Home Health News Being Overweight Increases Risk of STDs and Unplanned Pregnancies?

Being Overweight Increases Risk of STDs and Unplanned Pregnancies?

by Erika Nicole Kendall

Many thanks to Chi Chi for this link.

I… um… I’m just going to post the article, and then share a few of my thoughts:

Being obese can really get in the way of your sex life—and not necessarily in the ways you might think. According to a study published in the British Medical Journal, people who are obese are less likely to have been sexually active in the past year, but surprisingly, they’re more likely than people with an average body weight to have sexually transmitted diseases and unplanned pregnancies. I’m no rocket scientist, but something tells me those are the results of not practicing safe sex.

Researchers in France surveyed 12,364 men and women between the ages of 18 and 69. Half of the participants were in the normal weight range, while the rest were overweight or obese. The survey showed that obese women were 30 percent less likely to have had sex at all in the past year, while obese men were 70 percent less likely to have had more than one sexual partner.

Despite spending less time frolicking between the sheets, single obese women reported unplanned pregnancies four times more often than thinner, unmarried women. That’s because obese women are less inclined to seek birth control advice or use oral contraceptives, say the study’s authors. Research presented at the American Congress of Obstetricians and Gynecologists 58th Annual Clinical Meeting last month backs up these findings. Data from the CDC’s Youth Risk Behavior Survey shows that obese and overweight adolescent girls are less likely to use condoms or other birth control methods.

Chalk it up to low self-esteem. Past research has shown that obesity is related to poor body image, which is associated with high-risk sexual behavior, like unsafe sex. And it’s not just women. The French survey also showed that obese men were much more apt to have had an STD, despite fewer sexual partners.

Though weight did not appear to affect women’s ability to climax, erectile dysfunction was two and a half times as common in obese men as in men with healthy BMIs. Because the penis requires healthy blood flow to become erect, ED can often be a sign of undiagnosed heart disease or circulation issues—all the more reason why someone with ED symptoms should put their embarrassment aside and talk to their doctor.

No matter how much you weigh, or how you feel about your body, these studies underscore how important it is to always put your health first. We all hate exposing our flabby imperfections to strangers—whether it’s the gynecologist or our latest crush. Still, regular doctor’s visits, and a satisfying sex life, can help keep us healthy and happy. If losing weight helps get you there, even better. But even if you can’t get the scale to budge, never let those extra pounds diminish your value. That’s not the way to hotter sex. Loving yourself is.

Now… before we come jumping head first into the comments to play the role of “PR Person for The Overweight Delegation,” let’s be realistic, here.

You’re talking to Erika, here. I have NO desire to beat any woman with poor body image over the head with “what’s wrong with her.” I also have no desire to ignore a very real and realistic problem just for the sake of protecting the image of “The Strong Overweight Woman” or “The Strong Black Woman.” Not gonna do it.

The reality is… in a society that openly and outwardly devalues women who don’t look the way society wants them to look… it is wholly realistic to expect those women to have less-than-healthy body images.

It is also realistic to expect that those women would feel less than worthy of attention from those whom they desire.

It, furthermore, feels realistic – at least, to me – that a woman who’s self-esteem has already been beaten down by society for not looking the way they want her to look, who also doesn’t feel like she’s worthy of the attention of those she finds desirable, would also be more willing to “do extra things” to get and/or keep the attention she has.

Which means.. if she thinks her current significant other might leave her or be less compelled to give her attention if she turns down condomless sex… and she already feels like it’s unlikely that she’d ever get the attention of another… is it so unlikely that she’d just “suck it up and do it anyway?”

Before I unleash this topic… let me declare a few obvious things.

All women have body image and self-esteem issues.

All women feel some sense of desperation for a man’s attention at one point in time or another.

All women, unfortunately, have felt that pain of having to make the hard decision that’s in their best interest and suffered the consequence (regardless of whether or not that’s for the better.)

However… I also know that this site reaches out to a lot of women who are currently uncomfortable with their bodies, and while I know that there are women of all body sizes who frequent this site? I also know that a lot of the women who frequent this site are larger than the size society says a woman should be. So yes… I’m taking the “weight bait” on this one. Commenters may not.. but its obvious to me that this is going to be a more prevalent issue with overweight women because society beats us over the head so often.

