If You Are An Overweight Girl You Are Less Likely To Use Condoms, Study Finds

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A new research study of the sexual behavior of teenage girls finds that high-risk sexual activities are apparently affected not only by girls’ actual weight but also by their perceptions about their weight—whether accurate or not. According to the study “girls who perceived themselves as overweight were less likely to have ever had sex”.

A group of researchers at the University of Pittsburgh School of Medicine led by Aletha Akers, M.D., M.P.H., and assistant professor of gynecology and reproductive sciences, looked at the relationship between weight and sexual behavior among adolescent girls. Their research was based on self-reported data from a nationally representative sample of more than 7000 high school girls who completed the 2005 Youth Risk Behavior Surveillance survey,

The Study Design

The study looked at three elements related to the participating girls’ weight:

  • Their body mass index, as determined from their self-reported data;
  • The girls’ perceptions of their weight, i.e., whether they considered themselves over- or under-weight;
  • The match (or mismatch) between girls’ actual BMI and their self-perceptions.

These weight-related factors were analyzed in relation to six types of the self-reported sexual behavior:

  • Whether they ever had vaginal sexual intercourse;
  • Whether they had sexual relations before they were 13 years old;
  • Whether they had more than three sexual partners;
  • Whether they drank alcohol;
  • Whether they reported using condoms during sexual activity;
  • Whether they were using oral contraceptives at the time of their last sexual activity.

The Study Results

Nearly half of the girls who responded to the survey reported that they had engaged in sexual relations. There was no distinction based on either their actual weight or how they perceived their weight.

Overall, girls at either weight extreme—both under and over—were more likely to engage in risky sexual behaviors. Furthermore, any girl who merely believed herself to be overweight had a higher likelihood of not using a condom the last time she had sexual relations. While overweight girls were generally less likely to be sexually active, when they did have sex, they reported lower levels of condom use. The same was true for girls who merely thought they were fat—even the underweight girls. Girls who considered themselves overweight were also more likely to have had sex at an early age.

Some patterns of unsafe sexual behavior were found to vary according to the girls’ ethnicity as well their real and perceived weight. For instance,

  • Latinas were most likely to report all of the identified high-risk behaviors, regardless of weight.
  • Caucasian girls who thought they were underweight were more likely to have had sex.
  • Higher numbers of sexual partners were reported by both overweight African-American girls and Caucasian girls who believed they were underweight.
  • Condom use was less likely among overweight Caucasians and underweight African-Americans.

Education about safe-sex practices and sexual health may need to be modified and targeted if it is to have the maximum desired influence on girls who are either over- or underweight and also girls of different ethnic backgrounds.

And while both weight and ethnicity may influence a girl’s chance of engaging in sexually risky behavior, “Knowing how a girl perceives her weight may be just as important as knowing her actual weight," noted Dr. Akers.

The Pittsburgh study, “Exploring the Relationship Among Weight, Race, and Sexual Behaviors Among Girls,” by Aletha Yvette Akers, Cheryl P. Lynch, Melanie A. Gold, Judy Chia-Chi Chang, Willa Doswell, Harold C. Wiesenfeld, Wentao Feng, and James Bost, appeared in the journal Pediatrics in October and November 2009. An abstract is available here

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