User:Mzimet/Disordered eating

Disordered Eating
Disordered eating is characterized by regularly engaging in unhealthy eating patterns. These abnormal eating behaviors are varied and are often symptoms to the onset development of an eating disorder. Examples of disordered eating patterns include (and aren't limited to) restriction of caloric intake, avoidance of specific food groups, emotional eating, self-induced purging, binge eating, overall restriction of food consumption, habitually eating particular foods/meals, abusing diet pills (such as laxatives), excessive exercise, etc. People's intensity, fixation, and display of the these maladaptive eating behaviors vary. People who engage in disordered eating behaviors customarily meet the clinical diagnosis of an eating disorder. However, an individual can engage in habitual disordered eating patterns, yet cease to meet the clinical diagnosis of an eating disorder. Furthermore, disordered eating is frequently used interchangeably with eating disorder, as the physiological/psychological symptoms and behavior around food extensively overlaps. Without intervention or treatment, engaging in these maladaptive symptoms hinder a person's holistic health and their ability to maintain daily functionality.

Disordered Eating Among Queer Identities
Research indicates that eating pathology is increasingly prevalent among queer identities compared to their cis-gender heterosexual counterparts. Current literature has examined disordered eating behaviors (e.g., restricting, binging, purging, compulsive exercise) among gender and sexually diverse individuals (e.g., lesbian, transgender, gay, bisexual, gender-nonconforming, etc.) to uncover potential contributing trans-diagnostic risk factors. Specifically, how disordered eating patterns arise through the perspective of identity development as it relates to one's socio-cultural context. Prior research indicates possible disparities of eating disorder symptomatology are mediated by minority stress variables affecting marginalized identities. Minority stress factors include the following relevant risks; heterosexist discrimination, internalized homophobia, sexual orientation stigma, sexual and physical abuse, and sexual objectification. These factors are considered to be contributing factors of identity confusion that provoke the formation of disordered eating. The formation of eating disorders among queer minority identities are analyzed through sociocultural perspectives to provide a better understanding of the etiology of abnormal eating behaviors.

Minority Stress Model & Eating Disorders
Developed by social psychologists, the minority stress model informs that members of minority groups (encompassing race, sexuality, gender, age, disability, socioeconomic status, etc.) experience greater detrimental effects regarding psychological health, physical health, poverty, marginalization, etc. The minority stress model posits that because of their minority identity, these individuals are increasingly privy to overarching disparities in comparison to the dominant group counterpart. The social factors subjecting minority groups to harmful effects are labeled as stressors. External stressors, called dixal stressor, included aspects such as rejection, prejudice, discrimination, social exclusion, social cultural pressures, and stigmatization aimed at minority identities. Internal stressors are called proximal stressors which are byproducts of dixal stressors. Proximal stressors within sexual and gender minorities (SGMs) include internalized homophobia, concealment of sexuality/gender, depression, victimization, trauma, abuse, thinness-based dissatisfaction, etc. Research shows that sexual, physical, and emotional abuse, as well as eating disorder symptomology, are increasingly prevalent among SGM than cis-gender heterosexual individuals. The empirical research discussed utilizes this model to research the coalesce of dixal stressors and proximal stressors causing higher risks of eating disorder behaviors among SGMs.

In applying this model researchers have uncovered strong evidence that dixal stressors, such as discrimination against an SGMs, creates proximal stressors of body dissatisfaction. Minority identity responses to dixal stressors of discrimination against their identity lead to adapting coping strategies that covertly repress their identity. A study examining 962 queer individuals found that sexual minority stress lead to poor mental health outcomes including eating and body image shame and dissatisfaction. The study informs that sexual minority individuals who experience heterosexist discrimination engaged in higher rates of sexual orientation concealment. Current research indicates that socio-cultural values confine minorities to socially accepted ways of express one's identity. Furthermore, individuals opposing standardized roles of gender-expression experience greater minority stress that encourage taking-on maladaptive behaviors (in the form of coping mechanisms) as an avenue to reduce the discrimination against their identity. These unhealthy behaviors may express themselves in the form of disordered eating patterns, and psychopathologies that convoluted their ability to embrace an authentic-rooted identity.

Gender Dysphoria & Sociocultural Pressure
Gender dysphoria is a clinical diagnosis marked by internal dissatisfaction and psychological distress of feeling incongruence between one's assigned birth-sex and their preferred gender identity/experience. Gender dysphoria is experienced by many populations but is exceedingly prevalent among sexually and gender diverse individuals, specifically transgender and non-binary identities. The overall experience of gender misalignment can lead to development of depression, anxiety, and even disordered eating behaviors. Possible disdain and in alignment to one's assigned gender identity is oftentimes mediated by sociocultural attitudes from one's environment and binary ideals of gender. These factors can cause body dissatisfaction as well as body dysmorphia. Dissatisfaction is oftentimes underlined by societal pressure to outwardly express gender identity in alignment to socially accepted stereotypes accompanying a specific gender. Pressure to align with gender stereotypes can manifest in preoccupation with appearance and influence an individual to take on the appearances (i.e., wardrobe, mannerisms, outward attitudes, body shape) of a certain gender identity. The internalization and pressure to take on externally accepted expressions of gender that are inauthentic exacerbated feelings of incongruence to preferred expression of gender. The act of internalizing these appearance ideals and incorporating them into one's expressions is known to cause gender dysphoria.

