health should mean a rot more than escape from death or for that matter, escape from disease

7/29/2019 Health Should Mean a Rot More Than Escape From Death or for That Matter, Escape From Disease

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CHAPTER - I

INTRODUCTION

HEALTH SHOULD MEAN A ROT MORE THAN ESCAPE FROM

DEATH OR FOR THAT MATTER, ESCAPE FROM DISEASE.

BACKGROUND OF THE STUDY :-

Obesity is perhaps the moat prevalent from of malnutirition. As a

chronic disease , prevalent in both developed and developing countries,

and affecting children a well as adults. Early childhood overweight that

persists into adulthood is associated with more severe obesity among

adults. Among adolescents self image, communication problems and

difficulties both in school and home obesity:

Renstick etal. (1997) stated that having family members who are

emotionally available and appropriately involved in their lives has proved

to be a key-factor in the well being of adolescents.

Puberty marks the beginning of accelerated physical growth, which

can as much as double adolescents nutritional requirements for iron,

calcium, zinc & protein. At the same time, growing independence the

need for peer acceptability, concern physical appearance, and an active

lifestyle may affect eating habits, food choices, nutrient intake, and thus

nutritional status.


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Excess intake of calories, sugar, fat, cholesterol and sodium is

common among adolescents and if found in all income and social /ethnic

groups and both genders.

world health organization (WHO)(2008) described obesity as an

escalating epidemic and one of the neglected public health problems of

present time.

Mehta. M Bhasin. s. k. etal. (2007) cited that prevalence of

obesity and overweight among the study subjects was 5.3% and 15.27%

respectively.

Manuraj etal. (2007) reported that the proportion of overweight

children increased from 4.94% of the total students in 2003 to 6.57% in

2005. The increase was significant in both boys and girls. The proportion

of overweight children was significantly higher in urban regions and in

private schools.

The prevalence of overweight and obesity among children and

adolescents has increased significantly in the developed countries during

the past two decades and similar trends are being observed even in

developing world, through less rapidly.

The consequences that are associated with adolescent obesity both

during adolescence and adult life which include increased incidence of

coronary artery disease and hypertension, diabetes, obstructive sleep

apnea, esophageal reflux and gastric emptying disturbances, osteoarthritis


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and flat feet, psychological dysfunction, self-esteem and social isolation.

dyslipidemia and over all increase in morbidity and mortality in later life.

SIGNIFICANCE AND NEED FOR STUDY:-

National center for health statistics (NCHS) USA reported that

nearly 15% of adolescents in the united states were obese. A recent study

conducted among affluent public school children in new Delhi, revealed

prevalence of overweight (BMI >25-30) of about

25% and 75% respectively.

Abdellah described 21 nursing problems subsumed under one of

three categories, physical, social emotional need of a client. The second

problem is optimal activity. exercises, rest and sleep and nutrition for all

body cells. According to her theory proper exercise and balance diet for

the correction of existing obsesing. may be the most effective method to

curb the over fat condition.

Sumithra etal (2009), Stated that more cases of slipped femoral

epiphysis, joints problems in adolescents for excess weight bearing, over

weight girls have tendency to be glucose intolerant in their pregnancy

giving birth to bigger babies and in turns, girls babies amongst those

newborns are become pre-diabetic even before their pregnancy.

During the clinical experience the investigator found out that the

obese adolescent girls had problems like body image disturbance and


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complications like Diabetes, hypertension, & coronary artery disease. Due

to their sedentary life style and eating habits make them become obese.

A good counseling and motivation can go a long way in getting rid

of extra kilos and inches. Nurses being in close contact for long periods

while the patient is indoor can effectively do the job of a counselor.

Nurses could be involved in running weight management clinics. They

can provide the people with knowledge about obesity its risks and right

method of assessing obesity. They should encourage them to consume a

healthy diet and engage in regular physical activity. A through knowledge

of various parameters of assessing obesity is of paramount important to

nurses.

STATEMENT OF PROBLEM

A Descriptive study to Assess the Knowledge and life style factors on

Obesity Among Obese Children Age Between 12 15 Years at Selected

School

OBJECTIVES:-

Assess the knowledge of the School age children regarding the

obesity.

Assess the life style factors of School age children age between

12 15 years

To determine the association of knowledge on management of

obesity with selected demographic variables such as age,

educational status, sex , Fathers occupation , education of the


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parents, family income, Types of family, total no of children,

Food habits.. Religion, BMI.

OPERATIONAL DEFINITIONS

OBESITY:-

obesity is defined as an excess accumulation storage fat in the

body and is evidence when a person (he/she) having 20% more weight

over the maximum desirable weight for his ( or) her height and age. BMI

is more than 25.

KNOWLEDGE

Information acquired through experience or education.

In this study it refers to the understanding and the responses of the

respondents regarding obesity management as measured by knowledge

questionnaire.


