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Global prevalence of obesity and overweight among medical students: a systematic review and meta-analysis

• Arman Shafiee 1   na1 ,
• Zahra Nakhaee 2   na1 ,
• Razman Arabzadeh Bahri 3 ,
• Mohammad Javad Amini 1 ,
• Amirhossein Salehi 4 ,
• Kyana Jafarabady 1 ,
• Niloofar Seighali 1 ,
• Pegah Rashidian 5 ,
• Hanieh Fathi 1 ,
• Fatemeh Esmaeilpur Abianeh 3 ,
• Samira Parvizi Omran 3 ,
• Mahmood Bakhtiyari 6 &
• Amirhesam Alirezaei 4  

BMC Public Health volume  24 , Article number:  1673 ( 2024 ) Cite this article

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Obesity is a global health concern, and understanding its prevalence among medical students is crucial for shaping targeted interventions. This systematic review and meta-analysis aim to comprehensively assess the prevalence of obesity and overweight among medical students.

A systematic literature search was conducted across major databases, including PubMed, Scopus, and Web of Science, in order to identify relevant studies that evaluated obesity and overweight among medical students. Inclusion criteria encompassed published and peer-reviewed studies reporting the prevalence of obesity among medical students.

A total of 1245 studies were screened based on their titles and abstracts, and 99 studies comprised a total sample size of 47,455 medical students across diverse geographical regions were included in this study. The overall pooled prevalence of overweight among medical students was estimated at 18% (95% CI: 17%—20%), with obesity at 9% (95% CI: 7%—11%). The combined prevalence of excess weight (overweight and obesity) was calculated to be 24% (95% CI: 22%—27%). Meta-regression results indicated a significant correlation between study year and overweight/obesity prevalence ( p  < 0.05), with a trend towards increasing prevalence over time. Male medical students exhibited a higher pooled prevalence, increasing with the percentage of male participants.

This systematic review and meta-analysis provide a comprehensive overview of the prevalence of obesity among medical students globally. In summary, obesity and overweight present a substantial worldwide health concern, especially among susceptible groups such as medical students, whose prevalence is on the rise. It is crucial to grasp the extent and contributing factors of obesity among medical students to formulate precise interventions aimed at fostering healthier habits and alleviating the adverse impacts of obesity on both physical and mental health.

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Introduction

In recent decades, obesity has emerged as a global health concern, and its prevalence is increasing dramatically worldwide [ 1 , 2 , 3 ]. Obesity is characterized by excessive accumulation of body fat within adipose tissue, which may lead to adverse health effects [ 4 ]. Globally, body mass index (BMI) is the most commonly used to classify overweight and obesity in adults and is defined as weight in kg/height in m 2 . Individuals with a BMI between 25 and 29.9 kg/m 2 are considered overweight, and Individuals with a BMI ≥ 30kg/m 2 are considered obese. Obesity is further classified into three severity levels: class I (BMI 30.0–34.9), class II (BMI 35.0–39.9), and class III (BMI ≥ 40.0) [ 5 ]. Several studies have identified obesity and overweight as risk factors for chronic and life-threatening illnesses, including diabetes [ 6 ], various cancers [ 7 , 8 ], cardiovascular disease [ 9 ], and hypertension [ 10 , 11 ]. The increasing prevalence of obesity and overweight, and its resulting mortality and morbidity, threaten people’s health in many countries. In addition, it causes destructive health conditions and financial burdens on people and society [ 12 , 13 ].

Obesity is a multifactorial pathology, and it has been suggested that the increasing prevalence can be attributed to lifestyle changes, particularly nutritional behavior and inadequate physical activity [ 14 , 15 , 16 ]. While the general population is affected by the obesity epidemic, certain subgroups, such as medical students, may be particularly vulnerable. Medical students, a population that should act as healthy role models, often face unique challenges that can contribute to unhealthy lifestyle habits, including long hours of studying, high levels of stress, and limited time for physical activity and self-care [ 17 ]. Shift work may have significant repercussions on the health of the worker and has been linked to unhealthy lifestyles [ 18 ]. A study demonstrated that those who work in shifts have a greater risk of being obese than regular 8-h workers [ 19 ]. Furthermore, medical students face a higher risk of developing psychological issues, such as feeding and eating disorders (FEDs) [ 20 , 21 , 22 ]. A study estimated that the prevalence of FEDs symptoms in medical students is approximately 17.35% [ 23 ]. Socioeconomic and psychological elements significantly affect dietary habits and physical inactivity [ 23 ]. Eating habits have a stronger impact on BMI than physical activity [ 24 ]. The dietary habits observed among medical students include irregular meals, skipping meals, insufficient intake of fruits and vegetables, high consumption of candies and alcohol, and excessive consumption of fried and fast foods [ 23 , 25 , 26 ]. Accordingly, exposure to these known and unknown factors may increase the risk of overweight and obesity among medical students.

Given the fact that obesity negatively impacts an individual’s physical and mental health [ 27 ], understanding the prevalence of obesity among medical students is crucial for identifying potential risk factors and developing targeted interventions to promote healthier lifestyles within this population. Several studies from different countries have reported the prevalence of obesity among medical students [ 28 , 29 , 30 ]. However, to the best of our knowledge, this study is the first systematic review and meta-analysis to explore the current state of obesity prevalence among medical students. Also, our study aims to take advantage of all available data on the topic to offer new insights into the prevalence and distribution of obesity within BMI subgroups in medical students.

The primary objective of this study is to investigate the prevalence of obesity and overweight among medical students globally. Following the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) checklist [ 31 ], our methodology encompasses key steps to ensure transparency and rigor in our research.

Research question

Our research seeks to ascertain the global prevalence of obesity and overweight among medical students, with a specific focus on studies employing body mass index (BMI) as the primary metric for the measurement of obesity and overweight.

Search strategy

We conducted a comprehensive search across various databases, including PubMed, Scopus, and Web of Science, from the inception to August 4th, 2023, to identify relevant studies. The search terms included variations of "medical students," "obesity," "overweight," and "BMI."

Eligibility criteria

The population, intervention, comparison, and outcome (PICO) framework was followed in this study and were as follows: Population (P): medical students; Intervention (I): none; Comparison (C): overweight, obese, or healthy medical students; and Outcome (O): prevalence of obesity or overweight among medical students. We included cross-sectional, descriptive, observational studies conducted globally that involved medical students. Studies were considered if they explored the prevalence of obesity and overweight, using BMI as the measurement tool. We excluded studies that did not meet these criteria or lacked essential information. No limitation was imposed regarding the original language of the identified articles or the gender of the evaluated medical students.

Study selection

Two independent reviewers screened the identified studies based on the title and abstract. Full-text assessments were performed to ensure the inclusion of relevant data. Any discrepancies in selection were resolved through discussion or consultation with a third reviewer.

Data extraction

We extracted pertinent information from the selected studies, including study design, geographic location, sample size, and prevalence rates of obesity and overweight among medical students. We prioritized data collected using the World Health Organization (WHO) criteria for obesity and overweight classification (BMI > 30 for obese, 25 < BMI ≤ 30 for overweight).

