Gender Differences in Physical Activity, Sedentary Behaviour and Obesity among Adults in Benghazi, Derna and Al Bayda, Libya: The Moderating Role of Socioeconomic and Demographic Characteristics

Abstract

Background/Objectives: Overweight, obesity, physical inactivity and sedentary behaviour are important public-health concerns in Libya, with substantial differences between women and men. However, multi-city evidence examining whether gender and socioeconomic characteristics modify the relationships between movement-related behaviours and adiposity remains limited. This study estimated BMI-defined overweight/obesity and insufficient physical activity and examined the associations of physical activity (PA) and sedentary behaviour (SB) with adiposity among Libyan adults in Benghazi, Derna, and Al Bayda, with particular attention to gender and socioeconomic/demographic moderation. Methods: A cross-sectional online survey included 2,000 Libyan adults aged 20–65 years recruited using a city-stratified, quota-based non-probability strategy. Participants completed a self-administered Arabic Microsoft Forms questionnaire incorporating the WHO Global Physical Activity Questionnaire. PA was expressed as MET-minutes/week, insufficient activity as <600 MET-min/week, and SB as daily sitting/reclining time. BMI was calculated from self-reported height and weight. Multivariable linear regression examined continuous BMI, while modified Poisson regression with robust variance estimates adjusted prevalence ratios (aPRs) for BMI-defined overweight/obesity. Gender and socioeconomic/demographic moderation were examined using prespecified interaction terms. Results: Overall, 72.4% had overweight/obesity and 39.2% had obesity; prevalence of overweight/obesity was higher among women than men (79.2% vs. 65.0%). Insufficient PA affected 42.0% overall and was more frequent among women. Higher PA was inversely associated with BMI (β = −0.18, p < 0.001), while greater SB was positively associated with BMI (β = 0.21, p < 0.001). Insufficient PA was associated with higher overweight/obesity prevalence (aPR = 1.19, 95% CI 1.13–1.25), while each additional sedentary hour/day was associated with aPR = 1.07 (95% CI 1.05–1.09). PA × gender (p = 0.006) and SB × gender (p = 0.002) interactions indicated stronger associations among women. Education, household income, and age significantly moderated these relationships, whereas employment and marital status did not.  Conclusion: Overweight/obesity and insufficient physical activity were common in this three-city Libyan online sample. Movement-related behaviours were associated with adiposity, with stronger associations among women and evidence that education, income and age further conditioned these relationships. The findings support gender-responsive and socioeconomically sensitive obesity-prevention planning, while the cross-sectional, self-reported and non-probability design precludes causal or population-representative interpretation.