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CHAPTER II

REVIEW OF LITERATURE

Kaneria.Y etal. (2006) undertaken a investigation to make a

comparative assessment of overweight and obesity in two different socio-

economic groups of school age children from udaipur city (Rajasthan),

ranging from 12 to 17 years, on the basis of 85th

and 95th

percentile of

body mass index (BMI). One group of children belonged to affluent upper

middle class society, while the other group was not so affluent. The first

group consisted of 268 children, and the second one comprised of 250

children. Result showed a significant increase in over weight (3.25%) in

the affluent group as compared to then non affluent group. Obesity in

the affluent group was 3.73% but no case of obesity (0%) was observed in

non-affluent group. Hence, the comparative data clearly delineates that

obesity is an increasing malady of affluent population.

Sharda Sidhu etal. (2004) conducted a study; an attempt has been

made to assess the prevalence of overweight and obesity in school

children (between 10 15 years of age) of the affluent families of

Amritsar district of Punjab, a state in rapid economic and epidemiological

transition. A total of 640 children (323 boys and 317 girls) were measured

for height and weight. Overweight and obesity were assessed using age

and sex-specific body mass index (BMI) cut-off points. 9.91% boys and

11.99% girls were overweight, and 4.95% boys and 6.31% girls were

obese. The prevalence of overweight and obesity among the affluent

children in Amritsar was as high or higher as in some industrialized

countries.


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Ramachandran (2002) cited that the prevalence of diabetes

mellitus (DM) and cardiovascular disease (CVD) was increasing in urban

India. Overweight in adolescence was a marker of overweight in adult

age, and it shows an association with the above diseases. There had been

major data from India on the prevalence of childhood obesity. The

objective of the study was to quantify the prevalence of overweight and its

risk factors in adolescent children in urban India. School students in the

age group of 13 18 years (n=4700, M:F 2382:2318) were studied. Body

mass index (BMI) was measured. Data on physical activity, food habits,

occupation of parents

and their economic status, birth weight of the children and age at

menarche in girls were obtained by questionnaire. Age-adjusted

prevalence of overweight was 17.8% for boys and 15.8% for girls. It

increased with age and was higher in lower tertiles of physical activity

and in higher socio-economic group. Birth weight and current BMI were

positively associated. The study highlighted the high prevalence of

overweight in adolescent children in urban India. Life style factors

influenced BMI in adolescent age.

LITERATURE RELATED TO OBESITY AND ITS HEALTH RISK

AMONG SCHOOL CHILDREN.

Kolsgaard etal. (2008) conducted a study to identify differences in

the prevalence of metabolic syndrome between obese and overweight

Norwegian and immigrant children and adolescents. Two hundred and

three overweight and obese Norwegian, Pakistani, Tamil and Turkish


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patients aged 6-17 years living in Norway were included. Metabolic

syndrome was defined as the presence of at least three abnormal values of

waist circumference, blood pressure, fasting triglycerides fasting glucose

and HDL cholesterol results showed that the prevalence of metabolic

syndrome was significantly higher among immigrant compared to

Norwegian subjects. The prevalence of metabolic syndrome increased

with increasing severity of obesity and reached 50% in severely obese

immigrants and 30% in severely obese Norwegians.

Park. K (2008) stated that obesity was a health hazard and a

determinant to well being which is reflected in the increased morbidity

and mortality. Obesity is a positive risk factor in the development of

hypertension, diabetes, gall bladder disease and coronary heart disease,

especially the hormonally related and large bowel cancers. Varicose

veins, abdominal hernia, osteoarthritis of the kness, hips and lumbar

spine, flatfeet and psychological stresses particularly during adolescence.

Manuraj etal. (2007) conducted a study to determine the

relationship of obesity and blood pressure in Ernakulam, Kerala. They

used a stratified random cluster sampling method to select children. Blood

pressure and Anthropometric data were collected from 20,263 students

during 2005-2006. Gender, age and height were considered for

determining hypertension. Systolic incident of hypertension was found in

17.34% of over weight children versus 10.1% of the remaining students.

Choudhry. p (2005) cited that there has been a significant rise in

many adult diseases linked with obesity like Insulin resistance type 2


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diabetes, hypertension, coronary artery disease, hyperlipidemia and

stroke. These diseases have been shown to have their origin in

adolescence, especially in children who are getting bulkier relative to

themselves.

Stein AD etal. (2005) conducted a review of studies from countries

undergoing the nutrition transition. Five birth cohorts with measures of

child growth and outcome through adolescence were identified, from

china, India, Gualtemala, Brazil and the Philippines. Generally consistent

associations of growth failure in early childhood and development of

overweight in later childhood with the risk of elevated blood pressure,

glucose and serum lipids in adulthood were observed.

Bhatia V (2004) cited that type 2 diabetes mellitus (DM) has

traditionally being considered a disease of adults. However, in the last 2

decades, it is increasingly being reported in children and adolescents.

Obesity is a strong correlate, and the increasing prevalence of obesity and

poor physical activity is precipitating type 2 DM at younger ages in the

ethnic groups at risk. Indians and other south Asians are among the ethnic

groups.

