In the midst of public health panic over obesity, a parallel concern about “fat” girls and their sexuality exists. In particular, the question that appears to be on many researchers’ minds these days is: “Are “fat” girls at higher risk of sexual dysfunction or STI/pregnancy risk than girls of average BMI (body mass index)?” One way that researchers have attempted to answer this question is by searching for statistical correlations between BMI, sexual behavior and self-esteem.
Indeed, several recent studies have focused on the relationship between body image or body size and sexual health, with a special concern around girls and women. For example, the authors of a recent study (Bajos et al., 2010) found links between obesity and “adverse sexual health outcomes” for both men and women, noting that obese women were less likely to access family planning, more likely to have unplanned pregnancies and less likely to consider sexuality an important part of their “personal life balance.” In a June 2010 interview for HealthDay News, Bajos went well beyond the reach of his data to make generalized comments about obese women:
“Being obese has a strong influence on people’s sexual life. Because of social pressure or social stigmatization, obese women are less likely to engage in sexual intercourse and more likely to find sexual partners via the Internet. Because of their obesity, they are not comfortable meeting men through friends, through work, through parties.”
In that same interview, Bajos made the assertion (despite any direct evidence from his data) that:
“a lot of these problems are driven by the stigmatization of obese women [because] these women are more likely to have low self-esteem.”
Beyond this particular study, researchers’ focus on female bodies and sexuality even occurs when larger cross-sectional studies survey both men and women about sexuality and sexual pleasure. Typically such studies describe associations between BMI and sexuality factors as measured by sexual attitude or behavior measure (Addofson et al 2004).
While the BMI measure is ubiquitous as an indicator of health, its measurement problems are numerous. For example, BMI does not account for the ratio of muscle and fat in bodies (e.g. why a bodybuilder or elite athlete could be labeled as overweight or obese) nor does it take into account a number of other important factors related to health beyond height and weight including cholesterol levels, blood pressure and family history of diabetes, all things commonly associated with obesity and poorer health (Burkhausera and Cawley, 2008).
Despite concerns over the adequacy of BMI as an indicator of health, BMI continues to be a popular measure in population-based studies of sexuality, sexual health and obesity. Another recent study that garnered press attention was led by Dr. Margaret Villers of Medical University of South Carolina. The study findings (based on data taken from the CDC’s Youth Risk Behavior Surveillance System, a large scale data set that gathers information of youth behaviors ranging from sexual behavior to substance use to violence) were presented at the 2010 ACOG conference in San Francisco under the title “Sexual Behavior in Obese and Overweight Adolescent Females.” The researchers found that overweight and obese girls were more likely to have sex before the age of 13, have three or more sexual partners during their teen years and were less likely to use contraception. Although the findings have yet to be peer reviewed, or published, the results have been taken up by a number of news outlets and sexual health blogs including the Black AIDS Institute and Kinsey Confidential, a sexual health blog from the Kinsey Institute for Research in Sex, Gender and Reproduction. Eric Grollman, a sociology doctoral student at Indiana University, had this to say about about the Villers study:
Given the link between weight and attractiveness – a societal standard of beauty that favors skinny bodies over fat bodies – some might find the study’s findings surprising: why are heavy girls having more sex with more partners? [In a press release from Dr. Villers’ university – see Brazell reference below], Dr. Villers and her fellow researchers provide two possible explanations for the difference in sexual behavior among teen girls: development during puberty and self-esteem. The researchers suggest that overweight and obese girls may begin puberty sooner and thus develop faster, which may put them at risk from more pressure from boyfriends and friends to have sex.
Since Villers’ study has yet to be published, reviewing the findings is a bit of a challenge. But the popularity of the initial report of the study by MSNBC reinforces a number of ideas about sexuality and obesity, and especially about the sexuality of girls and women: early puberty means more sexual activity and/or body shame, which leads to sexual pressure from partners. In the press release from her department at the Medical University of South Carolina, Villers points to the need for conversations about sexuality and safer sex regardless of what “daughters” weigh; at the same time Villers’ work presents a clear message about the dangers of not just female teenage sexuality but in particular of obese female sexuality.
Portrayals of overweight girls and women, both in mainstream media and by many health and sexuality researchers, seem to be making several assumptions. These include perceptions that obese women don’t deserve positive messages about their bodies or that these positive messages can only come from a (male) romantic partner (who is then demonized as pressuring the girl into sex). These messages speak to larger assumptions that obese girls/women are (and perhaps should be?) disempowered in terms of their sexuality.
