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Silverstein S, Santibañez T. A qualitative investigation of tattooing as an adaptive appearance investment: positive body image and eating disorder recovery in a predominantly transgender and gender expansive sample. Eat Disord 2024:1-22. [PMID: 39104263 DOI: 10.1080/10640266.2024.2381319] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 08/07/2024]
Abstract
Tattooed individuals often express the positive effects of wearing body art toward improved self-image and confidence. This research builds on prior data exploring the positive effects of tattooing and investigates how tattoos impact one's relationship to eating disorder (ED) recovery and body image. We held three focus groups lasting 60 minutes each, recruiting participants via purposive snowball sampling (n = 15), with additional opportunities to respond to focus group prompts asynchronously. Eligible participants were individuals with lived experience of an ED, self-identified as being in recovery, had three or more tattoos, and spoke English. Participants predominantly held gender-expansive (n = 4 Non-Binary, n = 3 Genderqueer, n = 3 Cisgender Women, n = 3 Transgender, n = 2 Transmasculine, n = 2 Gender Non-Conforming, n = 2 Intersex, n = 1 Cisgender Man) and non-heterosexual identities. Focus groups were held between April 2021 and July 2023 and followed a semi-structured interview format. Primary analyses focused on participants' responses to open-ended prompts regarding how they understood the relationships between tattooing, body image, and ED recovery. Thematic analysis identified four core themes: Tattooing allowing for embodiment, tattooing allowing for recovery-oriented behaviors, tattooing enabling positive body image, and tattooing facilitating empowerment. An overarching message was that tattooing is a therapeutic and transformative process, allowing for self-determination. Participants indicated that tattooing can be experienced as a powerful mechanism for behavioral change and shifts in relationship to one's body. Participants expressed that tattooing can be an effective route towards both gender euphoria and body liberation, enhancing one's ability to maintain ED recovery.
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Romano KA, Sandoval CM, Lewis RJ, Heron KE. Daily Relationship Functioning and Disordered Eating Behaviors Among Sexual Minority Women in Same-Sex Relationships. Ann Behav Med 2024; 58:412-421. [PMID: 38581675 PMCID: PMC11112276 DOI: 10.1093/abm/kaae016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/08/2024] Open
Abstract
BACKGROUND AND PURPOSE The present study aimed to examine associations between different types of relationship functioning and disordered eating behaviors (DEBs) in the everyday lives of sexual minority women in same-sex relationships-an at-risk population that has not been assessed in this context. METHODS Participants included 321 young sexual minority women (Mage = 27.56, SD = 3.67) in same-sex relationships who completed surveys assessing their daily relationship functioning and DEB use each day for a 14-day daily diary period. Multilevel structural equation modeling was used to examine daily-, person-, and couple-level associations among women's daily relationship functioning (general relationship functioning, positive and negative relational behaviors they and, separately, their partners engaged in) and DEBs (overeating, loss of control eating, emotional eating, and dietary restriction). RESULTS Results generally indicated that more positive and less negative daily relationship functioning across all assessed constructs was associated with less same-day emotional eating. In contrast, associations between all daily relationship functioning constructs and loss of control eating were not significant, nor were any relationship functioning-DEB associations at the couple level. More circumscribed patterns of association were identified for associations between the relationship functioning constructs, and overeating and dietary restriction. CONCLUSIONS Collectively, these findings provide insight into how aspects of daily relationship functioning map onto sexual minority women's daily engagement in DEBs that are linked to poor health long-term, and directions for future research and clinical practice that may warrant consideration moving forward to help advance the evidence-base and care for this historically overlooked and underserved population.
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Affiliation(s)
- Kelly A Romano
- Department of Psychiatry and Behavioral Sciences, University of Minnesota Medical School, Minneapolis, MN, USA
| | | | - Robin J Lewis
- Virginia Consortium Program in Clinical Psychology, Norfolk, VA, USA
- Department of Psychology, Old Dominion University, Norfolk, VA, USA
| | - Kristin E Heron
- Virginia Consortium Program in Clinical Psychology, Norfolk, VA, USA
- Department of Psychology, Old Dominion University, Norfolk, VA, USA
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3
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Sadeghi M, Jamali J, Sheybani F. Translation and Evaluation of Psychometric Properties of the Persian 8-Item Internalized Transphobia (IT) Scale in Iranian Transgenders. J Family Reprod Health 2024; 18:44-52. [PMID: 38863843 PMCID: PMC11162881 DOI: 10.18502/jfrh.v18i1.15438] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/13/2024] Open
Abstract
Objective Internalized transphobia (IT) is influenced by societal norms and expectations, and it can have significant negative effects on the well-being and mental health of transgender individuals. The aim of this study was to translate and evaluate the psychometric properties of the Persian 8-item IT scale among Iranian transgender individuals in order to enhance the quality and quantity of research in this field. Materials and methods This cross-sectional and methodological study utilized convenience sampling to recruit 119 transgender individuals in Mashhad, the second most populous city in Iran, in 2021. The Persian translation of the IT scale was developed using the backward-forward translation method. Subsequently, various types of validity and reliability were assessed, including content validity using the content validity index (CVI) and content validity ratio (CVR), face validity based on the impact score, construct validity through confirmatory factor analysis (CFA), internal consistency measured by Cronbach's alpha, and test-retest stability analyzed using the intraclass correlation coefficient (ICC). Results The CVR ranged from 0.600 to 1, the CVI ranged from 0.800 to 1, and the impact score exceeded 1.5, indicating the appropriate content and face validity of the 8-item IT scale. The construct validity analysis revealed that the questionnaire is one-dimensional. The internal consistency, as measured by Cronbach's alpha, was 0.917, and the ICC for test-retest stability was 0.871. Conclusion The Persian version of the IT scale demonstrated high and acceptable psychometric properties. The brevity of this scale facilitates its dissemination and utilization in clinical settings.
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Affiliation(s)
- Mohaddeseh Sadeghi
- Student Research Committee, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Jamshid Jamali
- Department of Biostatistics, School of Health, Mashhad University of Medical Sciences, Mashhad, Iran
- Social Determinants of Health Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Farshad Sheybani
- Department of Psychiatry, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
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Quiñones IC, Selkie E, Mammel KA, Haedt-Matt A, Klump KL, Burt SA, Van Huysse JL. Disordered eating in transgender and gender non-conforming youth: A comparison to community-based and clinical samples. EUROPEAN EATING DISORDERS REVIEW 2024; 32:338-349. [PMID: 37905947 DOI: 10.1002/erv.3045] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2023] [Revised: 10/03/2023] [Accepted: 10/16/2023] [Indexed: 11/02/2023]
Abstract
OBJECTIVE This study investigates eating pathology in transgender and gender non-conforming (TGNC) youth compared to a community-based sample and individuals with eating disorders (EDs). METHOD Participants (ages 13-21 years) included TGNC youth from a paediatric gender clinic (N = 97), a demographically matched community-based sample of cisgender males (N = 97) and cisgender females (N = 97), and treatment-seeking patients with EDs (N = 112). The Eating Disorder Examination Questionnaire (EDE-Q) was used to assess ED cognitions and behaviours. RESULTS Transgender and gender non-conforming participants reported significantly higher EDE-Q global scores compared to the cisgender samples, but significantly lower than the ED sample. Transgender and gender non-conforming individuals reported a higher likelihood of objective binge episodes (OBEs) than the cisgender groups, albeit lower than youth with EDs. A substantial proportion of TGNC participants scored in elevated ranges on the EDE-Q global score (35% ≥ score of 3, 17% ≥ score of 4), significantly higher than cisgender males (0% ≥ score of 3, 0% ≥ score of 4) and females (9% ≥ score of 3, 3% ≥ score of 4). CONCLUSIONS Findings indicate that TGNC youth exhibit increased ED cognitions and OBEs compared to cisgender samples, highlighting the need for screening and addressing ED symptoms in this population.
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Affiliation(s)
- Isabel C Quiñones
- Department of Psychology, Illinois Institute of Technology, Chicago, Illinois, USA
| | - Ellen Selkie
- University of Wisconsin, Madison, Wisconsin, USA
| | - Kathleen A Mammel
- Department of Pediatrics, University of Michigan, Ann Arbor, Michigan, USA
| | - Alissa Haedt-Matt
- Department of Psychology, Illinois Institute of Technology, Chicago, Illinois, USA
| | - Kelly L Klump
- Department of Psychology, Michigan State University, East Lansing, Michigan, USA
| | - S Alexandra Burt
- Department of Psychology, Michigan State University, East Lansing, Michigan, USA
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Cusack CE, Silverstein S, Askew AJ, Simone M, Galupo MP, Levinson CA. Eating disorders among queer and trans individuals: Implications for conceptualization, assessment, and treatment. Bull Menninger Clin 2024; 88:128-147. [PMID: 38836851 DOI: 10.1521/bumc.2024.88.2.128] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/06/2024]
Abstract
Eating disorders (EDs) have been traditionally viewed as a disorder affecting cisgender, heterosexual women. Yet, the prevalence of EDs among queer and trans (QnT) individuals, coupled with the lack of interventions that attend to contextual factors related to sexual orientation and gender identity, underscore a critical health disparity issue requiring urgent attention. Here, we first review factors pertaining to QnT individuals' minoritized sexual and gender identities that are important to consider in ED conceptualization for this population (e.g., minority stressors, identity-based body image standards). Next, we describe problematic assumptions present in existing ED assessment and propose more inclusive approaches. Lastly, we provide suggestions for practices that providers can implement within their treatment of EDs among QnT individuals.
