Gender-Specific Determinants of Severe Obesity Among US Adults: Evidence from the NHANES Data

Severe obesity results from a complex interplay of factors. Reports have revealed that women in the United States are disproportionately affected by severe obesity. This study examined the gender-specific risk factors contributing to severe obesity in men and women, emphasizing demographic, socioeconomic, personal and dietary habits, and underlying comorbidities. Data were obtained from the 2017–2020 cycle of National Health and Nutrition Examination Survey (NHANES). Multivariable logistic regression models were utilized to study gender-specific risk factors for severe obesity. The weighted prevalence of severe obesity among females aged 20 years and above was 11.9%, compared to 6.2% among males. Being a non-Hispanic Asian, having underlying high blood pressure, and arthritis were significantly associated with severe obesity for females. The 31–40 years age group, being a non-Hispanic Asian, and having underlying high blood pressure were significantly associated with severe obesity for males. Self-reported sleeping trouble was a risk factor when data for both sexes were combined. The study establishes several demographic characteristics and comorbidities as risk factors for severe obesity among US adults. Although sex itself is not a modifiable risk factor, understanding unique risk factors is important for designing gender-specific interventions to reduce the severe obesity burden.