Sexual attraction to men as a risk factor for eating disorders: the role of mating expectancies and drive for thinness

Sexual attraction to men as a risk factor for eating disorders: the role of mating expectancies and drive for thinness. Pedro María Ruiz de Assin Varela, Jose Manuel Caperos & Elena Gismero-González. Journal of Eating Disorders volume 10, Article number: 52. Apr 15 2022. https://link.springer.com/article/10.1186/s40337-022-00576-z

Abstract

Background: Men tend to give more importance than women to physical aspects when selecting a partner; thus, the internalization of beauty standards and the ideal of thinness may be greater in populations attracted to men, placing them at a higher risk of eating disorders.

Methods: In a sample (n = 398) of heterosexual and gay men and women, we evaluated the drive for thinness, body dissatisfaction, and bulimic symptomatology. Using ANCOVAs, we analyzed the differences in symptoms score according to sex, sexual orientation and relational status including body mass index (BMI) as covariate; we also evaluated the mediating role of drive for thinness in the relationship between sexual orientation and body dissatisfaction.

Results: We found an increased drive for thinness and body dissatisfaction in men-attracted compared with women-attracted participants; also, body dissatisfaction was greater in women than in men. Heterosexual women presented higher bulimia scores than lesbian women. Gay men open to relationships presented higher drive for thinness and body dissatisfaction scores than those not-open to relationships. Finally, differences in body dissatisfaction between gay and heterosexual men were fully explained by drive for thinness, while, in the case of women, drive for thinness only partially explained these differences.

Conclusions: Attraction to men seems to be a risk factor for EDs in the case of gay men and heterosexual women. In addition, in the case of heterosexual women, other factors independent of the desire to attract men seem to be important.

Plain English summary: Eating disorders (EDs) are important and common diseases that affect different groups of people differently. Specifically, various studies show a higher prevalence of eating disorders in gay men and heterosexual women. This could be interpreted to be a result of their attraction to men, who tend to place a greater importance on physical attractiveness when looking for a partner. In this study, we compared different ED symptomatology (drive for thinness, body dissatisfaction, and bulimia) in a sample of heterosexual and gay men and women, addressing their relationship with sex, sexual orientation, and relational status. We found an increased drive for thinness and body dissatisfaction in men-attracted (gay men and heterosexual women) compared with women-attracted participants (heterosexual men and lesbian women); also, body dissatisfaction was greater in women than in men regardless of the sexual orientation. Finally, heterosexual women presented higher bulimia scores than lesbian women, and gay men open to relationships presented higher drive for thinness and body dissatisfaction scores than those not-open to relationships (and therefore less inclined to try to attract other people sexually). In summation, our results seem to support the idea that attraction to men seems to be a risk factor for EDs in the case of gay men and heterosexual women, although, in the case of women other factors that are independent of sexual orientation should also be important.

Discussion

Regarding the first aim of the study, and as previously described in the literature [7, 8, 12, 16], heterosexual women and gay men presented greater ED symptomatology than lesbian women and heterosexual men, but these differences depended on the specific symptomatology evaluated. In the case of drive for thinness, differences appeared in the men-attracted group, and, in this group, symptomatology was greater in men than women; Body dissatisfaction was greater in men-attracted participants regardless of their sex but was also higher in women regardless of their sexual orientation; Bulimia symptomatology was much greater in heterosexual than in lesbian women and was similar to men, regardless of their sexual orientation.

As proposed by Siever [27], ED risk may be partially driven by mating motivations. Given that men place more importance on body shape and physical features than women when choosing potential partners [26], people attracted to men may be under greater pressure to have an attractive physique, focusing on those aspects that are mainly considered to be attractive. The thin-ideal is typically the most widespread Western ideal of beauty [43]; and the internalization of thin-ideal places men-attracted people at risk of body dissatisfaction symptomatology. In recent years, the use of social media has been widely related to the exposure and internalization of such ideals [44,45,46,47,48]. Social networks affect the self-image of both men and women and, therefore, their idealized content serves as a comparison criterion for both sexes [49].

Gay men presented the highest drive for thinness scores of the four groups, higher than heterosexual women, suggesting a particular vulnerability to thin-ideal internalization. Some studies reported that bisexual and gay men are more susceptible than heterosexual men to social messages focusing on physical appearance [50] and place more importance on physical appearance and attractiveness [51]. Notably, Gigi et al. [50] found that they showed increased attention to social comparison information, increased internalization of cultural ideals presented in the media about appearance, and susceptibility to the influence of advertisements that emphasize appearance, which was interpreted as a consequence of interest to please other men. In this regard, Li et al. [30] reported that, when faced with a context of intrasexual competition, gay men reported more restrictive eating attitudes and more body image concerns than in non-competitive scenarios or than heterosexual men. According to the authors, contexts of intrasexual competition should elicit desires to be especially thin for many individuals given that intrasexual competition is established in relation to those characteristics that are desirable.

In the case of body dissatisfaction, on the one hand, we found a main effect of sexual orientation. Body dissatisfaction was higher in gay men than in heterosexual men, and also in heterosexual woman than in lesbian women. He et al. [52] analyzed 75 primary studies published between 1986 and 2019, finding that sexual minority men had a higher level of body dissatisfaction than heterosexual men (57 studies, 128 effect sizes), with small to medium effect sizes. This result partially support Siever’s view, as well as suggesting that the internalization of thin-ideal by women and gay men places men-attracted people at risk of body dissatisfaction symptomatology. Meanwhile, on the other hand, we also found a main effect of sex, with women presenting higher scores than men, regardless of their sexual orientation. In general, women are under greater sociocultural pressure of an aesthetic ideal and most studies reported a higher prevalence of body dissatisfaction in women [53]. Women, for example, have lower body satisfaction than men regardless of their BMI [54]. Up to 80% of women respondents expressed current dissatisfaction with their bodies [55], and body dissatisfaction was found to be the most potent predictor of EDs [56]. Social pressures mean that women see their appearance as a fundamental factor in their value as individuals and expect others to routinely examine them [57]. This may lead them to scrutinize their body image, increasing the risk of being dissatisfied with it [58, 59].