William.D & Frank. T etal. (2003) obesity was associated with

several health risks such as hypertension, hyper lipidemia and coronary

artery disease. Obesity also can have an adverse effect on quality of life

by limiting mobility, impairing physical capacity and reducing an

individuals capacity to perform activities of daily living.


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Scott. K. power etal. (2001) stated that diseases or conditions in

which obesity is a primary contributing factor adult onset diabetes,

menstrual abnormalities, reproductive problems, heart size and function,

arthritis, gout and hypertension.

LITERATURE RELATED TO MANAGEMENT OF OBESITY BY

DIET AMONG SCHOOL CHILDREN:

Yuasa. K etal. (2008) conducted a cross sectional questionnaire

based survey was performed in elementary and junior high school

students in Tokushima, Japan, during the summer of 2004. The

questionnaire consisted of 30 items such as physique, sleep, eating habits

diet, exercise, free time, and attending after school lessons. The study

revealed that eating meals as a family every day is associated with a lower

rate of obesity as well as getting good life style habits such as eating

balanced meals and getting enough sleep. If the 3,291 students who

responded to the questionnaire, 2,688 (81.7%) reported that they eat meals

with their family every day.

Wilson LF (2007) conducted a study involved the development and

administration of a questionnaire to middle school their attitudes about

overweight/obesity and what they felt would work for them. Adolescents

are willing to exercise more, to change eating habits to include more fruits

and vegetables, drink more water, and eat less junk food. They are not

willing to give up soda, video/computer games and watching television to

improve their health.


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Hagarty, M.A. Submide, C et al. (2004) adolescent obesity has

been historically attributed to inappropriate diet and exercise. If left

untreated may result in metabolic complication. Practitioners should focus

on using new BMI national guidelines for early identification of obesity.

Bonnie spear (2002) stated that soft drinks represent the 6th

single

highest contribution of energy to the diets of adolescents. Between 12-

16% of the daily Caloric intake comes from soft drink alone. The number

of servings of soft drink increase, so does the risk of obesity.

D. LITERATURE RELATED TO MANAGEMENT OF OBESITY

BY EXERCISE AMONG SCHOOL CHILDREN.

Loman, D.G (2008) conducted a qualitative study using focus

groups and interviews with 28 girls (12-18years of age) recruited from

schools and neighborhood health centers in a Midwest metropolitan area,

USA. An interview guide with 15 open ended questions was used, and

data were analyzed using content analysis. Results showed most girls

preferred the phrase physical activity over exercise. The benefits most

frequently mentioned included positive physical attributes, mental health

benefits, and staying healthy. Three major themes were identified;

autonomy (ask them what they like to do and then provide choices) fun

(being with friends, variation and enjoyment), and body image (gaining

weight, appearance, and self-confidence).


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Tsiaris MD etal., (2008) examined the effectiveness of CBT

(Cognitive behavioral therapy) program for improving the body

composition, diet, physical activity in overweight and obese adolescents.

(16 male, 31 female; aged 14.5+/-1.6>: body mass index 30.9+/-4.2) were

block matched into 2 groups by age, sex, tanner stage, BMI and hip and

waist circumferences were randomly assigned to CBT or no treatment

(control). CBT consisted of 10 weekly sessions, followed by 5 fortnightly

telephone sessions. CBT showed greater reduction in intake of sugared

soft drinks as a percentage of total energy. (CBT, -4.0+/-0.9%; control-

0.3+/-0.9%) which was related to reduction in weight, BMI, and waist

circumference. Changes in soft drink consumption may have contributed

to this result.

Alm. M etal. (2008) conducted a qualitative assessment of barriers

and facilitators to achieving behavior goal among obese inner city

adolescents in a weight management program in minnea polis, USA.

Totally 18 adolescents were interviewed to identify barriers and

facilitators to reaching behavior goals. Data were analyzed using

descriptive statistic. Results showed that the rationale for weight control,

adolescent girls and boys reported a desire to improve physical

appearance and physical conditioning, respectively. Barriers to reaching

physical activity goals among girls include unsafe neighborhoods and a

negative body image. Overall, coaching provided support that helped the

obese teens feel more successful in the goat setting process and address

issues related to their disruptive environments.


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Dudas, R.A etal. (2008) conducted a survey together dietary and

activity practices in a cross sectional, convenience sample of 100 children

presenting to an urban hospital setting in Baltimore, Maryland, USA.

They chose to emphasize bicycling because it is a widely available

activity that requires sustained level of moderate energy expenditure

results showed that the mean age of our population was 11.8 years and

56% were ever weight. They found that approximately half of our

participants do not eat breakfast, fruits, or vegetables regularly. More than

half never ride a bike to school, walk to school, or participate in any

organized sport. Riding a bicycle atleast 2 or more days during the week

is associated with a decreased likelihood of being overweight during

childhood.

