Weight (mis)Perceptions and Sexual Health Among U.S. Emerging Adults

Background/Purpose:

Negative sexual health outcomes, such as sexually transmitted infections (STIs) and unintended pregnancy are social problems in the U.S. and disproportionately impact vulnerable populations, including people of color and non-heterosexually-identified individuals.  Body image is one factor that impacts sexual behavior, with negative body image related to a greater likelihood of risky sexual behaviors that can lead to negative sexual health outcomes.  Existing research on body image and sexual behavior is conflicting for two sexual behaviors, age of first intercourse and number of lifetime sexual partners.  The current study aims to clarify these associations among a representative sample of young adults in the U.S.

Methods:

The current study utilized data from Wave III of the National Longitudinal Study of Adolescent to Adult Health (N = 5,261 males; 6,183 females).  Measures include weight misperception (computed using BMI weight categories and weight perception), age at first intercourse, number of lifetime sexual partners, gender, race, religiosity, and age.  Descriptive statistics and hierarchical linear regressions were used to test the hypotheses.

Results: 

Respondents were 18-28 years old (M age for males = 22.0, females = 21.8) at Wave III.  The majority of participants had accurate weight perceptions, 4.2% of males and 18.8% of females with a normal/healthy weight overestimated their weight, while 33.6% of males and 7.7% of females underestimated their weight.  In total, 37.8% of males and 26.5% of females had misperceptions of their weight.  African American males and females were more likely than participants of other races to overestimate their weight. Males who overestimated their weight had more sex partners than males who accurately perceived their weight (B = .77, p = .04), while the opposite was true for females (B = -.69, p = .004).  Additionally, females who overestimated their weight, compared to females who accurately perceived their weight, reported an older age at first sex (B = .30, p = .001). There was no association between weight perception and age at first sex for males.

Conclusions/Implications:

This is the first known study to explore the association between weight misperception, a proxy for body image, and sexual behavior among a nationally representative sample.  This study suggests that these relationships are vary based on race and gender.   For example, this study suggests that overestimating your weight may be a protective factor for females, while is serves as a risk factor for males.  Social work research, practice, and policy should address body image concerns in the context of race and gender.  Additionally, social workers should be engaged in altering the ideal body size and shape to be more realistic, as this may change the association between body image and sexual behavior.