Delayed marriage significantly reduces the risk of obesity among urban women in Pakistan, new research has shown.
Gendered social norms and urbanisation, play a role in shaping rising obesity rates
The study used data from the 2012–13 and 2017–18 Pakistan Demographic and Health Surveys and found that while over half of all adult women in Pakistan are overweight or obese, the protective effect of delayed marriage is particularly strong for those in urban areas.
Researchers showed that early marriage increased the risk of obesity by limiting fertility control, education, health knowledge and bargaining power.
The study, led by the University of York, highlights how gendered social norms, combined with urbanisation, play a significant role in shaping rising obesity rates in the country.
Health awareness
The research identifies several key pathways through which early marriage may contribute to a higher risk of obesity:
- Fertility: Early marriage often leads to premature and more frequent pregnancies, which are known to influence long-term weight retention.
- Education and Health Knowledge: Marrying later allows women to accumulate more schooling, literacy, and health knowledge, leading to better health behaviours and nutrition investment.
- Agency: A later age at marriage often reduces the spousal age gap, which is associated with increased decision-making power for women within the household, including dietary choices.
Nutrition transition
The study builds on earlier evidence that later marriage improves education, employment opportunities, decision-making power, and health, as well as the health of their children.
Wiktoria Tafesse, from the Centre for Health Economics at the University of York, said: "We focused on Pakistan as it is a developing country undergoing a nutrition transition, and where women tend to marry young - around 40% of the women in our data married before turning 18.
"We examined the age at marriage as a continuous factor, rather than comparing marriage impacts at pre and post the age of 18, to allow us to see how each extra year of delaying marriage affects later health outcomes."
Gender norms
For women living in urban areas, every additional year they delay marriage lowers their risk of obesity later on by about 0.7 percentage points. The effect is strongest for women who marry at age 23 or later.
Wiktoria Tafesse said: "Our findings provide a significant contribution to understanding the determinants of obesity and obesity-related non-communicable diseases in emerging economies, and how gender norms are shaping these outcomes.
"These findings underscore the importance of empowering girls and women with education, health information, and autonomy over marriage decisions, within a policy environment that rigorously enforces child marriage bans."
The study, part of the National Institute for Health Research (NIHR) funded research project Centre for IMPACT, is published in the journal, Economics and Human Biology.
