Institute of Health Sciences, Collegium Medicum, Jan Kochanowski University, Kielce, Poland.
Department of Rehabilitation, Holycross Cancer Centre, Kielce, Poland.
BMJ Open. 2021 Jul 30;11(7):e050127. doi: 10.1136/bmjopen-2021-050127.
As overall spread of obesity in populations is generally acknowledged to result from unhealthy lifestyles rather than individual genetic makeup, this study aimed to gain specific insights into its determinants through assessing the prevalent associations between individual socioeconomic status (SES) and weight loss in overweight and obese men and women.
A prospective, 2-year follow-up study covered 3362 (38.0% men) respondents, aged 43-64 years, body mass index ≥25 kg/m. Changes in body weight were estimated as a percentage of initial weight. Three categories of changes were defined: gained ≥3%, stable (gained <3% or lost <3%), lost ≥3%. Body weight loss was determined against three categories: lost ≥3 to <5%, lost ≥5 to <10%, lost ≥10%. Select SES variables (ie, gender, age, education, marital status, occupational activity and income) were determined in line with the Health Status Questionnaire. The associations between SES and body weight changes were analysed with the aid of logistic regression models. The results were presented as ORs with 95% CIs.
Only 18% of the respondents had complied with the medical recommendations on weight loss. Significant differences were encountered between the gender, age and occupational activity variables and the weight loss one. Multifactorial models were used to determine the following gender-specific associations between SES and weight loss. Men with moderate income had significantly higher odds for weight loss (≈75%), as compared with the higher earners, whereas women with low income, occupationally inactive, had significantly higher odds (≈30% and ≈50%, respectively), as compared with the high earners and occupationally active ones.
Lower education, male gender, lower income per household, older age and unemployment status were the established factors predisposing to obesity. While aiming to ensure effectiveness of the measures specifically aimed at preventing obesity, population groups deemed most at risk of potential weight gain must prior be identified.
由于人群中肥胖的普遍蔓延通常被认为是不健康生活方式的结果，而不是个体遗传构成的结果，因此本研究旨在通过评估超重和肥胖男性和女性个体社会经济地位（SES）与体重减轻之间普遍存在的关联，深入了解其决定因素。
一项前瞻性、为期 2 年的随访研究覆盖了 3362 名（38.0%为男性）年龄在 43-64 岁、体重指数≥25kg/m2的受访者。体重变化估计为初始体重的百分比。体重变化分为三个类别：增加≥3%、稳定（增加<3%或减少<3%）、减少≥3%。体重减轻分为三个类别：减少≥3%至<5%、减少≥5%至<10%、减少≥10%。根据健康状况调查问卷，确定 SES 变量（即性别、年龄、教育、婚姻状况、职业活动和收入）。利用逻辑回归模型分析 SES 与体重变化之间的关系。结果以比值比（OR）及其 95%置信区间（CI）表示。
只有 18%的受访者符合医学减肥建议。性别、年龄和职业活动变量与体重减轻变量之间存在显著差异。使用多因素模型确定了 SES 与体重减轻之间以下性别特异性关联。与高收入者相比，中等收入男性体重减轻的几率显著更高（≈75%），而低收入、不活跃职业的女性体重减轻的几率显著更高（≈30%和≈50%），与高收入和活跃职业者相比。
较低的教育程度、男性性别、家庭收入较低、年龄较大和失业状态是导致肥胖的既定因素。在努力确保专门针对预防肥胖的措施的有效性的同时，必须首先确定最有可能出现潜在体重增加的人群。