These simplistic and fat-phobic assumptions point to how research about sexuality is often more productive when it is not limited to simple associations. Instead, qualitative or mixed methods research (where both statistical/survey and open-ended questions are asked of participants) allow for greater understanding of how social context impacts the meanings that girls and women attach to their bodies and their sexual behavior. For example, what kinds of positive or negative messages do overweight or obese girls receive about their bodies from romantic partners, friends, or family? How did those messages make them think about their sexuality, and how do they resist or incorporate these messages into their lives? For that matter, what messages about sexuality or sexual behavior did they receive, and which had the most salience? How did those messages impact their view of their bodies?
While correlational studies will have a continued and important presence in almost all types of research, especially in public health, when the focus is on sexuality or sexual health, perhaps we need to think beyond numbers. In order to better understand how bodies and emotions relate to each other in the context of human sexuality, research about body size and sexuality warrants a more varied approach.
Natalie Ingraham is a doctoral student in sociology at the University of California, San Francisco. She is interested in fat studies, embodiment and human sexuality.
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References and Recommended Readings
- Adolfsson, Birgitta , Stig Elofsson, Stephan Rössner and Anna-Lena Undén. 2004. Are Sexual Dissatisfaction and Sexual Abuse Associated with Obesity? A Population-Based Study. Obesity Research, 12, 1702–1709.
- Bajos, Nathalie, Kaye Wellings, Caroline Laborde, Caroline Moreau. 2010. Sexuality and obesity, a gender perspective: results from French national random probability survey of sexual behaviours. British Medical Journal, 340:c2573. Accessed online at: http://www.bmj.com/cgi/content/abstract/340/jun15_1/c2573
- Brazell, Dawn. 2010. “Obese teens more likely to have unsafe sex.” Press release. Accessed March 12, 2011. http://www.musc.edu/catalyst/archive/2010/co6-18teens.html
- Burkhausera, Richard V. and John Cawley. 2008. Beyond BMI: The value of more accurate measures of fatness and obesity in social science research. Journal of Health Economics. 27:2, 519-529.
- Grollman, Eric. 2010. Plus-Size Girls Are More Likely To Have Sex Early And Unprotected. Kinsey Confidential blog. Accessed at: http://kinseyconfidential.org/plus-size-girls-unprotected-sex-early/
- Reinberg, Steven . 2010. Obesity Can Take Toll on Sex Life. HealthDay News. ©2011 HealthDay Accessed at: http://www.healthfinder.gov/news/newsstory.aspx?docID=640149
- Rothman, K.J. 2008. “BMI-related errors in the measurement of obesity.” International Journal of Obesity (2008) 32, S56-S59.
- Simopoulos, Artemis P. 1986. “Obesity and Body Weight Standards.”American Review of Public Health, 7, 481-92
- Villers, Margaret S. . 2010. Sexual Behavior in Obese and Overweight Adolescent Females. Presented at the annual meeting of the American Congress of Obstetricians and Gynecologists (ACOG), San Francisco, CA, May 2010.
Comments 16
Sonya Satinsky — March 22, 2011
Natalie, this is fantastic. A really great critique of a lot of the research out there on fat and sex, and how indications of sexual activity among fat women necessarily are portrayed as negative. If there's no dialogue about whether or not women are finding this sexual activity pleasurable and enjoyable, then how can we characterize these behaviors as "adverse sexual health outcomes"?
I wish I had a citation to give you to add to this, but once I get something published, you know I will!
Elizabeth F — March 22, 2011
This was really interesting!
It got me thinking about PCOS as a possibly more scientific explanation than the ones provided by Bajos. While it wouldn't explain all sexual risk taking or all obesity, both high sex drive and obesity are associated with it and it can develop in adolescence. PCOS in adolescence could explain some obese young people with a strong desire for sex. Without education about safe sex or a PCOS diagnosis to explain that "why am I so horny when sex isn't what good girls are interested in" feeling, there could be more propensity for risk.
Again, totally unscientific, but that's where my mind went.
