Eating Disorders and the LGBTQIA+ Community
Remember, eating disorders can impact individuals across the gender identity, race, sexual orientation, and ability spectrum. Today, registered dietitian and podcast host, Allison Tucker, RD, is discussing how eating disorders show up and impact those in the LGBTQIA+ Community. Take it away, Allison!
Eating Disorders and the LGBTQIA+ Community
Eating disorders don’t discriminate. But our systems, our healthcare, and even our cultural understanding of eating disorders often do. So, let’s talk about the reality: LGBTQIA+ folks are disproportionately affected by eating disorders, and yet they’re also more likely to fall through the cracks when it comes to diagnosis and support.
The Data Speaks (Even When Providers Don’t)
Trans and nonbinary people are four times more likely than cisgender people to experience eating disorders.
Gay and bisexual boys and men are more than twice as likely to have attempted to control their weight through disordered eating behaviors.
Lesbian and bisexual girls and women experience body dissatisfaction and disordered eating at similar or higher rates than heterosexual women, despite the myth that queer women are “immune” to body image issues.
LGBTQ+ youth are twice as likely to report restrictive eating, binge eating, and purging.
So no, it’s not “just a phase.” It’s not just about body image. And it’s not just happening in thin, white, cisgender women.
Why Is This Happening?
Eating disorders develop in response to many intersecting factors: biological vulnerability, trauma, cultural messages, genetics, perfectionism, and more. But in the LGBTQ+ community, there are unique contributors:
Body surveillance:
Body dysmorphia = a mental health condition that involves a person being overly focused on one or more perceived flaws in their appearance, often spending significant time worrying, checking, or trying to hide the flaw (even if it is minor or not noticeable to others).
Gender dysphoria = the distress or discomfort a person feels when their gender identity doesn’t align with the sex they were assigned at birth or with how their body looks or functions in relation to gender.
For many transgender and nonbinary individuals, body dysmorphia and gender dysphoria overlap, making it difficult to distinguish between body hatred driven by disordered eating and the distress of living in a body that doesn’t reflect one’s gender identity.
Pressure to fit the “ideal” body standards: Every subgroup has its own version of “ideal.” Gay men may feel pressure to be lean and muscular, trans folks may pursue dangerous weight loss methods to “pass”, and queer women may be impacted by contradictory body expectations (praised for rejecting mainstream beauty norms but still judged when they don’t conform).
Minority stress and trauma: Living in a society that is not built for you - one that questions your identity and invalidates your experience - is exhausting. Chronic stress, rejection (including from family), bullying, and trauma all raise the risk for mental health challenges, including eating disorders.
Barriers to care: Stigma. Lack of provider training. Fear of discrimination. Being misdiagnosed. Being told “you don’t look like you have an eating disorder.” These are just some of the reasons LGBTQIA+ folks often don’t get the care they need, or worse, are harmed in the care they receive.
What Inclusive Eating Disorder Care Actually Looks Like
Here’s the truth: if your care isn’t LGBTQIA+ affirming, trauma-informed, and weight-neutral, it’s not eating disorder care. It’s just perpetuating the same systems that contributed to the disorder in the first place. Collaborative Counseling & Nutrition believes in care that is inclusive, affirming, and grounded in lived experience rather than stereotypes.
At CCN, we’re committed to:
Asking, not assuming: We honor the identities and pronouns of every client, no questions asked, no justifications needed.
Creating safety: Psychological safety isn’t a bonus - it’s the bare minimum.
Understanding intersecting identities: Queer, trans, BIPOC, neurodivergent, disabled (these layers matter!)
Using non-pathologizing, strengths-based language: LGBTQ+ clients are not “difficult” or “noncompliant.” They’re navigating systems that weren’t built for them.
Centering lived experience: We don’t rely on outdated, whitewashed models of eating disorder treatment. We evolve because people deserve better.
Resources for Support
If you or someone you love is part of the LGBTQ+ community and struggling, here are a few resources that can help:
The Trevor Project – thetrevorproject.org | Crisis support for LGBTQ+ youth. Call 1-866-488-7386 or text “START” to 678678
Trans Lifeline – translifeline.org | Support by and for trans people. Call 877-565-8860
National Alliance for Eating Disorders – allianceforeatingdisorders.com | Offers virtual and in-person support groups, including LGBTQ+ specific groups.
GLMA: Health Professionals Advancing LGBTQ+ Equality – glma.org | Directory of LGBTQ+ competent healthcare providers.
The Body Positive – thebodypositive.org | Inclusive resources for developing a healthy relationship with food and body.
Moving Forward
If you or someone you know is struggling with an eating disorder and is part of the LGBTQIA+ community, reach out to the Collaborative Counseling and Nutrition Team today!
Sources Used
Diemer EW, White Hughto JM, Gordon AR, Guss C, Austin SB, Reisner SL. Beyond the Binary: Differences in Eating Disorder Prevalence by Gender Identity in a Transgender Sample. Transgend Health. 2018;3(1):17-23. doi:10.1089/trgh.2017.0043.
Austin SB, Nelson LA, Birkett MA, Calzo JP, Everett B. Eating Disorder Symptoms and Obesity at the Intersections of Gender, Ethnicity, and Sexual Orientation in U.S. High School Students. Am J Public Health. 2013;103(2):e16–e22. doi:10.2105/AJPH.2012.301150.
Watson RJ, Adjei J, Saewyc EM, Homma Y, Goodenow C. Trends and Disparities in Disordered Eating Among Heterosexual and Sexual Minority Adolescents. Int J Eat Disord. 2017;50(1):22-31. doi:10.1002/eat.22576.
Calzo JP, Austin SB, Micali N. Sexual Orientation Disparities in Eating Disorder Symptoms Among Adolescent Boys and Girls in the UK. Eur Child Adolesc Psychiatry. 2018;27(11):1471–1481. doi:10.1007/s00787-018-1120-1.
Nagata JM, Ganson KT, Austin SB. Emerging Trends in Eating Disorders Among Sexual and Gender Minority Youth. Curr Opin Psychiatry. 2020;33(6):562–567. doi:10.1097/YCO.0000000000000644.
