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Weight problems - a big issue for Lesbians ?

© Chicago FreePress Feb28th According to national health organizations, obesity is one of the nation’s top health concerns, impacting nearly a third of U.S. adults, and research indicates lesbians are not immune..

Several studies suggest that lesbians have a higher BMI (or Body Mass Index, a height-to-weight ratio) than their heterosexual counterparts. The Gay and Lesbian Medical Association and other health groups list obesity as a major health concern for lesbians, right alongside other issues like high rates of smoking and drinking.

While the health community is still far from clearly understanding lesbian health issues (there is a woeful lack of research that provides insight on their health risk factors), several studies suggest that lesbians tend to weigh more. A 2003 study conducted by San Francisco’s University of California School of Nursing found that, on average, lesbians carry more excess weight around their waistlines than heterosexual women and have a “significantly higher” BMI. The study suggested that because a BMI over 25 is generally associated with an increased risk for high blood pressure and heart disease, lesbians are at greater risk for these specific health concerns. The Chicago Health and Life Experiences of Women Study (CHLEW), an ongoing study of lesbian health issues, additionally discovered that more than half of its participants had a BMI that exceeded the recommended level, categorizing them as obese.

But while these studies and others suggest that lesbians tend to have a higher BMI, very little is known as to why.

Rebecca Fox, executive director of the National Coalition of LGBT Health, said that “there is such a lack of research on the GLBT community in general that it is hard to put studies that indicate lesbians have a higher BMI into perspective.”

Esther Rothblum, Ph.D., a women’s studies professor at San Diego State University who reviews literature and research regarding lesbians and weight, agreed, adding that, in addition to a severe lack of research, there are also many concerns with several past studies’ methodology.

For example, one major study, Rothblum said, used inappropriate samples by comparing the BMI of older lesbians found in GLBT community centers to young heterosexual college-aged women. Since BMI tends to increase with age, regardless of sexual orientation, it was no wonder the lesbians in the study weighed more.

Over the years, several researchers have attempted to discover the reasons behind the suggested higher rates of obesity among lesbians and have reached a variety of conclusions. One study suggested that lesbians are less concerned about weight because they have a better body image, for example; another said that lesbians are less concerned about their body image because they are not as impacted by the societal pressures placed on heterosexual women to appear a certain way in order to attract men. For years, feminist scholars and others have argued from both sides of the fence.

Even the U.S. Department of Health and Human Services, which lists obesity as an important health issue for lesbians to discuss with their doctors, stresses on its Web site that more research is needed in many areas, such as whether or not there is a different cultural norm among lesbians about weight. The national health organization also stresses that other factors linked to a higher BMI, such as socioeconomic status, dietary differences, race (few studies have sizable samples of lesbians of color) and age, need to be further researched and considered.

Meanwhile, another ongoing argument is whether discussing lesbians and their weight, regardless of what researchers have found thus far, is actually worth all the fuss. Some experts suggest that health organizations can’t see the forest for the trees, and all this focus on weight is at the expense of other key issues, such as unequal access to health care.

“It’s like scientists saying there is a correlation between cold weather and turkey death in November … but missing the most important variable—Thanksgiving Day,” said Marilyn Wann, a self-described fat rights activist and author of the book Fat? So!

Local researcher Tonda Hughes, director of the CHLEW study, is convinced that lesbians and obesity “is definitely a concern” in the GLBT community.

“But there is a reluctance to put this out there because people don’t want to further pathologize an already stigmatized group,” Hughes added. “But I think it’s increasingly clear it’s an issue of concern in the community, especially among minority lesbians.”

While some researchers warn that their higher BMI puts lesbians at greater risk for various health problems, others say that not enough research has been done in order to draw this conclusion. For example, there is no population-based data on cardiovascular disease among lesbians. Some researchers and activists say that without proper data, those in the health care industry are simply making an assumption.

“They are making a mountain out of a molehill,” Rothblum said.

“The health risk literature (on the link between weight and health risks) is so poor,” she added.

There are those within the health field that say weight, regardless of sexual orientation, has yet to be proven to be a direct cause of major health concerns. This supposed weak correlation between weight and health led to University of California, Davis, nutritionist and psychologist Linda Bacon’s development of the Health At Every Size (HAES) philosophy to health, which throws conventional dieting wisdom out the window.

