The prevalence of psychiatric disorders, such as major depression and anxiety, is higher in sexual minority individuals (eg, those who identify as gay, lesbian, or bisexual or are unsure of their orientation) than heterosexual individuals. Eating disorders and alcohol use also are more common in sexual minority groups, yet the extent to which they co-occur in these individuals is limited. The co-occurrence of eating and alcohol use disorders results in increased morbidity than either disorder alone and increased mortality for eating disorders. Extant studies have primarily included young women (for whom sexual identity is not assessed), suggesting that binge eating and inappropriate compensatory behaviors (eg, self-induced vomiting, diet pill misuse, and fasting) are key symptoms contributing to the co-occurrence, regardless of the primary eating disorder diagnosis. Despite its severity, treatment settings frequently overlook eating disorder and alcohol use co-occurrence and no empirically supported treatments exist to treat the disorders when they occur simultaneously. This is problematic because decreasing symptoms for one behavior might increase the presence or frequency of symptoms for the other disorder. One way to provide useful information for the treatment of eating disorder and alcohol use co-occurrence is to examine these associations within more homogeneous groups, ultimately identifying group-specific risk factors.