The Role of Hormonal Contraceptive Use in Mediating Sociodemographic Predictors of Overweight and Obesity among Women of Reproductive Age in Ghana

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ABSTRACT Background The global rise in overweight and obesity poses significant public health challenges, contributing to premature mortality and preventable disabilities. Moreover, efforts to increase reproductive autonomy through the promotion of modern contraceptive methods are underway, with persisting concerns regarding their potential influence on weight gain. This study aimed to identify the risk factors associated with overweight and obesity and to examine the mediating role of hormonal contraceptive use among Ghanaian women of reproductive age. Methods An analytical cross-sectional study was conducted using secondary data from the 2022 Ghana Demographic and Health Survey, which involved 6,181 women aged 20 years and above. Associations between overweight/obesity and various sociodemographic factors were assessed, and logistic regression models were used to estimate crude and adjusted odds ratios. Mediation analysis was performed via structural equation modelling to evaluate the indirect effects of hormonal contraceptive use on the relationships between the independent variables and BMI. Results The analysis revealed that factors such as age, educational attainment, literacy, marital status, religion, residential status, region, nature of employment, and wealth quintile were significantly associated with higher BMI. The results of the mediation analysis indicated that hormonal contraceptive use partially mediated the relationships between both age (9% of the effect) and marital status (9% of the effect). Conclusion Hormonal contraceptive use partially mediates the relationship between BMI and both age and marital status, indicating a modest but significant role in weight gain. Integrating individualized weight management counselling into family planning, especially those involving hormonal contraceptives with elevated BMIs, may increase the use of contraceptives while safeguarding women’s health since hormonal contraceptives play an indirect role in weight gain.

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