Women Face Greater Risk of Obesity in Low- and Middle-Income Countries

Study finds women are 2-3 times more likely to be affected than men

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 and 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,” says study author Thaís Rocha MD, PhD, of the University of Birmingham in Birmingham, U.K. “Interventions require a woman-centered approach to treating obesity, considering the cultural, social, and behavioral barriers and facilitators uniquely faced by women in following the recommended diet-based and physical activity interventions and appropriate medical treatment.”

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.

“This high burden of obesity in women in low- and middle-income countries can be explained by underlying biological, sociocultural, and socioeconomic factors that are uniquely faced by women,” Rocha says.

Rocha 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 and Shakila Thangaratinam of the University of Birmingham; Javier Zamora of the University of Birmingham and the Instituto de Salud Carlos III in Madrid, Spain; Borja Fernandez-Felix of the Instituto de Salud Carlos III; and Wiebke Arlt of the Medical Research Council London Institute of Medical Sciences in London, U.K.

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

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.