Disparities in DSM-5 Defined Eating Disorders by Sexual Orientation Among U.S. Adults

 

The increased occurrence of disordered eating behaviors among sexual minorities is well established; however, few studies have examined disparities in eating disorder diagnoses among this population. This study sought to examine lifetime prevalence estimates of DSM-5 defined EDs, including anorexia nervosa (AN), bulimia nervosa (BN), and binge-eating disorder (BED) as a function of sexual orientation. We then compared prevalence of EDs based on experiences with perceived discrimination. Method: A nationally representative sample of U.S. adults (N = 35,995) participating in the 2012-2013 National Epidemiologic Survey on Alcohol and Related Conditions-III completed structured diagnostic interviews. Results: Prevalence rates were significantly higher among sexual minorities than heterosexual respondents for all EDs: AN = 1.71% (SE = 0.50) versus 0.77% (SE = 0.07), BN = 1.25% (SE = 0.37) versus 0.24% (SE = 0.03), BED = 2.17% (SE = 0.52) versus 0.81% (SE = 0.05). Odds of lifetime diagnosis were significantly greater among sexual minorities for AN (adjusted odds ratio [AOR] = 1.93), BN (AOR = 3.69), and BED (AOR = 2.32), after adjusting for sociodemographic variables. Sexual minorities reporting experiences with perceived discrimination had significantly higher prevalence of AN than those not endorsing perceived discrimination: 3.78% (SE = 1.43) versus 0.82% (SE = 0.33); AOR = 5.06. There were no significant differences in prevalence of BN or BED by perceived discrimination. Discussion: Findings indicate that sexual minorities are disproportionately affected by EDs. Further research is needed to better understand mechanisms contributing to these disparities and heightened risk for EDs. Keywords: discrimination; eating disorders; health disparities; minority health; prevalence; sexual minorities. Int J Eat Disord . 2020 Feb;53(2):278-287. doi: 10.1002/eat.23193. Epub 2019 Oct 31. PMID: 31670848 DOI: 10.1002/eat.23193.  FROM WIKIPEDIA: A sexual minority is a group whose sexual identity, orientation or practices differ from the majority of the surrounding society. Primarily used to refer to LGBT or non-heterosexual individuals, it can also refer to transgender, non-binary (including third gender) or intersex individuals.