Disparities in violence, depression, and excess weight among Brazilian women according to sexual orientation: insights from a national health survey

Aim This study aimed to examine disparities in violence, depression, and excess weight among Brazilian women according to sexual orientation. Subject and methods This cross-sectional study used microdata from the 2019 Brazilian National Health Survey. The sample included 44,608 heterosexual, 326 bisexual, and 394 homosexual women. The dependent variable was excess weight (i.e., overweight and obesity). The independent variables were depression and violence. Analyses were stratified by sexual orientation and adjusted for sociodemographic covariates. Chi-square tests and generalized linear models (GLMs) with a binomial logistic distribution were performed. Odds ratios (OR) and their respective 95% confidence intervals (CI) were used as measures of effect, accounting for sample weights and the complex sampling design. Results Sexual minority women reported a substantially higher prevalence of depression and violence than heterosexual women. In multivariable analyses, depression was associated with higher odds of excess weight only among heterosexual women. No significant association between depression and excess weight was observed among bisexual or homosexual women. Psychological, physical, and sexual violence were not associated with excess weight in any group. Conclusion Among heterosexual women, depression was associated with excess weight. Among bisexual and lesbian women, no statistically significant association was observed; however, these findings should be interpreted with caution given the smaller sample sizes and lower statistical power in these subgroups. Violence was not associated with excess weight among Brazilian women, regardless of sexual orientation.