The association between sexual orientation and eating disorders‐related eating behaviours in adolescents: A systematic review and meta‐analysis

• Published in: European eating disorders review 2023-01, Vol.31 (1), p.46-64
• Main Authors: Cao, Zhangqi, Cini, Erica, Pellegrini, Dario, Fragkos, Kostantinos C.
• Format: Article
• Language: English
• Subjects: Adolescent; adolescents; Binge eating; diet pill use; dieting; Eating behavior; eating disorder; Eating disorders; Feeding and Eating Disorders - epidemiology; Feeding Behavior; Female; Humans; Male; Meta-analysis; purging; Review; Reviews; Sexual Behavior; sexual minorities; Sexual orientation; Systematic review; Teenagers
• ISSN: 1072-4133; 1099-0968
• DOI: 10.1002/erv.2952

Background Sexual orientation is usually developed during the adolescence, which coincides with the eating disorders peak onset. This paper aims to explore existing literature to identify whether there is an association between sexual orientation and eating disorder‐related eating behaviours (EDrEBs) in this age‐group. Methods This review was based on the PRISMA guidelines, covering the published articles between 1990 and 2021. A meta‐analysis of the proportion of sexual orientation and the adjusted odds ratio (OR) with 95% confident intervals was reported. Results Ten studies (412,601 participants) were included in this review. The results demonstrated adolescents identified as minority sexual orientation, particularly homosexual males were with higher OR of EDrEBs, as follows: Homosexual (binge eating: M = 7.20, F = 2.14; purging: M = 5.40, F = 2.41; diet pills use: M = 3.50, F = 2.59; dieting: M = 3.10, F = 1.75); Bisexual (binge eating: M = 4.60, F = 2.26; purging: M = 4.44, F = 2.37; diet pills use: M = 3.42, F = 2.30; dieting: M = 2.36, F = 1.86). Conclusions Adolescents who were of a minority sexual orientation were more vulnerable to EDrEBs than their heterosexual peers. Healthcare professionals and sexual minority communities should be primed to facilitate earlier recognition and access to services in these vulnerable groups. Key points Adolescents who were of a minority sexual orientation were more vulnerable to eating disorder‐related eating behaviours (EDrEBs) than their heterosexual peers. Although this higher vulnerability applies to both sexes, sexual minority (SMin) adolescent males appear to have higher ORs than their SMin female counterparts in comparison to their respective reference heterosexual group. The highest odds ratio (OR) for EDrEBs, i.e. binge eating, purging, diet pill use, was been observed in homosexual males.