Quality assessment

The Newcastle–Ottawa Scale (NOS), which is a validated and easy-to-use scale, was used to assess the quality of the included articles (Supplemental Table 1). The NOS for cross-sectional studies contains seven items within three domains, including selection, comparability, and outcome, with an overall score of nine. The selection domain has four questions and a maximum score of five scores. The comparability domain has a maximum score of one. The outcome domain has two questions and a maximum score of three scores. A score of 7–9 indicates high quality, 4–6 indicates high risk, and 0–3 indicates very high risk of bias. Quality assessment was checked independently by two authors, and any disagreements were resolved by a third author.

Data synthesis

We synthesized the extracted data using a random effect meta-analysis, synthesizing the overall prevalence rates of obesity and overweight among medical students. Subgroup analyses were conducted based on geographic regions and study characteristics to explore potential variations. Publication bias was examined through doi plots and Peter's test, with statistical relevance set at a p -value below 0.1 [ 32 , 33 ]. All statistical operations and the production of graphs were conducted using STATA and R software(meta package) [ 34 ].

The systematic review and meta-analysis aimed to examine the prevalence of overweight, obesity, and overall excess weight among medical students. A comprehensive search of electronic databases identified 1,245 articles. After screening titles and abstracts, 254 articles underwent full-text review, with 99 studies meeting the inclusion criteria and included in the meta-analysis (Fig.  1 ).

PRISMA flow diagram

Characteristics of included studies

The 100 included studies encompassed a total sample size of 47,455 medical students. These studies were conducted across diverse geographical regions, representing both developed and developing countries. The included studies were conducted in Bahrain, Bangladesh, Bosnia and Herzegovina, Cameron, China, Egypt, Saudi Arabia, Greece, India, Iran, Iraq, Lithuania, Malaysia, Mexico, Morocco, Nepal, Oman, Pakistan, Poland, Romania, Russia, Singapore, Slovakia, South Africa, Spain, Sudan, Syria, Thailand, Tunisia, Turkey, United Arab Emirates, the United States of America, and the United Kingdom. Predominantly, cross-sectional designs were employed, and data collection periods ranged from 1992 to 2023. However, most studies were published in recent years, ranging from 2018 to 2023.

Prevalence of overweight, obesity, and excess weight

The overall pooled prevalence of overweight among medical students was estimated to be 0.18 (95% CI: 0.17 – 0.20), while the pooled prevalence of obesity was 0.09 (95% CI: 0.07 – 0.11). The combined prevalence of excess weight (overweight and obesity) was calculated to be 0.24 (95% CI: 0.22 – 0.27) (Fig.  2 ).

Results of meta-analysis for the prevalence of ( a ) excess weight (overweight/obesity); ( b ) overweight; and ( c ) obesity among medical students

Meta-regression analysis

A meta-regression was conducted to explore potential sources of heterogeneity across studies. Variables such as study year, percentage of male participants, and mean age of population were considered. The results indicated that the study year significantly correlated with overweight/obesity prevalence ( p  < 0.05) (Fig.  3 ), with a trend towards increasing prevalence over time. Male medical students exhibited a higher pooled prevalence of overweight/obesity, as the prevalence increased with the increased percentage of male participants. No significant associations were observed between the mean age of the population and the aforementioned outcomes (Supplementary Table 2).

Scatter plot of meta-regression analysis for the association between ( a ) percentage of male participants, and ( b ) study year with the prevalence of overweight/obesity among medical students. Bubble size represents the weight of the study

Publication bias

Doi plot and Peter’s regression test showed possible publication bias across the included studies for the primary outcome (Fig.  4 ) ( p -value < 0.001).

Doi plot for prevalence of excess weight (overweight and obesity) among medical students

Obesity has become one of the greatest health burdens of our era. As the World Health Organization states, around 2 billion people worldwide were reported to be overweight in 2016, of which more than 650 million people were considered to be obese, something around 13% of the whole population [ 35 ]. Globally speaking, 37% of men and 38% of women are considered to be overweight with a BMI greater than 25 kg/m2 [ 36 ]. Around 50% of obese people are distributed in only 10 countries, including the United States, China, India, Russia, Brazil, Mexico, Egypt, Germany, Pakistan, and Indonesia. In Europe, there is an upward trend towards obesity, and 17% of adults are obese [ 37 ]. As it has been long noticed before, obesity is not only an appearance complication but can also be a risk factor for health conditions of great significance, such as hypertensive diseases, dyslipidemia, obstructive sleep apnea, cancers, and etc. [ 11 , 38 , 39 ]

In the present systematic review and meta-analysis, we aimed to inquire into the prevalence of overweight, obesity, and overall excess weight among medical students. Overall, 254 studies were fully reviewed, of which 99 articles met the inclusion criteria and were used in this study. The sample consisted of 48,683 medical students coming from diverse backgrounds, representing both high and low-income countries. Data extraction was performed on relevant studies since 1992 to 2023. The total pooled prevalence of overweight among medical students was estimated to be 18.5% (95% CI: 16.5%—20.5%), while the pooled prevalence of obesity was 9% (95% CI: 7%—11%). The combined prevalence of excess weight (overweight and obesity) was calculated to be 24% (95% CI: 21%—26%). Moreover, the results specified that there is an obvious association between the year the study was conducted and the prevalence of overweight/obesity, meaning as time passes, the prevalence grows. Furthermore, it was indicated that male medical students had a slightly higher pooled prevalence of overweight/obesity.

Medical education is known to be one of the most demanding academic subjects there are. Education programs are usually too time-consuming, and plenty of medical students tend to ignore the importance of healthy nutrition and physical activity. In a study by Shah T. et al. (2014), 34% of medical students consumed fast food because healthy homemade food was just not available [ 40 ]. In another study by Savić S. et al. (2020), a major part of medical students did not have any form of physical activity throughout the week (64.3% of the study population) [ 41 ]. It has also been stated in another paper that university students with BMIs in normal ranges tend to participate more regularly in physical activities than underweight or overweight students [ 42 ]. Since medical students are the next generation’s medical doctors and, therefore, future leaders of health care procedures, it is of utmost importance to find out if overweight and obesity can be an actual concern for the group.

