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Sexual orientation disparities in eating disorder symptoms among adolescent boys and girls in the UK

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Abstract

Much of the research on sexual orientation disparities in eating disorder behaviors has been conducted in the USA, Canada, and Australia. Data on the associations of sexual orientation and eating disorder symptoms among adolescents in the UK are lacking. Participants were children from the Avon Longitudinal Study of Parents and Children, a youth cohort born 1991–1992 (n = 5048; 53% female; 12% sexual minority). Sexual orientation was assessed at 16 years. Eating disorder symptoms were assessed at 14 and 16 years. Multivariable regression models (adjusting for BMI, ethnicity, socioeconomic status) examined associations between sexual orientation and (1) odds of past-year purging and binge eating, and (2) mean differences in body dissatisfaction, pressure to increase muscularity (boys only), and Dutch Eating Behavior Questionnaire subscales. At age 14, gay and bisexual boys and mostly heterosexual girls reported greater body dissatisfaction than their same-gender heterosexual peers. All sexual minority boys and mostly heterosexual girls reported greater mean dysfunctional eating behaviors than their same-gender heterosexual peers. At age 16, gay and bisexual boys had 12.5 times the odds of heterosexual boys of binge eating; mostly heterosexual boys had over three times the odds of reporting binge eating. Sexual minority girls had over twice the odds of heterosexual girls of purging and binge eating. By mid-adolescence, sexual minority youth in the UK had elevated risk for eating disorder symptoms, suggesting the need for early prevention efforts.

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Acknowledgements

This work was supported by the UK Medical Research Council (Grant 74882) and the Wellcome Trust (Grant 076467), which supported the Avon Longitudinal Study of Parents and Children (ALSPAC). Additional support was provided by the National Institute on Drug Abuse (K01DA034753 to J.P.C.), the Leadership Education in Adolescent Health project, Maternal and Child Health Bureau HRSA (6T71-MC0009, MC00001 to S.B.A.), and a National Institute of Health Research UK clinician scientist award (DHCS/08/08/012) to N.M. The content is solely the responsibility of the authors and does not necessarily represent the official views of the funding agencies. The authors would like to thank the ALSPAC team of investigators and staff, and the thousands of participants in ALSPAC.

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Authors and Affiliations

  1. Division of Health Promotion and Behavioral Science, San Diego State University Graduate School of Public Health, 5500 Campanile Dr., San Diego, CA, 92182-4162, USA

    Jerel P. Calzo

  2. Institute for Behavioral and Community Health, San Diego, CA, USA

    Jerel P. Calzo

  3. Department of Pediatrics, Harvard Medical School, Boston, MA, USA

    Jerel P. Calzo & S. Bryn Austin

  4. Division of Adolescent/Young Adult Medicine, Boston Children’s Hospital, Boston, MA, USA

    S. Bryn Austin

  5. Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, MA, USA

    S. Bryn Austin

  6. Behavioural and Brain Sciences Unit, Institute of Child Health, University College London and Great Ormond Street Hospital, London, England, UK

    Nadia Micali

  7. Child and Adolescent Psychiatry Division, University Hospital of Geneva, Geneva, Switzerland

    Nadia Micali

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  1. Jerel P. Calzo
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  2. S. Bryn Austin
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  3. Nadia Micali
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Correspondence to Jerel P. Calzo.

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Calzo, J.P., Austin, S.B. & Micali, N. Sexual orientation disparities in eating disorder symptoms among adolescent boys and girls in the UK. Eur Child Adolesc Psychiatry 27, 1483–1490 (2018). https://doi.org/10.1007/s00787-018-1145-9

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  • DOI: https://doi.org/10.1007/s00787-018-1145-9

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