The influence of sex and sexual orientation disparities on eating disorder behaviours and suicidality in a large Chinese adolescent’s sample

Abstract

Abstract Background and aims: Disordered eating leads to impaired well-being including physical health, psychosocial functions, and medical complications. There are insufficient studies have focused on the influence of sex and sexual orientation disparities on disordered eating. This study aimed to investigate disordered eating among male and female adolescents with different sexual orientations in a school sample.Method: Data was analyzed from 11,440 Chinese school adolescents with a mean age of 14.74 years (SD = 1.46). Self-reported data was gathered on sociodemographic information including sexual orientation, eating disorder (ED) behaviours, health factors (Self-rated health, cognitive function), mental health factors (depression, anxiety, suicidal ideation, non-suicidal self-injurious behaviour), and social functioning (school bully victimization, and school bully perpetration). Logistic regression models were used to estimate risk factors associated with disordered eating.Results: Overall, the prevalence of dietary restriction presented sex disparities—a total of 2,610 female adolescents (49.41%) reported having dietary restriction, while 2,064 male adolescents (33.69%) reported having dietary restriction. In the unidentified sexuality group adolescents tended to be less likely to engage in disordered eating. Using heterosexual orientation as reference group, being unidentified sexuality individuals was associated with lower risk in dietary restriction and purging in both male and female adolescents. Using heterosexual orientation as reference group, female sexual minority groups were at high risk of disordered eating, with bisexual orientation and homosexual orientation had a higher likelihood of objective binge eating. Conclusions: The results revealed significant sex and sexual orientation differences across the prevalence of ED behaviours. The study indicated that the sexual awareness period could be critical for understanding adolescents’ eating behaviours. It is important to guide adolescents to healthy eating during the process of sexual awareness. Considerations should be implemented by clinicians when creating interventions for disordered eating behaviours among different sex and sexual orientation groups.