Background: Physical activity is well recognized as an important lifestyle behavior for the development and maintenance of individual and population health and well-being. Most studies indicate an inverse relationship between physical activity (PA) and obesity. Physical activity might reduce the risk associated with overweight and obesity. The aim of this study was to explore association of physical activity, sitting time and television (TV) watching time with overweight/obesity in rural and peri-urban population of Birbhum district, West Bengal for the development of intervention and prevention strategies for obesity in a middle-aged and elderly population.

Methods: A cross-sectional study was performed on 1791 (men 1387; women 404)adults with a mean age 50.43 ±7.55years in Suri-1 block of rural and peri-urban areas from March 2023 to December 2023 in the study areas of Birbhum district, West Bengal. A pretested standardized questionnaire was used for physical activity at workplace (employees [paid/unpaid]/ business).

Results: The prevalence of obesity was found in the least to the moderately and severe active group compared to sedentary physical activity group. TV watching time was comparatively higher for females than males in our study. Time spent watching TV and sitting behavior was positively associated with risk of obesity and overweight.

Conclusion: Time spent sitting while at work, TV viewing, and non-TV leisure-time sitting were not associated with incident or prevalent obesity in this study. Prior obesity was associated with the amount of time an individual spent sitting while watching TV, suggesting that the relationship between sedentary behavior and obesity may be more complex than has been suggested previously. The possibility of reciprocal or reverse causality in this association requires further research attention.