Research indicates that the pressure to express socially acceptable forms of gender appearance and expression are seen in the form of objectification and sexualization of the body. A 2019 study examined body image concerns among 205 transgender women expressing eating disorders symptomology through the lens of objectification theory constructs. The objectification constructs (i.e., sexual objectification, internalization of sociocultural standards of attractiveness, body surveillance, body dissatisfaction) were incorporated to study predictors of ED behaviors. These variables were significant to include, as trans-women experience gender-based oppression in the form of sexual objectification and discrimination towards their identity. The research found that the objectification constructs, especially internalization of sociocultural attractiveness standards, were correlated to body dissatisfaction and ED symptomatology. Additionally, exposure to minority stressors increasingly pronounced body image dissatisfaction, internalization of appearance-ideals, gender dysphoria, and eating disorder behaviors among sexual and gender diverse identities. These implications inform that eating disorder behaviors may have been adopted among sexual/gender diverse individuals as an unhealthy stress-induced response to gender dysphoria and internalization of minority stressors in relation to their identity. Implying that disordered eating symptomatology is adapted as a social-emotional coping mechanism to greater align to societal expectations of ‘normal’ identity expressions.

Gender Dysphoria & Eating Disorders
The trends uncovered indicate that disordered eating among sexual and gender diverse individuals compared to cis-gender heterosexual counterparts consistently held disparities. Research has recently examined gender dysphoria and disordered eating symptomology among non-binary and transgender individuals to better understand the source of maladaptive eating behaviors within this community. Research collected through clinical reports and assessment intakes, retrieved from eating disorder treatment centers, indicated that participants experiencing gender dysphoria experience higher rates of eating disorder behaviors in comparison to those not experiencing gender dysphoria. Furthermore, trans-men and trans-women had higher rates of disordered eating behaviors when compared to cis-gender individuals, however, the highest rates were found among trans-men. Disordered eating behaviors were noted to be 19 times more common in trans-men, while disordered eating behaviors were 10 more common in trans-women. Indicating that gender dysphoria is a trans-diagnostic risk factor that mediates the development of eating disorders, especially among trans identities.

A Norwegian study took this investigation a further step by synthesizing the internalization of minority stress alongside gender dysphoria symptoms to explain the disproportionate rates of psychopathology among transgender identities when compared to a non-transgender population. The study examined non-binary and transgender individuals ranging from the ages of 18 to 59 years old. Researchers uncovered that for individuals aged 18 to 22 years old minority stress predicted gender dysphoria. While in the 23 to 59 year old age group gender dysphoria significantly mediated minority stress and eating disorder behaviors. Additionally, gender dysphoria was a more statistically significant predictor of minority stress and disordered eating behaviors in the older age group. The onset and intensity of gender dysphoria and corresponding eating disorder behaviors is dependent on the stages of gender transitioning, which includes 14 stages. Further research should examine which stages are accompanied by increasing rates of gender dysphoria and eating disorder symptomatology.

While pressures to align with gender stereotype appearances can cause dissatisfaction, this pressure can also cause temporary but unhealthy satisfaction for certain individuals when engaging in eating behaviors. Incorporating minority stress through the experience of gender dysphoria allows researchers to explore specific risks uniquely experienced by trans and non-binary individuals. For transgender individuals experiencing gender dysphoria, adopting eating disorder behaviors may serve as an unhealthy coping mechanism to acquire the stereotypical appearances commonly associated with their preferred gender-identity. Through the lens of internalized gender stereotypes, developing eating disorder behavior holds the capacity to increase feelings of gender congruence and satisfaction. This implies that there is commonly an exchange of satisfaction at play when engaging in eating disorder behaviors. For example, an individual feeling intensely incongruent with their feminine appearance may engage in restrictive behaviors to achieve a body shape stereotypically associated with women. In this exchange, the act of restricting increases the degree to which their external appearance maintains congruence. Bringing the person closer to their preferred gender identity and increasing feelings of satisfaction with their body and gender. With this intention, engaging in disordered eating patterns serves as a mediator to alleviate dissatisfaction with gender expression. However, disordered eating behaviors become a harmful coping mechanism adopted as a stress-induced response from internalization of gender stereotypes, social pressures, expectations of appearance, homophobia/transphobia, and body image ideals.

Treatment
The literature maintains that risk factors of disordered eating among sexual and gender diverse minorities can be explained by factors of minority stressors, gender dysphoria, and abuse. Current research has discovered that transgender individuals experience eating disorders at greater rates and are exposed to greater risk factors, such as sexual objectification and dehumanization. Hence, development of transgender-affirming training and treatment approaches within eating disorder health care settings is necessary for positive intervention outcomes. The integration of trauma-informed care within treatment programs will further reduce disordered eating symptomatology. Understanding these risk factors allows researchers and clinical treatment setting to reduce barriers to treatment and provide interventions that address symptoms caused by the outlined risks. Reinforcing diverse identities in seemingly unconventional expressions of sexuality, gender fluidity and appearance is essential to provide a safe space for an individual to nurture their holistic identity with empowerment and not shame.