The role of hormonal contraceptive use in mediating sociodemographic predictors of overweight/obesity among women of reproductive age in Ghana

TL;DR

This study examines if hormonal contraceptives affect weight gain in Ghanaian women and finds they are not linked to higher BMI.

Contribution

The study is the first in Ghana to use mediation analysis to assess hormonal contraceptives' role in BMI determinants.

Findings

Hormonal contraceptives had no significant indirect effect on BMI determinants.

Age, education, marital status, and wealth were strongly associated with high BMI.

Contraceptive use neither directly nor indirectly influenced BMI in the study population.

Abstract

The global rise in overweight and obesity poses significant public health challenges, contributing to premature mortality and preventable disabilities. Moreover, efforts to increase reproductive autonomy through the promotion of modern contraceptive methods are underway, with persisting concerns regarding their potential influence on weight gain. This study aimed to identify the risk factors associated with overweight and obesity and to examine the mediating role of hormonal contraceptive usage among Ghanaian women of reproductive age. An analytical cross-sectional study was conducted using secondary data from the 2022 Ghana Demographic and Health Survey, which involved 6,181 women aged 20 years and above. The data was cleaned and analysed with Stata Corp version 18. Associations between overweight/obesity and various sociodemographic factors were assessed, and survey-adjusted logistic regression model was used to estimate adjusted odds ratios. Survey-adjusted mediation analysis was performed via structural equation modelling to evaluate the indirect effects of hormonal contraceptives use on the relationships between the independent variables and BMI. The analysis revealed that factors such as age, highest educational attainment, marital status, religion, residential status, region, nature of employment, and wealth quintile were significantly associated with high BMI with the exception of contraceptive usage. The results of the mediation showed that, hormonal contraceptives had no significant indirect role on the relationship between high BMI and its covariates. The study revealed several determinants of high BMI, however, hormonal contraceptives neither directly nor indirectly influenced high BMI. Whereas, there is the need to integrate weight management counselling into family planning for general well-being, there is the need to intensify education to dispel misconception about the weight gain associated with the usage of hormonal contraceptives to maximize the uptake of contraceptives and improve the overall health of women in Ghana.

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