J Endocrinol Metab

Journal of Endocrinology and Metabolism, ISSN 1923-2861 print, 1923-287X online, Open Access

Article copyright, the authors; Journal compilation copyright, J Endocrinol Metab and Elmer Press Inc

Journal website https://jem.elmerpub.com

Original Article

Volume 16, Number 5, October 2026, pages 217-227

Prevalence, Geographic Distribution, and Socioeconomic Disparities of Normal-Weight Central Obesity: An Analysis of 46,493 Adults

↓ Figure 1. Geographic distribution of the prevalence of normal-weight central obesity (NWCO) by department among Peruvian adults with normal body mass index (BMI), ENDES 2018–2024. (a) Department-level point map using the corrected estimand among adults with normal BMI (range: 24.0–41.9%). (b) LISA classification; no statistically significant local clusters were identified. Global Moran’s I = 0.167 (Monte Carlo P = 0.070).

↓ Figure 2. Concentration curve for normal-weight central obesity (NWCO) by wealth index, ENDES 2018–2024. The curve below the diagonal indicates concentration among higher wealth groups. Concentration index = 0.100.

↓ Figure 3. Temporal trends in normal-weight central obesity (NWCO) prevalence overall and by sex, ENDES 2018–2024. Annual change was not statistically significant overall (−0.46 pp/year, P = 0.172), among men (−0.21 pp/year, P = 0.356), or among women (−0.63 pp/year, P = 0.101).

↓ **Table 1.** Characteristics of Peruvian Adults According to Body Weight Phenotype and Central Obesity, ENDES 2018–2024
Characteristic	NW without CO (n = 30,586)	NWCO (n = 15,907)	OW/OB without CO (n = 8,173)	OW/OB with CO (n = 84,568)	Total (N = 139,234)
Values are weighted percentages or weighted means. Percentages are column percentages within each phenotype. NW: normal weight; NWCO: normal-weight central obesity; OW/OB: overweight/obesity; CO: central obesity; WC: waist circumference; BMI: body mass index; SD: standard deviation.
Sex
Female	29.7	78.6	22.3	54.3	51.8
Male	70.3	21.4	77.7	45.7	48.2
Age, years, mean (SD)	36.9 (18.2)	44.8 (19.7)	34.8 (12.3)	44.9 (16.2)	42.6 (17.1)
Age group
18–29	48.5	29.8	39.5	19.8	26.2
30–44	23.2	25.1	41.3	33.1	30.8
45–59	13.4	18.9	14.9	27.0	23.1
≥ 60	14.8	26.2	4.2	20.1	19.0
Wealth index
Lowest wealth quintile (Q1)	28.7	19.3	19.6	12.0	16.0
Low wealth quintile (Q2)	21.2	19.0	24.2	19.1	19.6
Middle (Q3)	19.3	19.4	21.4	22.3	21.3
High wealth quintile (Q4)	16.6	19.5	19.4	23.1	21.4
Highest wealth quintile (Q5)	14.2	22.7	15.5	23.6	21.7
Area of residence
Urban	72.6	80.9	80.8	87.5	83.8
Rural	27.4	19.1	19.2	12.5	16.2
WC, cm, mean (SD)	79.4 (5.5)	87.9 (5.9)	84.1 (6.0)	99.5 (9.2)	93.8 (11.5)
BMI, kg/m², mean (SD)	22.3 (1.6)	23.5 (1.3)	26.9 (2.4)	30.2 (4.0)	28.1 (4.6)

↓ Table 1. Characteristics of Peruvian Adults According to Body Weight Phenotype and Central Obesity, ENDES 2018–2024

Characteristic

NW without CO (n = 30,586)

NWCO (n = 15,907)

OW/OB without CO (n = 8,173)

OW/OB with CO (n = 84,568)

Total (N = 139,234)

Values are weighted percentages or weighted means. Percentages are column percentages within each phenotype. NW: normal weight; NWCO: normal-weight central obesity; OW/OB: overweight/obesity; CO: central obesity; WC: waist circumference; BMI: body mass index; SD: standard deviation.

