Prevalence of obesity among hormonal contraceptive users and non-users in Jimma town

Abstract

Introduction: The increasing prevalence of overweight and obesity among women of reproductive age group as part of the increasing worldwide epidemic of obesity is a critical public health problem for women of childbearing age. With obesity rates at epidemic proportions, any association between obesity and strategies that prevent undesired pregnancies constitutes a significant public health and economic concern. Unfortunately; the relationship between obesity and contraception has not been extensively studied. Very few studies were available with regard to the nature and magnitude of the problem in Ethiopia and none available for study area. Therefore this study was aimed at determining the prevalence of obesity among hormonal contraceptive users and non-users and identifying factors associated to obesity among women of child bearing age. Methods and materials: a comparative community based cross sectional study was conducted in Jimma Town from March, 6-13/2013. Simple random sampling technique was employed to recruit 343 hormonal contraceptive users and 343 non users with a total sample size of 686.WHO steps approach instrument for collecting surveillance data for assessment of risk factors for chronic non-communicable diseases was used to collect data on selected socio-demographic characteristics and lifestyle risk factors. Physical measurements of weight, height, waist circumference and hip circumference were carried out. Data were entered, cleaned and analyzed using SPSS for windows version 16. A bivariate analysis was conducted to select candidate variables at P value of 0.25.Finally multivariable logistic regression was fitted to isolate an independent predictors of overweight/obesity. Results were presented using 95% confidence intervals and adjusted odds ratios. P < 0.05 was used to determine statistical significance. Result: Prevalence of overweight and obesity based on BMI cutoffs were 23.1% and 7.4%, respectively. The prevalence of central obesity was 21.0% and 18.5% based on WC and WHCR respectively. Both overweight/obesity (BMI >25kg/m2) and central obesity were significantly higher (chi-squared test P < 0.05) among hormonal contraceptive users than non-users. Multivariable logistic regression showed that duration of hormonal contraceptive use, type of oil/fat usually used for meal preparation and marital status were significantly associated to overweight/obesity (BMI>25kg/m2. Duration of hormonal contraceptive use, level of physical activity and fruit and vegetable consumption were significantly associated to central obesity measured by WC.While central obesity as measured by WHCR was significantly associated to age group and hormonal contraceptive use for two years and above. Conclusion: The study showed that the prevalence of obesity among study population was high and requires public health attention. Lifestyle factors like physical activity and dietary factors were important factors independently associated to obesity in this population. Hormonal contraceptive use for two years and above was independent predictor of central obesity measured by WHCR. Like several other public health challenges, overweight and obesity should be tackled early before it gets out of hand ensuring that people have access to healthy diets and get involved in physical activities