Elsevier

Social Science & Medicine

Volume 214, October 2018, Pages 35-40
Social Science & Medicine

Short communication
Experiences of weightism among sexual minority men: Relationships with Body Mass Index, body dissatisfaction, and psychological quality of life

https://doi.org/10.1016/j.socscimed.2018.08.018Get rights and content

Highlights

  • Weightism was experienced by 39% of sexual minority men.

  • Weightism evidenced a weakly curvilinear relationship with Body Mass Index (BMI).

  • In general, as BMIs increased, experiences of weightism markedly increased.

  • Weightism and body image mediated the link between BMI and quality of life (QoL).

  • Adjusted for these mediators, the negative link between BMI and QoL became positive.

Abstract

Rationale

Experiences of weightism are associated with reduced psychological quality of life among heterosexual men and women. However, despite noted vulnerability to body image pressures, weightism has not been quantitatively examined among sexual minority men. We tested two hypotheses: first, that Body Mass Index (BMI) and weightism would evidence a curvilinear relationship, such that underweight and overweight men would report experiencing more weightism than men in the “normal” weight range; and second, that a negative association between BMI and quality of life would be explained by experiences of weightism and body dissatisfaction.

Method

Sexual minority men living in Australia and New Zealand (N = 2733) completed an online survey and provided data on their height, weight, experiences of weightism, body dissatisfaction, and psychological quality of life.

Results

Participants' BMIs ranged from 14.15 to 68.12 with 3.0% classified as underweight, 50.5% as “normal” weight, 28.0% as overweight, and 17.4% as obese. Weightism was experienced by 38.9% of participants. As predicted, weightism evidenced a curvilinear relationship with BMI, such that underweight and overweight participants reported experiencing more weightism relative to “normal” weight participants. Yet, this curvilinear relationship evidenced a dominant linear component: Overall, weightism markedly increased as BMI increased, and obese participants reported experiencing the most weightism. In addition, we found evidence supporting our hypothesis that men with higher BMIs would report experiencing more weightism and higher body dissatisfaction, and through these variables, reduced quality of life. Adjusted for body dissatisfaction and weightism, the formerly negative association of BMI with psychological quality of life became (weakly) positive.

Conclusions

Weightism is a salient phenomenon experienced by sexual minority men in smaller and larger bodies with potential direct and indirect adverse effects on psychological quality of life. Whilst BMI and weightism evidenced a curvilinear relationship, the burden of weightism is disproportionately borne by sexual minority men with higher BMIs.

Introduction

Worldwide increases in body weight (World Health Organization, 2016) have been accompanied by increased weightism (Andreyeva et al., 2008; Puhl et al., 2008). Weightism (or weight stigma) refers to negative treatment of people on the basis of their body weight and/or size (Puhl and Brownell, 2001) and is inclusive of stereotypes (e.g., the stereotype that larger individuals lack willpower), prejudice (e.g., the treatment of larger individuals as incompetent), and discrimination (e.g., the denial of employment opportunities to larger individuals) (Papadopoulos and Brennan, 2015; Puhl and Heuer, 2009). While substantive work has examined negative effects of weightism in women (Puhl and Heuer, 2009), and an emerging body of work has examined weightism in heterosexual men (Himmelstein et al., 2018), scant research has examined weightism in sexual minority men. Thus, we recruited a large and geographically representative sample of sexual minority men to examine how weightism is experienced by sexual minority men of different body weights. Moreover, we evaluated a model of how weightism and body dissatisfaction might explain the well-established negative relationship of body weight with psychological quality of life (QoL) (e.g., Schwimmer et al., 2003).

Experiencing weightism is associated with a range of adverse psychological outcomes (Papadopoulos and Brennan, 2015; Puhl and Heuer, 2009; Vartanian and Smyth, 2013), including, most notably, poorer psychological QoL (Latner et al., 2013; Papadopoulos and Brennan, 2015). Psychological QoL provides an overarching measure of general psychological wellbeing and is increasingly being used to gauge the size and severity of mental health-related public health burdens, including weightism. Notably, the association of weightism experiences with poorer psychological QoL remains significant after controlling for Body Mass Index (BMI) (e.g., Hunger and Major, 2015; Latner et al., 2013), suggesting that experiences of weightism, rather than simply weight itself, may explain why heavier individuals have lower levels of psychological wellbeing.

Despite worldwide increases in men's BMIs (World Health Organization, 2016), few studies of weightism have been conducted with men. One notable and recent general population study by Himmelstein et al. (2018) showed that approximately 40% of heterosexual men reported experiencing weightism. Further, underweight and overweight men reported more weightism relative to “normal” weight individuals. In women, the relationship between weightism and BMI is linear, in that weightism increases as BMI increases (Puhl and Brownell, 2001). This can be attributed to the Western female body “ideal” which emphasises thinness, with heavier women more likely to experience weightism (Puhl and Brownell, 2001). By contrast, the Western male body “ideal” emphasises lean muscularity (e.g., Hargreaves and Tiggemann, 2006). Therefore, in men, we would expect experiences of weightism to demonstrate a curvilinear (U-shaped) relationship with BMI, such that men with either high or low BMIs are more likely to experience weightism (Himmelstein et al., 2018).

