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Scotland's Chief Statistician today published a Scottish Health Survey topic report on obesity.

The report has two distinct parts. The first examines the different ways of measuring overweight and obesity and recommends the most appropriate measures to use. The second looks at the associations between various factors and prevalence of overweight and obesity.

Main findings:

• Various measures were examined (BMI, waist circumference, waist hip ratio, waist height ratio and the WHO combined measure of BMI and waist circumference) to compare their ability to predict obesity-related health problems.
• BMI>=30 was considered to be the most appropriate measure of obesity as it was the strongest predictor for nearly all of the outcomes examined and it is easier to collect than other measures.
• The WHO combined measure of BMI and waist circumference (WC) was considered to be the best measure of overweight including obesity. It was found to be more specific than BMI>=25 and reduced classification bias (i.e. whereby people with high lean muscle mass would be classified as overweight by BMI alone). However, it was noted that this measure is more difficult to collect than BMI alone.
• Variables related to energy expenditure (physical activity and sedentary behaviour) were strongly associated with obesity for men and women.
• Dietary factors were significantly associated for men and women but had opposite effects. For women, low dietary quality was significantly associated with being obese but for men, those with higher dietary quality and who ate five portions of fruit and veg per day had higher odds of being obese. As the results for men contradict evidence found elsewhere, they should be interpreted with caution.
• For women, obesity is significantly associated with area-level deprivation (SIMD) but not for men.
• Male never-smokers and ex-smokers had higher odds of being obese when compared to current smokers and the relationship was strongest in men with no educational qualifications.
• There was no significant association between smoking and obesity for women but there was an association with increased risk using the WHO combined measure whereby never-smokers and ex-smokers had greater odds of being at increased risk of obesity-related diseases.
• It should be noted that significant associations do not indicate causality and some of the associations seen could be bi-directional, such as physical activity and obesity.

Official Statistics are produced by professionally independent statistical staff.

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