Scottish Health Survey - topic report: equality groups

8 Obesity

Summary

• Men were more likely to be overweight than women.
• Prevalence of overweight and obesity increased with age, peaking at age 55-64.
• Chinese and Asian Other respondents had significantly lower levels of overweight and obesity than other ethnic groups.
• Buddhists and Hindus had low levels of obesity whilst Church of Scotland members had significantly higher levels than the national average.
• Respondents with limiting long-term conditions were more likely to be obese than those with non-limiting conditions but there was no different in the rates of overweight for these two groups.

8.1 Measures of overweight and obesity

Participants' height and weight were measured during the interview. Body Mass Index (BMI), defined as weight (kg)/height (m2), is a widely accepted measure that allows for differences in weight due to height. However, BMI has some limitations: it does not distinguished between mass due to body fat and mass due to muscular physique. It also does not take account of the distribution of fat. The merits of BMI as an indicator are discussed in more detail in the Scottish Health Survey topic report on obesity.¹

BMI was calculated for all those participants for whom a valid height and weight measurement was recorded and were classified into the following BMI groups:

8.2 Overweight and obesity by gender

There was no significant gender difference in the prevalence of obesity, although men were more likely to be overweight than women (69% compared with 61%).

8.3 Overweight and obesity by age

Prevalence of overweight and obesity increased with age, peaking at age 55-64, before falling slightly for older age groups. 16-24 year olds were least likely to be overweight (35%) or obese (13%) whilst 55 to 64 year olds were the most likely to be overweight (77%) or obese (36%).

Figure 8A: Prevalence of overweight including obesity, by age, 2008-2011 combined

8.4 Overweight and obesity by ethnic group

The highest prevalence of obesity was among African, Caribbean or Black respondents (35%) but this was not significantly different from the average.

Previous research has found that Asians in Britain were almost four times as likely to be obese than White ethnic groups². Similarly another study found that South Asian children born in Britain between 1991 and 1999 were more likely to be overweight and obese than White children.³ These findings have not been replicated in the Scottish Health Survey results as they show no significant difference between White British and Asian Indian and Pakistani ethnic groups. This may be down to small sample sizes, however. What is interesting is the difference between Asian ethnic groups. Chinese and Asian Other respondents had the lowest prevalence of overweight (41% and 45% respectively) and obesity (4% and 9% respectively), and this was significantly lower than the national average.

Figure 8B: Prevalence of obesity, by ethnic group, 2008-2011 combined

8.5 Overweight and Obesity by religion

Buddhist and Hindu respondents had the lowest prevalence of obesity (both 15%); significantly lower than the national average (27%). People who said they belonged to no religion also had a slightly, but significantly, lower prevalence of obesity than the average (26%). Respondents who were members of the Church of Scotland were most likely to be obese (30%), significantly more so than average.

These patterns were similar but less marked, in relation to overweight including obesity prevalence. The only religions which stood out as significantly different to the national average (65%) were Church of Scotland (67%) and Buddhist (42%).

Figure 8C: Prevalence of obesity, by religion, 2008-2011 combined

8.6 Overweight and Obesity by disability

Prevalence of obesity was significantly associated with disability. 34% of respondents with a limiting, long-term condition were obese, compared to 30% of those with a non-limiting condition, and 24% of those without a condition. There was no difference in the prevalence of overweight including obese between those with a limiting and non-limiting condition (both 68%) . This was, however, significantly higher than the prevalence of overweight including obese among those with no long-term condition (63%).

It is possible that respondents with physical impairments may become overweight as they are less capable of being physically active. It is also possible that those who are overweight and obese develop debilitating and longstanding condition as a consequence of their unhealthy weight. The point has been made, however, that whether obesity is the cause or the result of having a disability, the association presents a major challenge to public health.⁴

8.7 Overweight and obesity by sexual orientation

There was no significant association between sexual orientation and the prevalence of overweight or obesity.