Resilient Minds and Bodies: Body Size, Body Image, Discrimination, and Mental Health among Sexual Minority Women

Introduction: Discrimination threatens the health of sexual minority women (SMW) with high body mass index (BMI).  Despite research indicating that on average SMW have higher BMI than heterosexual women, few have examined how size-discrimination and body image are associated with the mental health of SMW.  Guided by Resilience Theory, we sought to fill this gap by assessing a process of stress and coping among SMW who experienced size- discrimination.   

Method: We used data from the Michigan Smoking and Sexuality Survey, a cross-sectional study of young (age 18-24) SMW (n=232).  Using multivariate linear regression, we evaluated the deleterious effects of discrimination on depressive symptoms and self-esteem, respectively.  Then, we examined the role of body image in this process via three models of resilience: 1) compensatory (the main effect of body image bolsters health), 2) protective (body image buffers the effects of discrimination), and 3) protective-stabilizing (levels of body image reduce or amplify the effects of discrimination).  In all models, we adjusted for race/ethnicity and sexual identity.

Results: Both compensatory models were significant (depressive symptoms [F=5.99, p<.001]; self-esteem [F=6.96, p<.001]).  Each additional experience of discrimination was associated with increases in depressive symptoms (b=.13) and self-esteem (b=.09), respectively. Conversely, greater body image was associated with fewer depressive symptoms (b=-.22) and greater self-esteem (b=.41).   No interaction effects were significant.

Discussion: We discuss body image as a compensatory asset available to SMW to counter the mental health consequences of size-discrimination, and offer recommendations about how to bolster psychosocial assets and reduce size-discrimination among young SMW.