Among 10,740 non-pregnant Congolese women aged 15–49 drawn from the nationally representative 2023 Demographic and Health Survey, 19.5% met BMI criteria for overweight or obesity (≥25 kg/m²). Wealth emerged as the dominant structural driver: compared with the poorest quintile, odds of excess weight rose progressively to 1.65× in middle-income households, 2.41× in rich households, and 4.19× in the richest — a striking dose-response gradient. Urban residence roughly doubled risk versus rural living (aOR ~1.67 inverse), and significant provincial variation clustered excess weight in conflict-affected eastern zones including Nord-Kivu and Sud-Kivu, while larger household size appeared modestly protective.
This preprint — not yet peer-reviewed — lands at a critical juncture in global nutrition epidemiology. Sub-Saharan Africa is experiencing a well-documented nutrition transition where caloric surplus increasingly overlaps with micronutrient deficiency, yet country-level granularity has been sparse for the DRC specifically. The wealth-obesity gradient documented here mirrors patterns seen in low-income countries generally, where processed foods penetrate rising-income urban households before health infrastructure can respond. The conflict-zone clustering in eastern DRC adds a geopolitical dimension rarely captured in obesity literature. Limitations include the cross-sectional DHS design, which precludes causal inference, and BMI's known insensitivity to body composition variation across ethnic groups. Nonetheless, the 10,740-person nationally representative sample lends statistical credibility. If confirmed post-review, these findings argue strongly for wealth-stratified and regionally targeted obesity prevention policy in the DRC.