(PS7-62) Investigating the Importance of Household Income on Eating Disorder Symptoms in Sexual and Gender Minority Individuals

Sexual and gender minorities (SGM) have been found to be at greater risk of developing eating disorders (EDs) and disordered eating behaviors when compared to their cisgender heterosexual peers (Nagata et al., 2020). The relationship between socioeconomic status (SES) and EDs is less clear. Historically EDs were thought to be “diseases of affluence” (Huryk et al., 2021), but contemporary research indicates that EDs occur across the socioeconomic spectrum (Barakat et al., 2023) and some studies suggest that the prevalence of EDs is higher in individuals of lower SES (Burke et al., 2023). While SES and SGM status have been examined separately in relation to EDs, there is a significant gap in ED literature regarding their intersection. This study (N=115) examined the intersection between SGM status and SES on ED symptomology in a sample of adults (ages 19-64) from across the United States who met criteria for either anorexia nervosa (AN), bulimia nervosa (BN), or OSFED-atypical AN (AAN). Participants completed measures of demographic information and ED symptomology. The Eating Disorder Examination Questionnaire (EDE-Q) and Eating Disorder Fear Questionnaire (EFQ) captured ED symptomology. Approximately 36% of the sample identified as SGM. Based on methodology from Mikhail et al. (2023), household income was used as a proxy for SES. Participants reported their income on an 8-point Likert scale from < $20,000 to >200,000 and were divided into 2 groups: lower household income (LHI; n=72) and higher household income (HHI; n=43) based on the median household income ($74,580) defined by the US Census Bureau. Independent samples t-tests were used to analyze the differences in ED symptoms by SGM status and median household income. A Bonferroni correction was applied, and the alpha level adjusted to α=0.005. One-way ANOVA was then used to compare the mean scores on the previously mentioned scales in 4 groups: LHI, NSGM (n=39); LHI, SGM (n=33); HHI, NSGM (n=35); and HHI, SGM (n=8). Results revealed no significant differences in EDE-Q and EFQ scores between groups on both t-tests and the ANOVA. While not significant (p=0.024), there was a moderate effect size (d=.446) between the SGM group (M=4.28) and the NSGM group (M=4.96) on the EFQ’s Fear of Social Eating subscale. These findings support the idea that ED symptoms are present across the SES spectrum and not limited to those of higher SES, although a limitation of the study is that 64.3% of the sample were below the US median household income. Results also suggest that household income does not compound SGMs’ likelihood to endorse ED symptomology. Clinically, this outcome reinforces the need to improve access to ED services for marginalized individuals, such as those who identify as SGM and those of lower SES. Also, the finding that SGM participants showed lower fear of social eating than NSGM participants, while non-significant, may indicate a point of resilience in SGM populations. Future research should examine the role of SGM status in fear of social eating.