That being said… what, on Earth, do we do about this? For all women, but especially those who our country insists upon demeaning?

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Dre January 13, 2011 - 4:33 PM

I usually don’t comment often, but this article struck a cord with me…As a STD/HIV educator I find htis article to be very misleading and lacking detail. Dealing with the issues of STDs on a daily basis, I can not say that I have seen trends that are mentioned in this article, one reason may be that I work on an HBCU campus in south. The article speaks of subjects who were over weight or obese, was this by BMI standards or self identified? I ask this because down south, a person over weight may not self identify as being “fat”, they may consider themselves “thick” etc. which may not cause for self esteem issues etc. because this is deemed as acceptable. With that being said, I am not convinced that a persons weight contributes to their risky sexual behavior. I have come in contact with just as many skinny women in my profession who seem to have issues practicing safe sex….to say this is a weight issue is ridiculous. If a woman lacks the morals and judgement to use protection then that’s one thing, but to say that it is because “I’m fat and he may not want me if I don’t” is simply a cop out. Where is the accountability??

Also, as for the unplanned pregnancies, the article failed to mentioned that the majority of birth control methods have a weight limit on them. Many women are unaware and think they are protected from unwated pregnancies and they are not because of their weight.

Lastly, STDs/HIV do not have a weight limit, if you are engaging in risky activitiy while over weight, losing weight will not solve the problem, you have to know your own self worth pre and post weight loss!

Shae January 13, 2011 - 5:41 PM

I agree with your point on this article… I also just learned something from your statement, I did not know that the majority of Birth Control methods has a weight limit on them… I guess I will have to research more on this myself, I guess I assumed BC pills and other methods being effective if used properly, I never figured weight in the picture….wow this is interesting….

Jaci January 14, 2011 - 11:16 AM

Speaking from my own past and my risky behavior. I totally agree with Erika on this one. At 20, I was overweight, unhealthy, and my self esteem was in the tank. I craved male attention. And when I got it, I didn’t care if we were safe or not. In fact, I don’t remember ever really thinking about condoms or birth control. I was more concentrated on the fact that someone wanted to “have” me.

Erika January 14, 2011 - 11:49 AM

*big hug*

I know it took a lot to share that.

I was always tied up in long-term relationships when I was at my heavier weights, but I can’t honestly say that this wouldn’t have been me if things hadn’t come around differently. In fact, the thought frightens me… and I think that’s why this is such a big deal to me. I’m also kind of sad – I won’t lie – that the conversation is being dismissed (see here: http://www.facebook.com/BlackGirlsGuideToWeightLoss/posts/122353801168264 ) because, again, people would rather play PR person for overweight women than actually addressing the issue so that a woman who’s reading my site and going through this issue can feel like maybe there IS a solution that she just can’t see. I just.. I don’t know.

I do know that your story resonates with me in a way that makes me nervous for what my past could’ve looked like had I made a small number of decisions differently. Seriously. Sigh.

Nae June 26, 2014 - 7:05 AM

Yep, sounds like me too. During my younger years,( high school through early college)

My self esteem was soo low I allowed one person to become my everything and then some. We had condomless sex 90% of the time, making sure his sperm wasn’t in contact with me at all. I wasn’t even thinking he would mess around because he “loved” me.

Never got pregnant, not once. But I did wind up contracting two Human Papillomavirus strands from him. That was the wake up call.

Now granted my weight wasn’t high then, I actually lost alot while I was with this person but my body image and self esteem were not stable at all.

If God blesses me with daughters, I need to have a game plan to attack the issue of body image, sex, love and self esteem. They all matter!!!

Great article btw!