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Affiliation(s)
- Claire E Cusack
- Department of Psychological and Brain Sciences, University of Louisville, Louisville, Kentucky
| | | | - Autumn J Askew
- San Diego State University/University of California San Diego Joint Doctoral Program in Clinical Psychology
| | - Melissa Simone
- Assistant Professor, Department of Psychology, University of Colorado Denver
| | - M Paz Galupo
- Audre Lorde Distinguished Professor of Sexual Health & Education, Brown School Department of Social Work and Public Health, Washington University in Saint Louis
| | - Cheri A Levinson
- Associate Professor, Department of Psychological and Brain Sciences and Child and Adolescent Psychology and Psychiatry, Department of Pediatrics, University of Louisville
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Yesildemir O, Akbulut G. Gender-Affirming Nutrition: An Overview of Eating Disorders in the Transgender Population. Curr Nutr Rep 2023; 12:877-892. [PMID: 37864747 DOI: 10.1007/s13668-023-00504-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/03/2023] [Indexed: 10/23/2023]
Abstract
PURPOSE OF REVIEW Transgender individuals are vulnerable to many nutrition-related conditions, especially eating disorders due to gender dysphoria. This review aims to summarize the current literature on eating disorders in transgender individuals. The issues that should be considered in nutrition care for the transgender population are discussed regarding public health. RECENT FINDINGS Transgender individuals can exhibit disordered eating behaviors to overcome the stress they experience due to stigma, discrimination, social exclusion, and abuse. Recent studies showed that disordered eating and clinical eating disorders are more prevalent among transgender than cisgender people. It is very important for a multidisciplinary team working in the clinic to understand the epidemiology, etiology, diagnostic criteria, and treatment of eating disorders in the transgender population. However, multidisciplinary nutritional care is limited due to the lack of transgender-specific nutrition guidelines. It is safe to say that adhering to a generally healthy nutritional pattern and using standardized nutrition guidelines. We recommend that health professionals working with patients/clients with eating disorders receive continuing education in transgender health, be empowering and inclusive, address patients/clients with their gender identity nouns and pronouns, and develop nutritional treatment plans that are not gender-specific. Eating disorders are a significant public health problem in the transgender population. Therefore, clinical screening and early intervention are necessary to identify and treat eating disorders in transgender people. Eating disorders in the transgender population should be monitored routinely, and gender-affirming care should be provided as well as treatment of eating disorders.
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Affiliation(s)
- Ozge Yesildemir
- Department of Nutrition and Dietetics, Faculty of Health Sciences, Bursa Uludag University, Bursa, 16059, Turkey.
| | - Gamze Akbulut
- Department of Nutrition and Dietetics, Faculty of Health Sciences, Istanbul Kent University, Istanbul, 34433, Turkey
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Saxena V, Xu A, Kinley K, Tsheten T, Gyeltshen T, Tobgay T, Zajkowski TY, McFarland W, Khandu L. Stigma and discrimination against transgender men in Bhutan. PLoS One 2023; 18:e0287745. [PMID: 37471374 PMCID: PMC10358905 DOI: 10.1371/journal.pone.0287745] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2023] [Accepted: 06/13/2023] [Indexed: 07/22/2023] Open
Abstract
BACKGROUND While transgender people worldwide face high rates of stigma and discrimination, there are few studies of transgender men (also "trans men") in Asia. We measured the prevalence of, and factors associated with, stigma and discrimination faced by trans men in Bhutan to bring visibility to their experiences and inform health and social policy changes. METHODS This cross-sectional survey was conducted in nine regions in Bhutan from November 2019 to January 2020. A total of 124 trans men were recruited using a hybrid venue-based and peer-referral approach. Data were collected using an interviewer-administered questionnaire. Multivariate logistic regression characterized associations with experiencing stigma and discrimination when accessing health services. FINDINGS Participants were young (48.0% 18-24 years) and 48.4% had migrated from a rural to an urban area. The majority (95.2%) experienced stigma because people knew or thought they were trans men. Associations with frequent experiences of stigma were living with their partner as a couple (adjusted odds ratio [AOR] 3.07, 95% CI 1.27-7.44) and being unemployed or a student (3.22, 1.44-7.19). Nearly half (47.6%) said they experienced discrimination when accessing health care because people knew or thought they were a trans man; this experience was associated with migration (2.42, 1.08-5.39) and having >15 trans men in their social network (3.73, 1.69-8.26). Most (94.4%) experienced verbal violence, 10.5% experienced physical violence, and 4.8% experienced sexual violence. INTERPRETATION Our study found high rates of stigma, discrimination, and interpersonal violence due to being a trans man in Bhutan. Findings highlight the urgent need for strengthening laws and regulations to protect the rights of transgender persons, particularly when accessing health services, recognizing partnerships, and preventing violence in public spaces.
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Affiliation(s)
- Vinita Saxena
- University of California Los Angeles, Los Angeles, CA, United States of America
| | - Audrey Xu
- Stanford University, Stanford, CA, United States of America
| | - Kinley Kinley
- Department of Public Health, National HIV, AIDS and STIs Control Program, Ministry of Health, Thimphu, Bhutan
| | - Tashi Tsheten
- Queer Voices of Bhutan, LGBTIQ Network of Bhutan, Thimphu, Bhutan
| | | | | | | | - Willi McFarland
- San Francisco Department of Public Health, San Francisco, CA, United States of America
| | - Lekey Khandu
- Department of Public Health, National HIV, AIDS and STIs Control Program, Thimphu, Bhutan
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Kalash N, Harb H, Zeeni N, El Khoury M, Mattar L. Determinants of body image disturbance and disordered eating behaviors among self-identified LGBTQ individuals. J Eat Disord 2023; 11:87. [PMID: 37268956 DOI: 10.1186/s40337-023-00810-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/20/2022] [Accepted: 05/15/2023] [Indexed: 06/04/2023] Open
Abstract
It has been previously established that sexual minorities are more likely to suffer from mental health illnesses due to experiencing unique stressors such as fear, anxiety, stigma, harassment, and prejudice. Results revealed two noteworthy mental health disorders reported by lesbian, gay, bisexual, transgender, and queer (LGBTQ) individuals, disordered eating behaviors and disturbed body image. Yet, a-priori studies revealed inconsistent results with regards to body image concerns and eating disorder symptoms and attitudes among sexual minorities. Therefore, this cross-sectional study aimed at investigating the occurrence of disordered eating behaviors (DEB) and body image disturbance (BID) among sexual minorities in Lebanon. Additionally, the correlation between several determinants of DEB and BID including fear of negative evaluation, generalized anxiety, social support, and harassment levels have been examined. Generally, the present study revealed that LGBTQ population scored higher than cisgender and heterosexual individuals for the mean and global scores of the EDE-Q6.0 and BAS-2. Only generalized anxiety and fear of negative evaluation scales were significantly associated with DEB and BID among different sexual orientation and gender identity individuals. Therefore, it is very important that health professionals working with such vulnerable populations meticulously assess for disordered eating behaviors and body image disturbance for better communication and management.
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Affiliation(s)
- Nour Kalash
- Nutrition Program, Department of Natural Sciences, School of Arts and Sciences, Lebanese American University, P.O. Box 13-5053, Chouran, Beirut, 1102 2801, Lebanon
| | - Hana Harb
- Nutrition Program, Department of Natural Sciences, School of Arts and Sciences, Lebanese American University, P.O. Box 13-5053, Chouran, Beirut, 1102 2801, Lebanon
| | - Nadine Zeeni
- Nutrition Program, Department of Natural Sciences, School of Arts and Sciences, Lebanese American University, P.O. Box 13-5053, Chouran, Beirut, 1102 2801, Lebanon
| | - Myriam El Khoury
- Psychology Program, Department of Social Sciences, School of Arts and Sciences, Lebanese American University, Beirut, Lebanon
| | - Lama Mattar
- Nutrition Program, Department of Natural Sciences, School of Arts and Sciences, Lebanese American University, P.O. Box 13-5053, Chouran, Beirut, 1102 2801, Lebanon.
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Tran A, Darboe M, Goyal A, Birk N. Association between dating app use and unhealthy weight control behaviors and muscle enhancing behaviors in sexual minority men: a cross-sectional study. BMC Public Health 2023; 23:838. [PMID: 37161386 PMCID: PMC10170774 DOI: 10.1186/s12889-023-15715-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2022] [Accepted: 04/19/2023] [Indexed: 05/11/2023] Open
Abstract
BACKGROUND Body image concerns are prevalent and are viewed as risk factors for engaging in unhealthy weight control behaviors (UWCBs), such as purging, fasting, and the misuse of laxatives and diet pills. Studies have also linked UWCBs to the development of eating disorders. In the United States (U.S.), sexual minority men (e.g., bisexual, gay, and men who have sex with men) are prone to UWCBs often as a result of societal pressures to achieve certain standards of appearance - of which are often perpetuated through various media platforms. A growing number of studies have explored the possible role mobile dating applications ("dating apps") play in contributing to UWCBs. To our knowledge, such studies have not explored this possible relationship between dating apps and UWCBs in sexual minority men (SMM). To fill this gap in the scientific literature, the present study assessed the association between dating app use and UWCBs and muscle enhancing behaviors among a sample of adult SMM in the U.S. METHOD 549 SMM participated in an anonymous survey from Qualtrics Survey Panels. UWCBs and muscle enhancing behaviors were assessed through items adapted from national surveys. Body image dissatisfaction was assessed using the Male Body Attitudes Scales. Participants also reported their history of dating app use. We performed descriptive statistics, chi-square tests, and student's t-tests. Multivariable logistic regression models assessed the relationship between dating app use and UWCBs and muscle enhancing behaviors. RESULTS Dating app users had significantly higher body image dissatisfaction scores than non-users. Dating app users also demonstrated significantly elevated odds of engaging in four UWCBs and muscle enhancing behaviors: laxatives, diet pills, muscle-building supplements, and protein powders. CONCLUSIONS This is one of the first studies to assess dating app use and its association with UWCBs and muscle enhancing behaviors in SMM. Increased surveillance and detection for such behaviors among SMM, particularly those using dating apps, are needed.
