When it comes to a woman’s sex life, heavy may be better.

Women with a higher than normal BMI - the body mass index that quantifies whether we are overweight - are nearly two times more likely to have a history of sex with a man. 

But BMI didn't have an impact on factors such as the age of first having sex, the likelihood of cohabitation or the likelihood of having a lifetime male partner, according to a recent study.   

Researchers at the University of Hawaii, University of Colorado and Oregon State University set out to find just how weight impacts a person’s sex life - particularly a female’s - and recently reported their findings.

The results surprised even them, they noted in the Journal of Obstetrics and Gynecology. The researchers contacted more than 7,500 women aged 15-44 across the nation to interview them about their sexual behavior.

With approximately 63 percent of the American population falling into the overweight or obese category, Dr. Ann Hartlage, director of Rush University’s Medical Center’s Marital Sex Therapy program, discusses the validity of the research. Lots of issues influence women when it comes to sex and their bodies, she said.

Medill News: This study is getting lots of attention. What do you think of it?

Dr. Hartlage: In general, I thought it was an interesting study. From a methodological viewpoint, there were a lot of comparisons, and this comparison [of BMI to heterosexual sex history] seemed to be the only one that was statistically significant. If you make a lot of comparisons, then the odds that something just by chance will come up significant is higher than if you just compare just one thing.

MN: Why do you think that the correlation between BMI and sexual behavior hasn't been the subject of more research?

Dr. Hartlage: I think it’s because it’s against expectations. There’s a lot of pressure in our culture to be thin. There's the whole emphasis on beauty, looking good, the stars, etc. This goes against our expectations and that’s why I think it’s an interesting result.

MN: The researchers themselves seemed to be shocked by their own findings. They wrote in their report that “the finding that obese and overweight women were more likely than normal weight women to report a history of having had male sexual intercourse [was] somewhat unexpected.” What was your impression of that?

Dr. Hartlage: Part of that may just have been the way that they wrote it, because it’s more interesting if you write something that grabs attention. But again, it goes back to being counter-intuitive. With all the emphasis in our culture on being thin, the assumption is that no one will want to be sexually involved with a woman who is overweight.

MN: The researchers never give an explanation of their findings. One reason often given to explain why a woman has more sex is low self-esteem? Could that be a factor here?

Dr. Hartlage: I think that’s certainly possible. I don’t know of specific research in that area, but I had the same thought that you did, that seems very likely. One thing that’s easy to control, if you will, is having sex. Finding a partner with whom to be sexually involved is not that difficult. That’s one thing that a woman can do to get attention, so it may give her some solace if she has low self-esteem – “wow, look at all these people who are paying attention to me.”

Ironically, very few, almost none of the women I’ve treated for sexual dysfunction are significantly overweight. Some of the women I treat in marital therapy are maybe a little heavier than normal, but sex isn’t one of the problems. In my observation, that supports this article.

MN: Was there anything in this study that you think would help you to understand sexual behavior and sexual dysfunction in the women that you treat?

Dr. Hartlage: Hopefully, I don’t do this, but I think it’s important not to assume that if a woman is overweight, then her husband or partner perceives her as unattractive. I have a couple that I worked with - I viewed the woman as thin or having an average shape. But, interestingly, she saw herself as being too fat and that was an impediment to her enjoying sex.  Her husband on the other hand thought she was beautiful just the way she was.  So for her, the cultural stereotypes were hard to overcome.

MN: How do you treat that?

Dr. Hartlage: A woman can deliberately relax and look at her entire self in front of a mirror or in the shower, and reflect about each part of her body. Many of us glance only at the parts we don’t like about our bodies and ignore the rest. Some books, such as “Becoming Orgasmic,” by Heiman and LoPiccolo, have exercises in them that can help women be more accepting of their bodies.

There are several techniques for treatment with a professional. Some are what we call cognitive behavioral approaches.  I have women recognize all the negative automatic thoughts that they have about their weight, and deliberately try to think of alternative positive thoughts that are more rational. The patient mentioned above recognized intellectually that she did not perceive herself correctly, but it was such a strong belief that she had held for such a long time, she had difficulty overcoming it. 

Other things that I do are to have the woman think about events in her life that influenced her attitudes and how she feels about and interprets what happened to her. For example, if a woman’s parent told her that she was fat when she was a child, she may assume it to be true without questioning it. However, as an adult, she may reinterpret this as having to do with the parent’s critical nature and realize it has little to do with her.