|Year : 2013 | Volume
| Issue : 1 | Page : 66-70
Obesity and weight control measures: Findings from female college students of Agra
HK Thakkar1, K Srivastava2, SK Misra3, SC Gupta3
1 Department of Community Medicine, Govt. Medical College, Haldwani, Uttarakhand, India
2 Department of Community Medicine, Padmashree Dr. D. Y. Patil Medical College, Hospital & Research Centre, Dr. D. Y. Patil Vidyapeeth, Pimpri, Pune, India
3 Department of Social and Preventive Medicine, S. N. Medical College, Agra, India
|Date of Web Publication||14-Mar-2013|
H K Thakkar
Department of Community Medicine, Govt. Medical College, Haldwani - 263 139, Nainital, Uttarakhand
Source of Support: None, Conflict of Interest: None
Context: Obesity has negative health impacts. Obese people have higher risk of non-communicable diseases (NCDs). Overweight and obesity during young adulthood can track into later adulthood along with its higher risk for NCDs. Aims: To identify the weight control intention and dietary practices used among normal, overweight, and obese college females and to know the reasons for discontinuation among ever tried subjects. Settings and Design : A cross-sectional study conducted in urban and rural colleges of Agra. Materials and Methods: This was a cross-sectional study among 400 female college students. Height and weight were measured to assess body composition according to BMI (Body Mass Index) criteria (WHO 2002). Study included a semi-structured and semi-open-ended instrument to assess practices related to weight control. Their responses were collected, tabulated, analyzed, and interpreted. Statistical analysis used: Frequency. Results: The prevalence of overweight and obesity was found to be 18.5% and 4.5%, respectively, according to BMI (WHO 2002). One third of the subjects were recording their weight monthly. Slightly less than half of the subjects (46%) were trying to maintain optimum weight. Almost one third of these subjects (33.5%) were presently trying to lose weight. About one fifth of total 400 subjects (20.5%) were not concerned about their weight status. Majority of the subjects (85%) irrespective of their obesity status did not take any professional advice. More than half (52.7%) were resorting to physical activity to lose weight. Taking more fruits/vegetables (44.7%) was found to be the most common healthy dieting practices and most unhealthy was fasting (15.3%). More than one fourth (28.8%) of the subjects abandoned weight control practices because of shortage of time followed by 22.4% due to physical weakness. Conclusions: Collectively, results indicate female college students, regardless of weight status, would benefit from open discussions with health educators regarding healthy and effective dieting practices to achieve/maintain a healthy body weight.
Keywords: Body mass index, overweight, obesity, weight control practices, weight control intention
|How to cite this article:|
Thakkar H K, Srivastava K, Misra S K, Gupta S C. Obesity and weight control measures: Findings from female college students of Agra. Med J DY Patil Univ 2013;6:66-70
|How to cite this URL:|
Thakkar H K, Srivastava K, Misra S K, Gupta S C. Obesity and weight control measures: Findings from female college students of Agra. Med J DY Patil Univ [serial online] 2013 [cited 2020 Jul 12];6:66-70. Available from: http://www.mjdrdypu.org/text.asp?2013/6/1/66/108648
| Introduction|| |
In 2005, Non-communicable Diseases (NCDs) caused an estimated 35 million deaths worldwide, of which 80% occurred in low- and middle-income countries.  Just more than a quarter (27%) of all deaths in that year were considered premature deaths due to preventable NCDs.  Unhealthy diet and physical inactivity rank among the main risk factors for NCDs. This is recognized by WHO's Global Strategy for the Prevention and Control of Non-communicable Diseases. 