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Affiliation(s)
- Alvin Tran
- Department of Population Health and Leadership, School of Health Sciences, University of New Haven, 300 Boston Post Road, West Haven, CT, 06516, USA.
| | - Mabintou Darboe
- Department of Population Health and Leadership, School of Health Sciences, University of New Haven, 300 Boston Post Road, West Haven, CT, 06516, USA
| | - Anirudh Goyal
- Department of Population Health and Leadership, School of Health Sciences, University of New Haven, 300 Boston Post Road, West Haven, CT, 06516, USA
| | - Nick Birk
- Harvard T.H. Chan School of Public Health, 67 Huntington Ave, Boston, MS, MA, 02115, USA
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Muzi L, Nardelli N, Naticchioni G, Mazzeschi C, Baiocco R, Lingiardi V. Body Uneasiness and Dissatisfaction Among Lesbian, Gay, Bisexual, and Heterosexual Persons. SEXUALITY RESEARCH & SOCIAL POLICY : JOURNAL OF NSRC : SR & SP 2023:1-16. [PMID: 37363347 PMCID: PMC10010970 DOI: 10.1007/s13178-023-00805-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 02/27/2023] [Indexed: 06/28/2023]
Abstract
Introduction While sexual minority people have been widely considered at risk for developing a range of body image concerns, evidence of body dissatisfaction and shame amongst LGB (lesbian, gay, and bisexual) individuals is mixed. This study investigated differences in body uneasiness, body dissatisfaction, and self-blaming/attacking attitudes between LGB and heterosexual individuals, as well as within LGB groups, while also examining the predictive role of body mass index (BMI). Methods A sample of cisgender lesbian women (n = 163), gay men (n = 277), bisexual women (n = 135), bisexual men (n = 39), heterosexual women (n = 398), and heterosexual men (n = 219) completed an online survey assessing different aspects of body image between May and July 2020. Results Gay and bisexual men reported greater body image disturbance and self-blaming attitudes relative to heterosexual men. In contrast, lesbian women reported lower body uneasiness than their bisexual and heterosexual counterparts, but greater self-hate. Moreover, lesbian and bisexual women showed more body dissatisfaction than gay men, and bisexual individuals reported more body uneasiness than individuals in other sexual minority subgroups. Higher BMI emerged as a significant predictor of body image concerns and dissatisfaction. Conclusions Body image dimensions showed sexual identity-based differences. Determining the specific nuances of body image in LGB individuals can provide important information on potential risk factors that may impact mental health outcomes. Policy Implications In-depth knowledge of body dissatisfaction and uneasiness in individuals with LGB identities may have critical implications for the development of personalized prevention and treatment strategies.
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Affiliation(s)
- Laura Muzi
- Department of Philosophy, Social Sciences, Humanities and Education, University of Perugia, Piazza Ermini, 1, Perugia, 06123 Italy
| | | | - Gabriele Naticchioni
- Department of Dynamic and Clinical Psychology, and Health Studies, Faculty of Medicine and Psychology, Sapienza University of Rome, Rome, Italy
| | - Claudia Mazzeschi
- Department of Philosophy, Social Sciences, Humanities and Education, University of Perugia, Piazza Ermini, 1, Perugia, 06123 Italy
| | - Roberto Baiocco
- Department of Social and Developmental Psychology, Faculty of Medicine and Psychology, Sapienza University of Rome, Rome, Italy
| | - Vittorio Lingiardi
- Department of Dynamic and Clinical Psychology, and Health Studies, Faculty of Medicine and Psychology, Sapienza University of Rome, Rome, Italy
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Helminen EC, Ducar DM, Scheer JR, Parke KL, Morton ML, Felver JC. Self-Compassion, Minority Stress, and Mental Health in Sexual and Gender Minority Populations: A Meta-Analysis and Systematic Review. CLINICAL PSYCHOLOGY-SCIENCE AND PRACTICE 2023; 30:26-39. [PMID: 37197599 PMCID: PMC10187610 DOI: 10.1037/cps0000104] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Sexual and gender minority (SGM) populations report numerous mental health disparities relative to heterosexual and cisgender populations, due in part to the effects of minority stress. This article evaluated self-compassion as a coping resource among SGM populations by (a) meta-analyzing the associations between self-compassion, minority stress, and mental health; and (b) synthesizing evidence for the mediating effects of self-compassion between minority stress and mental health. Systematic searches of databases identified 21 papers for the systematic review and 19 for the meta-analysis. Significant meta-analytic associations were found between self-compassion and minority stress (n = 4,296, r = -.29), psychological distress (n = 3,931, r = -.59), and well-being (n = 2,493, r = .50). The research synthesis identified supporting evidence for self-compassion as a coping resource for SGM people. The results of this review warrant further self-compassion research, particularly longitudinal research, for SGM populations.
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Affiliation(s)
| | - Dallas M. Ducar
- Transhealth Northampton, Northampton, Massachusetts, United States
- School of Nursing, Columbia University
| | | | - Kari L. Parke
- Department of Criminal Justice, Saint Joseph’s University
| | | | - Joshua C. Felver
- Yang Tan Institute on Employment and Disability, ILR School, Cornell University
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12
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Schmidt M, Taube CO, Heinrich T, Vocks S, Hartmann AS. Body image disturbance and associated eating disorder and body dysmorphic disorder pathology in gay and heterosexual men: A systematic analyses of cognitive, affective, behavioral und perceptual aspects. PLoS One 2022; 17:e0278558. [PMID: 36472982 PMCID: PMC9725123 DOI: 10.1371/journal.pone.0278558] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2021] [Accepted: 11/18/2022] [Indexed: 12/12/2022] Open
Abstract
OBJECTIVE This study contributes to the quantitatively large, yet narrow in scope research on body image in gay men by assessing whether gay and heterosexual men systematically differ on various dimensions of body image disturbance and associated pathology, i.e., eating disorder and body dysmorphic disorder symptoms. Moreover, we examined the influence of general everyday discrimination experiences and involvement with the gay community on body image. METHOD N = 216 men (n = 112 gay men, n = 104 heterosexual men) participated in an online survey measuring the discrepancy between self-rated current and ideal body fat/ muscularity; drive for leanness, muscularity, and thinness; body satisfaction; body-related avoidance and checking; appearance fixing; overall body image disturbance; eating disorder and body dysmorphic disorder pathology; general everyday discrimination experiences; and involvement with the gay community. RESULTS Gay men showed a greater discrepancy between self-rated current and ideal body fat; higher drive for thinness, body-related avoidance, appearance fixing, overall body image disturbance, eating disorder and body dysmorphic disorder pathology; and lower body appreciation than heterosexual men (all p ≤ .05). Contrary to expectation, everyday discrimination experiences were more strongly associated with body image disturbance and eating disorder/ body dysmorphic disorder pathology in heterosexual men than in gay men (all p ≤ .05). Gay community involvement was not associated with any body image disturbance-, ED-, or BDD aspect in gay men (all p ≥ .20). DISCUSSION The results suggest greater body image disturbance in gay men than in heterosexual men regarding cognitions, emotions, behaviors, and perception as well as higher eating disorder and body dysmorphic disorder pathology. The results also suggest the dilemma of a thin, yet muscular body ideal in gay men. Surprisingly, discrimination experiences and involvement with the gay community did not explain differences in body image disturbance. Gay men may have become resilient to discrimination over time, and body ideals might differ across gay sub-communities.
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Affiliation(s)
- Michaela Schmidt
- Institute of Psychology, Department of Clinical Psychology and Psychotherapy, Osnabrück University, Osnabrück, Germany
- * E-mail:
| | - Christoph O. Taube
- Institute of Psychology, Department of Clinical Psychology and Psychotherapy, Osnabrück University, Osnabrück, Germany
| | - Thomas Heinrich
- Institute of Psychology, Department of Clinical Psychology and Psychotherapy, Osnabrück University, Osnabrück, Germany
| | - Silja Vocks
- Institute of Psychology, Department of Clinical Psychology and Psychotherapy, Osnabrück University, Osnabrück, Germany
| | - Andrea S. Hartmann
- Department of Psychology, Unit of Experimental Clinical Psychology, University of Konstanz, Konstanz, Germany
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Abstract
PURPOSE OF REVIEW Public policy efforts for prevention of and intervention upon eating disorders is severely limited in the United States due to the paucity of population-based data. This review article summarizes findings regarding eating disorders based on the National Epidemiological Studies on Alcohol and Related Conditions, Third Wave. The studies reviewed provide the most recent epidemiological indicators of anorexia nervosa, bulimia nervosa, and binge-eating disorder (BED) in the United States and demonstrate the utility of population-based data for validating the generalizability of findings from clinical samples. RECENT FINDINGS Anorexia nervosa, bulimia nervosa, and BED are widely distributed across sociodemographic characteristics, with substantially elevated risks for a variety of serious psychiatric, medical, and functional impairments, including heighted suicidality over the lifespan. Sexual minorities and individuals with adverse childhood experiences may be particularly vulnerable. Yet, many adults with eating disorders do not seek help, particularly professional help. National Epidemiological Studies on Alcohol and Related Conditions, Third Wave studies also validated some important clinical observations (e.g., overvaluation of shape/weight and physical inactivity in BED, more severe anorexia nervosa with onset prior to 14 years old). SUMMARY More rigorous population-based studies are needed to further advocate for appropriate resources and policies for eating disorders in the United States.
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Affiliation(s)
- Tomoko Udo
- Department of Health Policy, Management and Behavior
- Department of Epidemiology and Biostatistics, School of Public Health, University at Albany, Albany, New York
| | - Carlos M Grilo
- Department of Psychiatry, Yale School of Medicine, Yale University, New Haven, Connecticut, USA
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14
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Mahon C, Fitzgerald A, O’Reilly A, McDermott C, O’Connor C, Dooley B. An exploratory investigation of body esteem, body dissatisfaction and body change behaviours in sexual minority young adults from a risk and protective perspective. PSYCHOLOGY & SEXUALITY 2022. [DOI: 10.1080/19419899.2022.2130084] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Affiliation(s)
- Ciara Mahon
- School of Psychology, University College Dublin (UCD) (Ireland)
| | | | - Aileen O’Reilly
- School of Psychology, University College Dublin (UCD) (Ireland)
- Jigsaw, The National Centre for Youth Mental Health (Ireland)
| | | | | | - Barbara Dooley
- School of Psychology, University College Dublin (UCD) (Ireland)
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15
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Huckins LM, Signer R, Johnson J, Wu YK, Mitchell KS, Bulik CM. What next for eating disorder genetics? Replacing myths with facts to sharpen our understanding. Mol Psychiatry 2022; 27:3929-3938. [PMID: 35595976 PMCID: PMC9718676 DOI: 10.1038/s41380-022-01601-y] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/31/2021] [Revised: 04/20/2022] [Accepted: 04/26/2022] [Indexed: 02/07/2023]
Abstract
Substantial progress has been made in the understanding of anorexia nervosa (AN) and eating disorder (ED) genetics through the efforts of large-scale collaborative consortia, yielding the first genome-wide significant loci, AN-associated genes, and insights into metabo-psychiatric underpinnings of the disorders. However, the translatability, generalizability, and reach of these insights are hampered by an overly narrow focus in our research. In particular, stereotypes, myths, assumptions and misconceptions have resulted in incomplete or incorrect understandings of ED presentations and trajectories, and exclusion of certain patient groups from our studies. In this review, we aim to counteract these historical imbalances. Taking as our starting point the Academy for Eating Disorders (AED) Truth #5 "Eating disorders affect people of all genders, ages, races, ethnicities, body shapes and weights, sexual orientations, and socioeconomic statuses", we discuss what we do and do not know about the genetic underpinnings of EDs among people in each of these groups, and suggest strategies to design more inclusive studies. In the second half of our review, we outline broad strategic goals whereby ED researchers can expand the diversity, insights, and clinical translatability of their studies.