Jeannine January 14, 2011 - 2:02 PM

Sigh…at that article. I do think they are unfairly placing too much of the blame on being overweight. I think everyone’s situation is different but I think I was riskier when I was smaller. While I agree the risk factor is related to our self-worth, it doesn’t mean that just because you are overweight your self-worth is in the tank. I may not like the way I look in a mini skirt or a tank top but that doesn’t mean I think I’m totally worthless and can just give myself to a man to use & abuse me, leave me with an STD or a child he didn’t want. I am a single mother who had a child out of wedlock with a jerk who didn’t want her (he has since come around). However, I was very sexy, and hyper sexual because I was so sexy :-), when that happened and just made a bad decision not related to my self-worth but more related to my indifference about other aspects of my life that had nothing to do with how I looked and alchohol did not help either! What I mean is I didn’t engage in risky behavior often but I had a moment where I threw my caution and sense of responsibility out of the window! I can imagine how this could definitely happen to overweight women, but come on! We are not all monsters who don’t love ourselves, and eat all of our feelings, and attach onto whoever can stand to look at us. That’s just crap! I’m also not an overweight woman who thinks that it’s okay. Big is beautiful and all that mumbo jumbo. I’m just a woman who doesn’t think my self-worth is totally linked to how I look. That’s a very superficial part of who I am it’s not everything. Fat or not, I need to know how to love myself when I’m old and all 6 of my tatoos are sagging to the floor! LOL

I was totally aware of the birth-control issue and that is does have weight limits. So when you are overweight they actually work less or hardly at all. The percentage deifinitely drops from being 99% effective when you are packing some pounds. Top that off with that fact that birth control affects your hormones which can make it more difficult for some women to lose weight. Birth control or not, many of us have no excuse for not using condoms. That’s coming from someone who is allergic to latex, I still used them! I had my baby at the ripe old age of 28, LOL! And she is the only one! She was not born out of a series of risky behavior but just the one time. It happens…but I agree women need to work on their self-esteem and self-worth no matter what they weigh.

malpha January 14, 2011 - 2:14 PM

Well I wasn’t going to say anything because I’m not “morbidly” obese and I am queer/23yearold virgin, so this article is meaningless to me. But I live in a rural town where no one seems to know about birth control, because the young black women I know are routinely getting pregnant regardless of weight (and sadly, age) or just caught up in terrible, abusive relationships with men who cheat on them. And the issue seems to be lack of self-worth or aspirations for the future….things that aren’t going to change with your weight. This seems kind of like the Skinny Infographic we had. This lack of self-esteem and exercising proper sexual health business is not going to be cured by losing weight. After years of giving men what they want due to insercurities about your weight, are you really going to stop because you’re skinny now? Do you just magically learn to say no because you dropped 70lbs? Especially if everyone is giving you shade about the unsafe behavior you practiced when you used to be huge? That’s what sexual health and women’s initiatives are for and it needs to be taught regardless of weight. I feel like it’s all a part of a larger conversation and problem, so pointing out an aspect like weight out of context does not do anyone any help.

Natasha January 15, 2011 - 2:39 AM

“That’s because obese women are less inclined to seek birth
control advice or use oral contraceptives, say the study’s authors”
Wow, I think the article missed a major point – overweight and
obese women have fewer birth control options. For example, doctors
don’t recommend overweight women use the Patch or the Ring. I don’t
know about you, but when I’m not ‘frolicking between the sheets’
often, I tend to be lax about taking the Pill. Who needs the daily
reminder of what’s NOT going on? So, instead of making overweight
and obese women feel bad, these scientists should find more
(better) birth control options.

Rad October 18, 2014 - 8:06 PM

I agree. I’m overweight (always have been) but I never had a problem getting the D if I wanted. But for the most part I didn’t enjoy random people. Therefore I would have about 2 sexual partners a year. So injecting hormones into my body on a daily basis seemed crazy to me. Most times just as I was settling into birth control routine me and my partner would be over.

Daphne January 16, 2011 - 9:38 PM

I’m not sure there is a solution for this issue – at least, not a simple one. Short of a shift in societal mores in which women, regardless of size are valued and respected, I’m not sure what can be done. France has its own cultural issues with size, so I’m not that surprised by the conclusions made from the results.

I was aware of birth control methods having a weight limit, but that was after doing my own research. My doctor certainly never informed me of this, and I wouldn’t be surprised if it’s uncommon knowledge.

I certainly took some risks as a teenager and young adult. But honestly? My friends, who were all a lot slimmer than I was save one, engaged in those same, or riskier, behaviors. So based on anecdotal evidence, I can’t say that weight was the outlier. As Dre mentioned, in the South (I’m from Georgia), being overweight wasn’t the dealbreaker it might have been in other regions (or…..if I may be candid, if I wasn’t black). So, while I certainly didn’t have a constant barrage of gentlemen callers, I did have some romantic interests. And while I certainly was self-conscious about my size, I can’t say I had any self-esteem issues, either.

