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Associations of economic and gender inequality with global obesity prevalence: Understanding the female excess

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  • Wells, Jonathan C.K.
  • Marphatia, Akanksha A.
  • Cole, Tim J.
  • McCoy, David

Abstract

Obesity is widely assumed to be associated with economic affluence; it has therefore been assumed to become more common with economic development. However, obesity has also been associated with poverty. These contrary findings highlight the need for an examination of the contribution of social and economic factors to the global distribution of obesity. Males and females may be differently exposed to social and economic inequality, however few studies have considered possible gender differences in the association between socio-economic indices and obesity prevalence. We analysed between-country associations between obesity prevalence and three social or economic indices: per capita gross domestic product (GDP), the Gini index of national wealth inequality, and the gender inequality index (GII). We considered the genders separately, the gender average, and also the gender difference (female excess) in obesity prevalence. Across 68 countries listing sample size, there were 3 obese women for every 2 obese men. Within populations, obesity prevalence in males and females was strongly correlated (r = 0.74), however, only 17% of the female excess prevalence was accounted for by the gender-average prevalence. In both genders, there was a positive association between obesity prevalence and GDP that attenuated at higher GDP levels, with this association weaker in females than males. Adjusting for GDP, both the Gini index and GII were associated with excess female obesity. These analyses highlight significant gender differences in the global distribution of obesity, and a gender difference in the association of obesity prevalence with socio-economic factors. The magnitude of female excess obesity is not constant across populations, and is greater in countries characterised by gender inequality and lower GDP. These findings indicate that improving women’s status may be a key area for addressing the global obesity epidemic over the long term, with potential benefits for the women themselves and for their offspring.

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  • Wells, Jonathan C.K. & Marphatia, Akanksha A. & Cole, Tim J. & McCoy, David, 2012. "Associations of economic and gender inequality with global obesity prevalence: Understanding the female excess," Social Science & Medicine, Elsevier, vol. 75(3), pages 482-490.
  • Handle: RePEc:eee:socmed:v:75:y:2012:i:3:p:482-490
    DOI: 10.1016/j.socscimed.2012.03.029
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    5. Ehmke, Mariah D. & Restrepo, Brandon J., 2023. "COVID-19 Working Paper: Obesity Prevalence Among U.S. Adult Subpopulations During the First Year of the COVID-19 Pandemic," Administrative Publications 340802, United States Department of Agriculture, Economic Research Service.
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    9. Mohd Masood & Daniel D Reidpath, 2017. "Effect of national wealth on BMI: An analysis of 206,266 individuals in 70 low-, middle- and high-income countries," PLOS ONE, Public Library of Science, vol. 12(6), pages 1-16, June.
    10. He, Jun & Xie, Yongxiang, 2022. "The sociocultural mechanism of obesity: The influence of gender role attitudes on obesity and the gender gap," Social Science & Medicine, Elsevier, vol. 293(C).
    11. Melissa Neuman & Ichiro Kawachi & Steven Gortmaker & SV Subramanian, 2014. "National Economic Development and Disparities in Body Mass Index: A Cross-Sectional Study of Data from 38 Countries," PLOS ONE, Public Library of Science, vol. 9(6), pages 1-18, June.
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    13. Palència, Laia & Malmusi, Davide & De Moortel, Deborah & Artazcoz, Lucía & Backhans, Mona & Vanroelen, Christophe & Borrell, Carme, 2014. "The influence of gender equality policies on gender inequalities in health in Europe," Social Science & Medicine, Elsevier, vol. 117(C), pages 25-33.
    14. Samuel Encarnação & Filipe Rodrigues & António Miguel Monteiro & Hatem Gouili & Soukaina Hattabi & Andrew Sortwell & Luís Branquinho & José Eduardo Teixeira & Ricardo Ferraz & Pedro Flores & Sandra Si, 2023. "Obesity Status and Physical Fitness Levels in Male and Female Portuguese Adolescents: A Two-Way Multivariate Analysis," IJERPH, MDPI, vol. 20(12), pages 1-14, June.
    15. Rosinger, Asher & Tanner, Susan & Leonard, William R., 2013. "Precursors to overnutrition: The effects of household market food expenditures on measures of body composition among Tsimane' adults in lowland Bolivia," Social Science & Medicine, Elsevier, vol. 92(C), pages 53-60.
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    17. Ferretti, Fabrizio & Mariani, Michele, 2017. "Gender Discrimination, Gender Disparities in Obesity and Human Development," MPRA Paper 77728, University Library of Munich, Germany.

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