UC San Diego

Objective: Body image concerns are associated with health outcomes such as eating disorders and body dysmorphic disorder. Sexual minority populations have demonstrated a disproportionate risk for body image concerns. Additionally, both thinness and muscularity-oriented body image concerns are salient in men and women and are independently associated with body image disorders. Therefore, varying body image concern patterns may demonstrate independent pathways towards the development of body image disorders. A better understanding of heterogeneity in body image concerns and their association with body image disorders and associated health risk behaviors in sexual minority men and women is, therefore, needed. Methods: Study 1 and Study 2 examined the factor structure and measurement invariance, by gender, of self-report measures of disordered eating (Eating Disorder Examination-Questionnaire; EDE-Q) and drive for muscularity (Drive for Muscularity Scale; DMS), respectively. Study 3 explored the heterogeneity in body image concerns and associations with body image disorder symptoms, using latent profile analysis. All studies utilized the same samples of young adult sexual minority men (n = 479) and women (n = 483). Results: Studies 1 and 2 indicated factorial validity and measurement invariance by gender of the DMS and EDE-Q models. Study 3 revealed a 5-profile solution in men and a 4-profile solution in women, characterized by varying levels of both thinness and muscularity concerns. In both men and women, disordered eating and dysmorphic concern were highest when thinness concerns were high, regardless of muscularity concern. Moreover, in both men and women, high muscularity concern profiles demonstrated the highest levels of muscle-building behavior, and profiles with both high or moderate thinness and muscularity concerns demonstrated the highest probabilities of past year illicit appearance and performance enhancing drug misuse. Conclusion: Studies 1, 2, and 3 used psychometric and mixture modeling techniques to better characterize both body image concerns and body image disorders. Results from Study 3 further demonstrated that particular body image concern profiles, varying in levels of both thinness and muscularity concerns, may be at higher risk for greater disordered eating, muscle-building, and body dysmorphic concerns. Study findings have implications for prevention and treatment for body image disorders.