Image Dissertation Abstracts and
Author: Angela K. Picot
Title: The Relationship Among Community Affiliation,
Self-Esteem, and Eating Disorder Symptomatology in Gay and
Dissertation completed April 2004, Georgia State University,
Atlanta, Georgia, USA (Advisor/Supervisor: Lisa R. Lilenfeld)
Foundation and rationale of the research
Previous research has indicated that
sexual orientation may be relevant in understanding vulnerability
to eating disorder symptomatology. Specifically, gay men are
generally believed to be at increased risk, and lesbian women
at decreased risk, for developing negative body image and
disordered eating. The role of gay and lesbian community affiliation
in influencing levels of eating disorder symptomatology has
recently begun to be examined and merits further investigation.
Furthermore, due to the understudied nature of this population,
an examination of identified risk factors for eating disorder
symptomatology, including self-esteem, media internalization,
gender role identification, and ethnicity is indicated among
gay and lesbian individuals.
(1) Gay men will have greater eating disorder
symptomatology than straight men, and lesbian women will have
similar or less eating disorder symptomatology than straight
women. (2) Gay men will have greater eating disorder symptomatology
than lesbian women. Among the gay and lesbian individuals
only: (3) Affiliation with the gay and lesbian community will
moderate level of eating disorder symptomatology; (3a) Increased
community affiliation will be associated with high eating
disorder symptomatology among gay men; (3b) Increased community
affiliation will be associated with low eating disorder symptomatology
among lesbian women. (4) Self-esteem will be negatively associated
with eating disorder symptomatology. (5) Self-esteem will
be negatively related to community affiliation for gay men
and positively related to community affiliation for lesbian
women. (6) Media internalization, femininity, and Caucasian
identity will be positively associated with eating disorder
Participants consisted of 389 gay men, 381 lesbian women,
39 straight men, and 73 straight women who attended the 2002
Gay Pride Festival in Atlanta, Georgia, and completed a self-report
questionnaire comprised of several standardized measures and
demographic items. Measures included the Eating Attitudes
Test-26, the drive for thinness and body dissatisfaction subscales
of the Eating Disorder Inventory-2, the Drive for Muscularity
Scale, the Internalization subscale of the Multidimensional
Media Influence Scale, and the Rosenberg Self-Esteem Scale.
Community affiliation was assessed using a measure of participation
and involvement created for the current study. Sexual orientation
was assessed using a seven point Likert item based on the
Univariate general linear models and ANCOVAs,
as appropriate, were conducted to examine differences in eating
disorder symptomatology between groups. To address the moderation
hypothesis of the study, four separate hierarchical multiple
regression (HMR) analyses were conducted for gay men and lesbian
women separately, assessing all four dependent variables (e.g.,
EDI-2 body dissatisfaction, EDI-2 drive for thinness, drive
for muscularity, and eating pathology). Multiple linear regression
analyses and univariate general linear models were used to
evaluate additional hypotheses separately among gay men and
Gay men had similar levels of
body dissatisfaction, drive for thinness, and eating pathology
as straight men, and a trend approaching significance for
a higher drive for muscularity (n2=.009, Fchange(1,
410)=3.660, p=.056). Lesbian women had similar levels of body
dissatisfaction, drive for thinness, drive for muscularity,
and eating pathology as straight women. Gay men had similar
levels of drive for thinness and eating pathology as lesbian
women, yet were found to have greater drive for muscularity
(R²change =.083, Fchange(1,718)=66.96,
p<.01) and less body dissatisfaction (R²change=.05,
Fchange(1,738)=48.96; p<.01) than lesbian women.
Results of the moderation hypothesis found
that among lesbian women, there was a trend toward an interaction
between gender and community affiliation accounting for a
significant portion of the variance in drive for thinness
(R2change=.006, Fchange (1,
420)=3.7, p=.055). No significant differences in eating disorder
symptomatology were found among gay men at differing levels
of community affiliation.
Among gay men, self-esteem accounted for
a significant proportion of the variance in body dissatisfaction
(R2change=.132, Fchange (1,365)=70.0,
p<.01), drive for thinness (R2change=.097,
Fchange (1,365)=40.9, p<.01), drive for muscularity
(R2change=.155., Fchange (1,364)=70.56,
p<.01), and eating pathology (R2change=.097,
Fchange(1,368)=40.0, p<.01). The same relationships
held true for lesbian women, in that self-esteem accounted
for a significant proportion of the variance in body dissatisfaction
(R2change=.110, Fchange (1,348)=54.17,
p<.01), drive for thinness (R2change=.148,
Fchange (1,342)=62.09, p<.01), drive for muscularity
(R2change=.093, Fchange (1,335)=35.96,
p<.01), and eating pathology (R2change=.123,
Fchange (1,340)=49.38, p<.01). Community affiliation
was unrelated to self-esteem among both gay men and lesbian
When the first subhypothesis was examined,
media internalization explained a significant proportion of
the variability in body dissatisfaction (R2change=.067,
Fchange (1,365)=32.32, p<.01), drive for thinness
(R2change=.145, Fchange (1,365)=64.41,
p<.01), drive for muscularity (R2change=.169,
Fchange (1,368), p<.01) and eating pathology
(R2change=.092, Fchange (1,372)=37.57,
p<.01) in gay men. Similarly, media internalization accounted
for a significant proportion of the variability in body dissatisfaction
(R2change=.082, Fchange (1,351)=38.95,
p<.01), drive for thinness (R2change=.120,
Fchange (1,346)=49.10, p<.01), drive for muscularity
(R2change=.108, Fchange (1,340)=42.93,
p<.01), and eating pathology (R2change=.073,
Fchange (1,344)=27.89, p<.01) in lesbian women.
