Eating Concerns in College Women Across Sexual Orientation Identities

This study found that treatment-seeking sexual minority college women evidenced serious eating concerns. Regardless of sexual orientation and compared with those with low levels of eating concerns, women with high levels of eating concerns evidenced increased depression, increased generalized anxiety, and a greater likelihood of experiencing trauma. Regardless of eating concerns severity, sexual minority women evidenced greater depression, generalized anxiety, and likelihood of trauma than did heterosexual women, with bisexual women reporting the highest concerns. Keywords: eating concerns, college women, sexual orientation ********** Women have been found to be at a higher risk for eating concerns hen compared with men (e.g., Attie, Brooks-Gunn, & Peterson, 1990; Austin et al., 2009; Borman, 2005; Hoek, 1993; Hsu, 1989; Kjelsas, Bjornstrom, & Gotestam, 2004). However, conflicting research findings have emerged on the severity of eating concerns in sexual minority women (in this study, the term sexual minority is used to identify individuals who do not label their sexual orientation identity as heterosexual). Some researchers have argued that heterosexual women have higher levels of eating concerns than do sexual minority women. For example, heterosexual women have been found to report higher levels of eating disorder symptoms and concerns with their body size and shape in comparison with lesbian women (Strong, Williamson, Netemeyer, & Geer, 2000). Compared with heterosexual women, lesbians evidence more positive body image and fewer negative attitudes toward eating and weight (Owens, Hughes, & Owens-Nicholson, 2003). In addition, lesbian women are less likely to be dissatisfied with their body image, reduce fat and sugar intake, and control their weight when compared with heterosexual women (Polimeni, Austin, & Kavanagh, 2009). It is important to note that these findings on body image and eating concerns are based on the comparison of heterosexual and lesbian women and do not consider differences between other sexual orientation identity groups (e.g., lesbian and bisexual women), providing only a limited perspective on eating concerns differences in women across sexual orientation identities. Other researchers have identified eating concerns as an important issue for sexual minority women (e.g., Austin et al., 2004, 2009; Feldman & Meyer, 2007b; French, Story, Remafedi, Resnick, & Blum, 1996). Results from these studies suggest that sexual minority women may have rates of eating concerns that are equivalent or higher than those endorsed by heterosexual women. In a population of adult women, no differences were found in eating disorder prevalence between heterosexual women and lesbian and bisexual women, even across racial groups (Feldman & Meyer, 2007b). Yet, in another sample of adult women, group differences were found in women across sexual orientation identities (Koh & Ross, 2006). Specifically, bisexual women who reported being out were more than two times as likely to have an eating disorder in comparison with lesbians and twice as likely to have an eating disorder compared with heterosexual women. The conflicting findings on how sexual orientation identity may serve as a risk or protective factor for women's levels of eating concerns suggest a need for further examination to increase clinicians' understanding of clients at a higher risk for eating concerns. Given that college women seem to be particularly vulnerable to eating concerns (e.g., Berg, Frazier, & Sherr, 2009; Eisenberg, Nicklett, Roeder, & Kirz, 2011), it may be important to specifically examine this subgroup of women. Research is lacking, however, on how college women vary on rates of eating concerns across sexual orientation identities. A few researchers have examined eating concerns in college students in treatment across sexual orientation identities at a nationwide scale, using data from the Center for Collegiate Mental Health (CCMH; Hayes, Locke, & Castonguay, 2011). …