Eating disorders are pervasive in the LGBT community

Julia Laxer first developed bulimia when she was 14, shortly after she was raped. As the Portland, Oregon, resident describes it today at age 35, her eating disorder was a “bad seed” that was planted by the assault on her body—a seed that grew to merge with the various mental health challenges that post-traumatic stress disorder (PTSD) can bring.

San Antonio-based Eric Dorsa is 27 but recalls his eating disorders (he was diagnosed with anorexia nervosa and binge-eating disorder) starting when he was just an eight-year-old child and ramping up into a serious health problem at around age 12. Growing up in what he calls a “very conservative religious home,” Dorsa described an atmosphere of “shaming and secrecy” in which his disorder—which led to his hospitalization for heart failure—was never discussed. 

Dorsa and Laxer share more than just a history of struggling to recover from eating disorders. They are also both LGBT.

According to the National Eating Disorders Association (NEDA), some studies have shown that gay, lesbian, and bisexual teens are at a higher risk for bulimia and binge-eating disorders. One study found that among men with eating disorders, a staggering 42 percent identify as gay. Lesbian and bisexual women were also found to be about twice as likely to engage in binge eating.

The research on eating disorders in the LGBT community, though, is too limited to be considered comprehensively accurate. According to Amy Simpson, weekend programming lead at the Eating Recovery Center of Washington, there’s a strong need for further research, but it can also be complicated to conduct.

“It was safer to engage in an abusive relationship with the eating disorder than to deal with the truth.”

“What does exist is heavily reliant on self-reporting,” said Simpson, who identifies as queer and uses they/them pronouns. “With LGBT people, there’s a historic lack of trust with mental health professionals. We’re more likely to label an LGBT person with a mental disorder than we are with a heterosexual person.”

The statistics might also be skewed by who is most likely to seek treatment. Simpson said that, anecdotally, straight men are just as prevalent in recovery—but because people see eating disorders as primarily a young women’s issue, gay men have “more allowance to seek treatment.” Simpson said that in their experience of working with clients, one thing is eminently clear: Eating disorders are inextricably linked to a history of trauma. And for LGBT youth, trauma can be a many-headed monster.

“Many LGBT people do have their own personal sources of trauma, but also LGBT people experience trauma symptoms because of the fear of stigma, fear, or violence in the culture at large,” Simpson said. “The eating disorder and sexual and gender identity are all inextricably linked to the body. When you have the predisposition for the disorder as well as those identities, it can sometimes crash into this perfect storm of a need to control the body.”

For Dorsa, recovery didn’t take root until he was able to come out as a gay man. Dorsa is an alumni of the Eating Recovery Center, which runs treatment programs across Texas, California, Washington, the Carolinas, Ohio, and Chicago. Today he’s actively engaged in San Antonio’s gay community and performs as a drag queen. But during the early days of recovery, Dorsa remembers feeling like “people saw me for the first time” when he was a patient at Eating Recovery Center.

“There is a lot of shame in our culture still around sexuality. My eating disorder and my shame around my sexuality were kind of best buddies,” said Dorsa, who added that he’s met many LGBT people with eating disorders over the years.

“I feel like my eating disorder in a weird way protected me,” Dorsa said. “It was safer to engage in an abusive relationship with the eating disorder than to deal with the truth—that my family is not accepting and that the world held up this mirror that said I was unacceptable. I began to internalize that.”

Both Dorsa and Laxer spoke of their eating disorders as if they were separate entities, almost a shadow self that followed them around. Dora described feeling like “a walking eating disorder” at times, whereas Laxer called hers a “secondary identity” of its own. Dorsa felt like coming out as a gay man strengthened him in recovery, yet Laxer said she often felt like her bisexuality was invisible to others. When a queer person is constantly mistaken for straight, it can increase a sense of isolation, of being ignored. 

For Laxer, eating disorders are embedded in a spectrum of trauma recovery.

“Much like an alcoholic who just quits cold turkey one day and avoids the bottle, I ‘quit’ the lifestyle of pain I was self-perpetuating, due to internalized violence from my past traumas,” said Laxer. “However, like a person in recovery, it will never be easy for me. I am hard-wired differently, and my behaviors follow in suit.”

Simpson agreed that “disordered thinking and disordered urges” can be a lifelong struggle. But there’s one thing that the Eating Recovery Center staff consistently observes as part of the problem that allows eating disorders to take root: loneliness.

He’s still Facebook 
friends with people he was in the hospital with years ago. And just watching them survive and thrive inspires him. 

“Connection with a community corellates with a complete stop in eating disorder behavior,” said Simpson. “It doesn’t mean you’ll never struggle with eating disorder urges, but we do know that eating disorders thrive on isolation. For LGBT people, that means a culture that you can see yourself reflected in.”

These days, community is found online just as often as in the physical plane. Simpson recommends body-positive websites like TheBodyIsNotAnApology.com to clients, and Dorsa said that social media was—and still is—a major part of his recovery.

“People post everything from an inspirational quote to something they’re struggling with in life. From a recovery standpoint, you see the realness,” said Dorsa. “It’s a way to stay connected and involved even when maybe you didn’t have the money for treatment, or when your insurance dropped you.”

The impact of social media on recovery can continue years past the most acute crisis period, too. For some, that might take shape in something as simple as posting a lot of selfies on Instagram to boost self-confidence. Dorsa said that he’s still Facebook friends with people he was in the hospital with years ago. And just watching them survive and thrive inspires him.

“You see them get married and have kids or go to college,” said Dorsa. “Those weren’t things that were on my mind back then. I was more thinking ‘I can’t tell these strangers that I think I’m gay.’ It’s really cool to see people go from that to living and embracing their lives. It’s awesome.” 

Photo via Elizabeth Ann Colette/Flickr (CC BY 2.0) | Remix by Max Fleishman

Mary Emily O'Hara

Mary Emily O'Hara

Mary Emily O'Hara is an LGBTQ reporter. Her work has appeared in Rolling Stone, NBC Out, Daily Dot, Broadly, Vice, the Daily Beast, the Advocate, Huffington Post, DNAinfo, Al Jazeera, and Portland's Pulitzer Prize-winning newsweekly Willamette Week, among other outlets.