Healthy Weight in Lesbian and Bisexual Women Aged 40 and Older: An Effective Intervention in 10 Cities Using Tailored Approaches



      Lesbian and bisexual women are more likely to be overweight or obese than heterosexual women, leading to increased weight-related health risks.


      Overweight women aged 40 or older who self-identified as lesbian, bisexual, or “something else” participated in five pilot interventions of 12 or 16 weeks' duration. These tailored interventions took place at lesbian and bisexual community partner locations and incorporated weekly group meetings, nutrition education, and physical activity. Three sites had non-intervention comparison groups. Standardized questionnaires assessed consumption of fruits and vegetables, sugar-sweetened beverages, alcohol, physical activity, and quality of life. Weight and waist-to-height ratio were obtained through direct measurement or self-report.

      Analytical Plan

      Within-person changes from pre-intervention to post-intervention were measured using paired comparisons. Participant characteristics that influenced the achievement of nine health objectives were analyzed. Achievement of health objectives across three program components (mindfulness approach, gym membership, and pedometer use) was compared with the comparison group using generalized linear models.


      Of the 266 intervention participants, 95% achieved at least one of the health objectives, with 58% achieving three or more. Participants in the pedometer (n = 43) and mindfulness (n = 160) programs were more likely to increase total physical activity minutes (relative risk [RR], 1.67; 95% confidence interval [CI], 1.18–2.36; p = .004; RR, 1.38; 95% CI, 1.01–1.89; p = .042, respectively) and those in the gym program (n = 63) were more likely to decrease their waist-to-height ratio (RR, 1.89; 95% CI, 0.97–3.68, p = .06) compared with the comparison group (n = 67).


      This effective multisite intervention improved several healthy behaviors in lesbian and bisexual women and showed that tailored approaches can work for this population.
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      Jane A. McElroy, PhD, is Associate Professor of the University of Missouri, Department of Family & Community Medicine. Dr. McElroy is an epidemiologist focusing on health disparities, which includes sexual and gender minority research and environmental exposure and health risks.


      Suzanne G. Haynes, PhD, is Senior Science Advisor for the DHHS′ Office on Women's Health (OWH). Since 1992, she has supported lesbian health researchers through OWH initiatives, the HHS Coordinating Committee on LGBT Issues, and the Lesbian Health Fund Board.


      Michele J. Eliason, PhD, Professor, Department of Health Education, San Francisco State University, has experience conducting research and teaching about LGBTQ health including identity development, health care provider attitudes, physical health, substance abuse, and mental health aspects of stigma.


      Susan F. Wood, PhD, is Associate Professor, Health Policy and Management, and Director, Jacobs Institute of Women's Health at GWU Milken Institute School of Public Health. Her research focuses on women's health policy, reproductive health, cardiovascular disease, and health reform.


      Tess Gilbert, MHS, was a Senior Research Analyst at NORC at the University of Chicago. Ms. Gilbert is an epidemiologist who focuses on program evaluation, rural health, and the impact of disparities on health outcomes.


      Linda Toms Barker, MA, is a Principal Research Associate at IMPAQ International with more than 35 years of experience in program evaluation, emphasizing linkages from research to practice, identifying innovations and promising practices, and assessing the replicability of program models and strategies.


      Alexandra M. Minnis, PhD, MPH, is Senior Research Epidemiologist at the Women's Global Health Imperative, a program of RTI International. Dr. Minnis' research addresses structural and social environments that lead to reproductive health disparities, HIV prevention in women, and intervention evaluation.