities. Overall, the pattern suggests greater vulnerability rather than a single cause.
Minority stress and chronic stigma
A central framework for understanding these disparities is minority stress—the chronic strain that comes from stigma, discrimination, concealment, and rejection. For many LGBTQIA+ people, the stress of hiding one’s true self, fearing judgment, or facing harassment can contribute to emotional distress, which some cope with through disordered eating or compulsive exercise. Over time, these coping strategies can become entrenched behaviors that meet clinical criteria for an eating disorder.
Body image and gender dysphoria
Body image concerns are often intensified in LGBTQIA+ communities. Trans and nonbinary people may experience gender dysphoria, a disconnect between physical appearance and gender identity. Dietary restriction or extreme exercise can be used to align the body more closely with one’s gender presentation or to minimize distress related to body features that feel incongruent. Conversely, body dissatisfaction and social comparison—blamed on media, peers, or dating dynamics—can also fuel eating-disordered patterns in cisgender LGBTQIA+ people as they navigate norms around masculinity or femininity.
Trauma, violence, and safety concerns
Many LGBTQIA+ individuals have experienced or witnessed trauma, including harassment, intimate partner violence, or rejection by family or communities. Trauma exposure increases the risk of developing eating disorders as people seek control, safety, or numbness through food restriction, bingeing, or purging. Safe, affirming spaces and trauma-informed care are crucial for recovery.
Intersectionality: when multiple identities intersect
Cultural, racial, socioeconomic, and disability-related factors interact with sexual orientation and gender identity to shape risk and access to care. For some, intersecting identities may compound barriers to diagnosis and treatment, such as language barriers, lack of culturally competent care, or financial constraints. Recognizing intersectionality helps clinicians tailor approaches that respect an individual’s whole self.
Barriers to care and barriers to recovery
Despite high risk, LGBTQIA+ people often encounter barriers when seeking help. Fears of stigma in healthcare settings, past negative experiences with providers, or lack of knowledge among clinicians about LGBTQIA+-specific issues can delay assessment and treatment. Insurance limitations, limited access to LGBTQIA+-friendly services, and geographies without specialized care also impede recovery. Creating inclusive clinics—training staff, using affirming language, offering gender-affirming options, and providing evidence-based treatment for eating disorders—can improve engagement and outcomes.
What helps: inclusive, evidence-based care
Effective treatment for eating disorders in LGBTQIA+ people still follows core principles: early detection, individualized therapy, medical monitoring, and evidence-based interventions like cognitive-behavioral therapy (CBT) for eating disorders, family-based approaches when appropriate, and, for gender-diverse clients, integrated care that addresses gender identity alongside eating concerns. Peer support and community resources that affirm LGBTQIA+ identities can bolster motivation and reduce isolation. Important components include:
– A nonjudgmental, inclusive therapeutic alliance
– Safety planning and trauma-informed care
– Flexible treatment settings that respect gender identities and expression
What communities can do to reduce risk
Educational campaigns that challenge stereotypes about who gets eating disorders help reduce stigma. Schools, workplaces, and healthcare systems can promote inclusive messaging and easy access to screening for eating disorders. For LGBTQIA+ people, building networks of supportive clinicians, LGBTQIA+-friendly nutritionists, and mental health professionals can create a clearer path to care. Families and communities play a crucial role by learning signs of eating disorders, offering acceptance, and encouraging help-seeking without judgment.
Takeaway: empower, support, and seek care
Eating disorders among LGBTQIA+ people reflect a complex blend of individual experiences and social determinants. By acknowledging the higher risk, reducing barriers to care, and delivering affirming, evidence-based treatment, we can improve outcomes and ensure that everyone receives the compassionate support they deserve. If you or someone you know is struggling, reaching out to a trusted clinician or a local LGBTQIA+-affirming resource is a critical first step.
