Wage Penalties or Wage Premiums? A Socioeconomic Analysis of Gender Disparity in Obesity in Urban China

Global obesity as a major public health problem has increased at pandemic rate, with men often outpacing women. Survey data show that the overall prevalence of obesity is higher among women than men, yet in high-income developed countries, the prevalence of overweight is higher among men than women. The differential impact of different economic stages has prompted research in transition economies such as China. Using an instrumental variable approach based on a sample of 13,574 individuals from nine provinces in the Chinese Household Income Project (CHIP), we find a 7% excess-weight premium in wages for overweight men and a 4.6% penalty for overweight women, compared to their healthy-weight peers. We also find an inverse u-shaped association between the body mass index (BMI) and logarithm of monthly income for men, with an implied optimum above the threshold of obesity, while women are better off the slimmer they are. The excess-weight premium in wages for Chinese urban men might be associated with entrenched business practices of excessive dining and drinking associated with senior positions. Policies aimed at reducing obesity in China must be adapted to its unique sociocultural context in order to have gender-differentiated effects.