Department of Public Health and Community Medicine, AJK Medical College, University of Azad Jammu and Kashmir, Muzaffarabad, Azad Kashmir
Alumni-Rawalpindi Medical College, Tipu Rd., Rawalpindi, PakistanPakistan
Health Services Academy, Islamabad, PakistanPakistan
Department of Airport Health Karachi, Ministry of National Health Services Regulation and Coordination, Government of Pakistan, Islamabad, PakistanPakistan
Also available as PDF (figures and tables appear in the PDF).
Adolescence is one of the fundamental processes of life, where transformation in composition of the body along with behavioral and physiological take place making the adolescents one of the most vulnerable group of population in the community and it is extremely important to take care of their nutritional as well as health status. Present study was carried out to find the prevalence of obesity in adolescents of Islamabad, so that; their health and well-being can be improved. A total of 315 adolescents studying in different schools both male and female within the age range of 15-19 were selected after proper sample size calculation. For data collection a pre-tested self-report questionnaire was used in order to find out the level of obesity and factors leading to overweight and obesity. Results reveal that 74% of the adolescents living in Islamabad had a normal body mass index (BMI)-for-age, 17.4% are overweight while 8.5% are obese. It was found that with increase in age and grade, level of overweight and obesity was higher.
Keywords: Adolescents; Obesity; Overweight; Body mass index (BMI)
Adolescence is a phase of growth from childhood to adulthood characterized by structural body changes with unique distribution of body fat quantity and location along with physiological th changes. Adolescents constitute 1/6th of the world’s population and there are more than 1.2 billion adolescents globally forming 18% of world population while 88% of the adolescents live in developing countries. India is the leader in the group of adolescents globally while Pakistan th ranks 4th globally with an adolescent population of 41 million. The most concerning point regarding adolescents is that the urban population of adolescents which was 50% in 2009 will rise to 70% in 2050 and the largest increase will be in developing countries, an alarming situation putting additional burden to accommodate the health and well-being of this huge chunk
World Health Organization (WHO) has expressed concern about the prevailing trends of childhood obesity globally. The global prevalence of overweight and obesity has risen from
data from developing countries shows the rise in prevalence from 8.1% to 12.9% in boys, while 8.4% to 13.4% in girls.
The knowledge about one’s ideal body weight also has a role and is major driving force for the weight management strategies. The studies have shown that adolescents who have normal BMI-for-age but perceive themselves as obese or overweight are at greater risk for developing eating disorders. This wrong perception can lead them to potentially harmful behaviors like dieting, slimming pills, or diuretics, etc. although the onset of exercise to lose weight has no harmful effect.3 On the other hand, if a person is obese or overweight but perceives oneself to be normal, this self-perception can predispose such individuals to co-morbid conditions, which can be easily avoided by giving them awareness of the ideal BMI-for-age. Although, the topic of relationship between self-perception of ideal body size and obesity has been studied in the developed countries, the data on this topic in developing countries is scarce and there is a need to explore this in the developing countries.
The risk of being overweight in adulthood is greater with higher degrees of overweight in childhood and in the later adolescent years.4 Being overweight, in turn, is recognized as a significant risk factor for chronic diseases such as arteriosclerosis, ischemic heart disease and diabetes; all of which are major causes of morbidity and mortality.5,6
Overweight during adolescence also has social, economic, and psychological consequences, including effects on academic performance and psychosocial functioning.7 Obesity has numerous socially related consequences in later life such as lower wages, less likelihood of marriage, and less education.8
In order to improve the health and well-being of adolescents in school-going children. This study was designed to; assess the frequency of obesity pertinent to the adolescent population of Islamabad.
Table 1. General information, knowledge and self-perception of adolescents.
A cross-sectional study was conducted by interviewing 315 school children between 15-19 years of age selected from 4 private schools of urban Islamabad. Subjects were selected through convenient sampling; for each of the selected schools, healthy adolescents were included in this study. Children with physical or mental disability, and reported chronic illness were excluded.
