Demographic, Clinical, and Lifestyle-Related Factors Associated with Body Mass Index in Ghana: WHO STEPS Household Survey, 2014-2025

Abstract

Introduction: Globally, several populations suffer from obesity, which is defined as a body mass index (BMI) of at least 30 kg/m², and it is up to 25% in some regions of Ghana. Factors such as lifestyle behaviours, dietary intake, and some chronic illnesses. Objective: This study analysed data from a household survey to determine the predictors of high body mass index in Ghana, 2014 2025. Methods: This is a secondary data analysis of a study conducted across Ghana, involving both rural and urban communities to ensure national representativeness. The population included 4,464 adults aged 18 years and older, with 2,643 from rural areas and 1,821 from urban areas. Socio-demographic characteristics, clinical diagnoses, and selected lifestyle behaviours were extracted to inform the design of an effective, age-appropriate intervention. Bivariate and multivariable regression analyses were estimated. Statistical significance was determined at p < 0.05, and CI was set at 95%. Results from the analysis were presented as text, tables, and figures. Results: The median age is 58 years (IQR: 18.0). The median BMI is 22.94 kg/m² (IQR: 6.23). The median SBP is 124.33 mmHg (IQR: 27.33). The median SBP is 76.67 mmHg (IQR: 16.33). The prevalence of obesity in the study was 12.05% (95% CI: 11.13, 13.04). Most of the population were of normal weight, 2,468 (55.29%). High BMI (obesity) was higher among adults (14%) and middle-aged adults (16%), while underweight (low BMI) was higher among older adults (19%) and the oldest adults (28%). Increased age (β: -0.04, 95% CI: -0.04, -0.019) predicted lower BMI. Female sex (β: 1.91, 95% CI: 1.52, 2.25), urban dwelling (β: 1.98, 95% CI: 1.54, 2.23), and education (β: 0.96, CI: 0.59, 1.34) were all found to significantly increase BMI. However, alcohol, tobacco, and blood pressure were significant on bivariate tests (P < 0.05). Conclusion: Obesity in the population varies with age. Education on lifestyle modification, screening of at-risk groups, and control of the identified factors are necessary interventions. Ongoing surveillance and longitudinal research are essential to clarify causal pathways and to inform the development of effective, culturally tailored prevention and management strategies for obesity and related chronic diseases.