At the end of the day, a combo of things compelled me to change: the possibility of getting pregnant, thus not being able to go to college or graduate, and potentially shaming my family.

All that said, I’m also not about to deny that being heavy can compel a woman to be more desperate and engage in riskier sexual behavior. Regarding my aforementioned group of friends, there was another girl who was almost as heavy as I was, and I was surprised and sad to learn of some of the things she did. Difference between her and I? Opportunity perhaps, but more importantly, her self-image and esteem were in the toilet.

Serenity April 12, 2011 - 12:42 PM

I’m adding on with the dissenters. I am classified as morbidly obese (though I really suspect that I am fine!) and am trying to conceive without success. So what do I have to do? Not plan to get pregnant and get pregnant?

Kaycee July 30, 2011 - 11:43 PM

I think folks are getting caught up in the antedoctal and not seeing the article for its value—this IS an issue. Scientists like me don’t use the word prove, but its clear that it is a likelihood. I get that its not politically correct to say, but the truth is it makes sense and has the science to reinforce the thesis.

I know this to be true for myself and I’ve never been overweight or obese. Self-esteem is important and is the reason we do most of what we do. We can say it isn’t our experience, but that doesn’t make the numbers wrong.

Amanda July 31, 2011 - 2:18 PM

I agree with Kaycee. Without doubt, anecdotal evidence has value but it seems to be the primary source a lot of people are using to have a negative knee-jerk reaction to the whole topic. There might very well be problems with this study but it’s pretty firmly established that:

a) Western society places a high value on slimness and generally speaking, is less accepting of larger people – regardless of the attitude within specific communities. The African-American community as a general rule might very well be more accepting of bigger size women but since quite obviously many young Black girls are still having eating disorders, clearly, African-American women aren’t totally oblivious to media messaging and wider American societal pressures and beliefs.

and b) People with lower self-esteem or self-esteem self-worth issues tend to engage in more self-destructive behaviors – subconsciously or consciously. This isn’t by any means the first study to say that.

It’s not far-fetched to consider that maybe overweight women in Western society might be more prone to certain dangerous behaviors if one considers those two facts even though it’s by no means a given or a hard and fast rule. Why is it that using those two facts to help assess the potential worth of this study is sparking such an intensely negative reaction?

Erika Nicole Kendall July 31, 2011 - 2:52 PM

Too busy playing the role of PR instead of, at the bare minimum, using this as something to keep in mind when we approach our daughters. Growing up in a culture that puts a strange priority on being and looking a certain way (which is a double whammy for young girls of color), if a young girl feels an inordinate amount of low esteem because of this, she might be easily exploited. The willingness to downplay this can turn into dismissing this issue for a young girl and, in fact, leave her to grow up as an adult who is still easily exploited. It’s anecdotal, but it is “the story” for MANY women and girls right now. I cringe at how easily this was dismissed, just to protect “someone’s” image. Jeez.

Daphne July 31, 2011 - 6:48 PM

Well, I’m not sure the disagreement is so much “playing the PR role” as “personal experiences don’t line up with the study” position. I don’t dispute the correlative nature of this issue. But I also think that a study won’t open people’s eyes to this if what they SEE or think they know about what goes on with themselves or those around them doesn’t line up.

Not to mention that the people who commented may not represent the majority of the view on this issue. If this article was posted on another site, or if we’re being non-PC here, was directed to an audience that was mostly white or Asian, the responses would have likely been different. Culture matters.

I think it’s a bit unfair to declare those who challenge the study’s conclusions as playing the PR role. Especially since the very first commenter, Dre, brought up a valid question about HOW overweight vs normal was determined in the French study. For the record, the determination was based on BMI, which is problematic to start with. Not to mention the study relied on self-reported weight from the participants.

After reading the original article again and reviewing the results of actual study, I think iVillage made its own conclusions about which the study never specified. The study concluded that:

There is a link between BMI and sexual behaviour and adverse sexual health outcomes, with obese women less likely to access contraceptive healthcare services and having more unplanned pregnancies. Prevention of unintended pregnancies among these women is a major reproductive health challenge. Healthcare professionals need to be aware of sensitivities related to weight and gender in the provision of sexual health services.

