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 center dot 2 % (95 % CI: 34 center dot 9-35 center dot 6 %) of women were either overweight or obese in Bangladesh. At the individual- and community-level, higher age (adjusted odds ratio (aOR) = 5 center dot 79, 95 % CI: 5 center dot 28-6 center dot 34), secondary or higher education (aOR = 1 center dot 69 [1 center dot 60-1 center dot 78]), relatively wealthiest households (aOR = 4 center dot 41 [4 center dot 10-4 center dot 74]), electronic media access (aOR = 1 center dot 32 [1 center dot 26-1 center dot 37]) and community high literacy (aOR = 1 center dot 10 [1 center dot 04-1 center dot 15]) of women were significantly positively associated with being overweight or obese. Whereas, rural residents (aOR = 0 center dot 79 [0 center dot 76-0 center dot 82]) from larger-sized households (aOR = 0 center dot 80 [0 center dot 73-0 center dot 87]) and have high community employment (aOR = 0 center dot 92 [0 center dot 88-0 center dot 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.