High prevalence of overweight /obesity and central obesity among women in a rural district of Nepal in 2012-2013. A population-based study

Chandra Mandil Yogal ^1,2* Astrid Kamilla Stunes ^3,4 Sunila Shakya ⁵ Biraj Karmarcharya ² Rajendra Koju ⁶ Mats Peder Mosti ^3,7 Miriam K Gustafsson ^3,8 Bjørn Olav Åsvold ^10,9 Berit Schei ¹¹ Unni Syversen ^10,3

• ¹ Department of Clinical and Molecular Medicine, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Trondheim, Sør-Trøndelag, Norway
• ² Department of Community Program, Kathmandu University School of Medical Science, Dhulikhel Hospital Kathmandu University Hospital, Dhulikhel, Nepal
• ³ Department of Clinical and Molecular Medicine, Faculty of Medicine and Health Science, Norwegian University of Science and Technology, Trondheim, Norway
• ⁴ Center for Oral Health Services and Research, Mid-Norway (TkMidt), Trondheim, Norway
• ⁵ Department of Gynecology and Obstetrics , Kathmandu University School of Medical Sciences, Dhulikhel Hospital/Kathmandu University Hospital, Dhulikhel, Nepal, Dhulikhel, Nepal
• ⁶ Department of Internal medicine, Kathmandu University School of Medical Sciences, Dhulikhel Hospital/Kathmandu University Hospital,, Dhulikhel, Nepal
• ⁷ Department of Research and Development, Clinic of Substance Use and Addiction Medicine, St. Olavs University Hospital, Trondheim, Norway
• ⁸ Regional Education Center, Helse Midt-Norge, Trondheim, Norway
• ⁹ HUNT Center for Molecular and Clinical Epidemiology, Department of Public Health and Nursing, Faculty of Medicine and Health Science, Norwegian University of Science and Technology, Trondheim, Norway
• ¹⁰ Department of Endocrinology, Clinic of Medicine, St. Olavs University Hospital, Trondheim, Norway
• ¹¹ Department of Public Health and Nursing, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Trondheim, Sør-Trøndelag, Norway

The prevalence of overweight is rapidly escalating, especially in South-Asia. We aimed to estimate the prevalence of overweight/obesity and central obesity, and associated risk factors among women in a rural setting of Nepal. A cross-sectional study addressing reproductive health and noncommunicable diseases (NCDs) was conducted 2012-2013 in a rural district of Nepal. Married, non-pregnant women ≥ 15 years of age were included. Height, weight, and waist circumference (WC) were measured, and body mass index (BMI) calculated. WHO cut-offs for Asians were used to assess the prevalence of overweight (23.0-27.4 kg/m 2 ), obesity (≥ 27.5 kg/m 2 ) and central obesity (WC ≥ 80 cm). Data concerning socioeconomic and lifestyle factors were collected. Altogether, 1391 women 43.1 ± 14.4 years of age were included. The majority belonged to the Adhivasi/Janajati ethnicity, were uneducated and worked in agriculture. Altogether, 30.5% were overweight, 12.0% obese, and 34.2% centrally obese; 25.7% were both overweight/obese and centrally obese. Underweight (< 18.5 kg/m 2 ) was observed in 9.6%. Among women with normal weight or underweight, 14.9% and 15.3% had central obesity, respectively. Hypertension was observed in 13.4% and was associated with both overweight/obesity and central obesity. Instant noodle intake ≥ 2 times weekly was associated with increased prevalence of central obesity and overweight/obesity.In conclusion, we observed a high prevalence of overweight/obesity and central obesity among women in a rural district of Nepal, which entails an increased risk of metabolic complications and NCDs. Our findings underscore the need for public health programs addressing nutritional patterns and physical activity to prevent obesity.