摘要：Objective. We sought to determine whether lesbians have higher rates of overweight and obesity than women of other sexual orientations. Methods. We compared population estimates of overweight and obesity across sexual orientation groups, using data from the 2002 National Survey of Family Growth. Results. Adjusted multinomial logistic regression analyses showed lesbians have more than twice the odds of overweight (odds ratio [OR]=2.69; 95% confidence interval [CI]=1.40, 5.18) and obesity (OR=2.47; 95% CI=1.19, 5.09) as heterosexual women. Bisexuals and women who reported their sexual orientation as “something else” (besides heterosexual, lesbian, or bisexual) showed no such increase in the odds of overweight and obesity. Conclusions. Lesbian women have a higher prevalence of overweight and obesity than all other female sexual orientation groups. This finding suggests that lesbians are at greater risk for morbidity and mortality linked to overweight and obesity. This finding also highlights the need for interventions within this population. Obesity has reached epidemic proportions in the United States. 1 , 2 Healthy People 2010 identified obesity and overweight as an important public health concern, and a reduction in the rate of overweight and obesity is 1 of the 10 leading health indicators. 1 The causes of obesity are still not entirely understood. This chronic disease is linked to complex social, behavioral, cultural, physiological, metabolic, and genetic factors. 3 Previous research efforts have not considered sexual orientation as a possible risk factor for obesity, despite evidence that suggests lesbians have higher rates of overweight and obesity. 4 – 8 The reasons for lesbians’ overweight and obesity have not been thoroughly explored. 9 Studies suggest that differences in obesity rates by sexual orientation may be because of the variance in social, behavioral, and cultural norms by sexual orientation groups. It has been suggested that lesbians are less likely to consider themselves overweight compared with women in the general population. 5 A few studies, using convenience samples, explored the unique factors that may contribute to overweight and obesity in lesbians. 9 – 11 The results of these studies indicate that lesbian women have a better body image than do heterosexual women and pri-oritize a body image on the basis of physical function. 12 – 16 The evidence is inconclusive regarding lesbians’ exercise behaviors. It has been argued that lesbians are heavier, but more physically fit, because of their level of physical activity. 6 , 17 One study has disputed that lesbians’ exercise behavior explains their greater body mass index (BMI). 10 Other studies have emphasized that lesbians’ exercise behavior is not motivated by aesthetic reasons. 12 , 15 , 18 Although these smaller studies provide possible explanatory factors regarding obesity in lesbians, they do not adequately consider covariates shown in the literature to be risk factors for overweight and obesity. For women in the US general population, the correlates of obesity are increasing age, low education, or low economic status. 2 , 19 – 21 Black and Hispanic women have higher rates of overweight and obesity than do White women. 2 , 22 – 24 Among White, Black, and His-panic women, childbearing has been linked to weight gain. 25 – 29 Nativity has also been identified as a correlate of excess body fat: immigrants tend to have a lower BMI; however, this health advantage disappears as the length of residence in the United States increases. 30 – 36 Existing treatments and interventions focus on reducing energy intake by changing nutritional habits and increasing physical activity. 37 Because obesity is particularly prevalent in Black and Hispanic women, several interventions have targeted these specific groups. 38 – 40 By comparison, there are no interventions that target sexual-minority women. Whether a need for interventions that specifically target sexual-minority women exists depends on the confirmation that lesbians have a higher prevalence of overweight and obesity compared with other sexual orientation groups. We used population-based data to test the hypothesis that lesbians have higher rates of overweight and obesity compared with women of other sexual orientations. We have responded to the call for population-based studies to determine health disparities that was issued in the Institute of Medicine’s Report on Lesbian Health 41 and in the Healthy People 2010 Companion Document for Lesbian, Gay, Bisexual and Transgender (LGBT) Health . 42