Throughout the years, there have been a variety of studies focusing on the matter of excessive body weight in medical students. In the present study, we tried to gather such studies and assess and possibly compare their results. In a cross-sectional study by Bazmi Inam, S. N. (2008), overall, 112 out of 241 students (46.5%) in the study were reported to be overweight or obese (BMI > 25) [ 43 ]. A different research by Gopalakrishnan S. et al. (2012) showed that of the 169 medical students who participated in the study, respectively 21.3% and 26.6% were discovered to be obese and overweight, of whom above 50% didn’t exercise regularly, 60.4% did not consume the necessary portions of fruits and vegetables daily, and 68% had a positive family history of Diabetes Mellitus [ 44 ]. In another cross-sectional descriptive study done by Purohit G. et al. (2015), the prevalence of medical students with a BMI more than 25 in a 138-participiant sample was 35.5%. The study also stated that more than 90% of the participants were consuming fast food [ 45 ]. Smrithi Krishnamohan et al. designed a non-randomized controlled trial in a private medical college located in India to measure the efficacy of health education using social networking sites in promoting healthy lifestyles among medical students. The sample was selected from overweight/obese individuals, and all participants were divided into two groups: with (intervention arm) and without a Facebook account (control arm). Results showed a significant decrease in BMI among the control group. They came to the conclusion that except for the decrease in junk food intake, the use of Facebook as an effective tool to promote a healthy lifestyle, e.g., weight reduction, could not be proved confidently [ 46 ]. In a study by Bing Li et al., the association between body composition and physical fitness among Chinese medical students was assessed. A total of 2291 medical students were recruited to participate in this cross-sectional study. They concluded that higher fat mass was significantly associated with worse physical fitness among medical students [ 47 ]. Miloš Ž. Maksimović et al. carried out a cross-sectional study to assess the knowledge and approach of medical students towards cardiovascular disease (CVD) risk factors, e.g., obesity and overweight. They also compared 2nd year and last year’s medical student’s knowledge regarding the CVD risk factors. Results indicated that last year medical students were significantly more knowledgeable than those at the beginning of their studies. However, their total awareness of such risk factors needs serious improvement [ 48 ].

In order to further broaden our view, it is vital to compare the obesity statistics among medical students with those of non-medical students. In a study by Tokaç Er, N. et al. (2021), the overweight and obesity rates amongst 984 undergraduate students from Ankara University Faculty of Health Sciences were respectively 16.5% and 4.5% [ 49 ]. Jiang S. et al. (2018) conducted a study to assess the prevalence of overweight and obesity in a sample of 11,673 Chinese college students; results showed a 9.5% rate for overweight and obesity combined [ 50 ]. Further analyzing such studies and comparing them to similar studies in medical students might reveal a noticeable difference between the two groups.

The present study has strengths on several sides. First, we followed the PRISMA guidelines to ensure transparency and rigor in our research. Second, our search was as comprehensive as possible. We utilized three major databases (Pubmed, Scopus, and Web of Science) to cover all relevant articles. Third, every included article was quality assessed based on the Newcastle Ottawa assessment tool for cross-sectional studies. Fourth, in the meta-analysis phase, we carried out a subgroup analysis based on geographic regions and study characteristics to find any potential variations. Finally, based on our meta-regression analysis, we found out that as time passes, more medical students are prone to obesity, and also more male students are in danger of excess body weight than the female population.

Despite the mentioned strengths, our study had some noticeable limitations. First, in recent years, the COVID-19 pandemic has seriously affected everyone’s lifestyle and somehow transformed it into a more stressful one. Medical students are no exception in this matter. Thus, more evaluation of the possible impacts of the COVID-19 pandemic on medical students’ weight changes is of great interest. Another thing that could perhaps be classified as a limitation was the lack of nationality diversity among the included studies. Factors like diet and tendency to exercise can be poles apart in different parts of the world. That being so, a more nationally diverse set of studies can aid us in a better assessment of the medical students’ obesity rate. Most of the studies calculated BMI from self-reported weights and heights. It is crucial for studies to indicate the how they measured height and weight so that the actual assessment can be highlighted. Furthermore, we recognize that there can be a tendency in published papers to overrepresent their statistically significant findings. Moreover, the unpublished or grey literature that was not included in this review article can perhaps lead to an incomplete picture of obesity in medical students.

As always, there is room for further research; other groups of students who may be at risk of obesity can be targeted in the future. For instance, the same topic could be assessed among the populations of dental students and medical specialty residents. Furthermore, similar systematic reviews can be conducted to evaluate the prevalence of unhealthy diet and inadequate exercise among medical students as contributing factors for overweight and obesity.

In conclusion, we conducted a systematic review and meta-analysis to assess the prevalence of obesity and overweight among medical students and further understand the significance of obesity among them. Herein, we included a total of 99 articles. The results exhibited that the combined prevalence of excess weight (overweight and obesity) was calculated to be 24%. Owing to the fact that excess body weight can be the leading point of many health problems such as diabetes mellitus, hypertension, psychological disorders, and many more, perhaps counseling medical students to maintain healthier lifestyles can avoid plenty of such health issues [ 51 , 52 ].

Availability of data and materials

No datasets were generated or analysed during the current study.

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Acknowledgements

The authors would like acknowledge the clinical research development unit of Imam Ali Hospital Karaj, Iran.

To conduct this study, none of the people related to the study received any funds or grants from any institution, individual or organization.

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Arman Shafiee and Zahra Nakhaee are co-first authors of this manuscript.

Authors and Affiliations

Student Research Committee, School of Medicine, Alborz University of Medical Sciences, Karaj, Iran

Arman Shafiee, Mohammad Javad Amini, Kyana Jafarabady, Niloofar Seighali & Hanieh Fathi

Student Research Committee, School of Medicine, Gonabad University of Medical Sciences, Gonabad, Iran

Zahra Nakhaee

School of Medicine, Tehran University of Medical Sciences, Tehran, Iran

Razman Arabzadeh Bahri, Fatemeh Esmaeilpur Abianeh & Samira Parvizi Omran

School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran

Amirhossein Salehi & Amirhesam Alirezaei

School of Medicine, Guilan University of Medical Sciences, Rasht, Iran

Pegah Rashidian

Non-Communicable Diseases Research Center, Alborz University of Medical Sciences, Karaj, Iran

Mahmood Bakhtiyari

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A.S, Z.N: Conceptualization, Project Administration, Data curation, Writing- Original Draft, Writing – Review & Editing, Visualization. M.B, K.J, M.A: Validation, Resources, Methodology, Software, Formal analysis, Writing – Original Draft. R.A; H.F, S.P, N.S, A.SA; P.R; A.A: Writing- Original Draft, Writing – Review & Editing. R.A, F.E: Data curation, Project Administration.

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Correspondence to Arman Shafiee or Mahmood Bakhtiyari .

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Shafiee, A., Nakhaee, Z., Bahri, R.A. et al. Global prevalence of obesity and overweight among medical students: a systematic review and meta-analysis. BMC Public Health 24 , 1673 (2024). https://doi.org/10.1186/s12889-024-19184-4

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DOI : https://doi.org/10.1186/s12889-024-19184-4

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Exploring patient beliefs and perceptions regarding obesity as a disease, obesity causation and treatment

Affiliations.

