In Reply Drs Nguyen and Margo raise an important point that issues of muscularity and body dissatisfaction may be heightened in certain subpopulations of men, particularly those who are gay or bisexual. We agree with the concern they raise about media images targeting gay audiences as a potential influence.
We have seen similar disparities in our own work with adolescents and young adults.1,2 In a large survey of 2- and 4-year college students, men who identified as gay, bisexual, or not sure of their sexual orientation or who were classified as “discordant heterosexuals” (ie, identified as heterosexual yet reported same-sex partners) had significantly higher rates of unhealthy weight control behaviors, binge eating, and dissatisfaction with their body image or size compared with their heterosexual counterparts.2 These findings highlight the differences described by Nguyen and Margo even within the population of sexual minority males by including those with discordant identity and behaviors, as well as those who are not sure of their sexual orientation.
Eisenberg ME, Neumark-Sztainer D. Male Body Image and Weight-Related Disorders—Reply. JAMA. 2015;313(8):856-857. doi:10.1001/jama.2015.433