Kelly, G.A & Kelley, K.S (2008) used the meta analytic approach

to examine the effects of aerobic exercise on non high density

lipoprotein cholesterol in children and adolescents. Thirteen non HDL-C

out comes in 404 males and females (221 exercise, 183 control) were

available for pooling. A statistically significant decrease of 7% was found

for percent body fat (-2.1 +/- 0.5%) as well as 8% increase in aerobic

capacity, both secondary outcomes of the study.

Melynk, B.M.etal. (2007) cited that phase I and phase II clinical

trials were conducted with 23 overweight teens. The phases I trial used a

pre-experimental design with one group of 11 urban adolescent. The

phase 2 trial was conducted with 12 suburban teens using a randomized

controlled pilot study. COPE (creating opportunities for personal

empowerment) teens received a 15 session cognitive behavioural skills

building program that included physical activity. While the control group


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received an attention control program. Weight change and BMI were the

key out comes. Results showed cope teens experienced a significantly

greater reduction in weight and BMI than did teens in the control group,

who gained weight over time.

Kim, Y.H etal. (2005) conducted a study to determine the effects

of walking exercise training (WET) on metabolic syndrome risk factors

and body composition in obese middle school girls. A non equivalent

pretest post test experimental design was used. Twenty seven subjects

participated in this study from one womens middle school in Busan. The

participants were purposely allocated to an experimental group (n = 14)

and a control group (n=13). The experimental group participated in 30

60 minutes of WET with 55 to 75% of a maximal heart rate six days a

week for 12 weeks. Results showed that the prevalence of individual risk

factors on metabolic syndrome were improved in the experimental group

after the intervention. These results indicate that WET is effective in

decreasing risk factors of the metabolic syndrome and body compositioncomponents in obese middle school girls.

CONCLUSION

The above review of literature showed that there was a prevalence

of obesity among adolescent girls. Obesity was a positive risk factor in the

development of hypertension, cardiovascular disease and psychological

stress. Adolescents were changing their eating habits to include morefruits and vegetables, drink more water eats less junk food. Walking

exercise training (WET) was effective in decreasing risk factors of

metabolic syndrome and improves the body composition of adolescent

girls.


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CONCEPTUAL FRAME WORK

Conceptual frame work for a study is developed from the existing

theory and helps in defining the concepts of interests and proposing

relationship among them. The model give direction for planning, data

collection and interpretation of findings (Burns & Grove, 1995).

The frame work of present study was based on the modified Rosen

stocks health belief Model. (1996).

According to Rosen stocks health belief model, there are three

factors, individual perception, modifying factors and likelihood of taking

action which determines the individuals decision towards taking

preventive action. The model explains, a decision to take health action is

based on perception of susceptibility to conditions and the severity of the

consequences resulting from that condition. The preventing or reducing

the susceptibility to or severity of a sickness and the psychological as well

as the financial and other costs for pursuing a particular health action. The

model also includes cues to action that are internal or external stimuli to a

particular health behavior.

In this study, individual perception refers to the school children

perception of importance on prevention and management of obesity and

prevention of perceived susceptibility to get complications of obesity.

Modifying factors refer to knowledge and expressed practice of

School Children on management of obesity and demographic variables


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like educational status of school children, mothers education, fathers

occupation, type of family, familys monthly income and type of dietary

pattern.

Perceived threat of obesity is influenced by individual perception,

modifying factors and cues to action, which ultimately lead the individual

to take appropriate action.


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Individual perception Modifying factors Likelihood of Action

School age children knowledge

Regarding susceptibility to obesity

Age

Educational Status

Sex

Fathers occupation

Education of parents

Family income

Type of Family

Total number of children

Food habit

Religion

BMI

Perceived seriousness of disease

School age children knowledge

and expressed practice on

obesity management (pre test)

Demographic variables (School age

children education, Mothers

education,

Fathers occupation, familys

monthly income, type of family, type

of dietary pattern)

Perceived threat of obesity

Cues of action

Information, education and

communication package on

management of obesity after the data

collection

Perceived benefits

About life style changes, regular

exercise eating fat free diet

Likely hood of taking recommend

preventive health action

Gain knowledge on managemof obesity by diet and exercis

(post test)

change in expressed practice

towards management of obesi

(post test)

CONCEPTUAL FRAME WORK BASED ON ROSEN STOCHS HEALTH BELIEF MODEL


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CHAPTER- III

RESEARCH METHODOLOGY

Methodology of research refers to the investigations of the ways of

obtaining organizing and analyzing data. Methodological studies address

the development, validation and evaluation of research tools and methods.

This chapter deals with research design the setting sample and

sampling technique. It also deals with took and technique procedure for

data collection .The research approach used for this study was evaluative

approach .

Polit and Hunglel-2004

Research design

Descriptive Studies is to observe, describe, and document aspects

of a situation as or naturally occurs.Descriptive design was adopted for this study.

SETTING

The study was conducted at Dhanalakshmi Srinivasan Higher

Secondary school, Perambalur.

