Obesity and Occupational Disparities in Urban China: Evidence from a Large-Scale Cross-Sectional Study

Background/Objectives: Obesity has become a global public health crisis, with China now ranking among the countries with the highest number of obese adults. Urban China faces a growing burden of obesity, but little is known about how obesity prevalence differs by occupation. This study aimed to assess the prevalence of overweight and obesity in 2022 among urban adults in northern and southern China, and to examine disparities across occupational groups. Methods: This study utilized cross-sectional data from 2022 health examinations to calculate the prevalence of overweight and obesity in different occupations in cities of southern and northern China. A logistic regression model was applied to analyze association between occupational categories and obesity, controlling for confounding factors like age, gender and region. Results: A total of 1,427,978 participants in 2022 were included. The aggregate prevalence of overweight and obesity was 30.78% and 7.90%, respectively. After being adjusted by logistic regression, the study showed that the highest adjusted odds ratio of overweight was observed in the Real Estate Industry sector with AOR 1.17 (1.15, 1.19), while the lowest odds ratio occurred in the Mining Industry sector, which was 0.90 (0.80, 1.01). The highest adjusted odds ratio of the prevalence of obesity was associated with the Production and Supply of Electricity, Heat, Gas, and Water sector (AOR: 1.92 (1.78, 2.07)), whereas the lowest odds ratio was observed in the Scientific Research and Technical Services sector. After categorizing occupations into four broad groups, the Blue-Collar group had the highest adjusted odds ratio of the prevalence of overweight (AOR: 1.07 (1.06, 1.08)), whereas the Sales/Office group exhibited the highest odds ratio of the prevalence of obesity (AOR: 1.37 (1.35, 1.39)). Conclusions: The prevalence of overweight and obesity differed substantially across occupational groups especially for obesity. More detailed and occupation-specific BMI management policies should be released to reduce obesity-related health inequalities in urban China.