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Affiliation(s)
- Laura M Huckins
- Pamela Sklar Division of Psychiatric Genomics, Icahn School of Medicine at Mount Sinai, New York, NY, 10029, USA
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, 10029, USA
- Department of Genetics and Genomic Sciences, Icahn School of Medicine at Mount Sinai, New York, NY, 10029, USA
- Icahn Institute for Genomics and Multiscale Biology, Icahn School of Medicine at Mount Sinai, New York, NY, 10029, USA
- Seaver Autism Center for Research and Treatment, Icahn School of Medicine at Mount Sinai, New York, NY, 10029, USA
- Mental Illness Research, Education and Clinical Centers, James J. Peters Department of Veterans Affairs Medical Center, Bronx, NY, 14068, USA
| | - Rebecca Signer
- Pamela Sklar Division of Psychiatric Genomics, Icahn School of Medicine at Mount Sinai, New York, NY, 10029, USA
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, 10029, USA
- Department of Genetics and Genomic Sciences, Icahn School of Medicine at Mount Sinai, New York, NY, 10029, USA
| | - Jessica Johnson
- Pamela Sklar Division of Psychiatric Genomics, Icahn School of Medicine at Mount Sinai, New York, NY, 10029, USA
| | - Ya-Ke Wu
- School of Nursing, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
- Department of Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Karen S Mitchell
- National Center for PTSD at VA Boston Healthcare System, Boston, MA, USA
- Department of Psychiatry, Boston University School of Medicine, Boston, MA, USA
| | - Cynthia M Bulik
- Department of Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden.
- Department of Nutrition, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.
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16
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Springmann ML, Svaldi J, Kiegelmann M. A qualitative study of gendered psychosocial processes in eating disorder development. Int J Eat Disord 2022; 55:947-955. [PMID: 35608064 DOI: 10.1002/eat.23734] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/11/2022] [Revised: 05/05/2022] [Accepted: 05/06/2022] [Indexed: 11/09/2022]
Abstract
OBJECTIVE Gender and sexual identity constitute social categories that have been found to be important when identifying persons at risk for eating disorders (ED), since prevalence rates are especially high for women as well as persons of gender and sexual minorities. The objective of this study is to enhance the understanding of how these social categories relate to ED development. METHOD A qualitative, inductive approach was used in order to develop empirically grounded hypotheses about gendered aspects in ED development. Data are 14 narrative interviews with persons of diverse sexual and gender identities who recovered from anorexia or bulimia nervosa. Interviews were analyzed in depth using Grounded Theory Methodology and Voice Centered Listening. RESULTS Results suggest that social experiences related to female gender, as well as social experiences related to non-compliance with social gender norms, can be important for ED development. Those social experiences were described as influencing participants' self-worth, body image and self-regulatory strategies, which were connected to ED symptomatology. DISCUSSION Future research should further validate the gendered aspects presented in this paper, since including a broader array of gendered social aspects in ED research might help to improve etiological understanding and prevention methods. PUBLIC SIGNIFICANCE STATEMENT This study contributes a special perspective to research on eating disorders and gender, because it is based on first-person perspectives of formerly affected persons and integrates the experiences of persons with different gender and sexual identities. Participants described four categories of gendered social experiences relevant for their eating disorders. We discuss the potential of these categories to guide future research on the development of eating disorders and their prevention.
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Affiliation(s)
| | - Jennifer Svaldi
- Department for Clinical Psychology and Psychotherapy, Tübingen University, Tübingen, Germany
| | - Mechthild Kiegelmann
- Department for Psychology, Karlsruhe University of Education, Karlsruhe, Germany
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17
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Markey CH, August KJ, Kelly K, Dunaev JP. Perceptions of Weight Change Among Romantic Partners: Considering Body Image, Relationship Experiences, Gender, and Sexual Orientation. Front Glob Womens Health 2022; 3:798257. [PMID: 35669312 PMCID: PMC9163392 DOI: 10.3389/fgwh.2022.798257] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2021] [Accepted: 03/08/2022] [Indexed: 11/20/2022] Open
Abstract
Romantic relationship experiences have been found to be relevant to body image and weight in adulthood. In this study, we investigated predictors of heterosexual, lesbian, and gay romantic partners' (N = 500, Mage = 29.3) perceptions of their own and their partners' weight at the beginning of their relationship and 4.8 years later, on average. Perceived changes in participants' own weight status was associated with greater body dissastisfaction and longer relationship length. Perceived changes in partners' weight status was associated with their partners' BMI, as well as relationship quality. We also found that gender was important in understanding some of these associations. Implications of weight perceptions for individuals' and their partners' health and well-being and the critical role of relationship quality are discussed in the context of the health regulation model.
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18
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Addressing Weight Bias in the Cisgender Population: Differences between Sexual Orientations. Nutrients 2022; 14:nu14091735. [PMID: 35565703 PMCID: PMC9099522 DOI: 10.3390/nu14091735] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2022] [Revised: 04/12/2022] [Accepted: 04/20/2022] [Indexed: 01/11/2023] Open
Abstract
(1) Background: Weight bias (WB) is an implicit psychological construct that can influence attitudes, beliefs, body experience, and evaluation of specific psychopathology relationships. Sexual orientation has played a crucial role in developing and maintaining psychiatric conditions linked to body evaluation, but few studies have evaluated possible connected biases. Thus, the paper aims to assess potential relationships between sexual orientation and WB, looking at potential roles in specific psychopathology; (2) Methods: A total of 836 cisgender subjects participated in an online survey, aged between 18 and 42 years old. Two specific aspects of WB were evaluated with validated scales about beliefs about obese people and fat phobia. Demographic variables, as well as depression and eating concerns were evaluated; (3) Results: Gay men and bisexual women showed higher levels of fat phobia, depression, and eating concerns. Regression analysis showed that sexual orientation significantly predicted fat phobia (p < 0.001) and beliefs about obese people (p = 0.014); (4) Conclusions: This study confirms the vulnerability of gay men and bisexual women to cognitive bias about their own bodies, showing a potential vulnerability about body and weight concerns.
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19
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Brewerton TD, Suro G, Gavidia I, Perlman MM. Sexual and gender minority individuals report higher rates of lifetime traumas and current PTSD than cisgender heterosexual individuals admitted to residential eating disorder treatment. Eat Weight Disord 2022; 27:813-820. [PMID: 34057704 DOI: 10.1007/s40519-021-01222-4] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/14/2021] [Accepted: 05/20/2021] [Indexed: 11/25/2022] Open
Abstract
OBJECTIVE Trauma and posttraumatic stress disorder (PTSD) are associated with eating disorders (EDs), which occur across all sexual orientations and gender identities. Prior traumas and PTSD also are reported to occur significantly more frequently in individuals identifying as lesbian, gay, bisexual, transgender, queer or questioning, non-binary, or other (LGBTQ+), but little is known about rates of PTSD in LGBTQ+ individuals with EDs admitted to residential treatment (RT). METHOD Our sample included 542 adults with DSM-5 EDs admitted to RT at seven sites in the U.S. Rates of current presumptive PTSD (PTSD +) by LGBTQ + status were determined by responses on the Life Events Checklist (LEC-5) and the PTSD Symptom Checklist for DSM-5 (PCL-5). RESULTS Nearly 24% of admitting individuals self-reported as LGBTQ+, and these individuals had significantly higher LEC-5 total scores (5.6 v. 4.9), PCL-5 total scores (41.9 v. 34.0), and rates of PTSD+ (63% v. 45%) than non-LGBTQ+ individuals. The LGBTQ+ with PTSD+ group reported (1) significantly more unwanted sexual experiences, sexual assaults, physical assaults, and severe human suffering experiences, and (2) significantly greater ED, depressive and trait-anxiety symptoms than the non-LGBTQ+ group with PTSD+. CONCLUSIONS LGBTQ+ individuals had significantly higher rates of high impact lifetime traumas and presumptive PTSD+, as well as greater ED and comorbid symptom severity, than non-LGBTQ+ individuals. Development, implementation and assessment of integrated treatment protocols for LGBTQ+ individuals with an ED and PTSD+ is warranted to address the needs of this underserved and often overlooked population. LEVEL OF EVIDENCE Level III: Evidence obtained from cohort or case-control analytic studies.
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Affiliation(s)
- Timothy D Brewerton
- Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, SC, USA. .,Timothy D. Brewerton, MD, LLC, Mount Pleasant, SC, USA. .,Monte Nido and Affiliates, Miami, FL, USA.
| | | | | | - Molly M Perlman
- Monte Nido and Affiliates, Miami, FL, USA.,Department of Psychiatry and Behavioral Health, Florida International University Herbert Wertheim College of Medicine, Miami, FL, USA
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20
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Bays HE, Muñoz-Mantilla DX, Morgan R, Nwizu C, Garcia T“T. Obesity Pillars Roundtable: Obesity and Diversity. OBESITY PILLARS (ONLINE) 2022; 1:100008. [PMID: 37990704 PMCID: PMC10662096 DOI: 10.1016/j.obpill.2021.100008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/30/2021] [Revised: 12/24/2021] [Accepted: 12/26/2021] [Indexed: 11/23/2023]
Abstract
Background The clinical implications of obesity differ, depending on race, ethnicity, and sexual orientation. Methods This roundtable discussion included 4 obesity specialists with expertise in the clinical management of obesity among diverse populations including Blacks, Hispanics/Latinos, Lesbian-Gay-Bisexual-Transgender-Questioning (LGBTQ) individuals, and Native-Americans. Results One of the first obstacles towards overcoming disparities in managing obesity and its complications among diverse populations is understanding applicable terminology. This includes categorization terminology relative to Native Americans (for the purpose of assessing culture and possibly genetic predispositions), understanding the differences between Black African Americans and Black Africans, understanding the differences between the terms Hispanic and Latinx, and basic concepts behind different pronouns applicable to Lesbian-Gay-Bisexual-Transgender-Questioning (LGBTQ) individuals. After being better able to grasp the input from patients with diverse backgrounds, universal obesity assessment and management principles can be then tailored utilizing a patient-centered approach. Conclusion Understanding the unique genetic, culture, and terminology regarding patients of different races, ethnicities, and sexual orientation may help clinicians better engage patients in managing obesity via utilizing a more patient-centered approach.
