Table 1.
Studies (n = 15) that analyzed outcomes during the adolescent period (12–19 years old) or adulthood (12–25 years old).
| Authors (year) |
Source of Data and Sample | Sexual Orientation Measure |
Outcomes | Main Findings | |||||||
|---|---|---|---|---|---|---|---|---|---|---|---|
| Disordered Eating Behaviors | Weight-Related Behaviors | ||||||||||
| Binge | Purge | Diet | Diet Pills |
EB | PA | Body Image |
BMI | ||||
| Ackard, et al. (2008) | Source: Minnesota Student Survey Sample: 10,095 sexually active males (mean age of 16.7 ± 1.5, range 13–19); 82.9% White, 6.7% Black, 4.3% Asian, 6.1% Other/Multiracial | Sexual behaviors | ✔ | ✔ | ✔ | Males with same-sex and both-sex partners scored higher on several measures of disordered eating than heterosexual males. Rates of disordered eating behaviors were highest among males who reported having 3 or more sex partners of both genders. | |||||
| Austin, et al. (2004) | Source: Growing Up Today Study Sample: 10,583 females and males (age range 13–17); 93.3% White, 1.5% Asian, 1.5% Hispanic, 0.9% Aferican American, 0.8% Native American, 2.2% Other | Single item on sexual attraction/identity | ✔ | ✔ | ✔ | ✔ | ✔ | Among females, lesbians/bisexuals report being happier with the way their bodies look and being less concerned with trying to look like women in the media compared to heterosexuals. Mostly heterosexual females were more likely to report diet pill use and binging compared to heterosexual females. Among males, SM report wanting to look like men in the media and are more likely to report binging. | |||
| Austin, et al. (2009)c | Source: Growing Up Today Study Sample: 13,785 females and males (age range 12–23); 93.3% White, 1.5% Asian, 1.5% Hispanic, 0.9% African-American, 0.8% American-Indian, and 2.2% Other | Single item on sexual attraction/identity | ✔ | ✔ | Among females, lesbians and bisexuals were more likely to report binge eating compared to heterosexuals or mostly heterosexuals. Among males, SM were more likely to report both purging and binge eating than heterosexuals. | ||||||
| Austin, et al. (2013) | Source: Youth Risk Behavior Surveillance Survey (2005, 2007) Sample: 24,591 females and males (mean age of 15.9 ± 1.3, range 13–18); about 35.8% White, 24.9% Black, 18.1% Hispanic, 12.5% Asian, 8.8% Other (averaged across sex) | Sexual identity | ✔ | ✔ | ✔ | Ethnicity did not moderate the association between sexual identity and the three outcomes examined. For both females and males, SM had higher odds of purging and diet pill use. Bisexual females and males also had greater odds of obesity compared to heterosexual peers. | |||||
| Calzo, et al. (2013)c | Source: Growing Up Today Study (1999–2005) Sample: 5,868 males (age range 12–25); 93% White |
Single item on sexual attraction/identity | ✔ | Male SM reported increased desires for toned/defined muscles, bigger muscles and weight concerns compared to heterosexual males. | |||||||
| Calzo, et al. (2014)b,c | Source: Growing Up Today Study (1999–2005) Sample: 12,779 females and males (range 12–22) |
Single item on sexual attraction/ identity |
✔ | SM adolescents report lower moderate-to-vigorous physical activity and team sports involvement than their heterosexual peers. *Athletic self-esteem accounted for the differences across sex, while gender nonconformity accounted for differences in males. |
|||||||
| Calzo, et al. (2015)c | Source: Growing Up Today Study (2001–2005) Sample: 5,388 males (age range 15–20); 94% White |
Single item on sexual attraction/identity | ✔ | ✔ | ✔ | ✔ | ✔ | ✔ | SM males had higher odds for being lean-concerned but no higher odds of being muscle-concerned compared to heterosexual males, where indicators of being lean-concerned included elevated concern with weight and shape, binge eating, dieting, and purging. | ||
| French, et al. (1996) | Source: subsample of Minnesota population-based sample Sample: 788 males and females (age range 12–18); for the total sample: 86.4% White, 7.8% Black, 3.1% Asian, 1.6% Native American, 1.1% Hispanic | Sexual identity | ✔ | ✔ | ✔ | ✔ | ✔ | ✔ | Among females, SM reported a more positive body image than heterosexual peers and were less likely to report feeling overweight, but were no more likely to report disorder eating behaviors. Among males, SM were more likely to report a poorer body image and higher rates of ever binge eating, fear of out of control eating and laxative use than heterosexual peers. | ||