• 1 Diabetes Complications Research Centre, Conway Institute, School of Medicine and Medical Sciences, University College Dublin, Dublin, Ireland. [email protected].
• 2 MedFit Proactive Healthcare, Blackrock, Dublin, Ireland. [email protected].
• 3 MedFit Proactive Healthcare, Blackrock, Dublin, Ireland.
• 4 Department of Upper Gastrointestinal Surgery, Southmead Hospital, Bristol, UK.
• 5 Diabetes Complications Research Centre, Conway Institute, School of Medicine and Medical Sciences, University College Dublin, Dublin, Ireland.
• PMID: 32696243
• DOI: 10.1007/s11845-020-02319-y

Introduction: In patients with obesity (PwO) and heath care providers (HcPs), there appears to exist a discrepancy between recognition of obesity as a disease and the underlying biology of the disease. This is evident when considering PwO and HcPs appear to agree obesity is a disease but position lifestyle related factors as the main barriers to treatment with "eat less and move more" considered the best treatment approach. This does not align with current evidence regarding obesity treatments and the underlying pathophysiology. An understanding of PwO beliefs and perceptions may facilitate improved communication strategies with regard to the underlying pathophysiology of obesity as a disease. This has the potential to lead to improvements in both prevention and treatment strategies. Therefore, we evaluated PwO beliefs and perceptions of obesity as a disease, obesity causation and obesity treatment recorded during clinical evaluation.

Methods: As part of usual clinical practice we record 9 items to investigate beliefs and perceptions of obesity in PwO. We used a clinical audit to determine how frequently this information was formally recorded and to explore the association between beliefs and perceptions.

Results: The information was formally recorded in the patients' chart in 52 out of 108 patients (49%) who were part of an intensive lifestyle and medication program between 2018 and 2020. We found PwO tend to agree that obesity is a disease and that weight loss maintenance is dependent on willpower. A strong tendency towards agreement was present for the statement exercise is essential for weight loss. For the statement exercise is as effective as diet alone for weight loss, a tendency towards disagreement was present. Seventy-nine percent of PwO claimed to know the recommended guidelines for exercise with average response aligning with the America College of Sports Medicine recommendations. In exploring the relationship between responses, a number of significant associations were present which may facilitate future approaches to changing the narrative around obesity as a disease and isolating specific aspects of the message that need to be focused upon for the PwO.

Conclusion: PwO appear to have conflicting beliefs regarding obesity as a disease and the underlying biology. This has the potential to hinder attempts to treat the disease via lifestyle intervention and may also reduce likelihood to consider alternative treatment options. These beliefs and perceptions need to be explored further, along with those of HcPs, policy makers and the general public. Collectively this may facilitate changing the narrative around obesity as a disease and positively impact both the prevention and treatment of this disease.

Keywords: Management; Obesity; Patient beliefs; Treatment.

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470 Obesity Essay Topic Ideas & Examples

Looking for obesity essay topics? Being a serious problem, obesity is definitely worth writing about.

Obesity Essay: A Complete Guide and Topics

By: Nova A.

11 min read

Reviewed By: Jacklyn H.

Published on: Aug 31, 2021

Are you assigned to write an essay about obesity? The first step is to define obesity.

The obesity epidemic is a major issue facing our country right now. It's complicated- it could be genetic or due to your environment, but either way, there are ways that you can fix it!

Learn all about what causes weight gain and get tips on how you can get healthy again.

On this Page

What is Obesity

What is obesity? Obesity and BMI (body mass index) are both tools of measurement that are used by doctors to assess body fat according to the height, age, and gender of a person. If the BMI is between 25 to 29.9, that means the person has excess weight and body fat.

If the BMI exceeds 30, that means the person is obese. Obesity is a condition that increases the risk of developing cardiovascular diseases, high blood pressure, and other medical conditions like metabolic syndrome, arthritis, and even some types of cancer.

Obesity Definition

Obesity is defined by the World Health Organization as an accumulation of abnormal and excess body fat that comes with several risk factors. It is measured by the body mass index BMI, body weight (in kilograms) divided by the square of a person’s height (in meters).

Obesity in America

Obesity is on the verge of becoming an epidemic as 1 in every 3 Americans can be categorized as overweight and obese. Currently, America is an obese country, and it continues to get worse.

Paper Due? Why Suffer? That's our Job!

Causes of obesity

Do you see any obese or overweight people around you?

You likely do.

This is because fast-food chains are becoming more and more common, people are less active, and fruits and vegetables are more expensive than processed foods, thus making them less available to the majority of society. These are the primary causes of obesity.

Obesity is a disease that affects all age groups, including children and elderly people.

Now that you are familiar with the topic of obesity, writing an essay won’t be that difficult for you.

How to Write an Obesity Essay

The format of an obesity essay is similar to writing any other essay. If you need help regarding how to write an obesity essay, it is the same as writing any other essay.

Obesity Essay Introduction

The trick is to start your essay with an interesting and catchy sentence. This will help attract the reader's attention and motivate them to read further. You don’t want to lose the reader’s interest in the beginning and leave a bad impression, especially if the reader is your teacher.

A hook sentence is usually used to open the introductory paragraph of an essay in order to make it interesting. When writing an essay on obesity, the hook sentence can be in the form of an interesting fact or statistic.

Head on to this detailed article on hook examples to get a better idea.

Once you have hooked the reader, the next step is to provide them with relevant background information about the topic. Don’t give away too much at this stage or bombard them with excess information that the reader ends up getting bored with. Only share information that is necessary for the reader to understand your topic.

Next, write a strong thesis statement at the end of your essay, be sure that your thesis identifies the purpose of your essay in a clear and concise manner. Also, keep in mind that the thesis statement should be easy to justify as the body of your essay will revolve around it.

Body Paragraphs

The details related to your topic are to be included in the body paragraphs of your essay. You can use statistics, facts, and figures related to obesity to reinforce your thesis throughout your essay.

If you are writing a cause-and-effect obesity essay, you can mention different causes of obesity and how it can affect a person’s overall health. The number of body paragraphs can increase depending on the parameters of the assignment as set forth by your instructor.

Start each body paragraph with a topic sentence that is the crux of its content. It is necessary to write an engaging topic sentence as it helps grab the reader’s interest. Check out this detailed blog on writing a topic sentence to further understand it.

End your essay with a conclusion by restating your research and tying it to your thesis statement. You can also propose possible solutions to control obesity in your conclusion. Make sure that your conclusion is short yet powerful.

Obesity Essay Examples

Essay about Obesity (PDF)

Childhood Obesity Essay (PDF)

Obesity in America Essay (PDF)

Essay about Obesity Cause and Effects (PDF)

Satire Essay on Obesity (PDF) 

Obesity Argumentative Essay (PDF)

Obesity Essay Topics

Choosing a topic might seem an overwhelming task as you may have many ideas for your assignment. Brainstorm different ideas and narrow them down to one, quality topic.

If you need some examples to help you with your essay topic related to obesity, dive into this article and choose from the list of obesity essay topics.

Childhood Obesity

As mentioned earlier, obesity can affect any age group, including children. Obesity can cause several future health problems as children age.

