• Jose D Meisel, Valentina Esguerra, John K Giraldo, Felipe Montes, Ivana Stankov, Carlos A Meisel, Olga L Sarmiento, and Juan A Valdivia.
• Facultad de Ingeniería, Universidad de Ibagué, Carrera 22 Calle 67, 730001 Ibagué, Colombia; Social and Health Complexity Center, Bogotá, Colombia. Electronic address: jose.meisel@unibague.edu.co.
• Prev Med. 2023 Dec 1; 177: 107720107720.

ObjectiveWe investigate the obesity transition at the country- and regional-levels, by age, gender, and socioeconomic status (SES) and its relationship to three health behavior attributes, including physical activity (PA), sedentary activities (ST), and consumption of ultra-processed foods (CUPF) within the urban population of Colombia, from 20,010 to 2050.MethodsThe study is informed by cross-sectional data from ENSIN survey. We used these data to develop a system dynamics model that simulates the dynamics of obesity by body mass index (BMI) categories, gender, and SES. This model also uses a conservative co-flow structure for three health-related behaviors (PA, ST, and CUPF).ResultsAt the national level, our results indicate that the burden of obesity is shifting towards populations with lower SES as the gross domestic product (GDP) increases, particularly women aged 20-59 years with lower SES. Among this group of women, the highest burden of obesity is among those who do not meet the PA, ST and CUPF recommendations. At the regional level, our findings suggest that the regions are at different stages in the obesity transition.ConclusionsThe burden of obesity is shifting towards women with lower SES as GDP increases at the national level and across several regions. This obesity transition is paralleled by a high prevalence of women from low SES groups who do not meet the minimum recommendations for PA, CUPF, and ST. Our findings can be used by decision-makers to inform age- and SES- specific policies seeking to tackle the obesity.Copyright © 2023 The Authors. Published by Elsevier Inc. All rights reserved.

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