Obesity in French Inmates: Gender Differences and Relationship with Mood, Eating Behavior and Physical Activity

CONTEXT: Inmates, notably women, are at greater risk for obesity and metabolic complications than the general population according to several studies from high income countries. Data regarding French correctional institutions are lacking so far. To fill this gap, we have assessed in a sample from a French prison (33 females and 18 males) the gender-specific effect of incarceration on weight and body mass index (BMI) and examined their current metabolic status. Furthermore, to reveal the possible determinants of increased obesity, we analyzed emotional vulnerability, eating behavior and physical activity using self-reported questionnaires. RESULTS: In this sample, obesity (BMI≥30 kg/m(2)) was already frequent in women (18.2%) but rather scarce for men (11%) at prison entry. Incarceration worsened the rate of obesity in both genders (21.2% and 16.7% respectively). At the time of study, abdominal obesity estimated through waist circumference was particularly prevalent in women (69.7%) versus men (27.8%) and metabolic syndrome was detected in 33% of female against none in male inmates. Abdominal obesity was associated with female sex (p<0.03), low physical activity (p<0.05) and eating disorder (p = 0.07) in univariate analyses. Low physical activity remained significant as an explanatory factor of higher abdominal obesity in multivariate analysis. A marked difference between genders was found for practice of physical activity with a higher proportion of women compared to men being inactive (37.9% vs. 11.8%) and fewer women being very active (17.2% vs. 41.2%). CONCLUSION: This study revealed that a significant proportion of women of this correctional institution combined established obesity, a metabolic syndrome and very little practice of physical activity which put them at high risk of cardiovascular disease. Thus, obesity should be better surveyed and treated in prison, especially for female inmates. Increased physical activity, adapted to obese women, would be the first mean to decrease obesity and gender differences.