Females, at a very young age, are concerned about body weight and place high importance on appearance, which is dramatically influenced by the media. Unfortunately, the desire to be beautiful may result in unwanted outcomes. There are unique experiences of college females that may promote dieting, including fear of gaining weight, increased sense of independence that may promote experimenting with dieting (food restriction, use of supplements, and fad diets), and changes to daily schedule that affect eating and exercise habits. Given our culture, which suffers from a pathological emphasis on weight as a measure of a woman's worth, and given the continuing epidemic in our society of disordered eating, there are significant problems. Patton  reported that girls with a history of severe dieting were 18 times more likely to develop eating disorders than girls with no history of dieting, and girls with a history of moderate dieting were five times more likely to develop eating disorders than girls who did not diet. Given the myriad life issues that are relevant to women at the onset of the college years, to have a concept referring to the single superficial issue of body weight be so widespread and so influential is indicative of a larger cultural pathology. What is needed is a more aggressive message to the culture that contradicts this reductionist message. There remain gaps in the research related to dieting among college females. Namely, do normal weight individuals diet differently from those who are overweight or obese, and are there dieting practices used by females that can be adapted to promote a healthy body weight? Since it is well recognized that females diet, this study seeks to determine differences in weight control intention and dieting practices among normal weight, overweight, and obese female college students as well to identify weight discontinuation reasons among these groups.
| Material and Methods|| |
A cross-sectional study was conducted in 2009 among college going girls aged 18 to 24 years in randomly selected degree colleges of Agra (urban and rural). The sample size was estimated by using the formula 4pq/d 2 where prevalence was taken as 24%.  The required precision of the estimate (d) was set at 20%. Using the above-mentioned formula, the sample size was estimated to be 316 and rounding off a total of 400 college going girls of 18 to 24 years were included in the study.
Multistage stratified random sampling technique was used for selecting study subjects from colleges under the administrative control of Agra University, the details of which is available in another paper published by the authors.  Informed consent and cooperation was sought from all subjects prior to their participation in the study.
Anthropometric measurements were recorded by following accepted standards, the details of which may be found in another work of the authors.  The girls were grouped into four categories in accordance with WHO standards of body mass index (BMI).  Information was collected on a semi-structured pretested interview schedule which was administered to all the subjects that assessed weight record practices, weight control intention, physical activity and dieting practices, and reasons for discontinuation in those who had put any of these into practice at any point of time.
| Results|| |
Using the cut-off points,  the findings revealed that 23% of the subjects were either overweight (18.5%) or obese (4.5%), only 45.5% were having normal BMI and 31.5% had below normal BMI [Figure 1].
|Figure 1: Prevalence of obesity according to body mass index (WHO, 2002)|
Click here to view
[Table 1] shows the frequency of weight record among the subjects. One third of the subjects were used to weigh them monthly. About 18.5% of total used to take their weight as per their need like for medical check-up (7.3%) or during sickness (4.7%). About 8% of the subjects never weighed themselves. No significant difference was found among both the groups in weighing frequencies.
Slightly less than half of the subjects (46%) were trying to maintain current weight [Table 2]. Upon further analysis, it showed that more than three fourth (76.6%) of the subjects were normal and underweight with only 23.4% of overweight/obese subjects. Almost one third of these subjects (33.5%) are presently trying to lose weight. On further analysis, it revealed that among them majority (77.6%) are normal and underweight subjects. About one fifth of total subjects (20.5%) were not concerned about their weight status.
|Table 2: Weight-control intention and receipt of professional advice on weight among subjects|
Click here to view
Majority of the subjects (85%) irrespective of their overweight/obese status did not take any professional advice concerning their weight. Many being aware of the consequences of obesity, near to half of obese subjects took advice on weight loss. Strikingly, there were 10 subjects among normal or underweight category who wanted to lose weight. The difference between the groups regarding seeking professional advice was found to be significant.
It can be seen from [Table 3] that more than half (52.7%) were using exercise as a weight loss measure. Among dieting practices, taking more fruits/vegetables (44.7%) was the most common healthy weight loss measure observed among the subjects. Among unhealthy behavior, fasting was the most common (15.3%). Next to it was skipping either breakfast or meals (14.5% and 12%, respectively). The proportion of overweight and obese subjects for healthy weight loss behavior was found to be higher than normal and underweight subjects. Unhealthy behavior for weight reduction such as fasting (16.3%) and skipping meals (13%) were also more common among overweight and obese subjects.
