To examine the socioeconomic inequalities in overweight-obesity and their changes in two decades, among young adult women aged 18–29 years in Nepal.

Cross-sectional study based on Demographic and Health Surveys conducted in 2001 and 2022.

Nepal.

Data of young adult women aged 18–29 years were included for the study.

Socioeconomic inequalities in education, occupation and household wealth were analysed through regression-based inequality indices: the Relative Index of Inequality, the Slope Index of Inequality and the Concentration Index. A concentration curve was constructed to evaluate whether overweight-obesity skewed towards poverty or wealth.

We found an increase in the prevalence of overweight-obesity prevalence between 2001 (3.99%) and 2022 (15.45%), mostly in the oldest group (25–29 years), and among Janajati and rural residents. Socioeconomic gradients favoured wealthier, educated and employed women. A downward shift in wealth status was initially associated with a lower prevalence of overweight and obesity among women, but over time, it became linked to a higher prevalence.

The social gradient of overweight-obesity from 2001 to 2022 favoured women with higher socioeconomic status, and this shows a decreasing trend.