Kori Mclemore — March 24, 2011
I am disgusted by this. I am overweight, and was overweight in high school. I had my first sexual partner at age 16, and I always use a condom. Always have, always will. I don't think this study is going to help the sexual self esteem of overweight and obese adolescents. If you target young girls by saying, "fat girls are more likely to have more sex, at a younger age, with no protection, because they're fat and they have low esteem.", then wouldn't that just be reinforcing their 'low self esteem'? Every girl is worried about her body when she's in high school, but I would think the "hot" ones would be getting just as much sexual pressure as the "fat" ones. And regardless of size, every young girl is a beautiful special person and shouldn't be told otherwise by "fat sexuality" studies.
Katherine Martinez — March 25, 2011
Very interesting. I just completed my own dissertation work on self-objectification among consensual sadomasochists. A good proportion of my sample had high BMIs and explained their bodies as "larger than average," but also discussed their participation in SM communities as beneficial to their self-concepts. What would you say to perhaps publishing an article together?
les grosses, la sexualité et les sociologues… | l'énorme(s) blog — April 6, 2011
[...] voilà un article étatsunien intéressant, sur un blog universitaire de socio, sur les études (étatsuniennes, toujours) sur les grosses et leur sexualité. c’est en anglais, et si vous suppliez je vous le résume en français. body size, sexuality and girls: thinking beyond correlations [...]
[kinsey] Loving Your (Fat) Body Is Good For Your Health! « eGrollman — April 12, 2011
[...] in a 10-year national study that one’s subjective weight status predicts their health status — not their “actual” weight status (based on body mass index, or BMI). And, one’s subjective weight status as overweight or obese [...]
panicattack02 — March 27, 2012
Much appreciation for this article. Truly riveting and well written article. I will drop by again very soon.
It’s Time To Talk About Fatphobia | my sociology — June 6, 2013
[...] Beyond interpersonal interactions, there is a constant barrage of negative images in the media, coupled with the medical institution‘s obsession with obesity as a health problem. One of the most appalling things I saw in medical research was viewing positive body image in fat women (as though they are delusional) as a problem, specifically as a hindrance to them losing weight. Certainly perception of one’s body, specifically one’s weight, is a concern in terms of anorexia, bulimia, and other eating disorders. However, I find it troubling to view comfort with one’s body, or even fat pride, as a problem. For now, until we fully tease out how much of the poor health faced by fat people is the consequence of fatphobia, I remain skeptical of the automatic conflation of fatness with poor health. [...]
Conditionally Accepted | It’s Time To Talk About Fatphobia — January 3, 2014
[…] Beyond interpersonal interactions, there is a constant barrage of negative images in the media, coupled with the medical institution‘s obsession with obesity as a health problem. One of the most appalling things I saw in medical research was viewing positive body image in fat women (as though they are delusional) as a problem, specifically as a hindrance to them losing weight. Certainly perception of one’s body, specifically one’s weight, is a concern in terms of anorexia, bulimia, and other eating disorders. However, I find it troubling to view comfort with one’s body, or even fat pride, as a problem. For now, until we fully tease out how much of the poor health faced by fat people is the consequence of fatphobia, I remain skeptical of the automatic conflation of fatness with poor health. […]
Rabiah — January 24, 2014
Response to “Anita Sarkeesians haters”
Anita Sarkeesian is a feminist who produces regular online videos critiquing pop culture and the representation of females within. She has a passion for video games since her early childhood. She believes that video games not only increase knowledge but also teaches problem solving skills. Despite her great passion for games she was always disappointed with the representation of females within the games. Therefore, taking that into consideration she decided to create a webpage where people can watch her video about the negative representation of females in video games, and donate for the cause of hopefully eliminating the negative elements from the video games. The first 29 days of her donation webpage the response was very quite. However, she saddening began getting mobbed by angry online gamers. She was getting harassed and threatened, the angry mob of male online gamers even made a game called “Beat the bitch up”. This lasted for sometime until she began getting positive response and donations for the public. She raised $160.000 that is 25 times more than what she had originally hoped of getting. After reading through the article about Sarkeesian I am in a stare of shock. I cannot believe that she got harassed and threatened for doing something right. I want to know what the angry mobs of gamers were upset about? Did they enjoy exposed avatar females in their regular games? Or was this action taking as a threat of banning games. I believe that the very misleading stereotype about feminist such as “women who hate men”, may have been a bit of an influence on the rage of angry mobs as they felt threatened by a female trying to change or control what they really value in their life. Despite the excuses that can justify their wrongful action, it just gets me very intimidated that anything said and done online, even for a good cause, can turn a good person into a bad person. I am happy that someone has finally brought this issue to the public’s eye and something is being done about it.