POPULATIONThe target Population of this study was School Children age

between 12-15 years


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SAMPLE

The Sample consisted of 50 school children who were having BMI

above 25-32 Studying at Dhanalakshmi Srinivasan higher secondary

school.

SAMPLING TECHNIQUE

Sampling technique used for this study was convenience sampling .

SAMPLE SIZE is 50

INCLUSION CRITERIA

School Children who were hawing BMI 25-30 studying in

Dhanalakshmi Srinivasan Higher Secondary School.

School Children who are Present at the time of data

collection.

EXCLUTION CRITERIA

School Children had any chronic systemic disease and renal

problems.

School Children had any endocrine disorders physical

deformities

School Children had any endocrine disorders

DESCRIPTION OF TOOLS

Demographic Data

Knowledge Questionnaire

Check list to assess life style factors.


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SECTION-I

Demographic characteristics of school age include age, educational

status, sex. Fathers occupation, education of the parents, family income,

types of family, total number of children food habits, Religion, BMI.

SECTION-II

Consisted of knowledge questionnaire to assess the knowledge

related to definition of obesity causes, assessment and complication

management of obesity.

SECTION-III

Check list to assess the life style factors of obese children.

SCORING PROCEDURE

The total score of multiple choice items on knowledge regarding

managements of obesity was 20. Each item was given one mark for

Correct answer and zero mark for wrong answer.

PART I;- II

The result score was ranged as follows

Level of knowledge Score

Adequate 76-100%

Moderately adequate 51-75%

Inadequate 0-50%


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PART III

Check list consistant of 20 items. 4 Point rating scale used for this

study.

(rare -1 , Sometimes -2 , Ofter-3 never-0)

VALIDITY

The tool was evaluated by 3 experts who were requested to give

their valuable suggestion about the content areas. Relevence clarity and

appropriate need of the items.

RELIABILITY

Reliability of the tool was assessed by split half technique using

spearman- brown formula (knowledge score r=0.8, expressed practice r-

o.9)

DATA COLLECTION PROCEDURE

The study was conducted from 07-08-2011 to 17-08-2011, 50samples were selected using non-probability convenience sampling

technique at Dhanalakshmi srinivasan higher secondary school. The data

collection was conducted after obtaining consent from the each participant

who fulfill the criteria. The demographic data, knowledge life style

practice of the participants were assessed by structured interview

Questionnaire.

PLAN FOR DATA ANALYS

Data analysis enables the researcher to organize summarize

evaluate interpret and communicate numerical information. The data

collected from the subject were complied and analyzed using descriptive


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statistic such as a number of percentage, mean and standard deviation. Chi

square test was used to associated the pretest knowledge with

demographic variables.

ETHICAL CONSIDERATION

Permission was obtained from headmistress of Dhanalakshmi

Srinivasan Higher Secondary School to conduct the study. Participants

were informed about the study and written consent was obtained from the

individual participant. None of the subject were denied from their routine

and participant were told that they were under no obligation to participate

in the study and his data will be kept confidentially.


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CHAPTER IV

DATA ANALYSIS AND INTERPRETATION

This chapter deals with the analysis and interpretation of the data

collected. Analysis is the method for rendering, quantitative, meaningful

and providing intelligible information. So that, the research problem can

be studied and tested including the relationship between the variables.

The data collected were analyzed using appropriate statistical methods

and the results are presented in

Section 1 : Distribution of Demographic Variables

Section II : Distribution of level of knowledge of the Subjects

regarding the obesity

Section III : Checklist to assess lifestyle factors.

Section IV : To associate the knowledge with selected

demographic variables such as age, educational

status , sex, Fathers occupation, education of

the Parents, family income, Types of

family, total no of children, Food habits,

Religion, BMI.


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SECTION I

TABLE I

FREQUENCY DISTRIBUTION OF SAMPLE ACCORDING TO

THEIR DEMOGRAPHIC VARIABLES

S.

No.

DEMOGRAPHIC

VARIABLES

CATEGORYRESPONSE

FREQUENCYNO

PERCENTAGE%

1. Age a) 12

b) 13

c) 14

d) 15

5

7

23

15

10

14

46

30

2. Educational Status a) 6

b) 7

c) 9

d) 10

1

5

29

15

2

10

58

30

3. Sex a) boys

b) girls

23

27

46

54

4. Fathers occupation a) Farmer

b) Cooliec) Private employee

d) Government

employee

21

1212

5

42

2424

10


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5. Education of the

parents

a) illiteracy

b) Primary

education

c) Higher education

d) Graduate

2

14

24

10

4

28

48

20

6. Family income a) Rs. 5000

b) Rs. 5000-7000

c) Rs. 7000

d) Rs. 7000 above

21

9

9

11

42

18

18

227. Type of family a) Nuclear

b) Joint

35

15

70

30

8. Total Number of

Children

a) 1

b) 2

c) 2 above

10

30

10

20

60

20

9. Food habits a) Vegetarian

b) Non-vegetarian

10

40

20

80

10. Religion a) Hindu

b) Muslim

c) Christian

d) Others

46

4

0

0

92

8

0

0

11. BMI Calculation a) 25-27

b) 27-30

c) above 30

34

12

4

68

24

8


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RESULT:-

Table 1 show that out of 50 samples 5 (10%) of respondents were

between of 12 yrs, 7 (14%) of were 13 years, 23(46%) of were 14years and 15(30%) of were 15 years.

