Women face greater risk of obesity in low- and middle-income countries

Women in low- and middle-income countries, especially in the Sub-Saharan Africa region, may be 10 times more likely to have obesity or heart health issues than their male counterparts, according to a large meta-analysis published in The Journal of Clinical Endocrinology & Metabolism.

Obesity is a chronic disease characterized by an individual having an excess of body fat or abnormal fat accumulation. People who have obesity are at an increased risk for other serious diseases and health conditions.

Obesity kills at least 2.8 million people per year, yet the public still does not recognize it as a disease, and anti-obesity medications are still under prescribed and hard to access. Obesity is preventable, but according to the World Health Organization, the disease has nearly tripled since 1975. In 2016, 52% of adults and over 340 million children and teens were considered to have overweight or obesity.

"Our findings are important as they call for urgent actions targeting obesity awareness, prevention, treatment, and control in women in low- and middle-income countries,” said study author Thaís Rocha, M.D., Ph.D., of the University of Birmingham in Birmingham, U.K. 

The researchers included 3,916,276 people in the meta-analysis and found obesity does not manifest evenly across women and men in low- and middle-income countries, with women being 2-3 times more likely to be affected than men. They found the greatest disparity in the risk of obesity between women and men is in the Sub-Saharan region, where women are up to 10 times more likely to have obesity than men.

Senior study author Shakila Thangaratinam, M.D., Ph.D., of the University of Birmingham said, “For the first time, we are able to assess the extent of poor metabolic health faced by women compared to men in low- and middle-income countries. Funders and policymakers need to implement woman- centered measures addressing the underlying social, cultural and behavioral factors to improve their long-term metabolic health.”

The authors shared a few examples of the factors contributing to the higher rate of obesity in these women including:

• Weight gain during pregnancy and menopause. 
• Beliefs that larger body types indicate high socioeconomic status, and fertility associated obesity in women as a sign of “wealth and health.”
• Obesity risk seems to be positively and significantly associated with childhood deprivation in women but not men.
• Women are also more likely to be influenced than men by other factors predisposing them to obesity, such as poor dietary habits, sedentary lifestyles and price inflation.  

The other authors of this study are Eka Melson of the University of Birmingham; Javier Zamora of the University of Birmingham, Hospital Universitario Ramón y Cajal (IRYCIS) and the CIBERESP Instituto de Salud Carlos III in Madrid, Spain; Borja Fernandez-Felix of the CIBERESP Instituto de Salud Carlos III; and Wiebke Arlt of the Medical Research Council Laboratory of Medical Sciences and Imperial College London, U.K.

The study was funded by the Wellcome Trust and the NIHR Birmingham Biomedical Research Centre.

The manuscript, “Sex-Specific Obesity and Cardiometabolic Disease Risks in Low- and Middle-Income Countries: A Meta-Analysis Involving 3,916,276 Individuals," was published online.

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