Exploring the relationship between obesity and sexual risk behaviors among adolescent males

Background: Obesity rates among U.S. children continue to rise. Overweight girls report engaging in more sexual risk behaviors. Little research has explored the relationship between weight and sexual risk behaviors among adolescent males. Objective: We examined whether 3 weight indices predict sexual risk behaviors among U.S. adolescent males. Methods: We analyzed data from 8,065 high school attending males who completed the 2009 Youth Risk Behavior Surveillance survey. We used multivariate logistic regression to examine predictors of 6 sexual behaviors: ever had vaginal sex; sex before age 13 years; >4 lifetime sexual partners; and alcohol use, condom non-use, and contraceptive non-use at last sex. Covariates included age, race/ethnicity, history of intimate partner violence, body mass index (BMI), perceived weight, weight misperception (mismatch between BMI and perceived weight), sports team participation, disordered eating behaviors, and substance use. Results: BMI, weight perception, and weight misperception did not predict adolescent males' reports of having ever had sex, sex before age 13 years, > 4 lifetime sexual partners, condom or contraceptive non-use at last sex. BMI, weight perception, and weight misperception were associated with reports of alcohol use at last sex. Males with a low BMI or who misperceived themselves as underweight were less likely to report alcohol use at last sex. Those who were overweight or who perceived themselves as underweight were 5 times more likely to report alcohol use at last sex. Conclusions: Similar to studies among adolescent women, weight status (whether real or perceived) influences adolescent males engagement in sexual risk behaviors.