Regarding their educational status 5(10%) of them of 7th

std, 29

(58%) at 9th

std, and 15(30%) at 10th

std.

In relation Regarding the sex of their student, 23 (46%) among

them were girls and 27(54%) among them were boys.

In relation to their parents occupation 21(42%) of them were

farmers, 12(24%) of them were coolie, 12(24%) of them were

working as private employers, and 5(10%) is government

employers.

Regarding the family income 19(38%) of them having Rs. 5000 /

month, 10 (20% of them having Rs. 5000-7000/ month, 11(22%) of

them having Rs 7000/ month 10(20%) of them having Rs 7000

above income per month.

Table 6 shows out of 50 samples 14(28%) of respondent werebelongs to joint family and 36 (72%) of them belongs to nuclear

family.

Out of 50 samples the 10(20%) respondent having no brothers and

sisters 29(58%) of respondent having either one brother/sister and

11(22%) of respondent having 2(or) more brothers / Sisters).

Regarding history of food habit (10(20%) of their were vegetarian

and 40 (80%) of them were non vegetarian.

Table a shows that out of 50 samples 46(92%) belongs to the Hindu

and 4(8%) belongs to Muslims.

Among 50 samples BMI of 21-27, 34(68) respondent were 27-30%

and 4(8%) were > 30.


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AGE DISTRIBUTION OF OBESITY

10%

14%

46%

30%

0%

5%

10%

15%

20%

25%

30%

35%40%

45%

50%

Percentage

12 yrs 13 yrs 14 yrs 15 yrsAge


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SEX DISTRIBUTION OF OBESITY

boy, 46%

girl, 54%

boy

girl


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OBESITY CHILDREN FATHERS OCCUPATION

42%

24% 24%

10%

0%

5%

10%

15%

20%

25%

30%

35%

40%45%

Percentage

Farmer Cooley Private

Employee

Government

Employee

Father's Occupation


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OBESITY CHILDREN FAMILY INCOME

38%

20%22%

20%

0%

5%

10%

15%

20%

25%

30%

35%

40%

Percentage

Rs.5000 Rs.5000-7000 Rs.7000 Rs.7000 above

Family Income


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TYPES OF FAMILY OF OBESITY CHILDREN

Joint Family,

28%

Nuclear Family,

72%

Joint Family

Nuclear Family


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TOTAL NUMBER OF CHILDREN IN OBESITY

CHILDREN FAMILY

20%

58%

22%

0%

10%

20%

30%

40%

50%

60%

Percentage

1No. 2 Nos. 2andabove

Total Number of Children


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FOOD HABITS OF OBESITY CHILDREN

Vegetarian, 20%

Non-Vegetarian,

80%

Vegetarian

Non-Vegetarian


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RELIGION OF OBESTIY CHILDREN

92%

8%

0% 0%

0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%

Percentage

Hindu Muslim Christian Others

Religion


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SECTION II

TABLE 2

LEVEL OF KNOWLEDGE OF THE SUBJECTS REGARDING

OBESITY

Level of knowledge frequency Percentage

1)

2)

3)

Inadequate knowledge (75%)

7

37

6

14%

74%

12%

Table show the level op knowledge of the subjects regarding obesity. Out

of 50 samples, 7 (14%) pf them had inadequate knowledge and 37 (74%)

of them moderate knowledge and 6 (12%) of them adequate knowledge.


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SECTION III

TABLE 3

ASSOCIATION BETWEEN KNOWLEDGE AND SELECTED

DEMOGRAPHIC VARIABLES OF THE SUBJECTS

S.

No.

