Relationships between body size and sexual behavior in women

Body size influences women's social and sexual health experiences. Because of weight stigma, women of larger body size are often assumed to have fewer and narrower sexual experiences and may receive substandard sexual health care based on these beliefs. Research conducted on women in clinical weight-loss settings reveals mixed associations between body size and sexual behavior, but studies of women not involved in weight-loss trials are lacking. Sexually-active women (n = 238) between the ages of 18-56 completed an online survey measuring age, sexual relationship status, BMI, gender of sexual partners and sexual behaviors in the previous four weeks. Participants were predominantly in exclusive relationships (62.9%, n = 146) with men (82.8%, n = 197), and had a mean BMI of 29.33 (SD = 9.28). Logistic regression analyses were conducted to determine whether BMI predicted engagement in sexual behaviors after controlling for age and relationship variables. Results indicate that participation in self- and partner masturbation, performing or receiving oral sex, and penile-vaginal intercourse were not predicted by BMI. Odds of participation in penile-anal intercourse increased by a factor of 1.1 (95% CI: 1.01, 1.09) for one unit increase in BMI. In this sample, body size did not have a relationship with previous four weeks' sexual repertoire, with the exception of penile-anal intercourse. Therefore, practitioners working with women should not assume the range of women's sexual behaviors because of body size. Practitioners should consider a weight-neutral, sexual health for every size approach, which promotes healthy sexual behavior rather than weight loss.