The only thing gay males are known more for than being same-sex attracted is our dedication to looking good. We have even created sub-categories in our community to highlight precisely which body type we belong to and desire. From twinks and twunks to jocks and bears, we celebrate the bodies we have created. Even gay dating apps have questions dedicated to describing our bodies: thin, average, fit, toned, muscular, a few extra pounds. All of this examination of ourselves can lead to gay male eating disorders.

But we never talk about what it takes for some of us to create such spectacular forms. Eating disorders among males are much higher than most people know. Despite the stereotype that they only occur in women, about one in three people struggling with an eating disorder is male, and subclinical eating-disordered behaviors (including binge eating, purging, laxative abuse, and fasting for weight loss) are nearly as common among men as they are among women.

Males account for approximately 20% of people with anorexia nervosa, 30% of people with bulimia nervosa, 43% of people with binge eating disorder, 55-77% of people with other specified feeding or eating disorders, and 67% of people with an avoidant/restrictive food intake disorder. The prevalence of males living with an eating disorder may be much higher, and under-reporting may be related to underdiagnosis, misdiagnosis, and the stigma associated with eating disorders.

In the United States alone, eating disorders will affect 10 million males at some point in their lives. But due in large part to cultural bias, they are much less likely to seek treatment for their eating disorder. The good news is that once men find help, they respond similarly to treatment as women.

When we factor in our sexual orientation, the numbers look more distressing. Studies in 2007 were the first to assess DSM diagnostic categories; gay and bisexual men had a significantly higher prevalence of lifetime full syndrome bulimia, subclinical bulimia, and any subclinical eating disorder. At the time, gay men were thought only to represent 5 percent of the total male population in the United States. Yet, for males diagnosed with an eating disorder, 42 percent of them identify as gay.

Researchers believe that the natural structure of our community may be the cause. We, of course, sexualize other males, and they sexualize us in return.

With this sexual objectification comes obsessive body checking and comparing and a desire to make the cut and be approved as sexually desirable. But if you don’t meet the gay standard, then what?”

“Not measuring up to the gay ideal can lead to the development of body shame. And body shame can lead one right into eating disorder behaviors in an attempt to deal with these heavy feelings and fears of being rejected by one’s peers.”

If we are being honest with ourselves, we can admit that, on some level, we all have experienced these feelings. But, not all eating orders are the same, have the exact root causes and effects, or even the same treatments.

Gay Culture

There is no denying that physical features hold significant currency in our community. What might have started as a stereotype has become a tangible reality in which we all are forced to live.

There is no one single reason why an entire community could have such a disproportionate rate of eating disorders, but studies lean toward:

body dissatisfaction

discrimination, prejudice, and stigma

 bullying when younger 

social media

community physical and sexual standards

low self-esteem and loneliness

Post-traumatic Stress Disorder

sexual abuse

In 2007, Researchers Ilan H. Meyer, PhD., associate professor of clinical Sociomedical Sciences at the Mailman School of Public Health and principal investigator, and Matthew Feldman, PhD, of the National Development and Research Institutes and first author, surveyed 516 New York City residents; 126 were straight me,n and the rest were bisexual men and women.

According to the study results, more than 15 percent of gay or bisexual men had at some time suffered anorexia, bulimia, or binge-eating disorder, or at least certain symptoms of those disorders — a problem known as a subclinical eating disorder, compared with less than five percent of heterosexual men. 

“It is not clear why gay men have high rates of eating disorders,” says Dr. Meyer. “One theory is that the values and norms in the gay men’s community promote a body-centered focus and high expectations about physical appearance, so that, similar to what has been theorized about heterosexual women, they may feel pressure to maintain an ideal body image.”

To assess this theory, the investigators studied whether gay and bisexual men with greater connection and affiliation with the gay community are more likely to have eating disorders than those not affiliated with the gay community. Despite slightly elevated eating disorders among men who were active in gay recreational groups, men who said they felt closely connected to the gay community and who participated in a range of gay and bisexual organizations did not have higher rates of eating disorders than men who were not as closely affiliated with the community.

“Even gay and bisexual men who participate in gay gyms, where body-focus and community values regarding attractiveness would be heightened, did not have higher rates of eating disorders than those gay and bisexual men who participated in non-gay gyms or who did not participate in a gym at all,” observes Dr. Meyer. “This suggests that factors other than values and norms in the gay community are related to the higher rates of eating disorders among these men.”

