By Megan Dottermusch

I was in college when I first realized the serious consequences of eating disorders. As the risk manager on my sorority’s executive board, I was the designated confidante for members to discuss their personal and emotional issues with in full disclosure. While I could not give them formal counseling or medical advice, I could offer them an ear to listen and resources for treatment. It’s unfortunate, but in an atmosphere where you call more than 100 women your “sisters,” eating and body issues come up regularly.

After that experience, I considered myself pretty knowledgeable about issues surrounding body image. That was, until I learned about the theme for the National Eating Disorders Association (NEDA)’s annual awareness week, which took place February 22–28. NEDA’s campaign promoted the message “I had no idea,” suggesting the misconceptions and stereotypes surrounding eating disorders fuel stigmas and prevent recovery. I was intrigued and challenged myself to learn something new.

So here’s something “I had no idea” about: Gay and bisexual men are three times more likely to develop an eating disorder than straight men. One study, published in the International Journal of Eating Disorders, found that 15% of gay and bisexual men reported that they suffered from an eating disorder at least once in their lives, while only 5% of heterosexual men reported the same experience.

Looking at the bigger picture in the U.S., eating disorders are commonly portrayed as a female-only issue. But while 20 million women suffer from an eating disorder at some point in their lives, so do 10 million men — and 40% of these men identify as gay or bisexual.

To gain a better perspective on this under-represented community, I recruited expert and published author Leigh Cohn, the president of the National Association for Males with Eating Disorders (N.A.M.E.D.), to school me on this topic. Talking with him inspired me to share what I now know about this secret epidemic.

Cohn acknowledges there are a variety of factors that contribute to body image issues. Genetics, family background, peer pressure or trauma can increase the likelihood of developing an eating disorder. However, gay and bisexual men are bombarded with stereotypical images of men with “perfect” and “masculine” bodies every day in the media. It’s awesome that Modern Family and celebrities like Neil Patrick Harris are breaking down barriers and representing the gay community in mainstream media, but there is a flip side.

An oversaturation of unattainable male beauty in magazines (think GQ) and movies (think Magic Mike) places men at risk of developing an eating disorder. And while many television shows and movies now include gay or bisexual characters, most of them are white and one-dimensional: self-absorbed, thin, fashionable, and flamboyant. Stereotypes are limiting and promote an unfair and untrue representation of what gay and bisexual individuals look and act like, which can make the population vulnerable to further judgment, discrimination, and pressure to be thin.

I came across a study published by the American Journal of Public Health, which was referenced on the Davey Wavey Fitness blog. The study reports that when compared to straight men, gay men are 50% less likely to be obese. That is to say, overall, gay men are much more likely to be thin.

This propensity for being thin is driven at least in part by media images that display an ideal body type.

“Pick up a magazine that targets straight guys. On the cover, you’d probably see a deer in crosshairs, a football player, or a woman in a swimsuit,” Wavey, an AFPA-certified personal trainer and openly gay fitness blogger, writes. “Pick up a gay magazine and it’s probably a dude in his underwear.”

This idea of an ideal body is compounded by the fact that gay male culture places more significance on appearance than heterosexual culture. Gay and bisexual men have been found to be more dissatisfied with their bodies than heterosexual men, and a drive to pursue perfection can develop. Wavey says that he feels gay men feel intense pressure to overachieve.

“If society — or your family — treats you like you’re a second-class citizen, you may feel like you need to prove your worth by becoming an overachiever,” he writes. “Working out can become an obsession in the pursuit of perfection.”

There also is evidence that more pressure is placed on achieving perfection for people in relationships with men. In an article for NBC News, Ester Rothblum, a professor of women’s studies at San Diego State University, is quoted:

“People in sexual relationships with men — heterosexual women and gay men — get more pressure to look thin and to otherwise conform to attractiveness norms than do people in sexual relationships with women — lesbians and heterosexual men.”

When you think about it, this all makes sense. As a straight woman, I admit that part of my motivation for staying in shape is so that I appeal to the opposite sex. Investing in my physical appearance, according to stereotypical Western gender roles, is defined as a “feminine” trait. In turn, men who want to appear desirable to women are told to appear dominant, strong, and stable through a powerful stature and distinct muscle definition. These are simply my observations about what our gender norms dictate.

When you apply this to the gay male population, pressures from both sides of the scale apply: both to dwell on their appearance in order to attract other men, and also to evoke the “masculine,” domineering qualities that are evoked through a sculpted, lean physique that they themselves are attracted to. This can lead to a perceived need to achieve outward perfection and accordingly, obsessive, unhealthy fitness habits.

Gay and bisexual men may also have to contend with fear, shame, and inner conflict over their sexual orientation. Discrimination, bullying, stereotyping, lack of acceptance by family, and other cultural factors can be the source of these feelings.

Among other factors, many eating disorders take root in people suffering from low self-esteem and other psychological factors. The National Eating Disorder Information Centre (NEDIC) reports that this makes gay and bisexual men particularly vulnerable to eating disorders. Not only do they have to develop their own sense of self-worth as a gay man, but they also often have to fight for their rights to be accepted by society and those they love. Internalizing cultural and societal opposition is naturally damaging to one’s self-worth, and puts gay and bisexual men in danger of developing an eating disorder.

What You Can Do to Help

The good news is that there are several things you can do to help address the prevalent issue of eating disorders. You can raise awareness about the severity of eating disorders within the gay and bisexual male community by sharing this post and starting a conversation about it. You can also show your support and encourage loved ones who seem to be exhibiting signs of eating disorders (e.g., excessive exercising and dieting) to seek help.

Always remember that while building awareness is essential, eating disorders are medical conditions and should be diagnosed and treated as such. For more information on help and support, visit the websites of N.A.M.E.D. and NEDA. And if you or someone you love is in need of immediate support, call NEDA’s toll-free eating disorder helpline at 800-931-2237.

Want to do more? If this article hits home for you, helping the LGBT community with eating disorders could be your life’s purpose. A Master’s degree in counseling psychology will train you to become a therapist and allow you to help individuals cope with the pressures.

By raising awareness, providing support, and emphasizing self-esteem, self-worth, and acceptance, we can change the pervasiveness of eating disorders in all populations.

Megan Dottermusch is the community manager for Counseling@Northwestern, the Master of Arts in Counseling program offered online by The Family Institute at Northwestern University. She earned her bachelor’s degree in business marketing from the University of Maryland and was an active member of the Kappa Delta sorority. While serving as risk manager on her chapter’s executive board, Megan was a resource for members seeking help for personal and emotional issues in confidence. As a result, she has become passionate about combatting mental health stigmas, promoting proper nutrition and fitness, and practicing everyday mindfulness.