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Affiliation(s)
- Harold Edward Bays
- Medical Director/President Louisville Metabolic and Atherosclerosis Research Center, 3288 Illinois Avenue, Louisville, KY, 40213, USA
- Clinical Associate Professor, University of Louisville School of Medicine, Louisville KY
| | | | - Ryan Morgan
- LLC, Sub-investigator for Lynn Health Science Institute, Adjunct Clinical Professor for Oklahoma State University Center for Health Sciences, 3330 NW 56th St., STE 608, Oklahoma City, OK, 73118, USA
| | - Chima Nwizu
- Department of Clinical Affairs, Rocky Vista University Parker, Family Physicians of Greeley, 6801 W 20th Street, Suite 101, Greeley, CO, 80634, USA
| | - Theresa “Tess” Garcia
- Garcia Family Medicine, 1416 NW 7 Highway, Union Square, Eastern Jackson County, Blue Springs, MO, 64014, USA
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21
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Gulec H, Torun T, Prado ADS, Bauer S, Rummel-Kluge C, Kohls E. Eating attitudes and depressive symptoms in a LGBTIQ sample in Turkey. Front Psychiatry 2022; 13:1014253. [PMID: 36440428 PMCID: PMC9691651 DOI: 10.3389/fpsyt.2022.1014253] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/08/2022] [Accepted: 10/31/2022] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND Lesbian, gay, bisexual, transgender, intersexual and queer (LGBTIQ) individuals are often stigmatized due to their minority status. Sexual-minority stress is often discussed as a risk factor for the increased mental health problems reported in this population. OBJECTIVE The current study (1) investigated eating attitudes and depressive symptoms in a sexual minority sample from Turkey who identify themselves as LGBTIQ and (2) explored the role of sexual minority stressors beyond the potential predictors of eating attitudes and depressive symptoms in this population. METHODS Recruitment was supported and streamlined by several Turkish NGOs and LGBTIQ community networks. Sociodemographic measures, eating attitudes, depressive symptoms, sexual minority stressors (e.g., heterosexist experiences, internalized homophobia), and the potential predictors of eating attitudes and depressive symptoms were assessed with an anonymous online survey between February 2022 and June 2022. The sample consisted of 440 participants. The mean age was 31.92 (SD = 11.82). The majority of the participants reported their current gender identity as male (64.3%; n = 440) and their sexual orientation as attracted to men (62.8%; n = 439). For 79.7% of the participants, the assigned sex at birth was man (n = 439). RESULTS Two separate three-stage multiple hierarchical regression analyses were conducted, controlling for sociodemographic characteristics and the risk and protective factors of eating attitudes and depressive symptoms. Disturbed eating attitudes were predicted by assigned female sex at birth, higher scores for depression, social isolation, and the total number of heterosexist experiences, and lower distress related to heterosexist experiences. Depressive symptoms were predicted by assigned female sex at birth, lesbian sexual orientation, disturbance in eating attitudes, increases in generalized anxiety, and distress related to daily heterosexist experiences. CONCLUSION The current study demonstrated the significant role of sexual minority stressors in the prediction of disturbed eating attitudes and depressive symptomatology beyond the general psychosocial vulnerability factors. These findings emphasize the need for developing strategies to reduce prejudicial attitudes at the societal level and to enhance the skills of LGBTIQ individuals in coping with sexual minority stressors in Turkey.
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Affiliation(s)
- Hayriye Gulec
- Interdisciplinary Research Team on Internet and Society, Faculty of Social Studies, Masaryk University, Brno, Czechia.,Department of Psychology, Faculty of Arts and Sciences, Bursa Uludag University, Bursa, Turkey
| | - Tayfun Torun
- Department of Philosophy, Faculty of Arts and Sciences, Bursa Uludag University, Bursa, Turkey
| | - Aneliana da Silva Prado
- Department of Psychiatry and Psychotherapy, Medical Faculty, Leipzig University, Leipzig, Germany.,Department of Psychology, Federal University of Parana, Curitiba, Brazil.,Federal Institute of Education, Science, and Technology of Parana, Curitiba, Brazil
| | - Stephanie Bauer
- Center for Psychotherapy Research, University Hospital Heidelberg, Heidelberg, Germany
| | - Christine Rummel-Kluge
- Department of Psychiatry and Psychotherapy, Medical Faculty, Leipzig University, Leipzig, Germany.,Department of Psychiatry and Psychotherapy, University Leipzig Medical Center, Leipzig University, Leipzig, Germany
| | - Elisabeth Kohls
- Department of Psychiatry and Psychotherapy, Medical Faculty, Leipzig University, Leipzig, Germany.,Department of Psychiatry and Psychotherapy, University Leipzig Medical Center, Leipzig University, Leipzig, Germany
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22
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Wang H, Lou X. A meta-analysis on the social relationship outcome of being compassionate towards oneself: The moderating role of individualism-collectivism. PERSONALITY AND INDIVIDUAL DIFFERENCES 2022. [DOI: 10.1016/j.paid.2021.111162] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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23
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Ancheta AJ, Caceres BA, Zollweg SS, Heron KE, Veldhuis CB, VanKim NA, Hughes TL. Examining the associations of sexual minority stressors and past-year depression with overeating and binge eating in a diverse community sample of sexual minority women. Eat Behav 2021; 43:101547. [PMID: 34412003 PMCID: PMC8629849 DOI: 10.1016/j.eatbeh.2021.101547] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/14/2020] [Revised: 07/16/2021] [Accepted: 07/31/2021] [Indexed: 02/01/2023]
Abstract
Sexual minority stressors (e.g., stigma consciousness, internalized homophobia, discrimination) are posited to contribute to higher prevalence of overeating and binge eating among sexual minority women (SMW) relative to heterosexual women. Few studies have examined psychosocial mediators of the associations of minority stressors with overeating and binge eating in SMW. Using data from a diverse, community-based sample of SMW, we examined these associations, including the potential mediating effects of past-year depression. We also conducted exploratory analyses to determine if the associations of sexual minority stressors with overeating and binge eating differed by sexual identity or by race and ethnicity. The sample included 607 SMW (38.2% White, 37.1% African American, 24.7% Latina) with a mean age of 39.7 years. Approximately 17% and 9% of SMW reported overeating and binge eating, respectively, in the past 3 months. Greater stigma consciousness was associated with higher odds of overeating (AOR 1.31, 95% CI = 1.03-1.66). We found no significant associations between minority stressors and binge eating. Past-year depression did not mediate associations between minority stressors and overeating or binge eating. Although we found no sexual identity differences, stigma consciousness among Latina SMW was associated with higher odds of overeating relative to White SMW (AOR 1.95, 95% CI = 1.21-3.12) and African American SMW (AOR 1.99, 95% CI = 1.19-3.31). Findings highlight the importance of screening SMW for stigma consciousness as a correlate of overeating and considering racial and ethnic differences in overeating and binge eating in this population.
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Affiliation(s)
- April J Ancheta
- Columbia University School of Nursing, 560 W 168th St, New York, NY 10032, United States of America.
| | - Billy A Caceres
- Columbia University School of Nursing, 560 W 168th St, New York, NY 10032, United States of America.
| | - Sarah S Zollweg
- Columbia University School of Nursing, 560 W 168th St, New York, NY 10032, United States of America.
| | - Kristin E Heron
- Department of Psychology, Old Dominion University, Virginia Consortium Program in Clinical Psychology, 250 Mills Godwin Building, Norfolk, VA 23529, United States of America.
| | - Cindy B Veldhuis
- Columbia University School of Nursing, 560 W 168th St, New York, NY 10032, United States of America.
| | - Nicole A VanKim
- Department of Biostatistics and Epidemiology, School of Public Health and Health Sciences University of Massachusetts Amherst, 406 Arnold House, Amherst, MA 01003, United States of America.
| | - Tonda L Hughes
- Columbia University School of Nursing, 560 W 168th St, New York, NY 10032, United States of America.
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24
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Gomes SM, Jacob MC, Rocha C, Medeiros MF, Lyra CO, Noro LR. Expanding the limits of sex: a systematic review concerning food and nutrition in transgender populations. Public Health Nutr 2021; 24:6436-6449. [PMID: 33866993 PMCID: PMC11148592 DOI: 10.1017/s1368980021001671] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
OBJECTIVE To examine the literature and identify main themes, methods and results of studies concerning food and nutrition addressed in research on transgender populations. DESIGN A systematic review conducted through July 2020 in the MedLine/PubMed, Scopus and Web of Science databases. RESULTS Of the 778 studies identified in the databases, we selected thirty-seven. The studies were recent, most of them published after 2015, being produced in Global North countries. The most often used study design was cross-sectional; the least frequently used study design was ethnographic. Body image and weight control were predominant themes (n 25), followed by food and nutrition security (n 5), nutritional status (n 5), nutritional health assistance (n 1) and emic visions of healthy eating (n 1). CONCLUSIONS The transgender community presents body, food and nutritional relationships traversed by its unique gender experience, which challenges dietary and nutritional recommendations based on the traditional division by sex (male and female). We need to complete the lacking research and understand contexts in the Global South, strategically investing in exploratory-ethnographic research, to develop categories of analysis and recommendations that consider the transgender experience.
