Is Obesity and Overweight in Kerala a Phenomenon of Disease of Affluence?

Abstract

Background: Overweight and obesity may be socially patterned during economic and nutritional transition, but the extent to which this pattern represents a disease-of-affluence phenomenon in Kerala requires examination. This study assessed whether overweight/obesity among adults aged 45 years and above in Kerala was associated with socioeconomic status and related demographic, behavioural, food-security and health characteristics. Methods: Data were drawn from the Longitudinal Ageing Study in India Wave 1 (2017–18). The analytical sample included 1,985 adults aged 45 years and above. Overweight and obesity were combined as body mass index ≥25 kg/m². Descriptive statistics, chi-square tests and binary logistic regression were used to examine associations, with unadjusted and adjusted odds ratios estimated. Results: Overweight/obesity prevalence increased from 31.51% in the poorest group to 49.12% in the richest group and from 26.49% among respondents with no formal schooling to 52.74% among those with 10 or more years of education. In the adjusted model, the richest households had 1.78 times the odds of overweight/obesity compared with the poorest households, while respondents with 10 or more years of education had 2.34 times the odds. Female and urban respondents had higher odds, older age groups had lower odds, and multimorbidity was positively associated with overweight/obesity. Conclusion: The findings show a socioeconomic pattern consistent with the disease-of-affluence hypothesis, but the non-linear economic gradient and non-significant social-class association indicate a more complex relationship that should be interpreted as associative rather than causal.