Sex Differences in Abdominal Obesity Among Medical Students in Kazakhstan: A Cross-Sectional Study

Abstract Background Obesity and central adiposity are major public health concerns among young adults. Waist-to-height ratio (WHtR) is a simple anthropometric indicator of central adiposity associated with cardiometabolic risk. However, sex-specific data among medical students in Kazakhstan are limited. This study evaluated sex differences in WHtR-defined abdominal obesity, anthropometric indicators, and selected dietary and lifestyle characteristics. Methods A cross-sectional study was conducted between March and June 2026 among 100 undergraduate medical students at Karaganda Medical University, Kazakhstan, including 50 male and 50 female participants. Participant-reported anthropometric data included height, body weight, waist circumference, and hip circumference, from which body mass index, waist-to-hip ratio, and waist-to-height ratio were calculated. Abdominal obesity was defined as a waist-to-height ratio ≥0.50. Sex differences were assessed using Welch’s independent-samples t-test, Pearson’s chi-square test, and Fisher’s exact test where appropriate. Logistic regression was used to estimate crude and age-adjusted odds ratios (ORs) for abdominal obesity. Results The mean age was 19.99 ± 1.45 years, and the overall prevalence of abdominal obesity was 23.0%. Male students had higher mean waist circumference (83.73 ± 10.52 vs 71.05 ± 8.42 cm), waist-to-hip ratio (0.881 ± 0.055 vs 0.794 ± 0.055), and WHtR (0.472 ± 0.058 vs 0.430 ± 0.049; all p<0.001). Abdominal obesity was more prevalent among males than females (34.0% vs 12.0%; Pearson χ²=6.83, p=0.009). Male sex was associated with higher odds of abdominal obesity (OR 3.78, 95% CI 1.34–10.63); age adjustment did not materially alter the association (adjusted OR 3.74, 95% CI 1.32–10.63; p=0.013). Frequent fast-food consumption (62.0% vs 30.0%, p=0.001) and late evening eating (70.0% vs 44.0%, p=0.009) were also more common among males. Conclusions Male medical students demonstrated a higher burden of central adiposity and WHtR-defined abdominal obesity than female students. These findings support further evaluation of WHtR-based screening and sex-responsive obesity prevention within university health programmes.