Where exactly was self-esteem measured in this study?

Also, according to the study (full text):
Obese women were as likely to report a sexually transmitted infection in the past five years as women with a normal BMI (table 6), but obese men aged under 30 had a higher prevalence of self reported sexually transmitted infections in the past five years (P=0.005) (table 7)⇓. Obese men aged 30-49 with more than one sexual partner were less likely to have used condoms in the past 12 months than normal weight men (P<0.05). These associations were not true for overweight men.

So, unplanned pregnancies are an issue, presumably because obese women are less likely to see their doctor about contraception, and less use of condoms. STDs are a whole other issue, according to the study. None of that was correlated to self-esteem or self-image in the study. I’m not saying there is none – it just wasn’t measured in the French study.

In this instance, a non-scientific website drew conclusions of a certain nature, and yet people bringing forth their anecdotal evidence to disagree are playing the role of PR? So iVillage, via the original article, couldn’t have an agenda, but anyone who dissents does?

To be clear, I wholeheartedly agree that we should talk to our girls about this. My issue is that iVillage’s article is rather unconvincing, and given who I suspect their target audience is, I have no problems admitting my suspicions about their agenda.

Erika Nicole Kendall July 31, 2011 - 7:46 PM

“In this instance, a non-scientific website drew conclusions of a certain nature, and yet people bringing forth their anecdotal evidence to disagree are playing the role of PR? So iVillage, via the original article, couldn’t have an agenda, but anyone who dissents does? ”

My personal responses are related more to the dissention I’ve received since I originally posted my comments on this post almost a year ago, not necessarily the comments here. And even still, there’s a ginormous difference between “Well, in my experiences…” and “There’s no possible way…” Sharing anecdote to disagree is largely different from sharing anecdote with the goal of refuting something’s possible existence. Denying the existence of a problem = playing PR for the “maligned” group… at least, that’s how I see it.

And, for the record, I automatically assume EVERYONE has an agenda. I simply choose to use you (generalized) and your agenda as I see fit for discussion. *shrug*

Alasha July 31, 2011 - 7:28 PM

Oh for pete’s sake. I’d bet good money that the whole obesity+increased unplanned pregnancy bit is better tied to birth control pill dosage not being adeqate for an overweight woman rather than the self esteem issue.

I also could’ve sworn that I just read another recently published study stating that overweight women were getting in in in greater numbers than their normal weighted counterparts. Since I can’t publish the direct link from my research database, here’s an article about it.


Kaycee July 31, 2011 - 9:04 PM

I see folks are getting their feelings hurt and that’s never the point on this blog, so I will say this.

“But I also think that a study won’t open people’s eyes to this if what they SEE or think they know about what goes on with themselves or those around them doesn’t line up.”

This is alarming and true. And its killing us. We have got to stop the “me and my friends don’t…” as an excuse to dispute data. Especially that published in a peer-reviewed journal.

We are special just like our Moms told us, but we are not perfect, invincible, and always the exception. We ARE the rule. That’s why it’s called the rule, after all.

Don’t let your pride kill you, yall. Whether it’s weight, unprotected sex, or any other malady/unsafe practice.

Daphne July 31, 2011 - 10:15 PM


I can assure you my feelings are not hurt. My long-winded post was due to my read of the study on which the article was based, and refuted the conclusions that the iVillage article came to. So, ultimately, for me, it’s not about using anecdotes to refute what could be a real issue – it’s using the article as “data,” when the article blatantly misconstrued the results of the study. That’s my point. It has nothing to do with pride, feeling special, being the exception, denying anything, etc. There aren’t that many comments on this post, and from what I read, I don’t think anyone was denying the correlation full-stop. I’m certainly not. What I got was that issue may be more nuanced than: Overweight/obese women tend to have low self-esteem issues and thus engage in riskier sexual behaviors. For example, if standard contraception (outside of condoms) doesn’t work because you’re heavier, that throws a money wrench into the statement, for obvious reasons.

@ Erika,
Thanks for clarifying. You responded to Amanda, who responded to Kaycee, who appeared to address the comments here, so I thought you were addressing the same.

