Abstract
BackgroundThe prevalence of adult obesity is higher in women than men in most countries. However, the pathways that link female sex with excess obesity are still not fully understood. We examine whether socioeconomic and behavioural factors may mediate the association between sex and obesity in the Saudi Arabian setting where there is female excess in obesity.MethodsWe performed a mediation analysis using a cross-sectional, national household survey from Saudi Arabia with 4758 participants (51% female). A series of multivariable regression models were fitted to test if socioeconomic position, physical activity, sedentary behaviour, diet, and smoking mediate the association between sex and obesity (BMI >=30). The findings were confirmed using causal mediation analysis.ResultsWomen in this sample were roughly twice as likely as men to be obese (crude OR 1.9; 95% CI 1.6-2.3). The odds ratio remained significantly higher for women compared to men in models testing for mediation (OR range 1.95–2.06). Our data suggest that indicators of socio-economic position, physical activity, sedentary behaviour, diet, and smoking do not mediate the sex differences in obesity.ConclusionsOur analysis shows that most commonly measured risk factors for obesity do not explain the sex differences in its prevalence in the Saudi context. Further research is needed to understand what might explain the female excess in obesity prevalence. We discuss how data related to the lived experience of Saudi men and women may tap into underlying mechanisms by which the sex difference in obesity prevalence are produced.Electronic supplementary materialThe online version of this article (doi:10.1186/s12889-015-1608-6) contains supplementary material, which is available to authorized users.
Highlights
The prevalence of adult obesity is higher in women than men in most countries
Sample overview The survey used as the basis for the current analysis is a national, cross-sectional household survey conducted between August 2004 and 2005 by the Ministry of Health (MOH) of Saudi Arabia to estimate the prevalence of risk factors of non-communicable diseases (NCDs) in the population [17]
Our study showed that routinely measured risk factors for obesity do not explain the sex gap in its prevalence in Saudi Arabia
Summary
The prevalence of adult obesity is higher in women than men in most countries. the pathways that link female sex with excess obesity are still not fully understood. While women’s reproductive role is associated with the risk of obesity [2], studies have shown that the magnitude of the sex differences in obesity prevalence varies vastly across countries [3,4,5]. This suggests that factors beyond women’s biology may be at play and implicates the context in which individuals live. Sex differences in obesity prevalence among adults in Saudi Arabia have been reported as early as the 1980s. There is a need to understand the mechanisms that produce, in some countries, the female excess in obesity
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