[Table 4] explains the diverse reasons for discontinuation of weight control practices among subjects who have ever tried (170) any kind of weight control or loss practices. And, surprisingly, majority of these subjects (77.0%) were normal and underweight with only 23.0% of overweight and obese ones. More than one fourth (28.8%) of the subjects have left practices because of shortage of time. Slightly more than one fifth (21.2%) of the subjects felt of gaining desired weight and discontinued. This level of satisfaction among obese subjects was 14.2%. Overall, the difference between groups has not been found significant.
|Table 4: Reasons for discontinuation of weight control practices among ever tried subjects (n = 170)|
Click here to view
| Discussion|| |
According to World Health Organization (WHO, 2002), BMI provides the most useful, albeit crude, population level measure of obesity, and it can be used to estimate the prevalence of overweight/obesity within a population and the risks associated with it. According to this criteria, the present study shows that nearly one fourth (23%) of girls were either overweight (18.5%) or obese (4.5%) while only close to half (45.5%) of the study population were having a normal BMI and slightly less than one third (31.5%) of them were underweight. The study thus also exposed the fact that undernutrition is still prevailing in the state along with rise in overnutrition. The socioeconomic development of recent decades in Agra has generated a neo middle class, both at the rural and urban level, which may be responsible for rise in prevalence of overweight. The study done by Sharda Sidhu and Prabhjot  has reported a higher prevalence of overweight and obesity of 28.2% and 15%, respectively, among college girls of more than 18 years of age in Punjab as compared to our study. The higher prevalence of obesity/overweight may be because the study was done in an economically more developed state. Also, the difference in culture and food habits in Punjab might be responsible for it.
In Asian subjects, the risk associated with diabetes and cardiovascular diseases occurs at lower levels of BMI. This is attributed to body fat distribution; Asian Indians tend to have more visceral adipose tissue, causing higher insulin resistance, despite having lean BMI.  The Union Health Ministry of India in association with other health organizations has released new guidelines  for prevention and management of obesity and metabolic syndrome which was earlier proposed by WHO in 2000. If these criteria are taken into account as against WHO proposed criteria, nearly half of the subjects (42.5%) would be classified as either obese (23%) or overweight (19.5%). The study conducted by Augustine and Poojara (2003)  had also explored relatively higher prevalence of overweight but lower obesity, 24% and 10.5%, respectively, among college going girls of Ernakulam by using the similar cut-off points of overweight and obesity for Asia pacific inhabitants suggested earlier by WHO Regional report, 2000.
In the current study, one third of the subjects were used to weigh them monthly. Augustine and Poojara  showed that daily weighing of body weight fascinated many of the subjects. Findings from this study support the general belief that dieting by college females is a common weight management strategy in addition to physical activity, irrespective of weight status. Brenda et al.  conducted a study in USA among female college students aged 18 to 24 years which found 83% of college females reporting ever consciously trying to lose or control their weight. The different findings in these studies as compared to our study emphasize strong societal prejudice against overweight in developed countries.
Present study reported exercise as a major weight loss measure followed by taking more fruits/vegetables, avoiding high fat foods and sweets, and not eating between meals as the healthy weight loss measures among the subjects. Abraham and O'Dea  reported that females as young as 12 years of age had tried to lose weight, including 44% who dieted using food restriction and 78% who exercised to lose weight. Brenda et al.  also reported 80% of participants using physical activity to control weight. R. Tiwari et al.  conducted study in Gwalior city reported 36.3% of female doing mild to moderate exercise which is quite lower than our study. The reason is that their study has been conducted among higher income group who used to live a sedentary lifestyle.
