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Disparities in body mass index of women by sexual orientation

Pokrzywinski, Robin (2016) Disparities in body mass index of women by sexual orientation. Doctoral Dissertation, University of Pittsburgh. (Unpublished)

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Background: Obesity is a leading health indicator with larger body size associated with increased all-cause mortality. Sexual minority women (SMW) are reported to have higher body mass index (BMI) than heterosexual women.

Aims: The three aims of our research were to: 1) identify if, and what, differences exist in dietary intake of women by sexual orientation (SO); 2) investigate dietary consumption as a potential mediator between SO and BMI; and 3) explore current depression as a mediator with the sample stratified by lifetime history of depression.

Methods: This secondary analysis utilized Epidemiologic STudy of HEalth Risk in Women (ESTHER) Project data. Group comparisons were made between the SO groups for dietary intake from three-day food diary data. With SO as the predictor and BMI as the outcome, three models were tested: 1) total caloric intake as a mediator; 2) macronutrients (mean daily grams of: fat, carbohydrates, protein, and alcohol) as parallel mediators; and 3) current depression as a mediator with the ESTHER sample stratified by lifetime history of depression.

Results: SMW had significantly higher BMI than heterosexual women. Even after adjusting for education level and parity, SMW had higher daily consumption than heterosexual women of: caloric intake; total fat; total monounsaturated fatty acid; and total polyunsaturated fatty acid. Alcohol intake was significantly higher for SMW than heterosexual women but not after adjusting for education and parity. Total caloric intake and fat intake partially mediate the association between SO and BMI even when covariates are held constant (age, education, smoking status, physical activity). SMW had significantly higher rates of lifetime history of depression than heterosexual women. We did not find evidence that current depression mediates the relationship between the SO of women and BMI. We found that women with no lifetime history of depression did not have a significant association between the sexual orientation of women and BMI.

Conclusion: Our findings are of public health significance to this minority population. Research has traditionally concluded that SMW are disproportionately more overweight and obese than heterosexual women. We explored the influence of dietary intake and depression to help explain BMI differences.


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Item Type: University of Pittsburgh ETD
Status: Unpublished
CreatorsEmailPitt UsernameORCID
Pokrzywinski, Robinrmf45@pitt.eduRMF45
ETD Committee:
TitleMemberEmail AddressPitt UsernameORCID
Committee ChairMarkovic, Ninaninam@pitt.eduNINAM
Committee MemberBromberger,
Committee MemberEvans,
Committee MemberMichael , Marshalmarsmp@UPMC.EDU
Committee MemberAda,
Date: 29 June 2016
Date Type: Publication
Defense Date: 20 April 2016
Approval Date: 29 June 2016
Submission Date: 31 March 2016
Access Restriction: No restriction; Release the ETD for access worldwide immediately.
Number of Pages: 132
Institution: University of Pittsburgh
Schools and Programs: School of Public Health > Epidemiology
Degree: PhD - Doctor of Philosophy
Thesis Type: Doctoral Dissertation
Refereed: Yes
Uncontrolled Keywords: sexual minority women, body mass index, dietary intake, depression
Date Deposited: 29 Jun 2016 17:41
Last Modified: 15 Nov 2016 14:32


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