Demographic

Variables

Frequency Mean Df Chi-

Square

value

P- value

1. Age

a) 12 years

b) 13 years

c) 14 years

d) 15 years

5

7

23

15

13.2

12.85

12.34

12.26

1 41.11 *0.001

2. Educational Status

a) 6th

Std

b) 7th

Std

c) 9th

Std

d) 10th

std

1

5

29

15

2

13

12.68

11.8

1 44*

0.05

3. Sex

a) boys

b) girls

23

27

12.56

12.49 1 21 0.10

4. Fathers Occupation

a) Farmer

b) Coolie

c) Private employee

d) Government

employee

21

12

12

5

12.95

12.22

12.41

12.8

1 8.24 0.01


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5. Family Income

a) Rs 5000

b) Rs. 5000-7000

c) Rs. 5000

d) Rs. 7000 above

21

9

9

11

13.14

12.77

11.22

11.81

1 15 0.02

6. Types of family

a)Joint family

b) Nuclear family

15

35

12.53

12.51 1

33.80*

0.05

7. Total No of Children

a) 1

b) 2

c) 2 above

10

30

10

12.2

12.6

12.4

1 160.85

*0.001

8. Religiona) Hindu

b) Muslim

c) Christian

d) Other

46

4

0

0

12.4

13

-

-

1 4.53 0.02

9. Food habits

a)Vegetraian

b)Non-Vegetraian

10

40

12.6

12.45

1 4 0.02


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10. BMI Calculation

a) 25 27

b) 27- 30

c) >30

34

12

4

68

24

8

1 34.48

*0.05

Table 2 shows

Age (12-15 ) Years : P Value = 0.001

Educational Status ( 7th

to 10th

) : P Value = 0.05

Types of family : P Value = 0.05.

Total No of Children : P Value = 0.001

B.M.I. Calculation : P Value = 0.05


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CHECK LIST ON LIFE STYLE PRACTICES OF OBESITY

S.

NO

QUESTIONS

NO OF

STUDENTSHAVING THE

HABITS

PERCENTAGE

1. Habits of taking non-vegetarian per week 36% 72%

2. Habits of taking hotel foods per week 37% 74%

3. Habits of taking chocolates & snacks per

day.

44% 88%

4. Habits of taking sweet drinks (Fruits juices)

per day

37% 74%

5. Habits of taking Fried foods 38% 76%

6. Habits of taking more amount of milk per

daily (500ml)

26% 52%

7. Habits of taking Ice creams per day 23% 46%

8. Habits of taking packed Juices per day 25% 50%

9. Habits of taking any snacks in morning

instead of taking foods

23% 46%

10. Habits of taking pizza (or) Noodles 22% 44%

11. Habits of taking snacks while watching TV. 40% 80%

12. Habits of doing exercise per day 35% 70%

13. Habits of indoor games 35% 70%14. Habits of outdoor games 41% 82%

15. Habits of taking heavy foods after exercise 16% 32%

16. Habits of taking TV& playing videogames 39% 78%


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17. Habits of spending excess time spending in

computer

44% 88%

18. Habits of going parties along with the

parents

35% 70%

19. Will the parents get all the snacks what willyou ask

43% 86%

20. Will you parents restrict you while eating

snacks

35% 70%


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CHAPTER V

DISCUSSION

This chapter deals with the discussion of the study findings

This study was done to determine the management & prevention of

obesity among school children. A pre-experimental study was used to

conduct the study knowledge and expressed practice were assessed by self

administrated questionnaire non-probability purposive sampling techniquewas used. The study sample consisted of 50 school children, between 12-

16 years of age using the above tool, data were collected and analyzed and

the study findings revealed the following.

Table 1 shows that out of 50 samples 5 (10%) of respondents were

at 12Yrs 7 (14%) of were 13 years, 23 (46%) of were 14 years and

15 (30%) of were 15 years.

Regarding their educational status 5 (10%) of them at 7th

std 29

(58%) at 9th

std and 15 (30%) at 10th

std

Regarding the sex of their student 23 (46%) among them were gets

and 27 (54%) among them were boys.

In relation to their parents occupation 21 (42%) of them farmers 12

(24%) of them were coolie, 12 (24%) of them were working as

private employers and 5(10%) is government employers.

Regarding the family income 19 (38%) of them having

Rs.5,000/month, 10 (20% of them having Rs5000-7000/month, 11


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(22%) of them having Rs.7000/month 10 (20%) of them having

Rs.7000 above income per month.

Table 6 shows out of 50 samples 14 (28%) of respondent were

belongs to joint family and 36 (72%) of them belongs to nuclear

family.

Out of 50 sample the 10 (20%) respondents having no

brothers/sisters and 29 (58%) of respondent having either one

brother/sister and 11 (22%) of respondent having 2 (or) more

brothers/sisters)

Regarding history of food habits 10 (20%) of them were vegetarian

and 40 (80%) of them were non-vegetarian.

Table 9 shows that out of 50 samples 46 (92%) belongs to the

Hindu and 4 (8%) belongs to Muslims.

Among 50 samples BMI of 34 (68%) respondents were 26-30%

and 4 (8%) were >30.

The first objective of the study was to assess the knowledge

regarding prevention and management of obesity among school children.

The level of knowledge of the subjects regarding obesity out

of 50 samples 7 (14%) of them had inadequate knowledge and 37 (74%)

of them moderate knowledge and 6 (12%) of them adequate knowledge.


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CHAPTER VI

SUMMARY AND CONCLUSION

This chapter represents the summary, findings, conclusions

implications and recommendations which create a base for the researcher

for evidence based practice.

SUMMARY

The purpose of the study to assess the knowledge regarding obesity

among obese children Age between 12-16 years at selected school

ROSENTOCHS (1974)BECKER AND MAIMANS (1975) health belief

model was adopted for conceptual frame work. Descriptive design was

adopted for the study.

