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Background  In Ethiopia, limited information is available about the epidemiology of over-nutrition. This study assessed the prevalence of, and factors associated with overweight and obesity among adults in Hawassa city, Southern Ethiopia.    Methods  A community-based cross-sectional survey was conducted in August 2015 in the city. A total of 531 adults 18–64 years of age were selected using multistage sampling approach. Interviewer administered qualitative food frequency questionnaire was used to assess the consumption pattern of twelve food groups. The level of physical exercise was measured via the General Physical Activity Questionnaire (GPAQ). Based on anthropometric measurements, Body Mass Index (BMI) was computed and overweight including obesity (BMI of 25 or above) was defined. For identifying predictors of overweight and obesity, multivariable binary logistic regression model was fitted and the outputs are presented using Adjusted Odds Ratio (AOR) with 95% Confidence Intervals (CI).    Results  The prevalence of overweight including obesity was 28.2% (95% CI: 24.2–32.2). Significant proportions of adults had moderate (37.6%) or low (2.6%) physical activity level. As compared to men, women had 2.56 (95% CI: 1.85–4.76) times increased odds of overweight/obesity. With reference to adults 18–24 years of age, the odds were three times higher among adults 45–54 (3.06, 95% CI: 1.29–7.20) and 55–64 (2.88, 95% CI: 1.06–7.84) years. Those from the highest income tercile were 3.16 times (95% CI: 1.88–5.30) more likely to be overweight/obese as compared to adults from the lowest tercile. Having moderate (3.10, 95% CI: 1.72–5.60) or low (4.80 95% CI: 2.50–9.23) physical activity was also significantly associated with the outcome. Further, daily intake of alcohol and, frequent consumption of sweets, meat and eggs were associated with overweight/obesity. Conversely, no significant associations were evident for meal frequency, practices of skipping breakfast, behavior of eating away from home and frequency of consumption of fast foods, fruits and vegetables.    Conclusions  Prompting active lifestyle, limiting intakes of sweets, advocating optimum consumption of alcohol and calorie dense animal source foods, especially amongst the better-off segment of the population, may reduce the magnitude of over-nutrition.    Electronic supplementary material  The online version of this article (10.1186/s40608-019-0227-7) contains supplementary material, which is available to authorized users.

Prevalence and factors associated with overweight and obesity among adults in Hawassa city, southern Ethiopia: a community based cross-sectional study