Christina — January 24, 2014
Body Size, Sexuality and Girls: Thinking beyond Correlations
This study by Michalos, Ramsey, Eberts and Kahlke (2012) examine the relationship between health status and quality of life. To measure health status a variety of questions about everyday activities were asked to determine their level of heath. Later on questions about their perceived well-being were asked to determine their quality of life index. The amount of physical activity has also declined since 2002 but the satisfaction and happiness levels have increased. This study concluded, it is false to make assumptions about the quality of life based on only health because there are many variables that influence both. Now to relate this to the article of body size and sexuality it is fair to note that body size and sexuality might have some correlations but there is no causality involved. Even with limited involvement in physical activities people seem to be happier and more satisfied with their life which indicates that good health does not mean good life. This does not mean that we give up on exercise but it means that there are more than one factor that determines satisfaction and happiness. The study by Bajos et al. (2010) was conducted in France which is a completely different demographic with different attitudes towards obesity. Paris is the city of fashion which can affect women’s self esteem and the results. The media needs to stop drawing these negative conclusions about obese women because it is not representative of the entire population and can offend people. I want to conclude by agreeing with Michalos et al (2012) and say that good health does not mean good life.
Michalos, A. C., Ramsey, D., Eberts, D., & Kahlke, P. M. (2012). Good health is not the same as a good life: Survey results from brandon, manitoba. Social Indicators Research, 107(2), 201-234. doi:http://dx.doi.org/10.1007/s11205-011-9854-1
Brittany O'Grady — January 27, 2014
I found this article very interesting! I had never before even thought that there would be research done on the linkage between obese girls/women and sexual activity for the most obvious reason to me, categorizing women and girls as obese and then assuming that they will have some sort of difficulty with a sexual life just further stigmatizes those women and girls. Firstly I found that as said in the article a study done by Bajos et al (2010) found that those individuals who are considered obese do in fact face social stigmas and are apparently less likely to have sexual intercourse and are not comfortable in social situations where they would meet people. Bajos et al (2010) also made an empty comment that these problems that obese women face are because they are at a higher risk of having low self-esteem. This comment was made by Bajos et al (2010) with no research to actually back it up, these comments made by individuals who are supposed to be looked upon and intelligent individuals who 'have all the answers' just further stigmatizes and makes daily life harder for those people who are in fact obese. Research has also been done but not published by Dr. Villers which found that overweight girls are more likely to hit puberty at a younger age and develop much faster than others which then puts them in a position where they may be more likely to engage in sexual intercourse. It was also said that these obese girls are more likely to have sexual intercourse as young as 13, and have three sexual partners in their teen years. I found this particular research presented in the article to be very disturbing, although it has not yet been published it again just further stigmatizes these girls as being a minority group who should feel ashamed of their bodies and as shown through Dr. Viller's research they will apparently be more sexually promiscuous compared to their thin counterparts. The whole idea that girls and women who are obese will be subjected to all of these stigmas and 'hard times' when it comes to sexual activity is in my opinion absolutely appalling. Research may show that obese girls and women have lower self-esteem and would therefore have a more difficult time meeting people or engaging in sexual activity, but this all stems from a socially constructed ideal of what the perfect woman should look like. It could be just as likely that a woman who is 'thin' could have lower self-esteem or have difficulty being in a sexual relationship with someone just because of these unattainable socially constructed ideals that are impossible to live up to. Overall, I think more time should be spent researching society's body ideals and why that have a negative impact not only on those girls and women who are considered obese, but women of all shapes and sizes.
Christiana D. — January 28, 2014
Body Size Sexuality and Girls: Thinking beyond Correlations
The following article examines the connection between females who are obese and their sexual abilities. One study which was able to find a correlation between obese young women and their sexual health was composed by Bajos et al., 2010. The findings in the Bajos et al., 2010 suggest that obese women had a greater chance of not using contraceptives, for instance birth control, which will result in a greater chance of getting pregnant. In modern society, there are also many images of obese women being portrayed negatively which can reinforce many of the stigmas associated with obesity. Bejos argues that obese women are more likely to find suitable individuals to engage in sexual activity with through online methods. In modern society, there is so much negativity surrounding people who are obese. Obese women especially are often looked at as not being sexually attractive compared to other women in society who meet the norm. Many of these women are often below a size four. Bejos made a great point in saying that obese women are less likely to meet people/ sexual partners in person. This is the reason that they resort to online methods when finding sexual partners. Obese individuals whether it be men or women, are not comfortable putting themselves out there or even approaching men or women in public places because they are often times looked at in strange unsettling ways. Another key point in which Bejos points out is that obese women have “low self-esteem”. This is true in many ways because of all the social pressures that are placed upon people who do not fit a certain weight bracket. Another Study which was conducted by Dr. Villers suggests that obese young girls had a greater chance of having multiple sexual partners in their teenage years compared to thinner girls. Overall, I agree that more needs to be done in regards to communicating and educating young girls about sexual activity despite their body size.
