title: Weight misperception and unhealthy weight control behaviors among sexual minorities in the general adolescent population.
abstract: OBJECTIVE
  Gay, lesbian, and bisexual youth may experience significant body dissatisfaction. We examined sexual orientation differences in self-perceived weight status and the prevalence of potentially dangerous weight control behaviors in a representative sample of adolescents.
  
  
  METHODS
  Data were obtained from 12,984 youth between 2003 and 2009 over four cycles of the Massachusetts Youth Risk Behavior Survey, a statewide survey of ninth- through 12th-grade students. Self-perceived weight status and past-month unhealthy weight control behaviors (fasting >24 hours, using diet pills, and vomiting or using laxatives) were compared among gay/lesbian, bisexual, or self-identified heterosexual youth with same-sex partners, unsure youth, and exclusively heterosexual youth using logistic regression, adjusting for age and race/ethnicity.
  
  
  RESULTS
  Compared with exclusively heterosexual males, heterosexual males with prior same-sex partners and bisexual males were more likely to self-perceive as overweight despite being of healthy weight or underweight (respectively, adjusted odds ratio [AOR], 2.61; 95% confidence interval [CI], 1.68-4.05; and AOR, 2.56; 95% CI, 1.64-4.00). Compared with exclusively heterosexual females, lesbians and bisexual females were more likely to self-perceive as being of healthy weight or underweight despite being overweight or obese (respectively, AOR, 3.17; 95% CI, 1.15-8.71; and AOR, 2.00; 95% CI, 1.20-3.33). Unhealthy weight control behaviors were significantly more prevalent among sexual minority males (32.5%; AOR, 4.38; 95% CI, 3.38-5.67) and females (34.7%; AOR, 2.27; 95% CI, 1.85-2.78) when considered together relative to exclusively heterosexual males (9.7%) and females (18.8%).
  
  
  CONCLUSIONS
  One third of sexual minority youth engage in hazardous weight control behaviors. Future research should investigate underlying mechanisms and determine whether clinicians should routinely screen for these behaviors.
authors.affiliation: Department of Pediatrics, Boston University School of Medicine, Boston, Massachusetts; Division of Adolescent and Young Adult Medicine, Boston Children's Hospital, Boston, Massachusetts; Department of Pediatrics, Harvard Medical School, Boston, Massachusetts. Electronic address: scott.hadland@childrens.harvard.edu.
authors.forename: Scott E
authors.initials: SE
authors.lastname: Hadland
authors.affiliation: Division of Adolescent and Young Adult Medicine, Boston Children's Hospital, Boston, Massachusetts; Department of Pediatrics, Harvard Medical School, Boston, Massachusetts; The Channing Division of Network Medicine, The Brigham & Women's Hospital and Harvard Medical School, Boston, MA; Department of Social and Behavioral Sciences, Harvard School of Public Health, Boston, Massachusetts.
authors.forename: S Bryn
authors.initials: SB
authors.lastname: Austin
authors.affiliation: Department of Elementary and Secondary Education, Commonwealth of Massachusetts, Malden, Massachusetts.
authors.forename: Carol S
authors.initials: CS
authors.lastname: Goodenow
authors.affiliation: Division of Adolescent and Young Adult Medicine, Boston Children's Hospital, Boston, Massachusetts; Department of Pediatrics, Harvard Medical School, Boston, Massachusetts.
authors.forename: Jerel P
authors.initials: JP
authors.lastname: Calzo
mesh_terms: D000293:Adolescent; D000294:Adolescent Behavior / Q000523:psychology; D001727:Bisexuality / Q000523:psychology*; D001828:Body Image / Q000523:psychology*; D001835:Body Weight; D001068:Feeding and Eating Disorders / Q000453:epidemiology* / Q000523:psychology; D005260:Female; D006716:Homosexuality / Q000523:psychology*; D006801:Humans; D008297:Male; D012649:Self Concept; D015431:Weight Loss
keywords: Adolescent; Eating disorders; Obesity; Overweight; Sexuality