Sex-specific differences in obesity among adults in Bangladesh: a nationally representative cross-sectional study.

BACKGROUND: Bangladesh is facing a growing obesity epidemic; however, evidence on sex-specific patterns and socioeconomic determinants is limited. OBJECTIVE: We aimed to investigate sex differences in obesity prevalence and to assess how socioeconomic and demographic factors influence obesity risk among adult men and women. METHODS: We analysed data from the Bangladesh Demographic and Health Survey 2022. Prevalence of obesity (body mass index ≥25.0 kg/m²) among men and women was estimated by sociodemographic characteristics. Two multinomial logistic regression models were fitted: first, to quantify sex-specific odds of obesity with socio-demographic variables as interaction terms for effect modification; and second, adjusted sex-stratified models to assess determinants of obesity separately in men and women. RESULTS: Overall, 30% of our participants had obesity, with women more affected than men (36% vs 20%; adjusted OR (aOR) 2.75, 95% CI 2.53 to 3.00). Interaction analyses showed attenuation of the female-male difference among those with higher education (interaction aOR 0.57, 95% CI 0.43 to 0.74), richest quintile (interaction aOR 0.63, 95% CI 0.47 to 0.83) and urban residence (interaction aOR 0.81, 95% CI 0.68 to 0.96). Obesity was positively associated with age, education, wealth and urban residence, with stronger effects in men, except for higher education (interaction aOR 0.65, 95% CI 0.47 to 0.89), richest quintile (interaction aOR 0.72, 95% CI 0.54 to 0.98) and urban residence (interaction aOR 0.84, 95% CI 0.70 to 0.98). CONCLUSIONS: Obesity disproportionately affected women, although association with socio-demographic factors was stronger in men. Targeted sex-specific interventions that address socioeconomic and contextual determinants are needed to mitigate obesity burden in Bangladesh.