The purpose of this study was to assess the magnitude of central obesity and associated factors among public service office workers in Adama town. According to the study, 24.2% (95% CI: 20.9, 27.8) of the public service office employees had central obesity. The prevalence of central obesity was significantly greater among males (29.9%) than among females (14.9%) (X2 = 17.0 (df) = (1), p < 0.001).
The overall magnitude of central obesity in this study was lower than the prevalence of central obesity among public service workers in Bedele town [23], the pooled prevalence of central obesity among adult populations in Ethiopia[32], and the prevalence of central obesity among health service providers and public transportation workers in Nigeria and Peru [20, 33].
On the other hand, the magnitude of central obesity in this study is comparable to the magnitude of central obesity among health workers in Gaza strips in Palestine[34], two studies that found 24.6%, and 27.7% of central obesity among public service workers in the United States of America(USA) [35, 36].
Furthermore, the magnitude of central obesity in this study is higher than those of studies in the Oddo State in Nigeria(20.0%), rural Brazil(19.7%), Thailand(15.4%), and Ghana(25.7%) [37–40]. The variations in sample sizes, cutoff criteria, and socio-cultural and economic distinctions across the studies could all be contributing factors to the inconsistencies between the study findings.
In this study, the mode of transport to work and back home was found to be an independent determinant of central obesity. Accordingly, employees who used motorized transportation were more likely to be centrally obese than employees who walked or used bicycles to the office and returned home. These findings are consistent with studies that identified positive associations between the use of motorized transportation and increased risk of central obesity among urban dwellers [41, 42]. The growing prevalence of obesity among urban dwellers can be attributed, in large part, to the characteristics of cities that impede active commuting, such as walking and using nonmotorized transit[41].
Eating foods out of home has been common among communities in developed countries for several years and becoming a growing practice in developing countries as much as an increase of nearly 50%. This study showed that public service workers who consumed food away from their homes had increased odds of having central obesity compared to workers who consumed food from their homes. The finding is in line with a study in China that revealed an increased risk of obesity among individuals who frequently consumed food outside of their homes[43]. Such practices are particularly influenced by social and physical factors, income, types and number of restaurants, proximity to food establishments, and other factors [42–44]. The association between eating foods away from home and obesity is conceivable because foods prepared at restaurants and cafeterias may contain less dietary fiber, fruits, and vegetables. In contrast, it may contain high amounts of saturated fats, and beverages that promote the accumulation of excess fats around the abdomen[43].
There are conflicting links between alcohol consumption and obesity. This study, however, demonstrated statistically significant positive associations between alcohol use and central obesity, consistent with the findings of previous studies [21, 23, 37, 45, 46]. Alcohol is considered a nontrivial energy source that may lead to a positive energy balance, weight gain, and eventually the emergence of obesity among drinkers [21, 42, 47, 48].
Our finding showed that the odds of central obesity were significantly increased with increased age. The current finding is consistent with numerous studies that established an increased risk of obesity with aging in Ethiopia [21, 45, 49] and elsewhere[20, 37, 48]. The possible reasons are that hormone production and the response to thyroid hormone diminish as people get older. Such hormonal alterations may affect physical activity, body metabolism, and energy expenditure. As a result, there is a shift in body composition in which older individuals lose muscular mass and store larger amounts of fat than younger people [3, 5, 14, 15, 42].
In this study, workers who did not practice moderate physical activity had higher odds of having central obesity compared to their counterparts. The finding is in agreement with multiple studies in Ethiopia that documented positive associations between lack of moderate physical activity and increased odds of obesity [4, 16, 21]. A plausible explanation for this could be that people who engage in moderate physical activity may have improved preservation of lean body mass and less fat storage. Because of this, lack of moderate physical activity raises the chance of retaining excess calories, which could then be turned into body fat [5, 14, 15].
The presence of chronic illnesses was another factor associated with central obesity. Accordingly, employees who had chronic illnesses such as diabetes mellitus, hypertension, or both were more likely to have central obesity than those who had no chronic illnesses. The finding was in agreement with previous studies that identified associations between chronic illnesses and central obesity [37, 50]. The complex relationships between hypertension, diabetes, and other morbidities have been extensively discussed [51, 52]. In reality, it is challenging to determine which of these two conditions occurs first; thus, the temporal associations between obesity and chronic illnesses should be interpreted with caution. For example, obesity increases the risk of developing diabetes mellitus and cardiovascular problems [14]. Conversely, chronic illnesses increase the risk of obesity because individuals with chronic illnesses might shun physical activity or lead sedentary lives more than those who have no chronic illnesses.
Limitations of the study
We made utmost efforts to minimize the limitations of the study through training and the use of standardized tools. However, we acknowledge that the study cannot be free from recall and social desirability biases, as the data were collected via self-reports. The study was conducted among public office employees working at the Zonal level. Thus, the findings cannot be generalized to all office workers and the general population in the town