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Affiliation(s)
- Sávio Marcelino Gomes
- Programa de Pós-Graduação em Saúde Coletiva, Universidade Federal do Rio Grande do Norte, 59056-000 Natal, Natal, Rio Grande do Norte, Brazil
- Laboratório Horta Comunitária Nutrir, Nutrition Department, Universidade Federal do Rio Grande do Norte, 59078-970 Natal, Natal, Rio Grande do Norte, Brazil
| | - Michelle Cm Jacob
- Laboratório Horta Comunitária Nutrir, Nutrition Department, Universidade Federal do Rio Grande do Norte, 59078-970 Natal, Natal, Rio Grande do Norte, Brazil
| | - Cecília Rocha
- Centre for Studies in Food Security, School of Nutrition, Ryerson University, Toronto, ONM5B 2K3, Canada
| | - Maria Fa Medeiros
- Laboratório Horta Comunitária Nutrir, Nutrition Department, Universidade Federal do Rio Grande do Norte, 59078-970 Natal, Natal, Rio Grande do Norte, Brazil
| | - Clélia O Lyra
- Programa de Pós-Graduação em Saúde Coletiva, Universidade Federal do Rio Grande do Norte, 59056-000 Natal, Natal, Rio Grande do Norte, Brazil
| | - Luiz Ra Noro
- Programa de Pós-Graduação em Saúde Coletiva, Universidade Federal do Rio Grande do Norte, 59056-000 Natal, Natal, Rio Grande do Norte, Brazil
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25
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Murray MF, Cox SA, Henretty JR, Haedt-Matt AA. Women of diverse sexual identities admit to eating disorder treatment with differential symptom severity but achieve similar clinical outcomes. Int J Eat Disord 2021; 54:1652-1662. [PMID: 34260102 DOI: 10.1002/eat.23576] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/14/2021] [Revised: 06/08/2021] [Accepted: 06/26/2021] [Indexed: 11/09/2022]
Abstract
OBJECTIVE Sexual minority (SM) women may be at increased risk for certain eating disorder (ED) symptoms and report distinct body image concerns compared to heterosexual women. However, it is unclear how such symptoms differ across sexual orientations in treatment-seeking women, or if there are differences in treatment outcomes. This study examined group differences in (1) ED symptomatology at admission in a disaggregated sample of SM and heterosexual women presenting for ED treatment and (2) treatment outcomes. METHODS Adult women who admitted to higher levels of ED treatment across 48 locations of one treatment center between 2015 and 2018 completed self-report measures of ED symptomatology and quality of life (QOL) at admission and discharge. Participants identified their sexualities as heterosexual (n = 2,502, 80.2%), lesbian/gay (n = 134, 4.3%), bisexual (n = 270, 8.7%), "other" (n = 136, 4.4%), and unsure (n = 78, 2.5%). Objectives 1 and 2 were tested using one-way and repeated measures analyses of variance, respectively. RESULTS Group differences at admission emerged between lesbian/gay and heterosexual, bisexual and heterosexual, and bisexual and "other"-identified women on preoccupation and restriction, fasting, self-induced vomiting, shape and weight concern, and QOL. Bisexual women, in particular, admitted with the highest severity and at younger ages compared to heterosexual women. Despite such differences, women across groups achieved similar treatment outcomes at discharge. DISCUSSION Study findings underscore the importance of subgroup analyses of ED symptoms in SM women and have both clinical and research implications related to ED symptomatology in this population.
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Affiliation(s)
- Matthew F Murray
- Department of Psychology, Illinois Institute of Technology, Chicago, Illinois, USA
| | - Shelbi A Cox
- Center for Discovery, Discovery Behavioral Health, Los Alamitos, California, USA
| | - Jennifer R Henretty
- Center for Discovery, Discovery Behavioral Health, Los Alamitos, California, USA
| | - Alissa A Haedt-Matt
- Department of Psychology, Illinois Institute of Technology, Chicago, Illinois, USA
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26
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Body checking behaviors and eating disorder pathology among nonbinary individuals with androgynous appearance ideals. Eat Weight Disord 2021; 26:1915-1925. [PMID: 33063287 DOI: 10.1007/s40519-020-01040-0] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/22/2020] [Accepted: 09/29/2020] [Indexed: 10/23/2022] Open
Abstract
BACKGROUND Internalized sociocultural standards of attractiveness are a risk factor repeatedly linked to eating disorders; however, many nonbinary individuals do not conform to these standards. PURPOSE This study investigated the body checking behaviors and eating disorder pathology among nonbinary individuals with androgynous appearance ideals. METHODS Participants (n = 194) completed an online survey assessing body checking behaviors, body appreciation, gender congruence, and eating disorder pathology RESULTS: Body checking predicted eating disorder pathology, and body image significantly improved the model. Gender congruence did not additional variance in predicting eating pathology CONCLUSION: Though gender congruence was not a significant predictor of eating pathology, content analysis revealed unique body behaviors specific to nonbinary individuals' gender identity and gender expression. Clinical implications include expanding perceptions of eating disorder presentation when working with nonbinary individuals with androgynous appearance ideals. LEVEL OF EVIDENCE Level V, cross-sectional descriptive study.
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Rambarran N, Maule-O'Brien S, Naidoo K. My body. My politics. An exploration of body image and health in Barbadian sexual minority women. JOURNAL OF LESBIAN STUDIES 2021; 25:377-391. [PMID: 34157963 DOI: 10.1080/10894160.2021.1940755] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
There is a dearth of research on how pervasive Western stereotypes of the ideal body affect non-heterosexual women, and this body of research shrinks even further when considering sexual minority women in the Caribbean. This study aimed to uncover how negotiations between identity, desire, and body politics are being navigated and experienced by sexual minority women in Barbados, along with examining concerns about body image, the impact of societal expectations, and the consequences of these expectations on physical and mental health. Using a qualitative methodology that employed a semi-structured guide, thirteen women were interviewed over the course of a year. Thematic analysis revealed three major themes that centered around the interconnectivity of desire and presentation as it related to body image; distancing from Western influences and grappling with local body ideals; and the ways in which layered events and identities have resulted in complicated relationships with food. A selection of identified community needs is also offered in conclusion.
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Affiliation(s)
| | - Skye Maule-O'Brien
- Willem de Kooning Academy, Rotterdam University of Applied Sciences, Rotterdam, Netherlands
| | - Karen Naidoo
- The Chang School of Continuing Education, Ryerson University, Ontario, Toronto, Canada
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Hollett KB, Carter JC. Separating binge-eating disorder stigma and weight stigma: A vignette study. Int J Eat Disord 2021; 54:755-763. [PMID: 33480447 DOI: 10.1002/eat.23473] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/28/2020] [Revised: 12/22/2020] [Accepted: 12/23/2020] [Indexed: 11/11/2022]
Abstract
OBJECTIVE Vignette research on binge-eating disorder (BED) stigma is limited and lacking methodological rigor. Existing studies lack control vignettes and typically present characters with overweight or obesity, introducing the confound of weight stigma. This study examined BED stigma while addressing these limitations. METHOD Participants (N = 421) were assigned to read one of six vignettes describing a woman with either BED or no BED as well as either no mention of weight, a recommended weight, or an obese weight. Four questionnaires examined personality stereotypes, emotional reactions to the character, desire for social distance from the character, and blame attributions. RESULTS The character with BED was ascribed more negative personality characteristics and faced less positive emotional reactions than the character without BED, regardless of weight status. However, BED stigma did not emerge for social distance or blame attributions. Regarding weight stigma, evidence was limited and moderated by the presence of BED, suggesting no additive effect between BED stigma and weight stigma. In fact, blame attributions toward the character with obesity were reduced by the presence of BED. DISCUSSION The results reveal that BED is a highly stigmatized eating disorder and suggest that weight stigma may be driven by assumptions about a person's eating behavior rather than their body size per se. Future studies must consider the relationship between BED stigma and weight stigma when assessing either form of stigma. The results also indicate new information to be integrated into anti-weight stigma campaigns as well as policy and public health initiatives.
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Affiliation(s)
- Kayla B Hollett
- Department of Psychology, Concordia University, Montreal, Quebec, Canada
| | - Jacqueline C Carter
- Department of Psychology, Concordia University, Montreal, Quebec, Canada.,Department of Psychology, Memorial University of Newfoundland, St. John's, Newfoundland and Labrador, Canada
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Lathren CR, Rao SS, Park J, Bluth K. Self-Compassion and Current Close Interpersonal Relationships: A Scoping Literature Review. Mindfulness (N Y) 2021; 12:1078-1093. [PMID: 35309268 PMCID: PMC8932676 DOI: 10.1007/s12671-020-01566-5] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 11/23/2020] [Indexed: 12/12/2022]
Abstract
Objectives In order to provide a broad overview of the body of peer-reviewed literature on self-compassion and close relationships, this scoping review describes how self-compassion relates to thoughts, feelings and behaviors within the context of current personal relationships between family members, romantic partners, friends, or others referred to as "close". Methods Two reviewers independently screened peer-reviewed articles retrieved based on a defined search strategy within three online databases, extracted data from 72 articles that met inclusion criteria by consensus, and summarized findings thematically. Results: With few exceptions, self-compassion is positively associated with secure attachment, adaptive parenting behaviors, healthy family, romantic and friendship functioning, and constructive conflict and transgression repair behavior. In families, evidence suggests parent self-compassion is linked to supportive parenting behavior, which is in turn linked to higher levels of child self-compassion. Conclusions Self-compassion is associated with a wide variety of close interpersonal relationship benefits. These associations may be complex and bidirectional, such that positive social relationships promote self-compassion, while self-compassion promotes relational and emotional well-being. For a deeper understanding of these nuances and to establish causality, future research should include heterogeneous samples, longitudinal designs, observational and multi-informant methodologies, and consider attachment style and personality trait covariates. The potential implications for interventional research are discussed.
