This cross-sectional study examined how compassionate self-responding (CSR) and uncompassionate self-responding (USR) relate to—and moderate the link between depressive symptoms and—loss of control (LOC) eating and compensatory behaviors in 915 racially/ethnically diverse sexual and gender diverse (SGD) adults in the USA (mean age 36.7 years), using data collected via Qualtrics Panels in 2021.
USR was strongly associated with more frequent LOC eating across the full sample and all SGD subgroups (IRR = 1.97, p = 0.001) and with compensatory behaviors in sexually diverse cisgender women (IRR = 1.25, p = 0.02). CSR was generally not associated with either disordered eating behavior. Unexpectedly, **high CSR exacerbated** (rather than buffered) the link between depressive symptoms and compensatory behaviors in the full sample (IRR = 1.01, p = 0.007) and in several subgroups (cisgender women, cisgender men, bisexual, and gay individuals).
- Cross-sectional design prevents causal or temporal inferences. - All measures were self-report, raising risk of common method bias. - Gender diverse subgroups were collapsed due to recruitment difficulties, and several racial/ethnic groups (Asian American, Pacific Islander, Indigenous) were absent.
In SGD patients presenting with disordered eating, targeting self-critical and isolating thought patterns (USR) may be more clinically useful than simply promoting self-compassion, as higher CSR did not reduce—and in some groups amplified—the depression–compensatory behavior link. Clinicians should assess USR specifically rather than relying on composite self-compassion scores when evaluating eating disorder risk in SGD populations.
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