After taking consent from the head of organization and class teachers, a guided questionnaire was used among adolescents by using convenient sampling technique to assess their; age, grade, obesity trend in the family, knowledge and perception about weight, knowledge of ideal BMI, weight check in one year, self-perception, and BMI-for-age. The data was entered and analyzed using SPSS version 21. This study was approved from the Institutional Review Board (IRB) of Health Services Academy, Islamabad.
A total of 316 adolescents were interviewed and frequencies and 5,6 percentages of all the variables were calculated. Age and grade wise frequency of adolescents from various schools were evaluated (Table 1). Out of the total 316 respondents, 167 (52.8%) were females and 149 (47.1%) were males. Maximum adolescents were found in age group 16-17 years, which were 85 (26.9%), while the minimum respondents were found in the age range of 17-18 years which were 70 (22.15%). There were 167 (52.85%) students from the O levels, while 149 (47.15%) were from the A levels.
Maximum frequency of 187 was observed in adolescents who thought that none of their parent was obese, while 129
Female 167 52.8
Male 149 47.2 15-16 82 25.9 16-17 85 26.9
17-18 70 22.2 18-19 79 25.0 O levels 167 52.8
A levels 149 47.2 Don’t know 146 46.2 Know 170 53.8 Not checked 83 26.3 Checked 233 73.7 Just the right weight 198 62.7 Self-perception A bit too fat 79 25.0 Far too fat 39 12.3 said that at least one of the parents was obese (Figure 1).
There were 170 adolescents who had knowledge about the ideal weight for their age while 146 had no knowledge of what their ideal weight should be. There were 233 adolescents who had their weight checked in the last one year, while 83 of the adolescents had not checked their weight in the last one year. The maximum frequency of 198 was observed in adolescents who considered themselves to be of right weight, while only 39 considered that that are far too fat (Table 1). The BMI of the respondents was a very important variable which was based on the BMI-for-age of the individuals. When calculated, 234 respondents had a BMI-for-age value of less than +1 Z-score, 55 had a BMI-for-age value of greater than +1 Z-score, while 27 had a BMI-for-age value of greater than +2 Z-score.
In terms of percentage, 74% respondents had a BMIfor-age value of less than +1 Z-score, 17.4% had a BMI-for-age value of greater than +1 Z-score, while 8.5% had a BMI-for-age value of greater than +2 Z-score (Figure 2).
Obesity is considered a disease in its own right and in this study adolescents were found with this problem. Hence, it is also considered as one of the key risk factors for other chronic diseases together with smoking, high blood pressure and high blood cholesterol. In the analysis carried out for World Health Report (WHR) 2002, approximately 58% of diabetes, 21% of ischemic heart disease and 8-24% of certain cancers globally were attributable to a BMI above 21 Kg/m2. These findings are support-
standards. Obesity are now dramatically on the rise in low and middle-income countries particularly in urban setting.13 Supporting this statement studies from countries such as India,14 Sri Lanka,15 also show the high prevalence of overweight and obesity in their population and more so in urban, affluent settings. The prevalence of obesity, though representing a small proportion of our community, constitute a high prevalence of overweight and obesity i.e. (17.4%) and (8.5%) respectively. Our study is comparable to the data available from other countries like India, Sri 14-16 Lanka, Qatar and Iran. Study on dietary pattern of children among low socioeconomic group of Karachi showed obesity and overweight to be 4%.17 In our study, there is high prevalence of overweight and obesity compared to the above study.
Study has concluded that the obesity and overweight is prevalent in students of urban Islamabad. There is a high likelihood that a person who is overweight or obese in adolescence will carry it in the adult life and thus will be exposed to life-threatening noncommunicable diseases. However, an immediate intervention on healthy diet might be started to overcome this situation.
The authors declare that they have no conflicts of interest.