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Female obesity and socioeconomic gradients in small Island developing states

Tegunimataka, Anna LU and Karlsson, Omar LU (2026) In International Journal of Development Issues
Abstract
Purpose:
Rapid changes in diet, physical activity and food systems have contributed to rising obesity in developing countries. As national incomes increase, obesity often shifts from higher to lower socioeconomic groups, a process known as the obesity transition. Small Island Developing States (SIDSs) face particular risks because of limited health system capacity, geographic isolation and dependence on imported foods. This study aims to examine female obesity patterns across six SIDSs to identify their position within the obesity transition.

Design/methodology/approach:
The analysis uses nationally representative data from Demographic and Health Surveys and Multiple Indicator Cluster Surveys for Fiji, Haiti, the Maldives,... (More)
Purpose:
Rapid changes in diet, physical activity and food systems have contributed to rising obesity in developing countries. As national incomes increase, obesity often shifts from higher to lower socioeconomic groups, a process known as the obesity transition. Small Island Developing States (SIDSs) face particular risks because of limited health system capacity, geographic isolation and dependence on imported foods. This study aims to examine female obesity patterns across six SIDSs to identify their position within the obesity transition.

Design/methodology/approach:
The analysis uses nationally representative data from Demographic and Health Surveys and Multiple Indicator Cluster Surveys for Fiji, Haiti, the Maldives, Samoa, Timor Leste and Vanuatu. Female obesity prevalence was assessed across age and wealth groups. Predicted margins were estimated to examine socioeconomic gradients in obesity and to classify each country’s stage of the obesity transition.

Findings:
Substantial heterogeneity exists across countries. Haiti, Samoa, Timor Leste and Vanuatu exhibit early transition patterns, with obesity concentrated among women of higher socioeconomic status. Fiji shows a weakening positive gradient, suggesting movement between Stages 2 and 3. The Maldives demonstrates characteristics of a later transition stage, where obesity is increasing more rapidly among lower socioeconomic groups, indicating emerging health inequalities.

Originality/value:
To the best of the authors’ knowledge, this study offers one of the first cross-country assessments of obesity transition stages in SIDSs using harmonized survey data, providing evidence to support stage-specific and equity-focused obesity prevention strategies. (Less)
Please use this url to cite or link to this publication:
author
and
organization
publishing date
type
Contribution to journal
publication status
epub
subject
keywords
Small Island states, Female obesity, Obesity transition, Socioeconomic status (SES) gradient, Urbanization (urban–rural disparities)
in
International Journal of Development Issues
publisher
Emerald Group Publishing Limited
ISSN
1446-8956
DOI
10.1108/IJDI-01-2026-0029
language
English
LU publication?
yes
id
48656875-4071-4e43-a6e2-9592850dce3a
date added to LUP
2026-06-15 07:46:10
date last changed
2026-06-17 11:21:40
@article{48656875-4071-4e43-a6e2-9592850dce3a,
  abstract     = {{Purpose:<br/>Rapid changes in diet, physical activity and food systems have contributed to rising obesity in developing countries. As national incomes increase, obesity often shifts from higher to lower socioeconomic groups, a process known as the obesity transition. Small Island Developing States (SIDSs) face particular risks because of limited health system capacity, geographic isolation and dependence on imported foods. This study aims to examine female obesity patterns across six SIDSs to identify their position within the obesity transition.<br/><br/>Design/methodology/approach:<br/>The analysis uses nationally representative data from Demographic and Health Surveys and Multiple Indicator Cluster Surveys for Fiji, Haiti, the Maldives, Samoa, Timor Leste and Vanuatu. Female obesity prevalence was assessed across age and wealth groups. Predicted margins were estimated to examine socioeconomic gradients in obesity and to classify each country’s stage of the obesity transition.<br/><br/>Findings:<br/>Substantial heterogeneity exists across countries. Haiti, Samoa, Timor Leste and Vanuatu exhibit early transition patterns, with obesity concentrated among women of higher socioeconomic status. Fiji shows a weakening positive gradient, suggesting movement between Stages 2 and 3. The Maldives demonstrates characteristics of a later transition stage, where obesity is increasing more rapidly among lower socioeconomic groups, indicating emerging health inequalities.<br/><br/>Originality/value:<br/>To the best of the authors’ knowledge, this study offers one of the first cross-country assessments of obesity transition stages in SIDSs using harmonized survey data, providing evidence to support stage-specific and equity-focused obesity prevention strategies.}},
  author       = {{Tegunimataka, Anna and Karlsson, Omar}},
  issn         = {{1446-8956}},
  keywords     = {{Small Island states; Female obesity; Obesity transition; Socioeconomic status (SES) gradient; Urbanization (urban–rural disparities)}},
  language     = {{eng}},
  month        = {{06}},
  publisher    = {{Emerald Group Publishing Limited}},
  series       = {{International Journal of Development Issues}},
  title        = {{Female obesity and socioeconomic gradients in small Island developing states}},
  url          = {{http://dx.doi.org/10.1108/IJDI-01-2026-0029}},
  doi          = {{10.1108/IJDI-01-2026-0029}},
  year         = {{2026}},
}