Relationships of Gender, Sexual Orientation, Body Image, and Health-Related Quality of Life among College Students in Taiwan

Objective: To examine the relationships between body image and physical health, psychological, social relationships, and environment domains of health-related quality of life (HRQOL), and to explore if these relationships varied by gender and sexual orientation among college students in Taiwan.
Methods: Data from 1,058 participants were collected, using a cross-sectional survey administered via a popular bulletin board system commonly frequented by college students in Taiwan. Appearance evaluation (AE) and overweight preoccupation (OP) scales from the Multidimensional Body Self-Relations Questionnaire (MBSRQ) were used to measure body image, and the World Health Organization Quality of Life-BREF (WHOQOL-BREF) was used to measure HRQOL. Descriptive statistics, Pearson’s correlation, and multiple linear regression analyses were used to examine the relationships.
Results: Female college students paid more attention to body weight changes (p<0.001) than their male counterparts, but AE scores did not differ by gender. Females had significantly higher scores in the social relationships domain (β=12.94) of HRQOL than males (β=12.23), but there were no gender differences in other three domains. Body image and HRQOL did not differ significantly by sexual orientation. Significant positive correlation was found between AE and all four domain scores, with the correlation coefficients ranging from 0.307 to 0.529 in the total sample, and the correlation was also significant when stratified by gender and sexual orientation. AE was significantly associated with all four domain scores in both gender-specific models. We also found that factors affecting male students’ HRQOL seem to aggregate, and among male students, sexual orientation interaction effects were found with BMI in psychological domain and with cigarette use in environment domain. Finally, model fit statistics showed that R2 changed significantly when AE and OP were entered into the models, indicating 15.6%, 24.7%, 16.3%, and 6.5% increases in the variance explained in the physical health, psychological, social relationships, and environment domain scores, respectively, in the male-specific model, and 11.4%, 26.4%, 11.3%, and 10.5%, respectively, in the female-specific model.
Conclusions: Body image is an important factor when assessing HRQOL among college students. Differences by gender and sexual orientation should also be taken into consideration when developing interventions to promote healthy body image and improve HRQOL.