Sexual orientation disparities in purging and binge eating from early to late adolescence

To describe patterns of purging and binge eating from early through late adolescence in female and male youth across a range of sexual orientations.

Using data from the prospective Growing Up Today Study, a large cohort of U.S. youth, we investigated trends in past-year self-reports of purging (ever vomit or use laxatives for weight control) and binge eating at least monthly. The analytic sample included 57,668 observations from repeated measures gathered from 13,795 youth aged 12-23 years providing information collected by self-administered questionnaires from six waves of data collection. We used multivariable logistic regression models to examine sexual orientation group (heterosexual, "mostly heterosexual," bisexual, and lesbian/gay) differences in purging and binge eating throughout adolescence, with same-gender heterosexuals as the referent group and controlling for age and race/ethnicity.

Throughout adolescence, in most cases, sexual orientation group differences were evident at the youngest ages and persisted through adolescence. Among females and compared with heterosexuals, "mostly heterosexuals," bisexuals, and lesbians were more likely to report binge eating, but only "mostly heterosexuals" and bisexuals were also more likely to report purging. Among males, all three sexual orientation subgroups were more likely than heterosexual males to report both binge eating and purging. Within each orientation subgroup, females generally reported higher prevalence of purging and binge eating than did males.

Clinicians need to be alert to the risk of eating disordered behaviors in lesbian, gay, bisexual, and "mostly heterosexual" adolescents of both genders to better evaluate these youth and refer them for treatment.