Psychosocial factors of obesity among heterosexual and lesbian women

Understanding how obesity-related psychosocial factors vary by sexual orientation could explain why lesbians may be at greater risk for becoming obese than heterosexual women, and aid in the development of successful weight-loss programs for lesbians. Our objective was to examine the association between obesity and psychosocial factors (discrimination, depression, sexual abuse history, hostility, optimism and social support) in a community sample of self-identified heterosexual (N=400) and lesbian women (N=479), and to identify the psychosocial factors specifically associated with obesity among lesbians. Secondary data analysis was performed on information collected through the Epidemiologic Study of Health Risk in Women (ESTHER) Project, a cross-sectional study of women ages 36 to 64 in Pittsburgh, PA (2003-2006). Bivariate and multivariate logistic regression analyses were used to determine associations between obesity, psychosocial factors and sexual orientation. Obesity was defined as having a body mass index (BMI) >30. Psychosocial instruments used included: Experiences of Discrimination, The Center for Epidemiologic Studies Depression Scale, Cook Medley Hostility Scale, Life Orientation Scale and Interpersonal Support Evaluation List. Lesbians had a significantly higher rate of obesity than heterosexuals (40% vs. 30%, p<0.001). Except for mean number of experiences of discrimination (p<0.0001), there were no significant differences in mean psychosocial scores between obese lesbian and heterosexuals. Among lesbians, after adjusting for covariates, increasing experiences of discrimination (<0.0001) and having a history of sexual abuse (p<0.001) were associated with obesity. Findings suggest that lesbians have different patterns of obesity-related psychosocial factors than heterosexual women, demonstrating the need for lesbian-specific weight loss programs.