Weight Misperception and Unhealthy Weight Control Behaviors Among Sexual Minorities in the General Adolescent Population

Purpose: Gay, lesbian, and bisexual youth may experience significant body dissatisfaction. We examined sexual orientation differences in self-perceived weight status and the prevalence of potentially dangerous weight control behaviors in a representative sample of adolescents. Methods: Data were obtained from 12,984 youth between 2003 and 2009 over four cycles of the Massachusetts Youth Risk Behavior Survey, a statewide survey of ninth-through 12th-grade students. Self-perceived weight status and past-month unhealthy weight control behaviors (fasting >24 hours, using diet pills, and vomiting or using laxatives) were compared among gay/lesbian, bisexual, or self-identified heterosexual youth with same-sex partners, unsure youth, and exclusively heterosexual youth using logistic regression, adjusting for age and race/ethnicity. Results: Compared with exclusively heterosexual males, heterosexual males with prior same-sex partners and bisexual males were more likely to self-perceive as overweight despite being of healthy weight or underweight (respectively, adjusted odds ratio [AOR], 2.61; 95% confidence interval [CI], 1.68-4.05; and AOR, 2.56; 95% CI, 1.64-4.00). Compared with exclusively heterosexual females, lesbians and bisexual females were more likely to self-perceive as being of healthy weight or underweight despite being overweight or obese (respectively, AOR, 3.17; 95% CI, 1.15-8.71; and AOR, 2.00; 95% CI, 1.20-3.33). Unhealthy weight control behaviors were significantly more prevalent among sexual minority males (32.5%; AOR, 4.38; 95% CI, 3.38-5.67) and females (34.7%; AOR, 2.27; 95% CI, 1.85-2.78) when considered together relative to exclusively heterosexual males (9.7%) and females (18.8%). Conclusions: One third of sexual minority youth engage in hazardous weight control behaviors. Future research should investigate underlying mechanisms and determine whether clinicians should routinely screen for these behaviors. (C) 2014 Society for Adolescent Health and Medicine. All rights reserved.