Marriage contributes to higher obesity risk in China: findings from the China Health and Nutrition Survey

Background: To investigate the association between marriage and the prevalence of overweight and obesity in China. Methods: We conducted cross-sectional and retrospective cohort analyses using a nationwide sample of 36,310 individuals from the China Health and Nutrition Survey [2004-2015]. Results: The prevalence of overweight and obesity increased from 28.7% to 36.7% and from 8.0% to 14.5% between 2004 and 2015, respectively. The cross-sectional analysis showed that married individuals were at a higher risk of being overweight ( OR =2.18; 95% CI, 1.90-2.51) or obese (OR =1.95; 1.57-2.43) than never-married individuals. Divorced/widowed individuals were also at a greater risk of being overweight (OR =1.80; 1.51-2.13) or obese (OR = 1.67; 1.28-2.17) than never-married individuals. Retrospective cohort analysis showed that individuals who married during the study were 1.55 (1.13-2.11) times more likely to be overweight than those who remained never-married. Compared to those who remained nevermarried, individuals who remained married were 1.71 (1.42-2.07) and 1.45 (1.11-1.89) times more likely to be overweight and obese. Individuals who became divorced or widowed were more likely to be overweight (RR =1.59; 1.18-2.15) or obese (RR =1.63; 1.08-2.46) than those who remained never-married. However, the risk of being overweight or obese among those who became divorced or widowed did not differ significantly from the risk among those who remained married. Conclusions: Marriage contributes to an increased risk of overweight and obesity in China; however, this risk is not significantly reduced by exiting a marriage.