# A mixed methods approach to understanding obesity risk among sexual minority women

> **NIH NIH K01** · WASHINGTON UNIVERSITY · 2022 · $149,084

## Abstract

PROJECT SUMMARY/ABSTRACT
Obesity, a preventable and treatable condition, is associated with the leading causes of death in the United
States and worldwide. Women who identify as sexual minorities (SMW; i.e., women with sexual orientations
other than heterosexual) are up to twice as likely to have obesity compared to men and heterosexual women,
yet little is known about the mechanisms that confer heightened risk for these communities. The minority stress
model, which posits that historically marginalized populations, such as SMW, are at increased risk for stress due
to increased exposure to stigma and discrimination at the structural, interpersonal, and individual levels, can be
applied to help delineate potential factors that place SMW at greater risk for overweight and obesity. However,
limitations in the literature hinder our ability to address obesity disparities. First, SMW are often treated as a
homogeneous group, so we know little about risk factors for understudied subgroups of SMW (e.g., bisexual,
asexual, queer, pansexual, questioning). Second, among the limited research on obesity or the primary
behavioral drivers of overweight and obesity (i.e., energy-balance behaviors such as diet, physical activity, and
sedentary activity) among SMW, there is an overreliance on cross-sectional, retrospective self-report, or semi-
annual longitudinal designs. While these studies provide a foundation for understanding behavioral risk factors
among SMW, these methods are limited in the data they can provide. Experience sampling methods (ESM) can
advance our understanding by identifying temporally proximal risk factors for obesity (e.g., factors predicting
physical activity or high caloric intake) and disentangling risk factors from correlates. I will conduct a mixed
methods study to delineate factors and mechanisms that may be associated with obesity risk among SMW,
which is highly aligned with NIMHD’s focus on research that seeks mechanisms and pathways behind health
determinants that confer worse outcomes in health disparity populations. First, I will utilize a qualitative life history
approach to identify preliminary factors associated with the development and maintenance of weight-related
cognitions and behaviors (Aim 1). Second, I will use ESM to test the preliminary model identified in Aim 1 and
examine relationships between minority stressors and weight-related behaviors in real time in the natural
environment among SMW from diverse sexual orientation identities (Aim 2). These aims support my training
plan in which I will receive expert mentorship and training in: multi-level influences on SMW obesity outcomes
(Training Aim 1); qualitative data collection and analysis (Training Aim 2); ESM and advanced statistics for
ESM data (Training Aim 3); and career development (Training Aim 4). Results will be used to inform a model
of minority stress and obesity among SMW, which I will then test in a rigorous, large-scale, longitudinal trial
(R01). This K...

## Key facts

- **NIH application ID:** 10507447
- **Project number:** 1K01MD017630-01
- **Recipient organization:** WASHINGTON UNIVERSITY
- **Principal Investigator:** Lauren Alina Fowler
- **Activity code:** K01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2022
- **Award amount:** $149,084
- **Award type:** 1
- **Project period:** 2022-08-06 → 2027-03-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10507447

## Citation

> US National Institutes of Health, RePORTER application 10507447, A mixed methods approach to understanding obesity risk among sexual minority women (1K01MD017630-01). Retrieved via AI Analytics 2026-05-23 from https://api.ai-analytics.org/grant/nih/10507447. Licensed CC0.

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