Kaycee July 31, 2011 - 10:50 PM

Daphne—you misunderstood my comment. It was not directed at you. It was an observation I made after reading over several responses. I think people are choosing not to be honest with themselves because of the variables of the study: weight, sex, consequences and stigma.

The reaction to the article/study’s conclusions were not logical. They were emotional. And that’s fine. But such responses are often why we make poor choices in life.

I think taking issue with iVillage is okay, but takes much needed attention away from the bigger picture—a healthy body, mind, and spirit is vital to our growth as human beings.

Stefanie September 7, 2011 - 5:56 PM

1. From my experience, the African American community is NOT any more accepting of overweight people than other cultures. I have had enough issues with this to say that my point of view is accurate.
2. I’ve been overweight since I was 10 years old (I am 28 now) and during my promiscuous times (late teens to mid 20s) I knew of overweight AND non-overweight women who contracted STDs. Like someone else said in their reply post, this has more to do with self esteem and more importantly, a lack of common sense and wisdom, not weight. There are too many women who are fine as wine (laughs) who still feel like crap every day they look in the mirror. They will spend their lives opening their legs up for anyone who will give them a second look. On the flip side, I KNOW women who are much out of shape than myself who have always keep that ‘thang’ on lock and live by ‘no glove no love.’
3. I weigh more now than I did when I was running wild. I am surely not the same woman who did not care who ran up between her. I’m not ashamed because I know I have been changed. Praise God.
4. As far as pregnancy, well, I’ve only been pregnant once so far, given birth once. That was almost 11 years ago…I was on birth control for all of 2 months, if that….hmmm
5. The point of all of this is to say: (1) I am blessed by God. I am healthy, I get the opportunity to live a good life and (2) A study is just that – a study. It is done with a certain group of people and it’s an educated guess based on observation.

I think the study was good for what it’s worth. But I hope no overweight person would look at this and get concerned about their pregnancy chances (if they don’t want to be pregnant) or sexual health in a negative way. And I hope no non-overweight person will look at this and think they are in the clear…once again, the issue would be lack of common sense and wisdom, not weight.

JB September 11, 2011 - 3:42 PM

Well, I just thought I would shoot off a response.
I was not obese I was ‘thick’. I was considered the skinny one of all of my friends.
I had really low self esteem and I looked for male attention anywhere I could get it.
When I started having sex I was on the pill and well stocked with condoms.T
I kept track of all of my partners and got tested every 3-6 months.
Then I got genital warts.
I went to the free clinic to confirm it and then was notified that they did not treat it. So thankfully I had insurance and was able to go to a woman’s clinic and get treated. Well, I called up those partners(the most recent ones) and a few sympathized with me(because I told them to make sure they got tested).
Well, the person who gave it to me called me a dirty whore and said that he never wanted to speak to me again(fast forward three years later he still called me, but I told him we would never be anything).
A few months later, I have a new relationship(because it was going for a few weeks unlike most of my one nighters). Well, one weekend I got really sick and actually spent 21 days sick trying to self treat(thinking it was a yeast infection), even had the doctor give me the single dose to treat a yeast infection. So finally I am laying on my bathroom floor feeling like I am going to die. I call a few friends and they tell me to go to the hospital.
I go to the emergency room and all of the doctors in the obgyn dept. come check me out because surprise I have one of the worst cases of genital herpes they have ever seen! I start crying, not for me but because I am scared to tell my ‘boyfriend’. I call him and call him. No real answer for a few days.
So finally he comes over to tell me its over when I tell him what I was sick with, he denied it. But I told him he should go get tested. I was so naive at that time, I didn’t realize the reason why he wasn’t upset was because he already knew he had it.
For the record, we always started out with a condom, but once we would change positions, I did not know that he was taking off the condom.
That was 3 years ago.
I thought my life was over(it wasn’t). I took my medicine and everything has been fine since.
As far as guys go, any time I had sex after that, I always told the guys up front and we used condoms.
I go through periods where I have sex and then I take a break.
I haven’t had sex for a few months since I was raped by an acquaintance(long story).
So, now I plan on staying celibate until I get married(I still worry about how to tell the person that I truly care about).
I hope this story helps someone.
PS. I know you think I was young and foolish, but the thing is I was just foolish. I didn’t start having sex until I was 25.