Samantha Fallis — January 28, 2014
Body Size, Sexuality and Girls: Thinking Beyond Correlations
Self-Interpretation and Others Interpretations.
I unfortunately was not surprised by the fact that obese women and girls have been stigmatized for having difficulties obtaining a sexual relationship. In today’s society, appearance seems to be one of the most important things to people through; self-interpretation and the interpretation of others completely based on your initial appearance. The overall conclusions of Jennifer Aubrey’s study was previous studies suggested that women with a “low level of global self-esteem were adversely affected by exposure to sexually objectifying media.”(2006) Aubrey also concluded the current studies showed exactly the opposite but reasons such as avoiding sexually objectifying media could cause a change in the data (Aubrey, 2006). I definitely agree with both of these points as the media has grave impacts on the wellbeing of individuals who suffer from low self-esteem. “Gillen, Lefkowitz and Shearer (2006) found that young adult women's evaluating their appearance negatively was related to risky sexual behaviour.” One of my main concerns for women who have a larger than average body size is the idea that women can face regrettable sexual encounters due to a low self-esteem that disabled them from being able to say no, could have a truly awful social impact on them. Multiple participants in a study on sexual health and body size agreed that sexiness was not only about physical standards but was also about attitude (Satinsky et al. 2013). Interestingly enough when these same women were asked about their opinion on how sexy they were, almost all of them referred strictly to their appearance (Satinsky et al. 2013). This carries out the idea that women’s sexuality is shaped by attitude and appearance when interpreted by others and mainly focused on appearance when it is a self-interpretation. A participant in the study discussed her personal experiences that started when she was 16 and after her ex calling her a fat pig to one of her friends in a store her sexual relationships only went downhill (Satinsky et al. 2013). She started going onto dating sites strictly to find random men to have sex with because of her poor self-esteem from her previous relationship (Satinsky et al. 2013). This particular example relates to the text in showing how sexual encounters at a young age that induce an extreme low self-esteem based on obesity can dominate sexual relationships for many years after. I am going to finish off with a strong quote that I believe to be truly representative of our unfortunate society today. “ their sexual experiences are the outcomes of a fatphobic and weight-stigmatizing culture seeping into the social and sexual realms of women's lives.” (Satinsky et al. 2013).
Kristina — January 28, 2014
After reading this article I am so surprised to hear that BMI has been said to be some sort of indicator of sexuality, or sexual health for that matter! I agree with Natalie that there are many assumptions being made regarding the topic of overweight girls and women and their sexuality/sexual health.
As a female who has struggled with my weight, I would hate to be labeled as someone who would be less likely to access family planning or use protection for that matter. It is completely bias to judge women based on their weight and assume that every overweight female has self-esteem issues are is more likely to consider sexuality an important part of their life to have balanced. Natalie does a great job in pointing out that many of these studies are tarring with the same brush all overweight women.
I believe that each woman has her own unique life experiences and that there are an incredible amount of factors outside of being overweight that may influence a woman's sexuality and sex-life. For example, the way a young girl is raised may determine her moral compass regarding her sexual behavior. A women may have gone through a trauma in her life that now influences her choice to have multiple sex-partners or have un-protected sex. There are countless other explanations for why girls and women alike behave sexually in one way or another and to use solely a BMI measurement to explain a female's action is simply ridiculous.
Like Natalie, I agree that the types of "fat-phobic" assumptions discussed about female sexuality among over weight women are limited. Providing qualitative or a hybrid method to researching would prove to be of benefit. However, I am a firm believer that each girl/woman will provide different data to explain how girls and women experience meaning attached to their bodies and how this influences their sexual behaviors.
Alexz Ross — January 4, 2015
Very interesting article. I've learned a lot.Thank you very much sharing it!