Abstract

Background Obesity is a global public health problem. Data on the epidemiology of obesity in many sub-Saharan African countries including Nigeria is scant. The objectives of this study were to determine the prevalence of obesity, the associated sociodemographic and behavioural factors, as well as the impact of perceptions of large body size, on obesity and overweight, in Enugu Nigeria. Method A cross-sectional household survey of adults aged 20-60 years, was conducted using multi-stage cluster randomised sampling. This was preceded by a pilot study involving 79 adults and 29 households. Government-defined population census enumeration areas with definite geographic boundaries served as clusters. Anthropometric measurements were taken using standard methods. All prevalence estimates were population-weighted. Analyses were done at the 95% confidence level. Results Data from 6628 individuals from 2843 households were analysed. The overall population-weighted prevalence of obesity, overweight, normal weight and underweight are 6.8%, 19.0%, 65.1% and 9.1% respectively. Female gender, urban residents, adults older than 40 years of age, and high-income earners are more likely to be obese than their corresponding counterparts. Nearly 45% of the population perceive obesity as a desirable attribute. More than 50% of the population misperceive their body sizes. Positive perception of large body size is a significant predictor of obesity. Dietary factors do not have significant independent impacts on obesity. A third of the population is physically inactive. Conclusion The prevalence of obesity and overweight in Enugu Nigeria is high, with the burden of obesity fast approaching that of underweight. Female gender, urban dwellers, older adults and high-income earners are at higher risk for obesity and overweight. There is a high level of veneration of large body sizes and physical inactivity, which contributes to the high population burden of obesity and overweight. Important policy recommendations are made.