The Association between sexual orientation and body image, eating disorders, and body dysmorphic disorder in men

Abstract

This review summarizes core findings and trends regarding differences in perceptual, cognitive-affective and behavioral components of body image between homosexual (HOM) and heterosexual men (HEM). Furthermore, it provides a comparison of prevalences and symptoms of eating disorders (ED) and body dysmorphic disorder (BDD). There is no evidence for more negative body image in general in HOM compared to HEM. There are no differences in the way one's body is perceived and with regard to the discrepancy between the actual and ideal body. Further there are inconsistencies regarding group differences in preference for a thinner body type. However, HOM report greater body dissatisfaction and drive for thinness. While there are inconsistencies concerning the difference in the frequency of exercising, HOM show stronger avoidance and checking behaviors. Findings regarding drive for muscularity show no difference between the men. Moreover, no clear conclusion can be drawn with regard to the prevalence of ED, and there is no difference in prevalence of BDD. Nevertheless, there seems to be a trend towards more severe ED and BDD symptoms in HOM. For a more comprehensive understanding of body image, ED and BDD psychopathology in HOM and HEM, and to develop individualized interventions, more research is needed. Of particular interest are constructs that have been neglected, e.g., drive for leanness, cognitive bias, investment in one's own body, binge eating, and potentially mediating factors, e.g., affiliation with the gay community (including subgroups).