The association between Internet Usage and Overweight/Obesity modified by Gender: Evidence from a nationally representative survey in Nepal

Objective Using a nationally representative data, we examined the associations between internet use and overweight/obesity in people aged 15-49 years in Nepal, and the extent to which these associations vary by gender. Materials and methods The study analyzed the nationally representative Nepal Demographic and Health Survey (NDHS) 2016 data, collected between June 2016 and January 2017. The outcome was overweight/obesity. Exposures were internet use (IU) in the last twelve months and internet use frequency (FIU) in the last month. Multivariable ordinal logistic regression models were fitted to estimate the total effects of IU and FIU on overweight/obesity adjusted for minimal sufficient adjustment set of potential confounders. P-difference was extracted using a Wald test for the models with interaction terms. Results Of the 10,380 participants, 33.9% used internet in the last 12 months, and 13.1 % used less than/at least once in a week, and 17.5% used internet almost every day. The prevalence of overweight/obesity by IU was 38% (95% CI: 35.9%, 40.1%) for male and 44.1% (95% CI: 41.6%, 46.6) for female. The risk of overweight and obesity was significantly 1.55 times higher (aOR: 1.55; 95% CI: 1.40, 1.73; p < 0.001) among those participants who used the internet compared to the individual who did not use the internet in the last 12 months or earlier of the interview. Similar associations were observed when using the augmented measure of exposure-FIU. We observed modification effect of gender in the associations of IU (p-difference<0.001) and FIU (p-difference<0.002) with overweight and obesity in Nepal. Conclusions Our findings suggest that it is imperative for future overweight/obesity interventions in LMICs, including Nepal, to discourage unnecessary internet use, particularly among males.