New England Psychologist
November 2017

The statistics for eating disorders in the LGBTQ community are unsettling. According to the International Journal of Eating Disorders, 42 percent of men with this issue identify as gay or bisexual. The National Eating Disorder Association (NEDA) states that gay, lesbian, and bisexual people report binge-eating and purging as young as 12-years-old.

Many seeking treatment for an eating disorder also have a co-occurring disorder – anything from anxiety and depression to obsessive-compulsive disorder or posttraumatic stress disorder.

Statistics from the National Center on Addiction and Substance Abuse also show that up to 35 percent of people who abuse alcohol or drugs have an eating disorder, compared with 3 percent of the general population.

That’s where places like Walden Behavioral Care come in. With facilities in Massachusetts, Connecticut, and Georgia, they have specific treatment programs for the LGBTQ community with eating disorders.

They are the first facility based in New England to specifically treat this problem. Treating such conditions as anorexia, bulimia, binge-eating, orthorexia, avoidant and restrictive and other specified feeding and eating disorders, Walden addresses a “whole person approach” for both adults and adolescents.

Each campus location has either residential or outpatient treatment programs in one capacity or another. The Amherst location does not have a residential program, but it does have partial hospitalization and intensive outpatient sessions. They tend to see more adolescents than adults because of their proximity to colleges in the area.

Joanna Imse, MSW, LICSW, assistant program director at Walden’s Amherst campus, explained the goals of the program are to create “psychological scaffolding” for patients to begin their recovery. For some, the process may take less time than others. But for the LGBTQ community, an eating disorder may just be the tip of the iceberg.

“There is such limited data in the research on the LGBTQ community,” she said. “A significant number have eating disorders. But the ‘why’ is multi-layered.”

Social pressure and body dissatisfaction play a role. But when you feel like the body you have is not the body you need, controlling how it looks by starving yourself can change that. It’s not easy altering that mentality.

“Validation is a key component in trying to change that thought process,” said Imse. “If we say, ‘this is what you should do,’ we’re going to lose them. You’ve got to tell them you hear them and understand and let’s talk about how this is serving you.”

She said most people don’t come in planning to change every issue all at once. There’s an unpacking of problems and the priority is in dealing with the biggest issue first.

Troy Roness, Ed.M, MS, is an eating disorder advocate, speaker, author and member of the Junior Board at NEDA. He is also nine years into his recovery from having an eating disorder.

He didn’t think he had a problem until his body started shutting down. Due to his restricted food intake and excessive exercise he had a heart attack, his liver and kidneys weren’t functioning properly and he had several stress fractures. He was 22.

Now at 31, the disorder doesn’t affect him physically as it once did, but he still struggles emotionally. Roness said his faith and his sexual orientation are something with which he will always struggle. The belief that faith is good but sexual feelings are bad combined with a dysmorphic body view can be the catalyst that leads many down an unhealthy path as it did for him.

“Biology loads the gun,” said Roness, “but your environment pulls the trigger.”

Imse echoed his viewpoint that it’s difficult to maintain a healthy lifestyle if you feel like there’s something wrong with you. Along with medical stabilization and framing the family support network, the road to recovery is addressing those deep-seated issues.

“Acceptance is a lot of what we do,” she said of Walden’s treatment plan. “It’s the psychology behind how we help them feel safer in the body they have.”