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Affiliation(s)
- Christine R Lathren
- Department of Physical Medicine and Rehabilitation, University of North Carolina at Chapel Hill
| | - Sanjana S Rao
- Department of Physical Medicine and Rehabilitation, University of North Carolina at Chapel Hill
| | - Jinyoung Park
- Department of Physical Medicine and Rehabilitation, University of North Carolina at Chapel Hill
| | - Karen Bluth
- Department of Psychiatry, University of North Carolina at Chapel Hill
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Pereira H. Sexual Health Determinants of Normal Weight, Overweight, and Obese Sexual Minority Men. J Obes 2021; 2021:1272316. [PMID: 33815839 PMCID: PMC7994078 DOI: 10.1155/2021/1272316] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/15/2020] [Revised: 03/09/2021] [Accepted: 03/11/2021] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND With the growing recognition of overweight and obesity as significant, international public health concerns, the body of research investigating the relationship between body mass index (BMI), sexual health, and sexual functioning in sexual minority men is still scarce. OBJECTIVE The purpose of this study is to assess sexual health determinants (sexual behavior and sexual functioning) in relation to normal weight, overweight, and obesity among gay and bisexual men. METHODS AND MATERIALS The survey included four categories of questions/measurements, encompassing sociodemographic information, protected/unprotected sexual behaviors, sexual functioning, and BMI. The survey was conducted online, and recruitment consisted of online notifications (emails and electronic messages) and advertisements sent to LGBT community organizations, mailing lists, and social networks. RESULTS The study sample was composed of 741 gay and bisexual men, ranging in age from 21 to 75 years (M age = 43.30, SDage = 11.37); 62.5% of men self-identified as gay and 37.5% as bisexual. Prevalence of normal weight was 50.3%, of overweight, 33.3%, and of obesity, 16.4%. Participants with overweight and obesity showed a lower frequency of anal receptive sex without condoms when scompared to participants with normal weight. Hierarchical multiple regression analysis to assess the effects of BMI on sexual health showed that being younger in age, self-identifying as gay, being in a relationship, having longer penises, adopting insertive position in sex, and being normal weight were significant predictors of anal receptive sex without condoms, explaining 24.2% of the total variance. Yet, BMI was not predictive of sexual functioning. CONCLUSION These findings highlight the importance of including BMI in sexual behavior models of sexual minority men to better understand BMI's role in influencing sexual risk.
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Affiliation(s)
- Henrique Pereira
- Department of Psychology and Education, University of Beira Interior, Covilhã 6200-209, Portugal
- The Health Sciences Research Centre (CICS-UBI), Covilhã, Portugal
- The Research Center in Sports Sciences, Health Sciences and Human Development (CIDESD), Vila Real, Portugal
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Finlay-Jones A, Strauss P, Perry Y, Waters Z, Gilbey D, Windred MA, Murdoch A, Pugh C, Ohan JL, Lin A. Group mindful self-compassion training to improve mental health outcomes for LGBTQIA+ young adults: Rationale and protocol for a randomised controlled trial. Contemp Clin Trials 2021; 102:106268. [PMID: 33421648 DOI: 10.1016/j.cct.2021.106268] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2020] [Revised: 12/10/2020] [Accepted: 01/01/2021] [Indexed: 10/22/2022]
Abstract
BACKGROUND Young adults who are lesbian, gay, bisexual, trans, queer or questioning, intersex, asexual and other diverse genders and sexualities (LGBTQIA+) are more likely to experience mental health difficulties and are at significantly elevated risk of substance abuse, self-harm and suicide, relative to their heterosexual, endosex and cisgender peers. There is a need for effective mental health interventions for LGBTQIA+ young adults. Mindful Self-Compassion training is a promising approach; among LGBTQIA+ individuals, self-compassion accounts for more variation in mental health outcomes than bullying, victimization, and adverse childhood experiences combined. Furthermore, LGBTQIA+ individuals with high self-compassion report more positive identity and happiness, less self-stigma, and lower suicidality than those with low self-compassion. METHOD This paper outlines the rationale and protocol for a single-blind CONSORT-compliant randomised controlled trial, comparing group Mindful Self-Compassion to a delayed-treatment waitlist control group, for improving mental health, decreasing self-criticism and increasing self-compassion in LGBTQIA+ young adults (age 18-25 years). Mindful Self-Compassion training is an 8-week group program that focuses on cultivating self-compassion and mindfulness. While typically delivered as a face-to-face program, the proposed trial will investigate efficacy of the program when provided via videoconferencing. DISCUSSION Videoconference Mindful Self-Compassion training has the potential to improve the mental health of Australian LGBTQIA+ young adults and provide a possible cost-effective, scalable intervention for this population. The proposed trial will be the first to determine its efficacy for LGBTQIA+ young adults and will provide the first data on the delivery of the program via videoconferencing.
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Affiliation(s)
- Amy Finlay-Jones
- Telethon Kids Institute, PO Box 855, Perth 6872, Australia; School of Psychological Science, The University of Western Australia, 35 Stirling Highway, Perth, WA 6009, Australia.
| | - Penelope Strauss
- Telethon Kids Institute, PO Box 855, Perth 6872, Australia; School of Psychological Science, The University of Western Australia, 35 Stirling Highway, Perth, WA 6009, Australia.
| | - Yael Perry
- Telethon Kids Institute, PO Box 855, Perth 6872, Australia.
| | - Zoe Waters
- Telethon Kids Institute, PO Box 855, Perth 6872, Australia; School of Psychological Science, The University of Western Australia, 35 Stirling Highway, Perth, WA 6009, Australia.
| | - Dylan Gilbey
- Telethon Kids Institute, PO Box 855, Perth 6872, Australia; School of Psychological Science, The University of Western Australia, 35 Stirling Highway, Perth, WA 6009, Australia.
| | - Meg-An Windred
- Minus18, 81 Rupert St, Collingwood, VIC 3066, Australia.
| | - Adrian Murdoch
- Minus18, 81 Rupert St, Collingwood, VIC 3066, Australia.
| | - Charlotte Pugh
- Telethon Kids Institute, PO Box 855, Perth 6872, Australia.
| | - Jeneva L Ohan
- School of Psychological Science, The University of Western Australia, 35 Stirling Highway, Perth, WA 6009, Australia.
| | - Ashleigh Lin
- Telethon Kids Institute, PO Box 855, Perth 6872, Australia; School of Psychological Science, The University of Western Australia, 35 Stirling Highway, Perth, WA 6009, Australia.
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Springmann ML, Svaldi J, Kiegelmann M. Theoretical and Methodological Considerations for Research on Eating Disorders and Gender. Front Psychol 2020; 11:586196. [PMID: 33281684 PMCID: PMC7705215 DOI: 10.3389/fpsyg.2020.586196] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2020] [Accepted: 10/29/2020] [Indexed: 11/13/2022] Open
Abstract
Gender is a relevant factor in the etiology of eating disorders (ED) as evidenced by gender-specific components of disordered eating and by the high risk of ED among transgender individuals, in addition to other factors. However, research on connections between ED and gender identity are limited. Researchers who produce explanatory models, content themselves with faulting the sociocultural ideal of slimness for women, but they fail to grasp the connection between culture, gender and the body and they fall short of integrating this perspective into existing psychological knowledge about ED. Psychological research informed by feminist theory has begun to bridge this gap, but this growing area of research needs to be further developed and should include an understanding of ED in persons with all gender identities. This article expands the discussion of gender and ED, by grounding ED in an understanding of gender itself and by discussing methodological implications of this understanding.
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Affiliation(s)
| | - Jennifer Svaldi
- Department of Psychology, Clinical Psychology and Psychotherapy, University of Tübingen, Tübingen, Germany
| | - Mechthild Kiegelmann
- Department of Psychology, Clinical Psychology and Psychotherapy, University of Tübingen, Tübingen, Germany
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Nagata JM, Compte EJ, Cattle CJ, Flentje A, Capriotti MR, Lubensky ME, Murray SB, Obedin-Maliver J, Lunn MR. Community norms for the Eating Disorder Examination Questionnaire (EDE-Q) among gender-expansive populations. J Eat Disord 2020; 8:74. [PMID: 33292636 PMCID: PMC7722313 DOI: 10.1186/s40337-020-00352-x] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/11/2020] [Accepted: 11/10/2020] [Indexed: 12/27/2022] Open
Abstract
PURPOSE Gender-expansive individuals (i.e., those who identify outside of the binary system of man or woman) are a marginalized group that faces discrimination and have a high burden of mental health problems, but there is a paucity of research on eating disorders in this population. This study aimed to describe the community norms for the Eating Disorder Examination Questionnaire (EDE-Q) in gender-expansive populations. METHODS The participants were 988 gender-expansive individuals (defined as neither exclusively cisgender nor binary transgender) from The PRIDE study, an existing longitudinal cohort study of health outcomes in sexual and gender minority people. RESULTS We present the mean scores, standard deviations, and percentile ranks for the Global score and four subscale scores of the EDE-Q in this group as a whole and stratified by sex assigned at birth. Gender-expansive individuals reported any occurrence (≥1/28 days) of dietary restraint (23.0%), objective binge episodes (12.9%), excessive exercise (7.4%), self-induced vomiting (1.4%), or laxative misuse (1.2%). We found no statistically significant differences by sex assigned at birth. Compared to a prior study of transgender men and women, there were no significant differences in eating attitudes or disordered eating behaviors noted between gender-expansive individuals and transgender men. Transgender women reported higher Restraint and Shape Concern subscale scores compared to gender-expansive individuals. Compared to a prior study of presumed cisgender men 18-26 years, our age-matched gender-expansive sample had higher Eating, Weight, and Shape Concern subscales and Global Score, but reported a lower frequency of objective binge episodes and excessive exercise. Compared to a prior study of presumed cisgender women 18-25 years, our age-matched gender-expansive sample had a higher Shape Concern subscale score, a lower Restraint subscale score, and lower frequencies of self-induced vomiting, laxative misuse, and excessive exercise. CONCLUSIONS Gender-expansive individuals reported lower Restraint and Shape Concern scores than transgender women; higher Eating, Weight, and Shape Concern scores than presumed cisgender men; and lower Restraint but higher Shape Concern scores than presumed cisgender women. These norms can help clinicians in treating this population and interpreting the EDE-Q scores of their gender-expansive patients.
