ABSTRACT:
Obesity is a highly prevalent problem in Latin America, with a growing trend, primarily among the most disadvantaged social groups. This study aimed to analyze the social determinants of obesity inequities among the adult population of Ecuador. We conducted a cross-sectional study with a sample of 86,761 individuals aged 18 and over, using data from the 2018 National Health and Nutrition Survey. An exploratory analysis of the distribution of obesity (BMI ≥30 kg/m²) was performed according to various social indicators. To determine their association with the occurrence of obesity, multilevel Poisson models stratified by sex were estimated. We found a higher prevalence of obesity in women (29%) compared to men (18%) (p < 0.01), especially in the 45–64 age group (37% in women and 23% in men, p < 0.01). Regarding factors associated with obesity, it was found that women with no schooling had a higher prevalence of obesity (PRR 1.22; 95% CI 1.12–1.33) compared to those with higher education. In men with no schooling, the prevalence was lower (PRR 0.77; 95% CI 0.68–0.88) than in those with higher education. Regarding ethnicity, the prevalence of obesity was significantly lower in Indigenous people (p < 0.05) compared to mestizos in both women and men. Other social characteristics, such as marital status, place of residence, and occupation, showed significant associations with obesity. In particular, higher probabilities of obesity were observed in single women compared to married/cohabiting women, in rural versus urban areas, and in students versus working women. These findings suggest that the social pattern of obesity differs between women and men, highlighting the importance of public policies for obesity prevention with a gender and health equity focus.