Socioeconomic determinants of overweight and obesity in Ghana: evidence from the Annual Household Income and Expenditure Survey panel

Overweight and obesity are rising rapidly in Ghana, yet evidence on their socioeconomic determinants and short-term dynamics remains limited. This study examines the prevalence, determinants, and transitions of weight status using nationally representative panel data from the Annual Household Income and Expenditure Survey (AHIES) spanning 2022–2024. The analytical sample comprised 33,356 adults contributing 284,096 person-quarter observations. Descriptive statistics were used to assess prevalence patterns across socioeconomic groups. Correlated Random Effects (CRE) logistic regression models were employed to identify determinants of overweight and obesity, while transition matrices were used to analyse movements between BMI categories over time. The prevalence of obesity increased from 14.1% in 2022 to 16.8% in 2024, while normal weight declined slightly. Overweight remained relatively stable. Transition analysis showed strong persistence, with 67.3% of obese individuals remaining obese across consecutive periods. Women and urban residents were significantly more likely to be overweight or obese. Higher education was associated with higher obesity risk. These findings highlight substantial socioeconomic inequalities and short-term persistence in overweight and obesity in Ghana. Policy efforts should prioritise urban populations and women, while addressing structural drivers such as lifestyle changes and access to healthy environments to curb the growing burden of non-communicable diseases.