Distribution and social determinants of overweight and obesity: a cross-sectional study of non-pregnant adult women from the Malawi Demographic and Health Survey (2015-2016)

Abstract

OBJECTIVES: Hitherto regarded as a public health issue of well-heeled nations, overweight and obesity have emerged as a problem of concern in developing nations. Although social and demographic factors are equally important as proximal lifestyle factors affecting health, their role is neither well researched nor well understood. We conducted a novel study to determine the distribution, prevalence, and social and demographic determinants of overweight/obesity in Malawi.METHODS: A population-based, quantitative cross-sectional study using data from the Malawi Demographic and Health Survey (2015-2016) was conducted among non-pregnant women aged 18-49 years. A total of 6,443 women were included in the analysis. Overweight/obesity, defined as a body mass index (BMI) ≥25.0 kg/m2 , was the main outcome variable. The analysis was done in SPSS version 20.0; after calculating descriptive statistics, bivariate and multivariate logistic regression was conducted to evaluate associations and determine odds.RESULTS: In total, 16.8% and 6.3% of women were overweight and obese, respectively (p<0.001). Overweight and obesity were more prevalent in urban than in rural areas. The BMI distribution among women varied across different background characteristics. Women from the Ngoni ethnicity were more likely to be overweight/obese than others (adjusted odds ratio [aOR], 1.54; 95% confidence interval [CI], 1.14 to 2.08). Socioeconomic status (SES) and the age of the respondent were highly significant determinants that were strongly associated with being overweight/obese. The richest women were 3 times more likely to be overweight/obese than the poorest (aOR, 3.30; 95% CI, 2.46 to 4.43).CONCLUSIONS: Overweight and obesity were highly prevalent and significantly associated with increasing SES, age, and being from the Ngoni ethnicity. Holistic interventions should also focus on improving social determinants in order to entirely curb the epidemic.

Education and prevalence of overweight and obesity among reproductive age group women in Ethiopia: analysis of the 2016 Ethiopian demographic and health survey data

“…Besides, from the total participants who are overweight and obese, majority, 83.3% were urban dwellers and the remaining 16.7% were rural dwellers. This finding is in line with the Malawi and Indian studies that the prevalence of overweight and obesity was higher among women living in urban areas as compared to their counter parts [26,27]. Consistent finding has been also reported in other low and middle-income countries [36][37][38].…”

“…In this study the odds of being overweight and obese was more than 3 folds higher among women living in urban areas than those who live in rural areas. This finding is in line with the Malawi and Indian studies [26,27]. This could be due to the fact that urban dwellers are usually from middle and high income groups of people and, households with a high income tend to purchase food in bulk, spending more on both healthy and less healthy foods [47].…”

“…This finding is higher than previous studies conducted in Ethiopia [29,30]. However, it is lower than a study in Malawi that the prevalence of overweight and obesity among adult women was 16.8 and 6.3%, respectively [26]. This variation in the prevalence rates might be due to the differences in the age group of study participants.…”

“…This difference might be due to differences in sociodemographic and socioeconomic status of the people in these regions. For example, unlike Tigray region which contains both urban and rural residents, Addis Ababa and Dire Dawa are urban and people living in urban areas are at increased risk of being overweight and obese as evidenced in this and other previous studies [26,27,52,53].…”

“…The odds of being overweight and obese was a round 2 times higher among those who watch television at least once a week and use internet at least once a week respectively compared to those who did not use it at all. The possible explanation is that people who use media are more likely from medium and rich groups a very significant factor which is associated with overweight and obesity in this and other studies [26,27]. In addition, education was also associated with the odds of overweight and obesity.…”