Differences in prevalence and associated factors of underweight and overweight/obesity according to rural-urban residence strata among women of reproductive age in Bangladesh: Evidence from a cross-sectional national survey

Abstract

Objectives: This study aimed to investigate the differences in prevalence and factors influencing underweight and overweight/obesity stratified by region of residence among women of reproductive age in Bangladesh. Design: Secondary analysis of cross-sectional nationwide data. Setting: This study used Bangladesh Demographic and Health Survey 2014 data. Participants: A weighted sample of 16 478 women of reproductive age (15–49 years) were included in the analysis. Primary and secondary outcome measures: Using the Asian-specific cut-off for body mass index, the primary outcome of this study was categorised as: underweight (<18.5 kg/m2), normal weight (18.5 to <23.0) kg/m2 and overweight/obese (≥23.0 kg/m2) stratified according to rural–urban residence. Results: More than half of urban women (53%, n=2493) and one-third of rural women (33%, n=3968) were found to be overweight/obese. Around one-fifth of rural women (21%, n=2490) and almost one in eight urban women (12%, n=571) were reported as underweight. In the final multivariable analyses, increasing age, higher educational status and higher order wealth quintile, each had a significant positive association with being overweight/obese and an inverse association with being underweight. Urban unmarried women had lower odds of being overweight/obese compared with their married counterparts. Rural women who used contraceptives had significantly decreased odds (adjusted OR (AOR) 0.8, 95% CI 0.7 to 0.9) of being underweight compared with contraceptive non-users; no such association was noted in urban women. Women from Sylhet division in both urban (AOR 1.7, 95% CI 1.2 to 2.5) and rural regions (AOR 1.5, 95% CI 1.2 to 1.8) had increased odds of being underweight compared with women in Barisal division. Conclusions: This study found association of multiple factors with both overweight/obesity and underweight among Bangladeshi women of reproductive age. Public health programmes in Bangladesh aiming to prevent the double burden of mal Copyright Author(s) (or their employer(s)) 2020.