Results of the second subhypothesis revealed
that femininity accounted for a significant proportion of
the variance in body dissatisfaction, (R2change=.018,
Fchange (1,372)=8.53, p<.01) among gay men.
Femininity was found to account for a significant proportion
of the variability in drive for muscularity (R2change=.021,
Fchange(1,341)=7.65, p<.01) among lesbian women.
Among gay men, Caucasian identity significantly
accounted for higher levels of body dissatisfaction (n2=.014,
Fchange(1,281)=3.83, p=.05) and eating pathology
(n2=.02, Fchange(1,76)=5.47, p<.05),
than African American identity. Among lesbian women, Caucasian
identity significantly accounted for higher levels of eating
pathology, (n2=.011, Fchange(1,301)=4.05,
p<.05) than did African American identity.
Conclusions and Implications
In summary, this study found few differences
in eating disorder symptomatology based on sexual orientation.
It could be that differences noted in previous studies could
have been exaggerated due to the fact that gay and straight
individuals were dissimilar demographically. It is also possible
the straight sample in the current study may have not been
representative of the larger straight population.
The degree to which an individual participated in, and identified
with, their community did not appear to have a large influence
on the expression of eating disorder symptomatology among
gay men or lesbian women. The risk or protective components
of community affiliation that have been suggested may be quite
minimal, at least in the context of a festival where affiliation
is generally high. Rather than community affiliation, self-esteem
emerged as the more crucial construct in understanding how
an individual felt about his or her body. Additionally, internalization
of high standards of physical appearance, gender role identity,
and ethnicity each contributed in some way to our understanding
of eating disorder symptomatology among both gay men and lesbian
This study underscores that the effect of sexual orientation
on eating disorder symptomatology should not be overestimated.
Also, this study highlights topics, such as self-esteem and
the influence of the media, which may inform prevention programs
targeting general health and body perception in both men and
women, regardless of sexual orientation.
Balsam, K.F., & Rothblum, E.D. (2001, November). Disordered
eating and body dissatisfaction: A comparison of lesbian,
gay, and bisexual adults and their heterosexual siblings.
Paper presented at the 35th annual conference of the Association
for the Advancement of Behavior Therapy, Philadelphia, PA.
Beren, S.E., Hayden, H.A., Wilfley, D.E., & Grilo, C.M.
(1996). The influence of sexual orientation on body dissatisfaction
in adult men and women. International Journal of Eating
Disorders, 20(2), 135-141.
Bergeron, S.M., & Senn, C.Y. (1998). Body image and sociocultural
norms. Psychology of Women Quarterly, 22, 385-401.
Garner, D., Olmstead, M., Bohr, Y., & Garfinkel, P. (1982).
The eating attitudes test: Psychometric features and clinical
correlates. Psychological Medicine, 12, 871-878.
Garner, D., Olmstead, M.A., Polivy, J. (1983). Development
and validation of a multidimensional eating disorder inventory
for anorexia nervosa and bulimia. International Journal
of Eating Disorders, 2(2), 15-34.
Heffernan, K. (1994). Sexual orientation as a factor in risk
for binge eating and bulimia nervosa: A review. International
Journal of Eating Disorders, 16(4), 335-347.
Heffernan K. (1996). Eating disorders and weight concern among
lesbians. International Journal of Eating Disorders,
Ludwig, M.R., & Brownell, K.D. (1999). Lesbians, bisexual
women, and body image: An investigation of gender roles and
social group affiliation. International Journal of Eating
Disorders, 25, 89-97.
McCreary, D.R., & Sasse, D.K. (2000). An exploration of
the drive for muscularity in adolescent boys and girls. Journal
of American College Health, 48, 297-304.
Rosenberg, M. (1965). Society and the adolescent self-image.
Princeton, NJ: Princeton University Press.
Russell, C.J., & Keel, P.K. (2002). Homosexuality as a
specific risk factor for eating disorders in men. International
Journal of Eating Disorders, 31, 300-306.
Thompson, J.K., and van den Berg, P. (2002). Measuring body
image attitudes among adolescents and adults. In T.F. Cash
& T. Pruzinsky (Eds.). Body image: A handbook of theory,
research, and clinical practice (pp. 142-154). New York: