# A multivariate decomposition analysis of drivers of overweight and obesity among Ghanaian women

## TL;DR

This study identifies wealth, education, and urban living as key drivers behind rising overweight and obesity rates among Ghanaian women, using survey data from 2003 to 2022.

## Contribution

The study quantifies how socio-demographic factors, not just individual behavior, contribute to rising obesity rates in Ghanaian women.

## Key findings

- Over 43% of Ghanaian women were overweight or obese in 2022.
- Wealthiest women had over six times higher odds of obesity compared to the poorest.
- 22.5% of the increase in overweight/obesity prevalence was due to changes in population characteristics like education and marital status.

## Abstract

Overweight and obesity are rising globally, with Ghana experiencing significant increases among women over the past two decades, raising public health concerns. This study aimed to identify and quantify the key drivers of overweight and obesity among women of reproductive age in Ghana, analysing how these factors have contributed to prevalence changes over time.

Data from the 2003, 2008, 2014, and 2022 Ghana Demographic and Health Surveys were analysed using binary logistic regression to assess associations with factors such as age, wealth, and education. Multivariate decomposition analysis quantified the contributions of these factors to the observed increases in overweight and obesity prevalence over time.

Here we show overweight and obesity among Ghanaian women rise significantly, reaching 43% in 2022. Key drivers of change in overweight and obesity include wealth, education, urban residence, age, and region. Women in the wealthiest quintile have three times the odds of overweight (aOR: 3.07 [2.02–4.67]) and over six times the odds of obesity (aOR: 6.73 [3.80–11.91]) compared to the poorest quintile. Decomposition analysis shows that 22.5% of the increase in prevalence was due to changes in population characteristics, such as marital and educational status.

Our findings reveal that socio-demographic changes in society, beyond individual behavioural factors, drive the rising overweight and obesity prevalence among Ghanaian women of childbearing age. These findings highlight the dynamic factors influencing weight outcomes and the need for tailored strategies addressing the diverse and evolving determinants of overweight and obesity in Ghanaian women.

Overweight and obesity prevalence are rising globally, posing health challenges. We examined the main factors influencing the changing rate of overweight and obesity among Ghanaian women. We used data from surveys undertaken in 2003, 2008, 2014, and 2022. We assessed the association between overweight and obesity and factors such as age, wealth, and education, as well as their contributions to the changes in overweight and obesity. Results show 43% of Ghanaian women were living with overweight or obesity in 2022. Key drivers included socio-demographic factors such as age and wealth. These results suggest that addressing overweight and obesity in Ghana requires tailored interventions targeting these drivers of overweight and obesity to mitigate their impact and improve population health outcomes.

Mensah et al. examine factors driving overweight/obesity among Ghanaian women using data from 2003, 2008, 2014, and 2022 surveys. In 2022, 43% lived with overweight or obesity and the decomposition analysis shows 22.5% of the rise stemmed from shifts in population characteristics, including marital and education status.