Finding a 'Healthy Weight' in Lesbian and Bisexual Communities

Every year, the US Census Bureau and the Centers for Disease Control and Prevention administer the National Health Interview Survey to help track the health of the various demographic groups that make up the county's population. But it wasn’t until 2013 that the survey included questions about sexual orientation.

One finding that emerged was that lesbian and bisexual women are more likely to be obese than their heterosexual counterparts. Jane McElroy, associate professor of Family and Community Medicine at the University of Missouri-Columbia, is the first to publish research on interventions to specifically address the issue. Her study was published in the current issue of Women’s Health Issues.

We know that lesbian and bisexual women, as a group, have a higher prevalence of overweightness. And we think that part of that has to do with—there's an acceptance of a larger body size in the culture. And also associated with that acceptance, there is a sense of feeling okay about your body size, and also feeling good about yourself—better self esteem. 

On the one hand that seems really positive, and on the other hand it seems like it could mean that there are some health issues?

That's the conundrum. Is body size really what's important? What we were interested in looking at was a healthy weight. So we define that as a body size in which you're physically and mentally healthy. So that healthy weight is really what's important. So, whatever body size you are, can you be healthy at that weight? And that's what we wanted to look at and have more information on. 

What were the outcomes you were looking for? 

We looked at meaningful changes, not just small changes. Meaningful change in physical activity—number minutes that you're physically active. We looked at increasing fruit and vegetable consumption. We looked at decrease of alcohol consumption, decrease of sugar-sweetened beverages [consumption]. And improvement of quality of life in that mental and physical sense of how you feel. 

And then as two other pieces that weren't the focus but that we collected data on: looking at weight and weight height ratio. 

Was there a reason you didn't make weight the focus?

The community [of lesbian and bisexual women] is not very interested in getting on a scale and saying that you're healthy or you're not healthy. If you have larger body size, but you have no risk factors—your blood pressure is fine, your triglycerides are fine, your diet, your glucose is fine—if you have no risk factors and you're heavier, what's the problem?

So I think we were more interested in looking at healthy weight. How do you feel good at the size you are? I think this transcends all populations—it's not just for the lesbian and bisexual community—but for a lot of women, as you get older, you don't look like what you looked like at 16. And a lot of women, they're okay with that. But they want to be okay with that at a healthy weight. 

In addition to those you're looking at three different types of interventions. 

Yes. We looked at mindfulness approach—being thoughtful about what you did. We looked at pedometer use, the smart pedometers, the FitBits, using those. And then we looked at gym membership and personal trainers. 

And what did we learn? Was one intervention more effective than another?

Yes. We found that for improving minutes of physical activity, that mindfulness and the predominant groups were much better at improving total number of physical activity minutes, at improving those by 20 percent. And we found that the gym was better at improving waist to height ratio. 

Were there people who fared better than others? 

We had 95 percent of our participants achieve at least one of our goals, so in that regard is I would say no, not really. Everybody fared phenomenally on the study. It seemed to speak to a lot of different women on a lot of different levels. And one of the take home messages is looking at healthy weight and allowing women to have autonomy to choose how they want to achieve that healthy weight. I think was the strength of the study.

This story was produced by Side Effects Public Media, a news collaborative covering public health.