“Lesbians had a significantly higher body mass index, waist circumference,
and waist-to-hip ratio than their sisters,” say Stephanie A. Roberts,
M.D., and colleagues. This pattern of extra abdominal weight is one element
of the metabolic syndrome, a group of symptoms that increase risk for cardiovascular
disease.
Other risk factors, like smoking and exercise frequency, were similar in the
two groups of women. Diet did not vary significantly between the lesbians and
their sisters, except that the lesbians ate less red meat. Roberts suggests
that attitudes about weight may partially explain the differences but also
may complicate weight reduction efforts.
Roberts, a physician in private practice, and her colleagues from the School
of Nursing at the University of California, San Francisco, surveyed 324 lesbians
living in California and an equal number of their heterosexual sisters closest
in age. Their work reflects previous studies that show lesbians have a higher
body mass index (a ratio of weight to height used to define overweight and
obesity) and are less concerned about weight issues than heterosexual women.
In general, Roberts found that the lesbians surveyed were about a year older
(49.7 years vs. 48.9 years), more educated (17.5 years vs. 15.4 years) and
more likely to be employed fulltime (70 percent vs. 56 percent), compared to
their sisters.
On average, neither group fell into the ideal weight range. Both lesbians
and their sisters had body mass indexes over 25, a level that is associated
with increased risk for high blood pressure, coronary heart disease and severe
chest pain.
The lesbians’ waist circumference measurements and waist-to-hip ratios
were near or above cutoff marks for cardiovascular risk, says Roberts. They
also had a higher rate of weight cycling — gaining, losing and regaining
weight.
“Weight cycling has been associated with increased risk for cardiovascular
disease,” says Roberts.
The origin of these differences is unclear. Previous research has shown that
in addition to being less concerned about weight, lesbians are less likely
to perceive themselves as overweight, even when they are.
Roberts and her colleagues drew
two conclusions from their study. They recommend a second round of research
that would include not just self-performed measurements
of height, weight and waist size, but also an unbiased observer’s measurements
of those factors, as well as of blood pressure, triglyceride, HDL and LDL cholesterol,
and glucose levels. Tracking these diagnostic factors might provide insight
into lesbians’ vulnerability to the metabolic syndrome.
They also suggest that programs designed to reduce cardiovascular risk among
lesbians should focus on decreasing their added weight around the middle of
the body. Since heterosexual and lesbian women differ in their attitudes toward
weight, generalized educational messages might be seen as irrelevant by lesbians.
A more specific strategy may be needed, they say. This might begin by understanding
how lesbians view the issue of overweight.
“Weight control is often perceived as a conventionally feminine behavior,” says
Roberts. “A strategy that de-emphasizes traditional feminine values
may be the most effective for lesbians.”
