Abstract:
Introduction: Obesity is an increasing problem in South Asian countries and Sri Lanka is no exception. The
socioeconomic determinants of obesity in Sri Lanka, and in neighbouring countries are inadequately described. Aim
was to describe social, cultural and economic determinants of obesity in a representative sample from Kalutara
District in Sri Lanka.
Methods: This was a cross sectional descriptive study conducted among adults aged 35-64 years. A representative
sample was selected using stratified random cluster sampling method from urban, rural and plantation sectors of
Kalutara District. Data were collected using a pre-tested questionnaire. A body mass index of 23.01 kg/m2-27.50 kg/m2
was considered as overweight and ~27.51 kg/m2. as obese. Waist circumference (WC) of ~ 90 cm and ~80 cm was
regarded as high for men and women respectively. Significance of prevalence of obesity categories across different
socio-economic strata was determined by chi square test for trend.
Results: Of 1234 adults who were screened, age and sex adjusted prevalence of overweight, obesity and abdominal
obesity (high WC) were 33.2% (male 27.3%/female 38.7%), 14.3%(male 9.2%/female 19.2%)and 33.6% (male 17.7%/
female 49.0%) respectively. The Muslims had the highest prevalence of all three obesity categories. Sector, education,
social status quintiles and area level deprivation categories show a non linear social gradient while income shows a
linear social gradient in all obesity categories, mean BMI and mean we The differences observed for mean BMI and
mean WC between the lowest and highest socioeconomic groups were statistically significant.
Conclusion: There is a social gradient in all three obesity categories with higher prevalence observed in the more
educated, urban, high income and high social status segments of society. The higher socioeconomic groups are
still at a higher risk of all types of obesity despite other public health indicators such as maternal and infant
mortality displaying an established social gradient.