| Hadland, et al. (2014) | Source: Massachusetts Youth Risk Behavior Survey Sample: 12,984 females and males (age range 14–18); about 74.2% White, 11.8% Hispanic, 8.7% Black, 2.5% Asian, 2.9% Other/Mixed (averaged across sex) | Sexual identity and behaviors | ✔ | ✔ | ✔ | ✔ | ✔ | Among females, SM endorsed higher odds of fasting, diet pills use and purging than heterosexual peers, and were more likely to perceive self as healthy weight while being overweight or obese. Among males, SM endorsed higher odds of fasting, use of diet pills and purging than heterosexual peers, and were more likely to feel overweight while being healthy/underweight. | |||
| Katz-Wise, et al. (2014)c | Source: Growing Up Today Study (1996–2007) Sample: 13,952 females and males (age range 12–25); 93.3% White, 6.7% Other |
Single item on sexual attraction/identity | ✔ | ✔ | ✔ | Among females, SM reported greater rates of binge eating and fast food consumption than heterosexual peers. Bisexual females reported higher BMI at age 17 and greater increases in BMI than heterosexual peers over time. Among males, SM reported higher rates of binge eating and lower caloric intake than heterosexual peers. Gay males reported smaller increases in BMI over time and had a lower BMI than heterosexual peers at age 25. | |||||
| Mereish and Poteat (2015) | Source: Dane County Youth Assessment Sample: 13,933 females and males (age range 12–18); 73.5% White, 7.3% Multiracial, 5.3% Black, 5.1% Hispanic, 4.2% Asian, 0.6% Native American, 0.6% Middle-Eastern, 2.2% Other | Sexual identity | ✔ | ✔ | Compared to heterosexual peers, SM females were less likely to be involved in sports only, whereas SM males were less likely to be involved in sports and were also less likely to report physical activity. Disparity in BMI was only found among females, such that SM females were more likely than heterosexual females to report being overweight or obese. | ||||||
| Rosario, et al. (2014) | Source: Youth Risk Behavior Survey (2005, 2007) Sample: 65,871 females and males (age range 12–18); 53.2% White, 18.8% Hispanic, 19.2% Black, 8.8% Asian |
Sexual identity, behaviors and attraction | ✔ | ✔ | ✔ | ✔ | SM females were more likely to report purging and being overweight than heterosexual females. SM males were more likely than heterosexual males to get little physical activity, engage in purging, but less likely to have a diet low in fruits and vegetables. | ||||
| Shearer, et al. (2015)c | Source: Behavioral Health Screen Sample: 2,513 females and males (mean age of 17.24 ± 1.5, range 14–24); 59.7% White, 16.6% Hispanic, 9.1% Other, 8.1% Biracial, 4.7% Black, 1.8% Asian | Sexual attraction and behavior | ✔ | ✔ | ✔ | Females who reported attraction to both sexes or were unsure about their sexual orientation were more likely to report higher disordered eating symptoms compared to those endorsing attraction to one sex. Males attracted to other males reported higher rates of disordered eating symptoms compared to males only attracted to the opposite sex. | |||||
| Watson, et al. (2017)b | Source: Massachusetts Youth Risk Behavior Survey (1999–2013) Sample: 26,002 females and males (age range 12–18) | Sexual identity | ✔ | ✔ | ✔ | Although the overall prevalence of disordered eating behaviors has decreased from 1999–2003, sexual orientation disparities in disordered eating behaviors persisted for SM males and has increased for SM females over time. | |||||
| Yoon and So (2013) | Source: Korea Youth Risk Behavior Survey (2012) Sample: 11,829 females and males (age range 12–18); 100% Korean | Sexual behavior | ✔ | ✔ | SM females reported higher rates of moderate and vigorous physical activities, and muscular strength exercises than heterosexual females. SM males reported lower rates of muscular strength exercises and walking than heterosexual males. | ||||||
| TOTAL: | 7 | 9 | 7 | 7 | 2 | 4 | 5 | 8 | |||
EB = eating behaviors; PA = physical activity; SM = Sexual Minorities
a
Indicates factors associated with outcomes presented in paper
b
Indicates studies without description of race/ethnicity composition
c
Indicates studies that covered both adolescence and young adulthood (12–25 years old)