DETERMINANTS OF BODY MASS INDEX (BMI) AND OVERWEIGHT/OBESITY IN GHANAIAN ADULTS: EVIDENCE FROM THE 2014 DEMOGRAPHIC AND HEALTH SURVEY
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Background
Overweight and obesity are growing public health challenges in Ghana, contributing to the burden of non-communicable diseases (NCDs) such as hypertension, diabetes, and cardiovascular diseases. Yet nationally representative evidence on its predictors remains limited.
Objective
This study examined the sociodemographic and health-related determinants of Body Mass Index (BMI) and overweight/obesity among Ghanaian adults.
Methods
A secondary analysis was conducted using data from the 2014 Ghana Demographic and Health Survey (DHS), including 4,385 men and women aged 18 years and older. BMI was modelled as a continuous outcome using multivariable linear regression and a binary outcome (overweight/obesity defined as BMI ≥25 kg/m²) using logistic regression. All models included age, sex, education, marital status, residence, systolic blood pressure, and self-rated health status and were fitted with robust standard errors after conducting model diagnostics.
Results
The mean BMI was 23.9 kg/m² (SD = 5.3), with 33.6% of participants classified as overweight or obese. Female sex (β = +2.82, p < 0.001), urban residence (β = +2.25, p < 0.001), higher education (e.g., postgraduate: β = +7.26, p < 0.001), and higher systolic blood pressure (β = +0.03 per mmHg, p < 0.001) were significantly associated with increased BMI, while age (β = – 0.047, p < 0.001), rural residents (β = –2.25, p < 0.001) and self-rated very bad health (β = –1.66, p = 0.002) had lower BMI. Logistic regression showed that women had over three times higher odds of overweight/obesity than men (OR = 3.28, 95% CI: 2.79–3.85), and urban residents had 2.3 times the odds compared to rural residents (OR = 2.3, p<0.001). Marital status was also significant: currently married adults had higher odds of overweight/obesity than those never married (OR = 2.85, p < 0.001), and systolic blood pressure was positively associated with overweight/obesity (OR = 1.013 per mmHg, p < 0.001).
Conclusion
Sex, marital status, education, residence, health perception, and blood pressure significantly predict BMI and overweight/obesity in Ghana. Public health interventions should prioritize women, urban dwellers, and individuals with elevated blood pressure. Stratified and longitudinal studies are recommended to better understand these associations over time.
