Disparities in Weight and Weight Behaviors by Sexual Orientation in College Students

Abstract

In 2011, the Institute of Medicine highlighted the significant lack of research on the health of lesbian, gay, and bisexual (LGB) groups.1 Research has indicated that LGB adults experience worse health outcomes than their heterosexual peers. 2---11 These disparities may be attributable to an array of factors, including stigmatization, stress, and limited access to and use of health services. 1,12,13 Furthermore, much of the work in this area to date has not focused on the college years. Because nearly half of US high school graduates up to age 24 years are enrolled in postsecondary education, 27 colleges and universities offer unique environments for addressing health disparities among young people, including those of LGB students. For many, the college years represent a time during which health disparities emerge 28,29 and adverse changes occur in weight, dietary quality, physical activity, and other behaviors. 30---38 For LGB people, this age is commonly when sexual identity is declared and assimilation into the LGB community occurs. 39 Important postsecondary institutions that could act as platforms for intervention delivery include not only traditional 4-year universities but also 2-year community and technical colleges, which serve millions of students, particularly those from lower income and minority backgrounds. 40,41The objective of this study was to characterize gender-specific weight-related disparities among college students by sexual orientation. We analyzed state survey data of nearly 34 000 students attending a wide array of 2-and 4-year colleges and universities in 2007 to 2011, including a subsample of more than 2000 LGB-identified and LGB-questioning participants. This research was intended to fill several gaps in the literature. For example, although a recent wave of studies 11, 19,22---25 were published after the release of the Institute of Medicine report, 1 most of these studies used data from 1999 to 2007 and thus were not able to characterize disparities during the past 5 to 8 years (when important societal shifts in weight-related factors 42,43 and social shifts regarding LGB issues occurred). Moreover, a majority of these studies focused not on the college years but rather on adulthood overall (e.g., 18---74 years) or on adolescence (e.g., 9th---12th grade). Finally, only a small number of studies have examined population-level LGB disparities in dietary intake or physical activity, 11,20,25,26 which are critical factors to address in weight-related intervention strategies.Among the few population-based studies that have addressed diet and activity, unidimensional indicators have been used to assess fruit and vegetable consumption or moderate to vigorous intensity physical activity, but these studies have generally lacked characterization of other important dietary factorsObjectives. We assessed disparities in weight and weight-related behaviors among college students by sexual orientation and gender.Methods. We performed cross-sectional analyses of pooled annual data (2007-2011; ...

College Women's Weight-related Behavior Profiles Differ by Sexual Identity

“…To ensure that participants were not included in the dataset more than once and to maximize sample size, a college’s second year of data was included when the possibility of overlap in participants was expected to be negligible (ie, less than 2%), as others and us have done previously. 33,36,37 Six schools with a sampling percentage of less than 50% (ie, less than 50% of the student body were invited to participate in the survey) had a negligible percentage of overlap (estimated sample overlap range: 0.45%–1.57%). Thus, an additional year of data was included for these schools (N students = 6912).…”

“…This categorization is consistent with previous research using the Youth Risk Behavior Survey (YRBS) 37 and CSHS data. 33 …”

“…33 Other studies using longitudinal cohort data also found disparities across sexual orientation in unhealthy weight control behaviors and physical activity from adolescence into emerging adulthood. 15,34 However, none of these studies has explored the patterning of weight-related behaviors.…”

Youth experiences with multiple types of prejudice‐based harassment

“…Students who self-identified as heterosexual and also reported same-sex experience were categorized as "discordant heterosexuals" based on prior evidence that the health profile of discordant heterosexual youth is more similar to non-heterosexuals than to heterosexuals (Cochran & Mays, 2007Corliss, Goodenow, Nichols, & Austin, 2011;Laska et al, 2015).…”

Emotional Health of Lesbian, Gay, Bisexual and Questioning Bullies: Does It Differ from Straight Bullies?

“…Because many in this age group were not yet sexually active with a partner, preference was given to sexual identity for defining groups. Students who described themselves as heterosexual but also reported same-sex sexual experience were categorized as ''discordant heterosexuals,'' based on previous research demonstrating that the health profile of this group is more similar to non-heterosexuals than to heterosexuals Mays 2007, 2009;Corliss et al 2011;Laska et al 2015). Lesbian, gay, bisexual, questioning and discordant heterosexual youth are referred to here as LGBQ.…”