Gay men experience eating disorders and body dysmorphia more than any other population except for heterosexual women.
Why is that?
To help understand the link between gay culture and negative body image, eating disorders and body dysmorphia, we spoke to Carl Hovey, a psychologist and researcher at the Soho and Fidi locations of the Gay Therapy Center in New York.
Carl’s research took the form of a qualitative study. He interviewed a collection of gay men in New York City, asking open ended questions like, “Can you talk to me a little about how you experience your body, both now and in the past?”
“I wanted to try and get a narrative going of how ideas about the body are formed by messages from family, culture and society, and whether that was stable or unstable over time,” he explained.
“In speaking directly to the population, rather than trying to extrapolate meaning from person-less data, you get to hear nuanced explanations from the population you’re trying to understand.”
What constitutes an eating disorder? And what does body dysmorphia really mean?
Eating disorders are “illnesses in which people experience severe disturbances in their eating behaviors and related thoughts and emotions.” (Psychiatry.org). They can take many forms: anorexia nervosa (extreme food restriction, to the point of starvation), bulimia nervosa (sometimes referred to as “binging and purging” where one eats a large amount of food in a restricted period of time, and then force themselves to purge via vomiting or laxatives), or binge eating disorder (eating large amounts of food in a short amount of time and feeling a loss of control during the binge).
The public sometimes believes that eating disorders are simply about weight loss. However, while fixation on weight and body image are important factors in eating disorders, they are typically about shame and control. When someone feels a lack of control in their life, trying to control one’s body through food is a way in which to reclaim that control. There is often shame linked to the feeling of being out of control, which contributes to the compulsion and the need to find a new way in which to exert control.
According to the National Association of Anorexia Nervosa and Associated Disorders, eating disorders have the highest mortality rate of any mental illness.
Body dysmorphic disorder is a “psychiatric disorder characterized by excessive preoccupation with imagined defects in physical appearance.” (MedicineNet.com). It is a type of anxiety disorder, and a variant of obsessive-compulsive disorder.
When you experience body dysmorphia, you find yourself fixating on physical attributes on your own body. You find flaws in yourself and your body where others don’t, and you are unable to release the intense focus you have on them. Excessive energy then goes towards trying to find ways to hide or get rid of that flaw and you feel much of your value is tied up in your appearance.
Why does feeling a lack of control sometimes result in hyper-regulation of the body?
We exist in a culture that tells us our body is our value.
The compulsion to perform has increased exponentially over the last decade with the growth and popularity of social media, dating apps, and reality TV. If our bodies look “good” (good, for the most part, meaning small and controllable, rather than natural and healthy) more doors are opened.
If you fall under the current cultural definition of “good” looking, you can make a living as an Instagram influencer. If you live within a small body, you actually have financial benefits: you are more likely to be taken seriously in job interviews, you are able to find well-made clothes at a lower cost than those for larger bodies, and you have the ability to avoid the weight bias in medicine.
Why are the negative impacts affecting gay men more than straight men?
“The discrepancy between the rate among gay men and straight men is pretty dramatic,” Carl told us. “ So we know that there’s clearly something happening in the community, that predisposes them to these kinds of concerns.”
The goal of Carl’s research was to find out what it was that was causing these kinds of concerns.
Part of it, of course, can be attributed to what we call minority stress. Minority stress is what people within marginalized social groups experience: increased levels of stress due to lack of social, financial or structural support.
But what Carl found, was that the level of acceptance gay men found within their community was essentially linked to the acceptance they felt within their own body.
“One of the more surprising elements that came out of the research is how often experiences of the body–more specifically, whether or not an individual felt his body was acceptable or unacceptable in the marketplace of gay culture—was related to a feeling of inclusion or exclusion within that culture,” Carl said.
Gay culture, Carl went on to say, is defined through desire. It’s what separates gay men from mainstream heterosexual culture: this desire that for so long was considered taboo. And with so much of gay culture revolving around desire, rather than some sort of cultural heritage, gay men have found themselves in a position where they feel like they have to embody that desire–or else they won’t have a place within the culture and community.
“Let’s call it consumer commodity fetishism: where the body becomes perceived as a commodity in a marketplace,” Carl explained. “It’s ascribed a value–in a way that can be damaging to people’s self esteem and to their sense of who they are if it doesn’t live up to certain ideas or standards.”
There is an unspoken expectation within gay culture: you must be desirable at all times, or else you won’t fit into the cultural spaces reserved for gay men. This can lead to pressure to control the body at the expense of health.
Our bodies as Home
The connection between mind, body and community shows up in very direct ways. If you enter a new environment, and your body is tensed up and anxious, it doesn’t actually matter what the experience of being in that new place will be. Your body is tense and anxious, so the new environment will be experienced as a threat.
So, if you enter a culture of desire, without feeling as though your body fits into that script of what constitutes what is desirable, there will be an instinctive, natural sense of isolation.
Carl went on to explain how this is true, not only for isolating gay men from the larger queer community, but actually from their own identity.
“It makes sense that if there’s not a feeling that one’s body is a legitimate source of desire, one begins to feel very excluded,” he said. “Not just from the larger gay community. People even talked about feeling alienated from themselves, as though if their body didn’t fit a certain script, they weren’t even sure who they were as gay men. They felt very alienated in that way.”
So, how can we heal?
The first step, Carl tells us, just as it is with any type of healing, has to be awareness. “If they’re feeling really unhappy with their body, I think the first thing is to tune into the body and actually come closer to it,” Carl says. “And that sounds like an insane thing to say, because how could you come closer to something that you are, right? But the more aware that you can become about what’s happening in your body and about how you’re relating to it, the more you’re going to start to see options open that you didn’t know existed.”
Before awareness develops, Carl goes on to explain, people feel stuck. They don’t understand why they are feeling the way they’re feeling, what is contributing to it, and they definitely don’t know how to move forward from that feeling.
With awareness, comes understanding. Bringing awareness to your body, your relationship with your body, how you perceive it, how it feels to live in it, helps us to understand all of those things.
Carl does this with his clients in session. Rather than asking questions like “How did that make you feel then?” he’ll ask questions like, “How do you feel right now, as you’re telling me about it?”
This is learning to bring awareness to your body as you experience these feelings of anger, isolation, or disconnection. Only by taking the time to notice, to explore, and to understand those connections between our mind and our bodies will we ever be able to heal those links.