Sexual abuse, sexual orientation, and obesity in women.
BACKGROUND
Among adult women an association between childhood sexual abuse (CSA) and obesity has been observed. Research with lesbian women has consistently identified high rates of obesity as well as frequent reports of CSA, but associations between sexual abuse and obesity have not been fully explored. Our aim was to investigate the relationship between sexual abuse (SA) history and obesity among heterosexual (n = 392) and lesbian (n = 475) women (age 35-64) who participated in the Epidemiologic STudy of HEalth Risk in Women (ESTHER) Project in Pittsburgh, Pennsylvania.


METHODS
Obesity was defined as body mass index (BMI) > or =30. Covariates included self-reported SA, sexual orientation, demographic factors, and history of a depression or anxiety diagnosis. SA history was assessed by three factors: (1) SA experienced under the age of 18 by a family member or (2) by a nonfamily member and (3) forced, unwanted sexual experience(s) at age > or =18. Data were analyzed using chi-square tests and logistic regression models.


RESULTS
Multiple logistic regression analyses revealed that obesity was associated with African American race, lesbian sexual orientation, intrafamilial CSA, and history of mental health diagnosis. Protective factors were having a household income of at least $75,000 and having a bachelor's degree or higher.


CONCLUSIONS
Results suggest that lesbian women may be at greater risk of obesity than heterosexual women and that intrafamilial CSA--regardless of sexual orientation--may play a role in the development of obesity.
University of Pittsburgh, Graduate School of Public Health, Pittsburgh, Pennsylvania, USA. smithha@upmc.edu
Helen A
HA
Smith
Nina
N
Markovic
Michelle E
ME
Danielson
Alicia
A
Matthews
Ada
A
Youk
Evelyn O
EO
Talbott
Cynthia
C
Larkby
Tonda
T
Hughes
D000328:Adult; D001741:Black or African American; D000368:Aged; D015992:Body Mass Index; D002648:Child; D002650:Child Abuse, Sexual; D003430:Cross-Sectional Studies; D005260:Female; D018452:Homosexuality, Female; D006801:Humans; D016015:Logistic Models; D001523:Mental Disorders / Q000175:diagnosis; D008875:Middle Aged; D009765:Obesity / Q000208:ethnology / Q000209:etiology*; D012307:Risk Factors; D012742:Sex Offenses; D012959:Socioeconomic Factors; D044465:White People