ORIGINAL ARTICLE Determinants of body weight status in Malaysia: an ethnic comparison Andrew K. G. Tan • Steven T. Yen • Mustapha I. Feisul Received: 11 June 2010 / Revised: 14 January 2011 / Accepted: 14 January 2011 / Published online: 12 February 2011 Ó Swiss School of Public Health 2011 Abstract Objective To investigate the roles of sociodemographic and health lifestyle factors in affecting body mass index (BMI) across ethnic groups in Malaysia. Methods Data are obtained from 2,436 observations from the Malaysia Non-Communicable Disease Surveillance-1. The multi-ethnic sample is segmented into Malay, Chinese, and Indian/other ethnicities. Ordered probit analysis is conducted and marginal effects of sociodemographic and health lifestyle variables on BMI calculated. Results Malays between 41 and 58 years are more likely to be overweight or obese than their 31–40 years coun- terparts, while the opposite is true among Chinese. Retirees of Chinese and Indian/other ethnicities are less likely to be obese and more likely to have normal BMI than those between 31 and 40 years. Primary educated Chinese are more likely to be overweight or obese, while tertiary- educated Malays are less likely to suffer from similar weight issues as compared to those with only junior high school education. Affluent Malays and Chinese are more likely to be overweight than their low-middle income cohorts. Family illness history is likely to cause overweightness or obesity, irrespective of ethnicity. Malay cigarette smokers have lower overweight and obesity probabilities than non-cigarette smokers. Conclusions There exists a need for flexible policies to address cross-ethnic differences in the sociodemographic and health-lifestyle covariates of BMI. Keywords BMI  Ethnicity  Health lifestyle  Malaysia  Sociodemographics Introduction Malaysians are facing many of the health problems pre- dominantly encountered in other advanced economies. The Third National Health and Morbidity Survey (NHMS III) conducted in 2006 revealed that the prevalence of over- weight in terms of body mass index (BMI) increased from 16.6 to 28.6%, while obesity prevalence tripled from 4.5 to 14.2% as compared to statistics from NHMS II in 1996 (Ministry of Health Malaysia 2008). These statistics do not augur well for the health of the Malaysian population given that three of the five leading causes of death are obesity- related diseases and account for over one-third of all medically certified deaths in the country (Ministry of Health Malaysia 2005). The NHMS III also revealed that the 8.5% prevalence of underweight among adults was three times lower than that (25.5%) reported in the NHMS II in 1996 (Ministry of Health Malaysia 2008). Although this encouraging out- come has been attributed to progression in socioeconomic status and improvement in food intake in the country, Suzana et al. (2007) noted that a significant portion of elderly Malaysians are still susceptible to being under- weight and malnutrition risks. Thus, the problems of A. K. G. Tan (&) School of Social Sciences, Universiti Sains Malaysia, 11800 Minden, Penang, Malaysia e-mail: atan@usm.my S. T. Yen Department of Agricultural and Resource Economics, The University of Tennessee, Knoxville, TN 37996-4518, USA e-mail: syen@utk.edu M. I. Feisul Disease Control Division, Department of Public Health, Ministry of Health Malaysia, 62590 Putrajaya, Malaysia e-mail: feisulidzwan@gmail.com Int J Public Health (2012) 57:279–288 DOI 10.1007/s00038-011-0238-8 123