Here are a few topics you can choose from and discuss for your childhood obesity essay:

• What are the causes of increasing obesity in children?
• Obese parents may be at risk for having children with obesity.
• What is the ratio of obesity between adults and children?
• What are the possible treatments for obese children?
• Are there any social programs that can help children with combating obesity?
• Has technology boosted the rate of obesity in children?
• Are children spending more time on gadgets instead of playing outside?
• Schools should encourage regular exercises and sports for children.
• How can sports and other physical activities protect children from becoming obese?
• Can childhood abuse be a cause of obesity among children?
• What is the relationship between neglect in childhood and obesity in adulthood?
• Does obesity have any effect on the psychological condition and well-being of a child?
• Are electronic medical records effective in diagnosing obesity among children?
• Obesity can affect the academic performance of your child.
• Do you believe that children who are raised by a single parent can be vulnerable to obesity?
• You can promote interesting exercises to encourage children.
• What is the main cause of obesity, and why is it increasing with every passing day?
• Schools and colleges should work harder to develop methodologies to decrease childhood obesity.
• The government should not allow schools and colleges to include sweet or fatty snacks as a part of their lunch.
• If a mother is obese, can it affect the health of the child?
• Children who gain weight frequently can develop chronic diseases.

Obesity Argumentative Essay Topics

Do you want to write an argumentative essay on the topic of obesity?

The following list can help you with that!

Here are some examples you can choose from for your argumentative essay about obesity:

• Can vegetables and fruits decrease the chances of obesity?
• Should you go for surgery to overcome obesity?
• Are there any harmful side effects?
• Can obesity be related to the mental condition of an individual?
• Are parents responsible for controlling obesity in childhood?
• What are the most effective measures to prevent the increase in the obesity rate?
• Why is the obesity rate increasing in the United States?
• Can the lifestyle of a person be a cause of obesity?
• Does the economic situation of a country affect the obesity rate?
• How is obesity considered an international health issue?
• Can technology and gadgets affect obesity rates?
• What can be the possible reasons for obesity in a school?
• How can we address the issue of obesity?
• Is obesity a chronic disease?
• Is obesity a major cause of heart attacks?
• Are the junk food chains causing an increase in obesity?
• Do nutritional programs help in reducing the obesity rate?
• How can the right type of diet help with obesity?
• Why should we encourage sports activities in schools and colleges?
• Can obesity affect a person’s behavior?

Health Related Topics for Research Paper

If you are writing a research paper, you can explain the cause and effect of obesity.

Here are a few topics that link to the cause and effects of obesity.Review the literature of previous articles related to obesity. Describe the ideas presented in the previous papers.

• Can family history cause obesity in future generations?
• Can we predict obesity through genetic testing?
• What is the cause of the increasing obesity rate?
• Do you think the increase in fast-food restaurants is a cause of the rising obesity rate?
• Is the ratio of obese women greater than obese men?
• Why are women more prone to be obese as compared to men?
• Stress can be a cause of obesity. Mention the reasons how mental health can be related to physical health.
• Is urban life a cause of the increasing obesity rate?
• People from cities are prone to be obese as compared to people from the countryside.
• How obesity affects the life expectancy of people? What are possible solutions to decrease the obesity rate?
• Do family eating habits affect or trigger obesity?
• How do eating habits affect the health of an individual?
• How can obesity affect the future of a child?
• Obese children are more prone to get bullied in high school and college.
• Why should schools encourage more sports and exercise for children?

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Topics for Essay on Obesity as a Problem

Do you think a rise in obesity rate can affect the economy of a country?

Here are some topics for your assistance regarding your economics related obesity essay.

• Does socioeconomic status affect the possibility of obesity in an individual?
• Analyze the film and write a review on “Fed Up” – an obesity epidemic.
• Share your reviews on the movie “The Weight of The Nation.”
• Should we increase the prices of fast food and decrease the prices of fruits and vegetables to decrease obesity?
• Do you think healthy food prices can be a cause of obesity?
• Describe what measures other countries have taken in order to control obesity?
• The government should play an important role in controlling obesity. What precautions should they take?
• Do you think obesity can be one of the reasons children get bullied?
• Do obese people experience any sort of discrimination or inappropriate behavior due to their weight?
• Are there any legal protections for people who suffer from discrimination due to their weight?
• Which communities have a higher percentage of obesity in the United States?
• Discuss the side effects of the fast-food industry and their advertisements on children.
• Describe how the increasing obesity rate has affected the economic condition of the United States.
• What is the current percentage of obesity all over the world? Is the obesity rate increasing with every passing day?
• Why is the obesity rate higher in the United States as compared to other countries?
• Do Asians have a greater percentage of obese people as compared to Europe?
• Does the cultural difference affect the eating habits of an individual?
• Obesity and body shaming.
• Why is a skinny body considered to be ideal? Is it an effective way to reduce the obesity rate?

Obesity Solution Essay Topics

With all the developments in medicine and technology, we still don’t have exact measures to treat obesity.

Here are some insights you can discuss in your essay:

• How do obese people suffer from metabolic complications?
• Describe the fat distribution in obese people.
• Is type 2 diabetes related to obesity?
• Are obese people more prone to suffer from diabetes in the future?
• How are cardiac diseases related to obesity?
• Can obesity affect a woman’s childbearing time phase?
• Describe the digestive diseases related to obesity.
• Obesity may be genetic.
• Obesity can cause a higher risk of suffering a heart attack.
• What are the causes of obesity? What health problems can be caused if an individual suffers from obesity?
• What are the side effects of surgery to overcome obesity?
• Which drugs are effective when it comes to the treatment of obesity?
• Is there a difference between being obese and overweight?
• Can obesity affect the sociological perspective of an individual?
• Explain how an obesity treatment works.
• How can the government help people to lose weight and improve public health?

Writing an essay is a challenging yet rewarding task. All you need is to be organized and clear when it comes to academic writing.

• Choose a topic you would like to write on.
• Organize your thoughts.
• Pen down your ideas.
• Compose a perfect essay that will help you ace your subject.
• Proofread and revise your paper.

Were the topics useful for you? We hope so!

However, if you are still struggling to write your paper, you can pick any of the topics from this list, and our essay writer will help you craft a perfect essay.

Are you struggling to write an effective essay?

If writing an essay is the actual problem and not just the topic, you can always hire an essay writing service for your help. Essay experts at 5StarEssays can help compose an impressive essay within your deadline.

All you have to do is contact us. We will get started on your paper while you can sit back and relax.

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As a Digital Content Strategist, Nova Allison has eight years of experience in writing both technical and scientific content. With a focus on developing online content plans that engage audiences, Nova strives to write pieces that are not only informative but captivating as well.

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Obesity Awareness and Its Relationship to Sociodemographic Characteristics of Filipino Adults: A Survey Among Work-From-Home Employees in Metro Cebu, Philippines *

Jan louie gatillo.

1 Cebu Doctors’ University Hospital, Cebu City, Philippines

Ariane Corpuz

Theresa leyco, alexphil ponce.

2 Parents for Education Foundation (PAREF) Southcrest School, Inc., Cebu City, Philippines

Awareness and substantial understanding of obesity are essential components in its prevention and treatment. This study aimed to determine the degree of obesity awareness and its relationship to various sociodemographic characteristics among Filipino adults working from home (WFH).

Methodology

This is a cross-sectional survey conducted in Metro Cebu, Philippines. Included were non-healthcare WFH professionals aged 18-64. Researcher-made Obesity Awareness Questionnaire (OAC-20) was used.