Lisette May 1, 2012 - 12:06 PM

So agree or disagree that this is a problematic study…solutions, solutions for several possible problems?

How many overweight women actually know that their BC method might not be as effective as they think it is because of their weight? When I was at my heaviest, my OB/GYN did tell me that I would have to consider other BC methods because of my weight. I’m sure she is a minority, however. Some doctors might not bring it up either because they don’t think it’s important/don’t care or they’re not sure how to broach the subject. I know my doctor stumbled over trying to find a tactful way to tell me that I was getting too fat for the Patch, but I’m glad that she respected my health enough to tell me.

So do we tell our girlfriends to ask their OB/GYN about their birth control efficacy if the doctor doesn’t bring it up during their annual exam? Do we ask Planned Parenthood and other like-minded agencies/organizations to provide that information? Is this a conversation to have at the next girls’ brunch?

Thanks, Erika, for at least pointing out that this is a potential problem, whether people agree with it or not.

Lee March 19, 2013 - 9:32 PM

The article is quite interesting to me. From my point of view I have been aware of my cousins (at their healthy weight) sleep with this one and that one (no protection). But when they gained quite a bit of weight the numbers seemed to have increased. For me personally I have had self esteem issues when I was younger (and felt worthless/wanted the wrong attention). I still refused to be promiscuous though. But I chop that up to building up my self esteem.
I do not take birth control. IF I was sexually active with someone safety was always on my mind.

Katie C. March 20, 2014 - 5:27 PM

I would just add to your points that there have been studies that show physicians are more empathetic and nice to thinner patients, which leads me to conclude that overweight/obese women are less likely to visit their doctor regularly for birth control prescriptions or to ask questions about sexual health.

Erika Nicole Kendall March 21, 2014 - 7:55 AM

Excellent, excellent point. Fat prejudice makes people shy away from doctors in general, which makes me wonder if this same kind of result would be seen in other components of care, not just reproductive health.

Kaycee June 8, 2014 - 8:23 PM

I saw the article below and remembered this post:


Betsy July 7, 2014 - 12:39 AM

In this response, to much of a woman’s choice in birth control is being attributed to how her “low self-esteem” could lead to an inability to “say no” to a partner who refuses to wear a condom. That is far too much of an assumption. If the debated article is correct, I feel that there are far more likely reasons for the numbers. For instance, women living in poverty are fare more likely to be overweight because they survive off of cheaper, fattier foods and do not have time or economic means for gym access. Women living below the poverty line (actually more women living just above the poverty line who receive no medical assistance) tend to not seek out health care because of its costs. So, it CAN make sense that proportionally, larger women do not have access to preventative health care, such as birth control pills, shots, patches, diaphragms, etc. To offer another possible reason, psychology, larger women who do not attract as many sexual partners might feel that there is not need for them to prepare for sexual intercourse, because they might not be EXPECTING intercourse. The study says their most their larger participants had not had intercourse in the past year. It would medically make sense that a woman is not on birth control if she does not see a need for it if she is not expecting to have sex. I have not been on birth control since January of 2012. To suggest that a heavier woman is so desperate for attention that in the heat of the moment she cannot say “no” to a man who refuses a condom is a little to fanciful.

Erika Nicole Kendall July 7, 2014 - 6:59 AM

“To suggest that a heavier woman is so desperate for attention that in the heat of the moment she cannot say “no” to a man who refuses a condom is a little to fanciful.”

I don’t think it’s fanciful at all – a glance at the comments that have come before yours would’ve given you a glimpse of that. If anything, your desire to dismiss legitimate body image issues that women face instead of simply sharing otherwise salient context is a little questionable.

I wrote about the body image aspect because that is what spoke loudest to me at that time (in other words, it was something I was mentally processing for myself), and other readers have shared other contexts, and I genuinely appreciate someone bringing the poverty context to the equation. But the idea that poor body image and societal pressure converging to compromise a woman’s ability to make better choices is “fanciful” almost undermines your credibility, here. In a world that applies far too much pressure to women over their appearance and shames them for not looking like ‘the standard,’ leaving them to feel like they’d better “take what they can get,” overweight women are undoubtedly left at a disadvantage. We can’t ignore that, because that speaks to someone’s truth and pointing it out can help them realize they can make better choices.

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