Abstract

Obesity is an increasing public health concern in sub-Saharan Africa, especially in urban settings undergoing rapid nutritional and lifestyle transitions. This study aimed to estimate the prevalence of obesity and identify its associated risk factors among adults attending four district hospitals in N’Djamena, Chad. A descriptive and analytical cross-sectional study was conducted over a three-month period, involving 1,270 participants aged 25 to 65 years, recruited through systematic random sampling. Data were collected using a structured questionnaire, standardized anthropometric measurements, and biological tests. The overall prevalence of obesity was 11.2%, and 28.4% of participants were overweight. Obesity was significantly more frequent among women (71.1% of obese cases) and increased with age and monthly income. Bivariate analyses revealed significant associations between obesity and sex (p < 0.001), age (p < 0.001), education level (p = 0.010), and income (p = 0.029). Specific dietary behaviours such as high consumption of added sugars (p = 0.003), high salt intake (p < 0.001), and low fruit consumption (p = 0.023) were also significantly associated with obesity. In contrast, no significant association was found with physical activity, tobacco use, or alcohol consumption. Multivariate logistic regression identified female sex, older age, and higher income as independent risk factors for obesity. These results confirm the emergence of obesity as a major health issue in urban Chad, particularly among women with higher incomes, and underscore the need for context-specific and gender-sensitive preventive interventions.