Prevalence and determinants of general and abdominal obesity and overweight among older Iranian adults using 2016 and 2021 STEPS surveys

Obesity is a recognized risk factor for non-communicable diseases (NCDs). With Iran's aging population and ongoing demographic shifts, monitoring obesity trends among older adults is essential for public health planning. This cross-sectional study used data from the 2016 and 2021 STEPwise Approach to NCD Risk Factor Surveillance (STEPS) national surveys to estimate the prevalence of overweight, general obesity, and abdominal obesity among Iranian adults aged ≥ 60 years at national and subnational levels. Stratified cluster sampling was applied to select participants from urban and rural areas. Standardized WHO protocols were used to collect demographic, lifestyle, and anthropometric data. A total of 10,555 older adults were included. The prevalence of general obesity increased from 27.4% in 2016 to 29.1% in 2021, while abdominal obesity rose from 53.6% to 59.1% (p < 0.001). Higher prevalence was observed among women, individuals with lower physical activity, and those with higher socioeconomic status (p < 0.001). Factors associated with abdominal obesity included female sex, younger age, hypertension, smoking, hypercholesterolemia, and diabetes. The findings indicate a rising trend in both general and abdominal obesity among older Iranian adults. Identifying population subgroups with greater risk may support the development of targeted, community-based prevention strategies.