A mixed methods approach to understanding weight-related behavioral disparities among college students by sexual orientation

Abstract

Existing research has found that lesbian, gay, and bisexual (LGB) college students are less likely to engage in healthful weight-related behaviors than heterosexual students. This dissertation builds on these findings by addressing three aims: (1) to identify major weight-related behavioral profiles by sexual orientation and gender; (2) to examine the relationship between institutional supports for LGB college students and weight-related behaviors; and (3) to explore the context surrounding weight-related health among LGB college students.In Aim 1, data from the 2009-2013 College Student Health Survey were used to fit latent class models. Overall, four distinct profiles were identified: "healthier diet," "moderate diet," "unhealthy weight control," and "healthier diet, physically active." Heterosexual and bisexual women exhibited all four profiles, discordant heterosexual women did not exhibit a "moderate diet" profile, and neither gay/lesbian nor unsure women exhibited "healthier diet, physically active" profiles. Heterosexual men exhibited all four profiles, discordant heterosexual men exhibited two profiles ("healthier diet" and "unhealthy weight control"), and gay, bisexual, and unsure men did not exhibit "healthier diet, physically active" profiles.In Aim 2, institutional-focused LGB supports (including school policies, institution-administered LGB and diversity organizations, and housing) were associated with more favorable weight-related behavioral profiles for heterosexual and some bisexual women. In contrast, these supports were associated with less favorable weight-related behavioral profiles for some gay and unsure men. Student-engaged LGB supports (including courses offered and student-run LGB groups) were not associated with students' weight-related behavioral profiles across sexual orientation and gender.In Aim 3, individual interviews with LGB, queer, and pansexual college students were conducted. Many felt their sexual orientation helped them be physically activity, engage in healthful eating habits, and have a positive body image. However, their sexual orientation was also a source of stress that adversely impacted physical activity and eating habits. Participants identified the need for institutional-level interventions to promote physical activity, healthy eating, and positive body image among LGB students.