In the case of bulimia, lesbian women reported the lowest bulimia scores, being much lower than heterosexual women, while for men there were no differences based on sexual orientation. Higher body dissatisfaction was found to be a predictor of bulimia [53]. Gay men also presented high levels of body dissatisfaction; however, this did not translate into a high rate of reported bulimia symptomatology. Given that gay men still emphasize the importance of a lean but also athletic physique, with a low percentage of body fat [51, 60, 61], it seems logical that they would seek to minimize behaviors contrary to that ideal. In this sense, some authors already propose that for men, sexual attraction to men would only be a risk factor for restrictive eating symptomatology [14, 29]. Although there are others who continue to find significant differences in measures of bulimia or impulse regulation [33].

Lesbian women presented the lowest bulimia symptomatology. This result is in line with other studies suggesting that, in women, a lesbian sexual orientation would be a protective factor against EDs [12], being associated with lower body dissatisfaction [16, 17]. However, similar research has yielded contradictory results: Dotan et al. [62], in a recent meta-analysis examining the association between sexual orientation and disordered eating in women, reported that there was no significant difference in overall disordered eating between lesbians and heterosexual women, however, lesbians reported restricting less and bingeing more than heterosexual women.

The second aim of our study was to evaluate the effect of relationship status on ED symptomatology. According to Siever’s hypothesis, a greater symptomatology would be expected when looking for/or open to a new relationship than when monogamously mated. As expected, we found that gay men presented higher scores for body dissatisfaction and drive for thinness if they were looking for/or open to new romantic or sexual partners. This result would indicate a greater attention/concern to the evaluation of their own physical appearance when looking for partner. As Siever [27] suggested, gay men pursuing a partner suffer increased pressure to be physically attractive, and those who feel they do not meet the high attractiveness ideals of the gay community may experience heightened body image concerns, as they feel their bodies may not be appealing enough to attract a partner. Men in relationships may be less exposed to objectifying experiences within the gay culture compared with single men actively pursuing partners and putting themselves in environments where such pursuits may occur, such as in gay clubs or on dating websites and apps [63]. As Parker and Harriger [64] pointed out, among sexual minority men, the use of dating apps was found to be an ED risk factor, which is likely due to the added pressure to adhere to a certain aesthetic to attract more potential sexual partners. Brown and Keel [65] showed that, although it made no difference to heterosexual men, bisexual and gay men who were single had an increased drive for thinness, and that being in a relationship may be a protective factor for body image concerns and disordered eating among gay men. Cella et al. [33] also found gay sexual orientation associated with greater body dissatisfaction and abnormal eating behaviors in men, especially among those who were not in a sentimental relationship. All these findings support the notion that single men may be more concerned with their appearance than those in relationships; our results also support that gay men are at higher risk when they are open to finding a new partner.

In contrast, we did not find an effect of relationship status on the symptomatology of heterosexual women. As stated previously, Siever’s [27] hypothesis does not seem to apply fully in the case of women. This result is consistent with other studies that found that the symptomatology of lesbian women was not always less than that of heterosexual women [62], and that explanatory models of ED etiology followed similar patterns in lesbian and heterosexual women, but not in heterosexual and gay men [66]. Our mediation analysis pointed suggestively in the same direction. While in men the differences in body dissatisfaction derived from sexual orientation were fully explained by their drive for thinness, in the case of women, thinness only partially explained body dissatisfaction. Thus, the thin-ideal seem to fully explain differences in body dissatisfaction between heterosexual and gay men, but not completely between heterosexual and lesbian women.

The cognitive component of body dissatisfaction has been considered to contain two categories, preoccupation with the body and self-objectification on the one hand, and internalization of the thin-ideal, on the other [43]. Objectification theory [57] posits that girls and women are acculturated to internalize an observer’s perspective as a primary view of their physical selves, and that women could respond to sexual objectification in function of sexuality, age, ethnicity, and other physical and personal attributes. Cultural objectification can be internalized as self-objectification leading to increased body monitoring and body dissatisfaction [67,68,69]. Therefore, differences between lesbian and heterosexual women may lie not only in the direction of the attraction, but in a different internalization of gender roles [70, 71]. Gender role adoption is related to body dissatisfaction and EDs [72] and femininity has been considered a more critical factor than sexual preference on ED psychopathology [73]. The comparison of women with different sexual orientations could be involving two different issues, differences in the orientation of their attraction (mediated by the interiorization of beauty ideals), and differences in the process of socialization. This would explain both the inconsistency of results found in the literature on the relationship between sexual orientation and EDs in the case of women, as well as the results of the present study.

This study has several limitations. First, given the split of the sample into groups of sex, sexual orientation, and relationship status, some of these groups presented small sample sizes and the associated tests might have low statistical power. Likewise, the absence of significant results in some groups should be taken with caution. Despite this, descriptive measures of effect size seem to point in the direction of our conclusions. Second, we use the drive for thinness measure as a measure of the degree of internalization of thin-ideal, which does not fully correspond. However, different studies show a positive relationship between the two measures [74,75,76], therefore, we consider that the conclusions derived from the results are appropriate. Finally, while aiming to evaluate risk factors, the cross-sectional nature of data collection does not allow us to follow the evolution of the symptoms or to distinguish in the mediation models the antecedent variables from their outcomes.