A total of 458 employees participated in the study; mean age was 30.33 years (SD=6.96), mostly female (71.40%) and majority single (77.07%). The mean obesity awareness score was 79.18% (SD=9.02). Age ( p =0.198), BMI ( p =0.397), work hours/day ( p =0.101), and hours of physical activity/day ( p =0.458) were not associated with obesity awareness. Similarly, male vs. female ( p =0.515), and single vs. married respondents ( p =0.629) did not differ significantly in terms of average scores. However, higher educational attainment ( p =0.044) and higher socio-economic status ( p =0.002) were significantly associated with higher obesity awareness scores.

The surveyed WFH adults were aware of the majority of the important concepts on obesity. Educational attainment and socio-economic status were significant determinants of obesity awareness.

INTRODUCTION

Obesity is an accumulation of excess body fat which if not treated, may lead to other serious debilitating health conditions. Unfortunately, the worldwide prevalence of obesity has tripled between 1975 and 2016. In 2016, the World Health Organization (WHO) estimated that more than 1.9 billion adults were overweight and over 650 million were obese. 1 In the Philippines, the prevalence of obesity shows a gradually increasing trend as well. According to the recent Expanded National Nutrition Survey (2018), the prevalence of obesity increased from 20.2% in 1998 to 37.2 percent in 2018. 2

The employed sector is not exempt from the obesity pandemic. The 2010 National Health Interview Survey conducted in the United States of America (USA) revealed that those with longer working hours and who work in companies with a large number of employees were mostly overweight or obese. 3 A local study showed a 57% prevalence among employees, most of whom have sedentary work. 4 This problem is expected to worsen with the recent work environment restrictions brought about by the coronavirus pandemic. Due to the work-from-home (WFH) policies intermittently imposed for long periods from 2020-2021, an overall decrease in physical activity and an increase in meal frequency and snacking was noted among the adult working population. 5 , 6

Various disease conditions are linked to obesity such as cardiovascular disease, type 2 diabetes mellitus (T2DM) and cancer among others. 1 It is concerning that in the 2020 Philippine Statistics Authority (PSA) data, 5 of the 10 leading causes of death were obesity-related complications. 7

Obesity is even a risk factor for the dreaded severe coronavirus (COVID-19) infection which continues to wreak havoc on our country and the world. 8 With its devastating effects on health, WHO declared an obesity epidemic in 1997 and spearheaded public awareness campaigns. They also developed “A Global Action Plan on Physical Activity for 2018-2030,” to address this pressing problem. 1

In our country, the National Nutrition Council of the Department of Health conducted virtual forums on obesity awareness to continue the advocacy, promotion and provision of health and nutrition information to the general public during the COVID-19 pandemic. 9 Moreover, various medical societies formulated clinical practice guidelines to guide clinical practitioners. In the Philippines, there are clinical practice recommendations on obesity from the Philippine Association for the Study of Overweight and Obesity (PASOO) and the Family Medicine Research Group (FMRG) Guidelines of the University of the Philippines-Philippine General Hospital. 10

Huge advancements in diagnosis have taken place over the years. While body mass index (BMI) is still commonly used to diagnose obesity, numerous imaging procedures are now utilized to refine this diagnosis. Similarly, development of obesity treatment strategies proceeds at an accelerated pace, with numerous pharmacologic and surgical interventions to complement the fundamentally crucial adherence to diet, lifestyle and behavioral modification. 11 Multiple programs from government and the private sector were initiated to help solve the obesity problem, including information campaigns and lay fora on obesity and the operation of weight loss clinics. 12 , 13

Unfortunately, in spite of all these interventions, the incidence of obesity continues to rise. Awareness and a substantial understanding of its pathophysiology and its consequences are essential components in its prevention and treatment. Several studies involving students, employees and the general population revealed that these cohorts have ample knowledge on the basic concepts of obesity, specifically its risk factors. 14 - 16 However, one study highlighted the public’s unawareness on the link of obesity to cancer. 17 Majority were also unfamiliar about treatment options and most do not try to prevent themselves from becoming obese.

To date, there is no local data evaluating the degree of knowledge of this disease, especially among the employed, who are at most risk of becoming obese due to their current WFH set up. We lack evidence locally whether sociodemographics play a role in influencing the degree of obesity awareness.

The general objective of this study was to determine the awareness on obesity and its relationship to various socio-demographic variables among Filipino adults WFH in Metro Cebu, Philippines. The specific objectives were: (1) to describe the study population’s sociodemographic profile; (2) to assess their level of awareness according to the following: obesity as a disease and its risk factors, complications, diagnosis and management of obesity and (3) to determine if a relationship exists between the degree of obesity awareness and the sociodemographic factors studied.

METHODOLOGY

This was a cross-sectional survey conducted in Metro Cebu, Philippines, which included Filipino adult WFH employees aged 18 years and above. Subjects were non-healthcare professionals and were self-employed or employed in a company under a full WFH scheme/set-up or combined office work-WFH set-up during the survey period.

Excluded from the study were healthcare professionals such as medical doctors, nursing professionals, midwives, dentists, pharmacists, nurse practitioners, physician's assistants, emergency medical technicians, dieticians and nutritionists, and physiotherapists. 18

A sample size of at least 384 respondents was computed using EPI Info Stat Calculator for population surveys/descriptive studies and was based on the Philippines Statistics Authority (PSA) - Region VII’s labor force census. 19

This study sampled workers using the non-probability snowball sampling method from specified cities in Metro Cebu to ensure that these areas are well represented. Researchers had key contact persons—WFH employees from Cebu City, Mandaue City, Lapu-Lapu City and Talisay City. These key persons were asked to recruit other participants to join this study. Recruitment was done via various social media apps and email until the required sample size was surpassed.

The respondents were asked to answer a researcher-made instrument. The first part of the tool gathered various sociodemographic characteristics of WFH employees such as age, sex, marital status, height, weight, BMI, highest educational attainment, socio-economic status based on monthly household income, hours of work per day and hours of physical activity/exercise per day.

The second part, the Obesity Awareness Questionnaire (OAC-20), assessed the respondents’ awareness on obesity. OAQ-20 is made up of 20 items covering the following: obesity as a disease and its risk factors (7 items), complications of obesity (7 items), diagnosis of obesity (2 items) and management of obesity (6 items). All statements in the questionnaire were true regarding obesity. Respondents answered questions covering the aforementioned areas using a 5-point Likert Scale: 5-strongly agree, 4-agree, 3-undecided, 2-disagree and 1-strongly disagree.

The research instrument was subjected to content validity and reliability testing procedures. Content validity was done by a panel of experts: endocrinologists, clinical nutritionists and other internists. Content Validity Indices such as Item-level Content Validity Index (I-CVI) and Scale-Level Content Validity Index (S-CVI) were calculated. Furthermore, Attribute Agreement Analysis, a form of inter-reliability measure, was done to assess whether the experts’ relevance ratings were consistent with one another and if observer agreement was due to chance or not.