Instead of focusing on numbers on a scale and restrictive diets, HAES emphasizes celebrating the diverse shapes and sizes the human body comes in, finding joy in exercise and focusing on “intuitive,” yet nutritious, eating. Several studies suggest that this approach, which is more a lifestyle change than anything else, is far more effective. Bacon found during her own research that people who subscribed to the HAES approach maintained healthier behavior, healthier levels (such as blood pressure) and had higher self esteem than those using conventional weight-loss methods.

Lesbian Community Care Project executive director Catherine Jefcoat said that LCCP is “really into” the HAES approach. In fact, last year’s research pilot, “Let’s Get Real About Meals,” which addressed body image in the lesbian community, borrowed a lot from the HAES philosophy.

Jefcoat said that LCCP hopes to expand the pilot program. “At LCCP, we’re always thinking about the whole body,” Jefcoat said, adding that lesbians should embrace and celebrate their love of “all the shapes we come in” while still being aware of what they might be at risk for.

“It doesn’t mean that we shouldn’t discuss our risks and find ways to protect ourselves,” Jefcoat said. “But I don’t want to shame anybody. The thing for me is being healthy, no matter what size you are.”

Many GLBT advocates have embraced HAES, and vice versa. For example, Club Round, a “size-accepting” group based in Loves Park, Ill., that utilizes the HAES method, has two GLBT-specific support groups, as well as a GLBT liaison.

Although the HAES movement is gaining momentum, many still treat lesbian obesity as a grave concern. But some activists and researchers, particularly those who advocate for the rights of obese people, think something else is going on that keeps people fixated on lesbians and their weight, such as homophobia, sexism and a social stigma against people categorized as obese or overweight.

First of all, society continues to have negative attitudes about lesbians and their appearance, even within the larger GLBT community.

“For decades, the public has had issues with the appearance of lesbians, in general,” Rothblum said.. In the 1940s and 1950s, the stereotype was that lesbians were “mannish.” Now, she said, the stereotype is that lesbians are “fat and ugly.”

“Think of all the homophobic jokes there are about lesbians and weight,” Rothblum added.

Another potential underlying issue is sexism. In the U.S., women, through television and glossy magazines, are told to look a certain way. Western culture’s fixation on thinness has made the diet and weight loss industry a multi billion dollar giant.

“It is just a continuation of our culture obsessing over our (women’s) image,” Wann added.

While some research literature suggests that lesbians aren’t as impacted by societal pressures placed on women, many say lesbians can’t escape it.

“It is still there,” Rothblum said. “No women are immune.”

Others suggest that culture’s views of overweight and obese people factor into researchers’ obsession with lesbian appearance. Some go as far as to say that national health organizations are spreading their own hatred of plus-sized people. The injustices larger people face on a day-to-day basis have led to the creation of the so-called fat-positive movement, which calls for giving people categorized as obese or overweight equal rights and protecting them from discrimination. Leaders of this movement, like the many GLBT people who reclaimed the word “queer,” reclaimed the word “fat.” In fact, fat activism borrows a lot from the queer studies handbook.

Bevin Branlandingham is the host of “Femmecast: The Queer Fat Femme Podcast.” Branlandingham, a self-identified “fat femme” who advocates for fat rights, believes that gay and lesbian culture is unfortunately impacted by mainstream culture’s obsession over weight. She started her own podcast, which is geared towards fat femmes and queers, after recognizing a “deficit” in her own life.

“It came out of my journey towards self love,” Branlandingham added. Now, she is a voice of the fat-positive community. Her podcast celebrates a diversity of body sizes and empowers individuals to fight anti-fat discrimination.

“I feel people should be free to be themselves, and all body types should be celebrated,” she said.

“It doesn’t surprise me at all that queer people are at the forefront and that they get it,” Rothblum said, adding that historically, lesbians have been the forefront of many movements, such as reproductive rights.

Many GLBT-focused fat-positive groups are calling for health groups to separate health from weight and focus on issues that really matter. Many say that health care providers and organizations need to take their eye off the scale and focus on more important lesbian health issues.

“What really matters is exercise and proper nutrition, no matter what size you are,” Fox advised. “We need to make that the norm in our community.” Fox also noted that another focus should be creating culturally competent health care so that lesbians can access the care they need, such as life-saving screenings.

Branlandingham agreed, noting that she is still surprised by “the large numbers” of queer women she knows who still have yet to be screened for diseases like cervical cancer.

“It’s important our community sees health as a right,” Branlandingham said.. “It shouldn’t be defined by what your BMI is.”

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