So, in effect, being a gay male, with or without strong ties to the larger community, is a significant factor in whether or not one will develop an eating disorder.

Research shows that having unsatisfied friendships is another risk factor for bulimia. Another study indicated that not being happy in one’s romantic relationship also increased the likelihood of bulimic behaviors.

“Gay men are often marginalized, and not having a solid social support system can increase feelings of isolation and depression. In an attempt to fill the void and aching emptiness and to stuff down these strong negative feelings, some may turn to food as an emotional substitute, a surrogate of sorts, to ease the loneliness and to feel full. And to ensure that his body does not become the symbol of failure in the gay society—which would only lead to more isolation and loneliness—compensatory behaviors are used to rid himself of the shame.”

This suggests that being homosexual in a heterosexual world and the resulting creation of a gay male community is a significant factor in our developing eating disorders. This would explain why participation within the larger gay community, or not, did not affect the overall risk factor of developing this illness.

The fitness company Bony to Beastly conducted an insightful study into the desired body type of gay guys in dating situations. They surveyed 102 gay and bisexual males. Here are their findings:

When we asked men which degree of muscularity they found most attractive, 46% rated the “strong” physique as the most beautiful, 30% preferred the “athletic” physique, and 22% preferred the most muscular physique. (see below image)

Next, we asked guys what body-fat percentage they found most attractive in other guys. 65% chose the leanest physique, which is somewhere between 8–10% body fat. 34% chose the body with a flat stomach, somewhere around 14–17% body fat. Only one person preferred a higher body-fat percentage than that. (see image below)

Of course, this is a small sample size from a particular type of gay man already on the thinner side and looking to bulk up. However, these findings are similar to those of other, more prominent researchers.

Sub Cultures (Twinks, Jocks, and Bears)

As gay males, we seem split between wanting to be thin and trim to being toned and buff. The former is usually, but not always, a body top desired by younger gay males and those who find them sexually attractive. Older men who date guys under thirty are more likely to seek out so-called twinks than more muscular guys.

A 2020 Honors Thesis by Samuel Fogarty and Dr. Catherine Walker from Union College surveyed 204 gay males who self-described themselves as either Twinks, Jocks, or Bears to assess if gay male subculture played a role in developing an eating disorder. The short answer is yes.

  • Self-identified jocks reported significantly higher muscularity-oriented disordered eating than those who did not identify as jocks (t=2.90, p=.004).
  • Participants who identified with a subcultural identity reported higher eating pathology than participants who did not (t=2.04, p=.043).
  • Contrary to the hypotheses, self-identified twinks did not report higher eating pathology than men who did not identify as twinks (t=-.23, p=.821).

These results imply that gay subcultural identification may be a risk factor for disordered eating behaviors and attitudes among gay men.

HIV/AIDS

AIDS/HIV has shaped our culture in immeasurable ways. Few aspects of our lives have not been altered by this virus. In the 1990s, at the height of the crisis, there was severe panic about infection, mainly because there was no test yet. One of the main apparent signs was the loss of weight and muscle definition. To counter this and to prove they did not have HIV, a significant percentage of guys began bulking up at the gym. Of course, one can have HIV and be muscular, but at the time, it comforted some in our community.

“A number of studies have also established gay men exhibit higher rates of drive for thinness than heterosexual men (Martins, Tiggemann, & Kirkbride, 2007; Hunt, Gonsalkorale, & Nosek, 2012; Smith, Hawkeswood, Bodell, & Joiner,
2011). These inconsistencies point to a heterogeneity of the gay male community, which may distinguish between differing body ideals. Harvey and Robinson (2003) posit that this could be related to the AIDs epidemic of the 80s, a disease associated with weight loss and muscle wasting. To establish oneself as healthy and youthful, one would prefer to appear muscular; however, the epidemic also created a norm of extremely slender and thin gay men in their communities. Thus, these differing body ideals may have a historical origin that remains evident.”

This trend continued as those living with this virus began taking steroids to counter the effects of HIV. Now, the positive guys had muscles, one reason that gym culture became a staple in gay life.

Being Male

As much as being homosexual has shaped how we see ourselves physically, so has the basic fact of being a biological male. We are not immune from the expectations to be muscular and thus masculine, and we would argue that this pressure is more significant on us than on our straight brothers.

There are numerous studies on male body image, and results vary widely. Many men have misconceived notions about their weight and physique, particularly the importance of muscularity. Findings include:

Most males would like to be lean and muscular, representing the “ideal” male body type. Exposure to unattainable images in the media leads to male body dissatisfaction.