Content validation was done in the original 22-item tool. I-CVI is 1.00 for all items except 8 and 18. S-CVI is 0.98. All content validity indices were acceptable, thus, the proposed obesity awareness questionnaire achieved a satisfactory level of content validity. Items 8 and 18 were omitted in the final tool. To determine whether agreement among experts was due to chance, the p-values for each attribute’s Fleiss Kappa were compared to the significance level. With the p <0.05, all appraiser agreements then were not due to chance. Assessments made for each item, therefore, were consistent among appraisers and thus, reliable.

Finally, a total of 3 rounds of pre-testing was conducted. Results of these pre-tests were the bases for internal consistency or reliability testing (Cronbach’s alpha), and item analyses. The tool was evaluated as a unidimensional instrument, all 20 items measuring a single latent trait, in this case, obesity awareness. The over-all Cronbach alpha was 0.86. With a relatively high coefficient, this means that the items of the survey can reliably assess the same construct, obesity awareness, whether among healthcare professional or lay persons.

The Cronbach alpha for each sub-construct were as follows: obesity as a disease and its risk factors (7 items), 0.7; complications of obesity (7 items), 0.9; diagnosis of obesity (2 items), 0.4; and management of obesity (4 items), 0.4. The low value of alpha for the last two groupings could be due to the small number of questions, which came from a decision to include only extremely necessary items.

For example, the clinical diagnosis of obesity relies primarily on the patient’s BMI and/or waist circumference, hence, only these 2 were included in the assessment of awareness on the diagnosis of obesity.

Furthermore, the proposed instrument measures obesity awareness among the general public who we do not expect to be aware of less commonly used diagnostic measures which are costly, unstandardized or not widely available. So, BMI and/or waist circumference would suffice in both clinical and general settings. The same principle was applied in the finalization of the items for the management of obesity.

Nevertheless, we feel that these low ratings in the last 2 groupings should not devalue the proposed instrument, as alphas have been proven to be affected by the number of questions. Also, all 4 were necessary sub-constructs of obesity awareness as per content validation. There is a need to look into all these key areas to properly represent the entire spectrum of obesity awareness.

Remarkably, the Cronbach alpha for the non-healthcare professionals pre-testing and that of the healthcare professionals pre-testing were similar, 0.79 and 0.80, respectively. With similar Cronbach alpha values (≅0.80) for both test groups, this further indicates that items meant to assess awareness obesity may work for both populations.

The validated questionnaire was also translated into the Bisaya language. Forward translation was done by a certified linguist who is fluent in both the source and target language and is knowledgeable about health care terminology. The linguist was briefed by the authors regarding the content area of the construct of the instrument in the desired target language. Another linguist of the same caliber was tasked to perform blind back-translation.

The instructions, items and the response format of the translated and back-translated versions of the instruments were compared to the original regarding ambiguities and discrepancies of words, sentences and meanings. All comparisons were discussed, ambiguities and discrepancies were dealt with and resolved. Consensus was achieved thus generating the Bisaya version of the Obesity Awareness Questionnaire (OAC-20-B). The said version was subjected to the same rounds of pre-testing as indicated above. The over-all computed Cronbach’s alpha was 0.90.

Actual data collection was done from June 15 to July 31, 2021. Due to COVID-19 pandemic restrictions and for the safety of researchers and respondents, a self-administered survey was conducted online via Google Forms. The study was approved by the Cebu Doctors’ University Hospital Technical Review Board and Institutional Research Ethics Committee.

In the analysis of data, descriptive statistics (mean, SD, median, IQR, minimum and maximum Values) were used to describe the distribution of WFH employees in terms of numerical profile characteristics and obesity awareness assessment scores of respondents. Frequency and simple percentage were used to determine the distribution of respondents in terms of different categorical variables. Spearman’s Correlation was used to determine if there was association between numerical variables such as awareness scores and numerical/ordinal profile variables. Mann-Whitney U Test was used to determine if there was significant difference between 2 groups of respondents in terms of their obesity awareness scores. For all tests, confidence interval was set at 95%, relationship or comparison significant at <0.05, all hypotheses were tested at 0.05 level of significance. Data were entered with Microsoft Excel Spreadsheet and then analyzed with Minitab version 19.0 for Mac Mojave OS.

A total of 458 WFH employees participated in the study. As shown in Table 1 , the mean age of the cohort was 30.33 years and ranged from 18-64 years. There were 327 females (71.40%) and 131 males (28.6%). The married respondents comprised 22.93% of the population and 77.07% were single.

Sociodemographic characteristics of work-from-home employees in Metro Cebu

Self-reported height ranged from 1.25-1.88 meters while the self-reported weight ranged from 30-155 kg. Majority of the respondents had reported BMIs that were above normal. Using the Asia-Pacific cutoff, the computed BMI revealed 20 (4.42%) respondents were underweight, 159 (35.18%) were normal, 85 (18.81%) were overweight, 148 (32.74%) were pre-obese and 40 (8.85%) were obese.

Majority of the respondents were college graduates (82.53%) and more than 50% of respondents had level 2-3 monthly household income (PhP 10,481 to 41,924). Sixty-nine percent of the WFH employees worked 8 hours per day. It is noteworthy that more than half of the respondents had only 30 minutes or less of physical activity/exercise per day.

As shown in Figure 1 , the mean total obesity awareness score of the respondents was 79.18 with a standard deviation of 9.02 points. The lowest score was 47. About 25% of the awareness scores in the sampled population were less than or equal to 73 (Q1). The median score was 78, which means that half of the sampled population scored below this value. About 25% of the scores in the sampled population were greater than 84, i.e., 75% of the respondents scored 84 and below in obesity awareness. The highest obesity awareness score was 100.

Summary of respondents’ total obesity awareness scores.

To better understand the respondents’ awareness on obesity, item scores were computed and these are presented in Table 2 . When it comes to obesity as a disease and its risk factors, most respondents were aware that hormonal imbalances can affect a person’s weight. The mean score for this item was 4.30 (SD=0.63). WFH employees, however, were least aware of how common obesity is among Filipinos. The mean score for that item was 3.51 (SD=1.23).

Respondents’ scores on obesity awareness

In terms of complications, most respondents were aware that obesity is associated with elevated blood pressure and cardiovascular diseases as evidenced by a mean item score of 4.22 (SD=0.78). However, they were relatively less aware that obesity is actually associated with T2D, infertility, colon cancer and severe COVID-19 infection.

As far as diagnosis of obesity is concerned, most of the respondents were aware that BMI is commonly used to determine if a person is overweight or not, as evidenced by a mean item score of 4.31 (SD=0.74). However, much of the sampled population did not know that obesity can also be diagnosed by measuring waist circumference as well. A mean score of 3.32 (SD=1.09) supported this finding.

Respondents were also assessed in terms of their awareness in the management of obesity. WFH employees were aware that moderate intensity exercises can help achieve a healthy weight (mean score 4.22, SD=0.71) and that professional advice should be sought before losing weight (mean score 4.19, SD=0.76). On the other hand, only a few were aware that there are surgical treatment options for obesity (mean score 3.68, SD=0.87).