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Affiliation(s)
- Jason M Nagata
- Department of Pediatrics, University of California, San Francisco, 550 16th Street, 4th Floor, Box 0110, San Francisco, CA, 94158, USA.
| | - Emilio J Compte
- Eating Behavior Research Center School of Psychology, Universidad Adolfo Ibáñez, Santiago, Chile
- Research Department, Comenzar de Nuevo Treatment Center, Monterrey, Mexico
| | - Chloe J Cattle
- Department of Pediatrics, University of California, San Francisco, 550 16th Street, 4th Floor, Box 0110, San Francisco, CA, 94158, USA
| | - Annesa Flentje
- Department of Community Health Systems, University of California, San Francisco, San Francisco, CA, USA
- Alliance Health Project, Department of Psychiatry and Behavioral Sciences, University of California, San Francisco, San Francisco, CA, USA
- The PRIDE Study/PRIDEnet, Stanford University School of Medicine, Stanford, CA, USA
| | - Matthew R Capriotti
- The PRIDE Study/PRIDEnet, Stanford University School of Medicine, Stanford, CA, USA
- Department of Psychology, San José State University, San Jose, CA, USA
| | - Micah E Lubensky
- Department of Community Health Systems, University of California, San Francisco, San Francisco, CA, USA
- The PRIDE Study/PRIDEnet, Stanford University School of Medicine, Stanford, CA, USA
| | - Stuart B Murray
- Department of Psychiatry and Behavioral Sciences, University of Southern California, Los Angeles, CA, USA
| | - Juno Obedin-Maliver
- The PRIDE Study/PRIDEnet, Stanford University School of Medicine, Stanford, CA, USA
- Department of Obstetrics and Gynecology, Stanford University School of Medicine, Stanford, CA, USA
- Department of Epidemiology and Population Health, Stanford University School of Medicine, Stanford, CA, USA
| | - Mitchell R Lunn
- The PRIDE Study/PRIDEnet, Stanford University School of Medicine, Stanford, CA, USA
- Department of Epidemiology and Population Health, Stanford University School of Medicine, Stanford, CA, USA
- Division of Nephrology, Department of Medicine, Stanford University School of Medicine, Stanford, CA, USA
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Abstract
PURPOSE OF REVIEW To review the recent literature on eating disorders, disordered eating behaviors (DEB), and body image dissatisfaction among sexual and gender minority populations, including, but not limited to, gay, lesbian, bisexual, and transgender people. RECENT FINDINGS Overall, eating disorders, DEB, and body dissatisfaction are common among sexual and gender minority populations. Lifetime prevalence for anorexia nervosa (1.7%), bulimia nervosa (1.3%), and binge-eating disorder (2.2%) diagnoses are higher among sexual minority adults compared with cisgender heterosexual adults in the United States. Lifetime prevalence of eating disorders by self-report of a healthcare provider's diagnosis are 10.5% for transgender men and 8.1% for transgender women in the United States, including anorexia nervosa (4.2 and 4.1%) and bulimia nervosa (3.2 and 2.9%), respectively. DEB may be perpetuated by minority stress and discrimination experienced by these individuals. Body dissatisfaction may be a core stressor experienced by transgender people; gender dysphoria treatment has been shown to increase body satisfaction. A particular clinical challenge in caring for transgender youth with eating disorders is the standard use of growth charts based on sex. SUMMARY Novel research demonstrates that sexual and gender minorities with eating disorders have unique concerns with regards to disordered eating and body image.
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Affiliation(s)
- Jason M. Nagata
- Division of Adolescent and Young Adult Medicine, Department of Pediatrics, University of California, San Francisco, San Francisco, CA, USA
| | - Kyle T. Ganson
- Factor-Inwentash Faculty of Social Work, University of Toronto, Toronto, ON, Canada
| | - S. Bryn Austin
- Division of Adolescent and Young Adult Medicine, Boston Children’s Hospital, and Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, MA, USA
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King WM, Hughto JMW, Operario D. Transgender stigma: A critical scoping review of definitions, domains, and measures used in empirical research. Soc Sci Med 2020; 250:112867. [PMID: 32163820 PMCID: PMC7442603 DOI: 10.1016/j.socscimed.2020.112867] [Citation(s) in RCA: 37] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2019] [Revised: 01/09/2020] [Accepted: 02/17/2020] [Indexed: 12/23/2022]
Abstract
RATIONALE A growing body of transgender (trans) health research has explored the relationship between stigma and health; yet, studies have conceptualized and operationalized anti-trans stigma in multiple ways. OBJECTIVE This scoping review aims to critically analyze quantitative measures of anti-trans stigma in the U.S. using a socioecological framework. METHOD We organized and appraised measures from 126 included articles according to socioecological level: structural, interpersonal, or individual. RESULTS Of the identified articles, 36 measured anti-trans stigma at the structural level (i.e., institutional structures and policies), 102 measured anti-trans at the interpersonal level (i.e., community interactions), and 44 measured anti-trans stigma at the individual level (i.e., internalized or anticipated stigma). Definitions of anti-trans stigma varied substantially across articles. Most measures were adapted from measures developed for other populations (i.e., sexual minorities) and were not previously validated for trans samples. CONCLUSIONS Studies analyzing anti-trans stigma should concretely define anti-trans stigma. There is a need to develop measures of anti-trans stigma at all socioecological levels informed by the lived experiences of trans people.
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Affiliation(s)
- Wesley M King
- University of Michigan School of Public Health, 1415 Washington Heights, Ann Arbor, MI 48109, USA.
| | - Jaclyn M W Hughto
- Brown University School of Public Health, 121 South Main Street, Providence, RI 02903, USA.
| | - Don Operario
- Brown University School of Public Health, 121 South Main Street, Providence, RI 02903, USA.
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Kidd KM, Thornburgh C, Casey CF, Murray PJ. Providing Care for Transgender and Gender Diverse Youth. Prim Care 2020; 47:273-290. [PMID: 32423714 DOI: 10.1016/j.pop.2020.02.006] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
Transgender and gender diverse youth (TGDY) experience modifiable health disparities and difficulty accessing the physical and mental health care systems. Providers and staff should understand the unique needs of this population and provide affirming spaces where these resilient young people can thrive. In addition to addressing social, setting, and system level barriers to access, providers should consider offering comprehensive gender care because this reduces barriers to medical services and can improve health outcomes. This article educates providers about TGDY, reviews the role of mental health care, and provides an overview of medical interventions for gender affirmation.
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Affiliation(s)
- Kacie M Kidd
- Center for Adolescent and Young Adult Health, University of Pittsburgh School of Medicine, 120 Lytton Avenue, Pittsburgh, PA 15213, USA.
| | - Caitlin Thornburgh
- Center for Adolescent and Young Adult Health, UPMC Children's Hospital of Pittsburgh, 120 Lytton Avenue, Pittsburgh, PA 15213, USA
| | - Catherine F Casey
- Department of Family Medicine, University of Virginia, 1215 Lee Street, Charlottesville, VA 22908, USA
| | - Pamela J Murray
- Department of Pediatrics, West Virginia University, PO Box 9214, Morgantown, WV 26506, USA
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37
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Kamody RC, Grilo CM, Udo T. Disparities in DSM-5 defined eating disorders by sexual orientation among U.S. adults. Int J Eat Disord 2020; 53:278-287. [PMID: 31670848 DOI: 10.1002/eat.23193] [Citation(s) in RCA: 50] [Impact Index Per Article: 12.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/08/2019] [Revised: 10/15/2019] [Accepted: 10/15/2019] [Indexed: 11/06/2022]
Abstract
OBJECTIVE 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.
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Affiliation(s)
- Rebecca C Kamody
- Department of Psychiatry, Yale University School of Medicine, New Haven, Connecticut
| | - Carlos M Grilo
- Department of Psychiatry, Yale University School of Medicine, New Haven, Connecticut
| | - Tomoko Udo
- Department of Health Policy, Management, and Behavior, School of Public Health, University of Albany, State University of New York, Albany, New York
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Parker LL, Harriger JA. Eating disorders and disordered eating behaviors in the LGBT population: a review of the literature. J Eat Disord 2020; 8:51. [PMID: 33088566 PMCID: PMC7566158 DOI: 10.1186/s40337-020-00327-y] [Citation(s) in RCA: 82] [Impact Index Per Article: 20.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/08/2020] [Accepted: 09/22/2020] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND According to past research, lesbian, gay, bisexual, and transgender (LGBT) individuals experience a higher prevalence of psychopathology, which is attributable to the increased stress (i.e., stigma and prejudice) that they experience, as detailed by the minority stress model (MSM). MAIN This current literature review examined the empirical literature regarding the rates and types of, and risk factors for eating disorders and disordered eating behaviors in LGBT adults and adolescents, in addition to each individual subgroup (i.e., lesbians, gay males, bisexuals, transgender and gender-nonconforming individuals). CONCLUSION LGBT adults and adolescents experience greater incidence of eating disorders and disordered eating behaviors than their heterosexual and cisgender counterparts. Additionally, gay, bisexual, and transgender adults and adolescents were all at increased risk for eating disorders and disordered eating behaviors. Mixed results were found for lesbian adults and adolescents. Results are discussed within the framework of the MSM.
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Affiliation(s)
- Lacie L Parker
- Department of Psychology, Loma Linda University, 11130 Anderson Street, Suite 106, Loma Linda, CA 92350 USA
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O'Connor C, McNamara N, O'Hara L, McNicholas M, McNicholas F. How do people with eating disorders experience the stigma associated with their condition? A mixed-methods systematic review. J Ment Health 2019; 30:454-469. [PMID: 31711324 DOI: 10.1080/09638237.2019.1685081] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
BACKGROUND Public opinion research shows that eating disorders (EDs) are a major target of stigmatisation. To understand the implications of this stigma, research investigating how stigma is experienced by individuals with EDs is critical. AIM This paper aims to collate, evaluate and synthesise the extant empirical research illuminating how people with EDs experience the stigma associated with their condition. METHOD A systematic mixed-methods literature search was performed. Articles that met a specified set of inclusion criteria underwent a quality assessment and thematic synthesis. RESULTS Twenty-nine articles were included in the review. Studies were mostly qualitative and of reasonable methodological quality. The literature was characterised by five research themes, illuminating (i) the nature and prevalence of stigma experienced, (ii) stigma in families, (iii) stigma in healthcare contexts, (iv) self-stigmatisation and illness concealment, and (v) stigma resistance. CONCLUSIONS The reviewed research showed that people with EDs have extensive experience of stigma in diverse settings. They report that stigma has negative implications for their psychological wellbeing and likelihood of help-seeking. However, research also shows that people with EDs actively seek to resist and challenge stigma. The review identifies the outstanding gaps and weaknesses in this literature.
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Affiliation(s)
- Cliodhna O'Connor
- School of Psychology, University College Dublin, Dublin, Ireland.,School of Medicine & Medical Science, University College Dublin, Dublin, Ireland
| | - Niamh McNamara
- Department of Psychology, Nottingham Trent University, Nottingham, UK
| | - Lesley O'Hara
- School of Medicine & Medical Science, University College Dublin, Dublin, Ireland.,St. John of God Hospitaller Services, Dublin, Ireland
| | | | - Fiona McNicholas
- School of Medicine & Medical Science, University College Dublin, Dublin, Ireland.,St. John of God Hospitaller Services, Dublin, Ireland.,Our Lady's Hospital for Sick Children, Crumlin, Ireland
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