Determinants Of Body Mass Index (BMI) And Overweight/Obesity In Ghanaian Adults: Evidence From The 2014 Demographic And Health Survey

BackgroundOverweight and obesity are growing public health challenges in Ghana, contributing to the burden of non-communicable diseases (NCDs) such as hypertension, diabetes, and cardiovascular diseases. Yet nationally representative evidence on its predictors remains limited. ObjectiveThis study examined the sociodemographic and health-related determinants of Body Mass Index (BMI) and overweight/obesity among Ghanaian adults. MethodsA secondary analysis was conducted using data from the 2014 Ghana Demographic and Health Survey (DHS), including 4,385 men and women aged 18 years and older. BMI was modelled as a continuous outcome using multivariable linear regression and a binary outcome (overweight/obesity defined as BMI [&ge;]25 kg/m{superscript 2}) using logistic regression. All models included age, sex, education, marital status, residence, systolic blood pressure, and self-rated health status and were fitted with robust standard errors after conducting model diagnostics. ResultsThe mean BMI was 23.9 kg/m{superscript 2} (SD = 5.3), with 33.6% of participants classified as overweight or obese. Female sex ({beta} = +2.82, p < 0.001), urban residence ({beta} = +2.25, p < 0.001), higher education (e.g., postgraduate: {beta} = +7.26, p < 0.001), and higher systolic blood pressure ({beta} = +0.03 per mmHg, p < 0.001) were significantly associated with increased BMI, while age ({beta} = - 0.047, p < 0.001), rural residents ({beta} = -2.25, p < 0.001) and self-rated very bad health ({beta} = -1.66, p = 0.002) had lower BMI. Logistic regression showed that women had over three times higher odds of overweight/obesity than men (OR = 3.28, 95% CI: 2.79-3.85), and urban residents had 2.3 times the odds compared to rural residents (OR = 2.3, p<0.001). Marital status was also significant: currently married adults had higher odds of overweight/obesity than those never married (OR = 2.85, p < 0.001), and systolic blood pressure was positively associated with overweight/obesity (OR = 1.013 per mmHg, p < 0.001). ConclusionSex, marital status, education, residence, health perception, and blood pressure significantly predict BMI and overweight/obesity in Ghana. Public health interventions should prioritize women, urban dwellers, and individuals with elevated blood pressure. Stratified and longitudinal studies are recommended to better understand these associations over time.