Health Literacy in obesity: a comparative analysis of adults with and without obesity

Abstract Background Obesity remains a major public health issue and a key driver of non-communicable diseases, posing significant health, social, and economic burdens globally. Health literacy (HL) is recognized as an essential strategy for health promotion and empowerment, potentially improving individuals’ control over health outcomes, including obesity. This study aimed to assess health literacy levels among Portuguese adults with and without obesity. Methods A cross-sectional study was conducted through an online survey directed to Portuguese adults. The Portuguese version of the European Health Literacy Survey (HLS-EU-PT-Q16) was applied, and a 0-50 score was calculated. Reported weight and height were used to calculate the body mass index (BMI), classified according to World Health Organization standards. Statistical analysis included t-tests and Pearson's correlation tests, with a 5% significance level. Results A total of 3333 adults were surveyed: mean age 49 years (±12.25), 85.4% female, 79.7% with higher education, 76.1% employed full-time. According to calculated BMI, 35.5% (n = 1175) had obesity. In the full sample, the mean HL score (n = 3264) was 34.07 (±7.44), with 44.9% presenting a problematic or inadequate HL level. Among the subgroup of individuals without obesity, the mean HL score (n = 2094) was 34.96 (±7.34), with 39.9% presenting a problematic or inadequate HL level, while in the subgroup of individuals with obesity the mean HL score (n = 1148) was 32.47 (±7.39), with 54.1% presenting a problematic or inadequate HL level (p < 0.001). Conclusions Adults with obesity showed lower health literacy levels compared to those without obesity. These findings underscore the importance of integrating health literacy promotion into public health strategies aimed at preventing and managing obesity. Enhancing health literacy may empower individuals to make informed health decisions, contributing to better obesity control and overall health outcomes. Key messages • This study highlights a significant association between obesity and lower health literacy levels among Portuguese adults. • Initiatives to improve health literacy levels could be useful tools in managing the obesity epidemic.