Sex

Female

29.7

78.6

22.3

54.3

51.8

Male

70.3

21.4

77.7

45.7

48.2

Age, years, mean (SD)

36.9 (18.2)

44.8 (19.7)

34.8 (12.3)

44.9 (16.2)

42.6 (17.1)

Age group

18–29

48.5

29.8

39.5

19.8

26.2

30–44

23.2

25.1

41.3

33.1

30.8

45–59

13.4

18.9

14.9

27.0

23.1

≥ 60

14.8

26.2

4.2

20.1

19.0

Wealth index

Lowest wealth quintile (Q1)

28.7

19.3

19.6

12.0

16.0

Low wealth quintile (Q2)

21.2

19.0

24.2

19.1

19.6

Middle (Q3)

19.3

19.4

21.4

22.3

21.3

High wealth quintile (Q4)

16.6

19.5

19.4

23.1

21.4

Highest wealth quintile (Q5)

14.2

22.7

15.5

23.6

21.7

Area of residence

Urban

72.6

80.9

80.8

87.5

83.8

Rural

27.4

19.1

19.2

12.5

16.2

WC, cm, mean (SD)

79.4 (5.5)

87.9 (5.9)

84.1 (6.0)

99.5 (9.2)

93.8 (11.5)

BMI, kg/m², mean (SD)

22.3 (1.6)

23.5 (1.3)

26.9 (2.4)

30.2 (4.0)

28.1 (4.6)

↓ **Table 2.** Prevalence of NWCO Among Peruvian Adults With Normal Weight by Sociodemographic Characteristics, ENDES 2018–2024
Characteristic	Prevalence (%)	95% CI
Values are weighted percentages. Prevalences are estimated among adults with normal BMI. NWCO: normal-weight central obesity; CI: confidence interval.
Overall	35.1	34.4–35.9
Sex
Female	58.9	57.9–60.0
Male	14.2	13.4–14.9
Age group
18–29	25.0	24.0–25.9
30–44	36.9	35.6–38.2
45–59	43.3	41.3–45.3
≥ 60	48.9	47.1–50.8
Wealth index
Lowest wealth quintile (Q1)	26.7	25.9–27.6
Low wealth quintile (Q2)	32.7	31.4–34.1
Middle (Q3)	35.2	33.6–36.9
High wealth quintile (Q4)	39.0	37.0–41.0
Highest wealth quintile (Q5)	46.4	43.2–49.7
Area of residence
Urban	37.6	36.7–38.6
Rural	27.5	26.6–28.3
Natural region
Metropolitan Lima	38.5	36.7–40.2
Rest of the Coast	38.4	37.1–39.6
Highlands	30.8	29.9–31.7
Jungle	30.8	29.6–31.9

↓ Table 2. Prevalence of NWCO Among Peruvian Adults With Normal Weight by Sociodemographic Characteristics, ENDES 2018–2024

Characteristic

Prevalence (%)

95% CI

Values are weighted percentages. Prevalences are estimated among adults with normal BMI. NWCO: normal-weight central obesity; CI: confidence interval.

Overall

35.1

34.4–35.9

Sex

Female

58.9

57.9–60.0

Male

14.2

13.4–14.9

Age group

18–29

25.0

24.0–25.9

30–44

36.9

35.6–38.2

45–59

43.3

41.3–45.3

≥ 60

48.9

47.1–50.8

Wealth index

Lowest wealth quintile (Q1)

26.7

25.9–27.6

Low wealth quintile (Q2)

32.7

31.4–34.1

Middle (Q3)

35.2

33.6–36.9

High wealth quintile (Q4)

39.0

37.0–41.0

Highest wealth quintile (Q5)

46.4

43.2–49.7

Area of residence

Urban

37.6

36.7–38.6

Rural

27.5

26.6–28.3

Natural region

Metropolitan Lima

38.5

36.7–40.2

Rest of the Coast

38.4

37.1–39.6

Highlands

30.8

29.9–31.7

Jungle

30.8

29.6–31.9

↓ **Table 3.** Socioeconomic Inequalities in NWCO Prevalence, ENDES 2018–2024
Indicator	Estimate	95% CI	Interpretation
The SII is reported on the proportion scale and interpreted as percentage points after multiplying by 100. A positive concentration index indicates concentration among higher wealth groups. CI: confidence interval; NWCO: normal-weight central obesity; pp: percentage points.
Slope Index of Inequality (SII)	0.227	0.201–0.253	22.7 pp higher at the highest vs. lowest wealth rank
Relative Index of Inequality (RII)	1.91	1.79–2.05	Nearly double the prevalence
Concentration index	0.100	-	Concentration among higher wealth groups

↓ Table 3. Socioeconomic Inequalities in NWCO Prevalence, ENDES 2018–2024

Indicator

Estimate

95% CI

Interpretation

The SII is reported on the proportion scale and interpreted as percentage points after multiplying by 100. A positive concentration index indicates concentration among higher wealth groups. CI: confidence interval; NWCO: normal-weight central obesity; pp: percentage points.

Slope Index of Inequality (SII)

0.227

0.201–0.253

22.7 pp higher at the highest vs. lowest wealth rank

Relative Index of Inequality (RII)

1.91

1.79–2.05

Nearly double the prevalence

Concentration index

0.100

Concentration among higher wealth groups