Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2023 Jul 17:11:1195249.
doi: 10.3389/fpubh.2023.1195249. eCollection 2023.

Socio-geographical disparities of obesity and excess weight in adults in Spain: insights from the ENE-COVID study

Enrique Gutiérrez-González  1 , Marta García-Solano  1 , Roberto Pastor-Barriuso  2   3 , Nerea Fernández de Larrea-Baz  2   3 , Almudena Rollán-Gordo  1 , Belén Peñalver-Argüeso  2   3 , Isabel Peña-Rey  1 , Marina Pollán  2   3 , Beatriz Pérez-Gómez  2   3 ; ENE-COVID Study Group
Affiliations

Socio-geographical disparities of obesity and excess weight in adults in Spain: insights from the ENE-COVID study

Enrique Gutiérrez-González et al. Front Public Health. .

Abstract

Background: In Spain, differences in the prevalence of obesity and excess weight according to sex and sociodemographic factors have been described at the national level, although current data do not allow to delve into geographical differences for these conditions. The aim was to estimate national and regional prevalences of adult obesity and excess weight in Spain by sex and sociodemographic characteristics, and to explore difference sources of inequalities in its distribution, as well as its geographical pattern.

Method: ENE-COVID study was a nationwide representative seroepidemiological survey with 57,131 participants. Residents in 35,893 households were selected from municipal rolls using a two-stage random sampling stratified by province and municipality size (April-June 2020). Participants (77.0% of contacted individuals) answered a questionnaire which collected self-reported weight and height, as well as different socioeconomic variables, that allowed estimating crude and standardized prevalences of adult obesity and excess weight.

Results: Crude prevalences of obesity and excess weight were higher in men (obesity: 19.3% vs. 18.0%; excess weight: 63.7% vs. 48.4%), while severe obesity was more prevalent in women (4.5% vs. 5.3%). These prevalences increased with age and disability, and decreased with education, census tract income and municipality size. Differences by educational level, relative census income, nationality or disability were clearly higher among women. Obesity by province ranged 13.3-27.4% in men and 11.4-28.1% in women; excess weight ranged 57.2-76.0% in men and 38.9-59.5% in women. The highest prevalences were located in the southern half of the country and some north-western provinces. Sociodemographic characteristics only explained a small part of the observed geographical variability (25.2% obesity).

Conclusion: Obesity and overweight have a high prevalence in Spain, with notable geographical and sex differences. Socioeconomic inequalities are stronger among women. The observed geographical variability suggests the need to implement regional and local interventions to effectively address this public health problem.

Keywords: Spain; adults; geographical factors; obesity; sociodemographic factors.

PubMed Disclaimer

Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

Figure 1
Figure 1
Body mass index distribution among adult men and women in Spain, ENE-COVID study, 2020. Probability density functions for body mass index among men and women were estimated using Gaussian kernel smoothers with a bandwidth of one-fifth their weighted standard deviations and applying sampling weights to account for the different selection probabilities and non-response rates of study participants. The vertical dashed lines represent the weighted means of body mass index among adult men and women (26.8 and 25.7 kg/m2, respectively). Excess weight (BMI ≥ 25 kg/m2); obesity (BMI ≥ 30 kg/m2).
Figure 2
Figure 2
Prevalence (%) of obesity and excess weight by sex and age group in adult participants from ENE-COVID study.
Figure 3
Figure 3
Standardized* prevalences (%) of obesity and excess weight by level of education, census tract income and sex in adult participants in ENE-COVID study. *Standardized to the overall distribution of age, nationality, education, census tract income, disability and municipality size. O, obesity; EW, excess weight.
Figure 4
Figure 4
Crude prevalences (%) of obesity and excess weight by province and sex in adult participants from ENE-COVID study.
Figure 5
Figure 5
Crude prevalences of obesity and excess weight (%) by province, sex and age group in adult participants from ENE-COVID study.
See this image and copyright information in PMC

References

    1. World Obesity . (2022). World obesity federation global obesity observatory. World Obesity Atlas. Available at: https://data.worldobesity.org/publications/World-Obesity-Atlas-2022.pdf (Accessed March 26, 2023).
    1. OECD (2019). The heavy burden of obesity: the economics of prevention [internet]. OECD. Available at: https://www.oecd-ilibrary.org/social-issues-migration-health/the-heavy-b... (Accessed March 26, 2023).
    1. World Health Organization . (2022). WHO European regional obesity report. Available at: https://apps.who.int/iris/bitstream/handle/10665/353747/9789289057738-en... (Accessed March 26, 2023).
    1. World Obesity . (2022). World obesity publications. Available at: https://data.worldobesity.org/publications/
    1. World Health Organization . (2021). World Health Organization. Monitoring noncommunicable disease commitments in Europe 2021: are we on track to reach targets 10 years after the Moscow declaration and first United Nations high-level meeting? Copenhagen. Available at: https://apps.who.int/iris/handle/10665/350457 (Accessed March 26, 2023).

Publication types