Trends and Socio‑economic Inequalities of Overweight, Obese and Underweight Women of Reproductive Age in South Asian Countries: Bangladesh, India, Maldives, Nepal and Pakistan

Abstract

This thesis assesses the trends and prevalence of associations between overweight, obesity and thinness among women and social determinants in low-and-middle-income countries (LMICs) in South Asia. We investigated the differences in wealth, education, and residence. We used data from the Demographic and Health Surveys (DHS) of 3,132,203 women aged 15-49 across Bangladesh, India, Nepal, Maldives, and Pakistan between 2000 and 2022. Overweight and obesity rose significantly in all countries except the Maldives, ranging from 5% to 37%. It was more pronounced among urban (13% to 46% in Bangladesh), less educated (7.3% in India to 70% in the Maldives), and wealthier women (23% in Nepal to 73% in Pakistan). Thinness showed smaller but consistent shifts, apart from the Maldives where prevalence declined. The risk of thinness declined among women living in rural areas (49% in Bangladesh to 10% in the Maldives) with less education (52% to 3% in the Maldives), then among poorer women too (51% in Bangladesh to 8% in Nepal). Overall, the findings indicate progress in alleviating the burden of undernutrition, yet a shifting towards the risk of increasing overweight and obesity rates.