The sexual objectification of men and internalization of media images predict the drive for muscularity.

The desire for increased musculature is not uncommon, and it crosses age groups. Twenty-five percent of normal-weight males perceive themselves to be underweight, and 90% of teenage boys exercise to bulk up.

Body Dysmorphic Disorder & Muscle Dysmorphia

Body dysmorphic disorder (BDD) is a mental health condition in which you can’t stop thinking about one or more perceived defects or flaws in your appearance — a flaw that appears minor or can’t be seen by others. But you may feel so embarrassed, ashamed, and anxious that you may avoid many social situations.

When you have body dysmorphic disorder, you intensely focus on your appearance and body image, repeatedly checking the mirror, grooming, or seeking reassurance, sometimes for many hours each day. Your perceived flaw and the repetitive behaviors cause significant distress and impact your ability to function daily.

While scant literature exists regarding differences in body dysmorphic disorder (BDD) by sexual orientation, preliminary work has begun to reveal intriguing results. For instance, higher levels of self-reported symptoms of BDD have been found among gay men compared to their heterosexual counterparts. 

12.5% of men meeting a cutoff score for BDD identified as gay, suggesting a highly disproportionate prevalence rate, given estimates of gay men in the U.S. (i.e., roughly 2 to 4% of the population). The BDD clinic at Harvard Medical School and The Massachusetts General Hospital is currently examining sexual orientation differences in BDD among adolescents and adults and a subtype of BDD—muscle dysmorphia. 

Muscle dysmorphia (Bigorexia), a subtype of body dysmorphic disorder, is an emerging condition primarily affecting male bodybuilders. Such individuals obsess about being adequately muscular. Compulsions include spending many hours in the gym, squandering excessive amounts of money on supplements, abnormal eating patterns, or using steroids.

Men with bigorexia will often still view themselves as small regardless of how muscular they may be. They will likely become agitated, angry, and frustrated when they miss a workout session or do not eat according to their strict diet. It is estimated that 10% of men who frequent the gym have muscle dysmorphia.

Studies have supported the idea that homosexual males are more likely to strive for muscular physiques and will go to the gym with the purpose of putting on muscle. Overall lower body dissatisfaction and the desire to appear both thin and muscular or toned are more common in homosexual men than in heterosexual men.

There is a growing subset of gay males, called ROID PIGS, that engage in behavior associated with muscle dysmorphia. There seems to be just as much of a sexual component to the desire to increase their muscle mass as to the physical aesthetics achieved.

Types of Eating Disorders

Anorexia Nervosa

Anorexia (or anorexia nervosa) is a severe mental illness where people are of low weight due to limiting how much they eat and drink. They may develop “rules” around what they feel they can and cannot eat and things like when and where they’ll eat. Anorexia can affect anyone of any age, gender, ethnicity, or background.

In addition to limiting how much they eat, they may do lots of exercises, make themselves sick, or misuse laxatives to get rid of the food eaten. Some people with anorexia may experience cycles of bingeing (eating large amounts of food at once) and then purging.

Bulimia Nervosa

People with bulimia are caught in a cycle of eating large quantities of food (called bingeing) and then trying to compensate for that overeating by vomiting, taking laxatives or diuretics, fasting, or exercising excessively (called purging). People with bulimia strongly emphasize their weight and shape and may see themselves as much larger than they are.

What can you do?

If you, or someone you know, is experiencing any of the symptoms of an eating disorder, DO NOT IGNORE THE SIGNS. You must seek help as soon as possible from a trained professional.

We can not continue to ignore this obvious healthcare issue within our community.

  • In one study, gay and bisexual boys reported being significantly more likely to have fasted, vomited, or taken laxatives or diet pills to control their weight in the last 30 days.
  • Gay males are thought to only represent 5% of the total male population, but among males who have eating disorders, 42% identify as gay.
  • Gay males were seven times more likely to report binging and 12 times more likely to report purging than heterosexual males.
  • Compared with heterosexual men, gay and bisexual men had a significantly higher prevalence of lifetime full-syndrome bulimia, subclinical bulimia, and any subclinical eating disorder.

The National Eating Disorders Association (NEDA) has excellent information on how to gain help and support.

For a complete list of the signs and symptoms of an eating disorder, you can check out BREATH—Life Healing Center.

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