Dieting has been reported among normal and underweight individuals, in addition to those who are overweight.  Current study found that among unhealthy behavior, fasting was the most common weight loss measure. Next to it was skipping either breakfast or meals. Field et al.  suggested that dieting to control weight is often times ineffective; dieting remains popular among females. Brenda et al.  reported that the majority of participants (83%) used dieting for weight loss and reported that consciously eating less than you want was also prevalent among the subjects. They also reported breakfast skipping (32%) among female college students of USA, which is higher than our study. The study conducted by Augustine and Poojara  showed that breakfast was the most commonly skipped meal among the respondents (41%), which is higher than our study. They also found that 71% of the girls had tried at least once to lose weight which is higher than the present study. The higher literacy rate in South India may be responsible for this difference.
| Conclusion|| |
These findings suggest that health educators should promote education and intervention strategies for females that encourage appropriate weight control practices and dispel unhealthy and ineffective weight loss myths. Female college students, regardless of weight status, would benefit from open discussions with health educators to identify healthy and unhealthy dieting practices they use. Researchers can consider how to effectively target specific dieting practices among females to promote healthy eating and exercise to promote and maintain a healthy weight.
| Acknowledgement|| |
The authors are thankful to all the subjects for their cooperation.
| References|| |
|1.||Preventing chronic diseases: A vital investment. Geneva: World Health Organization; 2005. p. 9. |
|2.||The global burden of disease: 2004 update. Geneva: World Health Organization; 2008. Available from: http://www.who.int/healthinfo/global_burden_disease/GBD_report_2004update_AnnexA.pdf, [Last accessed on 2009 Apr 07]. |
|3.||Global Strategy for the Prevention and Control of Noncommunicable Diseases. Geneva: World Health Organization; 2000, Report A53/14. |
|4.||Patton GC. Onset of adolescent eating disorders: population based cohort study over 3 years. BMJ 1999;318:765-8. |
|5.||Augustine LF, Poojara. Prevalence of obesity, weight perceptions and weight control practices among college girls. Indian J Community Med 2003;25:189-90. |
|6.||Thakkar HK, Misra SK, Gupta SC, Kaushal SK. A study of prevalence of obesity among college going girls in Agra District of UP. Indian J Community Health 2010;22:61-4. |
|7.||World Health Organization (WHO). The World Health Report: Reducing Risks, Promoting Healthy Life. Geneva: WHO; 2002. p. 7-14. |
|8.||Sidhu S, Prabhjot. Prevalence of overweight and obesity among the college-going girls of Punjab. Anthropologist 2004;6:295-7. |
|9.||Wang J, Thorton JC, Russell M, Burastero S, Heymsfield S, Pierson RN Jr. Asians have lower body mass index (BMI) but higher percent body fat than do whites: Comparisons of anthropometric measurements. Am J Clin Nutr 1994;60:23-8. |
|10.||India reworks obesity guidelines, makes fitness norms tighter, The Hindu, 25 November 2008. Accessible from: http://www.hindu.com/thehindu/holnus/099200811252021.htm [Last accessed on 2012 Oct 08]. |
|11.||Malinauskas BM, Raedeke TD, Aeby VG, Smith JL, Dallas MB. Dieting practices, weight perceptions, and body composition: A comparison of normal weight, overweight, and obese college females. Nutr J 2006;5:11. |
|12.||Abraham S, O'Dea J. Body mass index, menarche, and perception of dieting among peripubertal adolescent females. Int J Eat Disord 2001;29:23-8. |
|13.||Tiwari R, Srivastava D, Gour N. A cross-sectional study to determine prevalence of obesity in high income group colonies of Gwalior city. Indian J Community Med 2009;34:218-22. |
|14.||Storz N, Greene W. Body weight, body image, and perception of fad diets in adolescent girls. J Nutr Educ 1983;15:15-8. |
|15.||Field AE, Austin SB, Taylor CB, Malspeis S, Rosner B, Rockett HR, et al. Relation between dieting and weight change among preadolescents and adolescents. Pediatrics 2003;112:900-6. |
[Table 1], [Table 2], [Table 3], [Table 4]