Latent Profiles of Disordered Eating Behaviors Associated with Bullying and Mental Health Among Sexual and Gender Diverse Youth

Objectives: This study examined associations of social identity and experience variables with specific patterns of disordered eating behaviors among sexual and gender diverse youth, a population at elevated risk of disordered eating behaviors and eating disorders. Methods: Using data from a nationwide U.S. survey of sexual and gender diverse youth between the ages of 13 and 18 ( n = 10,743), we determined profiles of engagement across three disordered eating behaviors: restriction, binge-eating, and purging through Latent Profile Analysis and examined the associations between profile membership and gender, sexual orientation, race/ethnicity, four types of bullying victimization (gender-based, sexual orientation-based, race-based, weight-based), lesbian, gay, bisexual, transgender, and queer (LGBTQ)-specific parental acceptance, and depressive and anxiety symptoms. Results: Three latent profiles emerged: (1) High Restriction & Binge-eating (28.6%), (2) Low Disordered Eating Behaviors (36.9%), (3) High Restriction (34.4%). All bullying victimization was significantly associated with increased odds of belonging to a disordered profile (Restriction and Binge-eating, and High Restriction); weight-based bullying was specifically associated with greater odds of belonging to the High Restriction & Binge-eating profile. Parental acceptance was most strongly associated with not belonging to either disordered profile. The High Restriction & Binge-eating profile was associated with more elevated depressive and anxiety symptoms than the High Restriction profile. Conclusions: Binge-eating distinguished two patterns of disordered eating behaviors among sexual and gender minority youth; the High Restriction & Binge-eating profile associated with slightly worse social experiences and outcomes. Future prevention and intervention efforts may focus on fostering safer environments for sexual and gender diverse youth through reducing bullying and increasing parental acceptance, as these social experience variables were more strongly associated with disordered eating behaviors profile membership than identity variables.