Multilevel exploration of individual- and community-level factors contributing to overweight and obesity among reproductive-aged women: a pooled analysis of Bangladesh Demographic and Health Survey, 2004–2018

Objectives: Overweight and obesity have been related to a variety of adverse health outcomes. Understanding the overweight and obesity epidemic in Bangladesh, particularly among reproductive-aged women, is critical for monitoring and designing effective control measures. The purpose of this study was to determine the prevalence of overweight and obesity in reproductive-aged women and to identify the risk factors of overweight and obesity. Design: A total of 70,651 women were obtained from the five most recent and successive Bangladesh Demographic and Health Surveys (BDHS). The multilevel logistic regression model was used to explore the individual-and community-level factors of overweight and obesity. Setting: Five most recent nationally representative household surveys across all regions. Participants: Reproductive aged (15-49 years) non-pregnant women. Results: Approximately 35.2% (95% CI: 34.9-35.6%) of women were either overweight or obese in Bangladesh. At the individual- and community-level, higher age (aOR=5.79, 95% CI: 5.28-6.34), secondary or higher education (aOR=1.69 [1.60-1.78]), relatively wealthiest households (aOR=4.41 [4.10-4.74]), electronic media access (aOR=1.32 [1.26-1.37]), and community high literacy (aOR=1.10 [1.04-1.15]) of women were significantly positively associated with being overweight or obese. Whereas, rural residents (aOR=0.79 [0.76-0.82]), from larger-sized households (aOR=0.80 [0.73-0.87]) and have high community employment (aOR=0.92 [0.88-0.97]) were negatively associated with the probability of being overweight or obese. Conclusion: Individual- and community-level factors influenced the overweight and obesity of Bangladeshi reproductive-aged women. Interventions and a comprehensive public health plan aimed at identifying and addressing the growing burden of overweight and obesity should be a top focus