Table 3 presents the results when assessing the relationship (or differences in terms sex and marital status) between the obesity awareness scores and various sociodemographic variables of the respondents. Age ( p =0.198), BMI ( p =0.397), hours of work per day ( p =0.465) and hours of physical activity per day ( p =0.765) were not associated with obesity awareness among the studied population. Sex ( p =0.515) and marital status ( p =0.629) were also not significantly associated with obesity awareness. On the other hand, educational attainment ( p =0.044) and socio-economic status ( p =0.002) were both associated with the respondents’ obesity awareness scores. For highest educational attainment and obesity awareness, the computed value (Spearman’s Rho) of 0.1 indicates that a positive monotonic correlation exists between the 2 variables. This means that higher levels of education were associated with higher obesity awareness scores. There was also a positive monotonic correlation between socio-economic status and obesity awareness scores as indicated by the computed value of 0.147. Similarly, higher socio-economic statuses were associated with higher obesity awareness scores. It must be noted, however, that these correlations do not imply a causal relationship (cause and effect).

Awareness on obesity and sociodemographic characteristics

In the Philippines, the prevalence of obesity showed a gradual increasing trend with 3 out of 10 adult Filipinos being overweight and obese. 2 To date, there are no studies focusing on obesity awareness among Filipinos, much less on the locally-employed sector.

The sampled population of Filipino adults WFH in Metro Cebu were aware of most of the important concepts on obesity as a disease and its risk factors, complications, diagnosis and management as evidenced by an overall average score of 79.18%, covering therefore nearly 80% of the salient facts regarding obesity. Perhaps the ease of accessing information through the internet may be the reason for their high level of awareness. The results in other countries are polarized with studies in China, Pakistan and India revealing cohorts who were knowledgeable on the core principles of obesity while studies done in the USA and United Kingdom (UK) showed otherwise. 14 - 17 , 20

The item that the respondents were most aware of is that BMI is a diagnostic tool for obesity. This is because BMI is commonly used and is regarded as the most useful population-level measure of overweight and obesity. 1 The second highest ranking in the overall awareness is that hormonal imbalances can affect a person’s weight. Hormonal influence is usually cited as one of the causes of obesity. 21 Although we are unsure how the respondents are particularly aware of this fact, it is nevertheless reassuring to know that this cohort realizes that obesity is a multifactorial condition, requiring holistic treatment and inputs from multiple disciplines.

On the other hand, the knowledge of waist circumference as an obesity diagnostic tool had the lowest awareness score. This was similarly noted in a study by Dunkley et al., (2009) were almost half the subjects had no previous knowledge of the importance of waist circumference measurement in screening for obesity. 22

Majority of the respondents are not aware of the increasing prevalence of obesity in the country. This might be because many people are unable to recognize those who are already overweight/obese which is supported in studies by Nanda (2021) and DeVille-Almond et al (2011). 20 , 23 This may be problem because recognizing a disease condition precedes treatment. In spite of the development of obesity treatment strategies, 11 our study revealed that too many respondents were still unaware that there are surgical options for treating obesity. This is likely because surgery is not usually discussed with the patient at the onset of treatment. Lifestyle and behavioral modifications are rightfully given greater emphasis in obesity management. 1 Surgical options such as gastric bypass are only suitable for a select group of morbidly obese patients or obese patients with co-morbidities. 11

Only a few respondents recognized cancer as an obesityrelated complication, 17 including in our study were mostly it ranked at the bottom half of the overall awareness ranking. This relatively low awareness regarding obesity and its complications is concerning since 5 of the 10 leading causes of death are obesity-related according to the 2020 PSA data. 7

Despite having sufficient awareness about obesity, the majority of the respondents had reported BMIs above normal. This is probably due to the significant reduction in physical activity, along with the tendency to overeat due to the sudden shift to WFH set-up for millions of employees around the world, the Philippines included, during the COVID-19 pandemic. 24 - 27 Another possible explanation of abnormal BMIs despite sufficient awareness is their misperception of weight and obesity, common among overweight/obese adults. 23 Nanda et al., showed that only a few persons knew their BMIs. 20

In addition, our study showed the respondents were knowledgeable on the nature of obesity, how it develops, what its predisposing factors are, and how to combat the disease. However, they were relatively less informed on its complications. This might be why this cohort is wellversed on obesity but are themselves above their ideal weight. Knowledge can strengthen one's determination to adhere to approved medical measures to treat obesity. By educating the public on the serious complications of obesity, the problem will transcend mere aesthetics and may motivate people to avoid and prevent this medical condition.

A previous study by the Canadian Institute for Health Information (2011) has concluded that there were associations between the sociodemographic factors and the likelihood of being overweight or obese. 28 However, this study did not assess the level of obesity awareness.

Our study also showed that obesity awareness is significantly related to the socioeconomic status. The higher the household monthly income, the higher the level of awareness. This may be due to the more ready access to obesity education similar to a study in Latin America. 29

There was also a significant relationship between higher educational attainment and obesity awareness. Those with lower educational levels were expected to score low, thus, less likely to be knowledgeable in lifestyle diseases such as obesity. 30 Having said that, it is interesting to note that the latest National Nutrition Survey showed that higher educational attainment had higher odds of becoming overweight/obese. 31 This implies that there is a gap in the knowledge on obesity and in the application of its concepts.

In interpreting the results of the study, there were few limitations that should be considered. Our study was sampled via non-probability, snow-ball sampling due to COVID-19 restrictions. Further, the weight and the height of the respondents were self-reported. Thus, responses were limited to the honesty of the participants. Also, this study did not look into confounding variables such as the participant’s access to social media, awareness of current events, current medical conditions and access to a healthcare practitioner which might have influenced awareness.

The sampled population of Filipino adults WFH in Metro Cebu were aware of majority of the important concepts on obesity as a disease and its risk factors, complications, diagnosis and management.

Age, BMI, hours of work per day, and hours of physical activity per day were not associated with obesity awareness among the studied population. Similarly, male and female, as well as single and married respondents do not differ significantly in terms of their average obesity awareness scores. However, higher educational attainment and socio-economic status were associated with higher obesity awareness.

Recommendations

This study provides novel information on the awareness on obesity among Cebuanos. However, the researchers recommend that a larger and a more diverse population be studied. Larger studies may also be done to establish cut-off scores. We also recommend community-wide workshops, not just lectures, with greater emphasis on the application of learned concepts.

Statement of Authorship

The authors certified fulfillment of the ICMJE authorship criteria.

CRediT Author Statement

JLG: Conceptualization, Methodology, Investigation, Resources, Writing – original draft preparation, Writing – review and editing, Visualization, Funding Acquisition; AC: Conceptualization, Methodology, Investigation, Resources, Writing – original draft preparation, Writing – review and editing, Visualization, Funding Acquisition; TL: Conceptualization, Methodology, Investigation, Writing – original draft preparation, Writing – review and editing, Supervision. Project Administration; AP: Methodology, Software, Validation, Formal analysis, Writing – original draft preparation, Writing – review and editing.

Author Disclosure

The authors declared no conflict of interest.

Funding Source