To date, we are unware of any quantitative research that has examined how weightism is experienced by sexual minority men (i.e., men who identify as gay or bisexual among other non-heterosexual identities). The rationale for such research is compelling. First, relative to their heterosexual counterparts, sexual minority men evidence increased rates of body dissatisfaction (Frederick and Essayli, 2016) and eating disorders (Calzo et al., 2017). Second, consistent with theories of multiple minority stressors, sexual minority men may be disproportionately impacted by weightism due to their increased likelihood of experiencing multiple intersecting and compounding discriminations (e.g., discrimination due to weight and sexual orientation) (Hatzenbuehler, 2009; Johnson and Acabchuk, 2018). Third, researchers have noted that the “male gaze”, a term used to refer to heterosexual men's tendency to evaluate women through a prism of sexual desire, is highly salient amongst sexual minority men (Wood, 2008). Extending this concept to the context of sexual minority men, it has been suggested that constant immersion in the “gay male gaze” might contribute to both increased appearance pressures and appearance-based stigmatisation within communities of sexual minority men (Martins et al., 2007).

Thus, we aimed to explore whether and how sexual minority men's experiences of weightism might be associated with their BMI and psychological QoL. Given the aforementioned research demonstrating lower psychological QoL among individuals with higher BMIs, we expected to observe the same in our sample of sexual minority men. Further to this, and in line with past research, we expected that higher BMIs would be associated with greater experiences of weightism. We expected this because the linear component of the curvilinear relationship of BMI with weightism is notably dominant over the quadratic component (as observed by Himmelstein et al., 2018). In turn, we proposed that those experiencing higher levels of weightism would report higher levels of body dissatisfaction (Harriger and Thompson, 2012), which in turn would be associated with reduced psychological QoL (Latner et al., 2013). In summary, drawing on a large sample of sexual minority men, we examined two hypotheses: first, that the relationship of BMI and experiences of weightism would be curvilinear; and second, that experiences of weightism and subsequent body dissatisfaction would explain the negative relationship of BMI with psychological QoL.

Section snippets

Procedure and participants

Advertisements were disseminated on four non-consecutive days in March and April 2017 via a popular geosocial networking app that caters exclusively to sexual minority men. The advertisements solicited volunteers for an online survey of “body image and body preferences” and appeared only to users located in Australia and New Zealand. The sample included 2733 individuals, who completed the survey in a median time of 11 min. The study protocol was approved by the Human Ethics Sub-Committee at the

Results

The sample included 2733 individuals who were near-exclusively cisgender male (99.1% cisgender male, 0.9% transgender or non-binary) and who belonged exclusively to sexual minorities (68.4% exclusively gay, 21.4% mostly gay, 8.4% bisexual, 1.1% mostly heterosexual, 0.7% other). Young, middle-age, and older men were well-represented in the sample (years of age; M = 33.93, SD = 11.94, range = 18 to 78). Participants were located in Australia (78.7%) or New Zealand (21.6%) and mostly belonged to

Discussion

We aimed to examine the relationship of weightism with BMI and psychological QoL among sexual minority men. As predicted, we found evidence that the relationship of BMI with experiences of weightism was curvilinear (albeit, weakly). Individuals in the “normal” weight range were treated better than individuals in the underweight and overweight ranges. By contrast, individuals in the obese weight range were treated the worst. These results dovetail with previous work with heterosexual men (

Conclusions

In conclusion, we found evidence that weightism is a salient phenomenon experienced by approximately 39% of sexual minority men. Contrary to previous research with heterosexual women, but consistent with research with heterosexual men, we found evidence to suggest that weightism has a curvilinear relationship with BMI, such that it is experienced by those in smaller and larger bodies. Nevertheless, sexual minority men in larger bodies were disproportionately burdened by weightism. Moreover, we

Acknowledgements

Scott Griffiths is supported by an Australian National Health and Medical Research Council Early Career Fellowship (grant number: 1121538). Fiona Kate Barlow is supported by an Australian Research Council Future Fellowship (grant number: FT150100147). The funders had no role in the collection or analysis of data, write-up of the manuscript, or the decision to submit the manuscript for publication.

References (25)

  • B.T. Johnson et al.

    What are the keys to a longer, happier life? Answers from five decades of health psychology research

    Soc. Sci. Med.

    (2018)
  • T.A. Ryan et al.

    Psychometric properties of the revised male body Attitudes scale among Irish men

    Body Image

    (2011)
  • T.L. Tylka et al.

    Support for an expanded tripartite influence model with gay men

    Body Image

    (2012)
  • T. Andreyeva et al.

    Changes in perceived weight discrimination among americans, 1995-1996 through 2004-2006

    Obesity

    (2008)
  • J.P. Calzo et al.

    Eating disorders and disordered weight and shape control behaviors in sexual minority populations

    Curr. Psychiatr. Rep.

    (2017)
  • D.A. Frederick et al.

    Male body image: The roles of sexual orientation and body mass index across five national U.S. Studies

    Psychol. Men Masc.

    (2016)
  • S. Griffiths et al.

    Relative strength of the associations of body fat, muscularity, height, and penis size dissatisfaction with psychological quality of life impairment among sexual minority men

    Psychol. Men Masc.

    (2018)
  • D.A. Hargreaves et al.

    Body image is for girls‘: a qualitative study of boys’ body image

    J. Health Psychol.

    (2006)
  • J.A. Harriger et al.

    Psychological consequences of obesity: weight bias and body image in overweight and obese youth

    Int. Rev. Psychiatr.

    (2012)
  • M.L. Hatzenbuehler

    How does sexual minority stigma “get under the skin?” A psychological mediation framework

    Psychol. Bull.

    (2009)
  • A.F. Hayes

    PROCESS: a Versatile Computational Tool for Observed Variable Mediation, Moderation, and Conditional Process Modeling [White Paper]

    (2012)
  • M.S. Himmelstein et al.

    Weight stigma in men: what, when, and by Whom?

    Obesity

    (2018)
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