The study was conducted from 07-08-2011 to 17-08-2011 samples

of 50 children were using Non-probability convenience sampling

technique. The investigator applied both descriptive and inferential

statistics to analyze the data collected from the subjects to find out the

knowledge on obesity.

THE MAJOR FINDINGS OF THE STUDY

Most of the participants about 7 (14%) of them had inadequate

knowledge and 37(74%) of them moderate knowledge and 6 (12%) of

them adequate knowledge of obesity.


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There was a significant association between knowledge and

demographic variables such as Age, Educational Status, Type of family,

Total number of children, BMI at P level > 0.005.

The present study assess the knowledge of obesity among obese

child and found that the majority of the subjects had inadequate

knowledge regarding obesity.

Considering the study findings an efforts was made by the

investigator and conducted awareness programme by using posters was

giving to the subjects and an awareness was treated regarding obese.

NURSING IMPLICATION

Nursing practice

The field of community health nursing has great responsibility to

protect the health of the children

Community health Nursing need to take up the responsibility to

create awareness among the obese children to improve their

knowledge by giving health education there by reduces the majority

of obesity rate.

Nursing practice in community should focus on the prevention of

illness and the promotion of health.

NURSING EDUCATION

This study emphasizes the need for developing good teaching skill

among student nurses on obese


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Nurse educator should plan and implement the workshops and

service education as these will update the knowledge of nurses who

plays a key role in assessing and managing children with obese.

NURSING RESEARCH

Evidence based nursing practice must take higher profile in order to

increase an awareness among obese children. The study findings can be

utilized for the development of research based policies and programmes.

The study provide scope for further studies.

NURSING ADMINISTRATION

Nurse Administrator efficient in organizing programme regarding

obese children to create awareness.

The administrator organize in service education programme among

nurses to update their knowledge on obese children.

The nurse administrated in hospital and community health centre

should develop guidelines for conducting descriptive on obese child

and create an awareness among obese children.

RECOMMENDATIONS

In the light of the findings of the study the following

recommendations are put forth.

A similar Study can be conducted in the school

A study can be under taken to evaluate the knowledge after an

awareness programme.


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A comparative study can be conducted to find out the similarity and

differences between knowledge of obese children in 400 settings.

periodical re inforcement can be done using various type of audio

visual aids.

Health Education on obese can be given at the School children.


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BIBLOGRAPHY

1. Achar (1999) Text book of pediatrics Chennai orient Longman

limited.

2. Brein M (2008) School meals for better nutrition and bone health

journal of family health care vol 181 (3), 103 5.

3. Broshan CA et al. (2005) Student nurses participate in public health

researchjournal of public health nursing vol (22); 260 6.

4. Burnks & grone, (1995) Understanding nursing research

Philadelphia, W.B.Saunders.co.

5. Chen my etal (2005) Considering the factors of gender and body

weight in the promotion of healthy behavior among adolescents

journal Nursing research, vol 13 (3), 235 43.

6. Daris judi et al (1994) Applied nutrition and diet therapy for

nurses Philadelpha, W.B. Saunders co.

7. Dinapoli p (2008) Understanding school age obesity Americanjournal of maternity child Nursing, vol 33 (2), 104 10.

8. Dorothy, R.M. (1999) The text book of pediatric nursing

Singapore, W.B. Saunders company.

9. Ghai O.P. (2000) Essential pediatrics, New Delhi, Mehta

publications.

10.Gupte suraj (2001) The short text book of pediatrics New Delhi,

jaypee publications.

11.Hagarty MA (2004) Adolescent obesity current trends in

identification and management journal of American academy of

Nurse practitioner, vol. 16 (11); 481 9.


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12.Howely SR et al (2006) Development of obesity prevention and

managementjournal of community health nursing, vol 23 (2) 69-

80.

13.Jackson D etal (2005) Mothers perception of overweight and

obesity in their children Australia journal of advanced nursing,

vol 23 (3), 8-13.

14.K. park (2008) Text book of preventive and social medicine, 19th

edition, New Delhi Bhanot Bhanarsidas publication, P. 332 35.

15.Kools S etal (2008) Pediatric hyperlipidemia journal of specialty

pediatric nurshing, vol 13 (3), 168 79.

16.Kothari C.R. (2000) Research methodology and techniques, New

Delhi, viswa prakaram publications.

17.Lane Tilleson (2005) Evaluating nursing outcomes journal of

national black nurses association vol 16 (2); 20 6.

18.Lissauer Tom, (2001)Illustrated text book of pediatrics, Edinburg,

mosby publications.

19.Loman OG, (2008) promoting physical activity in teen girls

American journal of maternal and child nursing, vol 33; 294

99.

20.M. Mesta et al. (2007) Obesity amongst affluent adolescent girls

Indian Journal of pediatrics, volume 74 23 25.

21.Manuraj et al. (2007) obesity in Indian children time trends and

relationship with hypertension The national medical journal of

India, vol 20 106, 288 90.

22.Melynk BM, (2007) The COPE Healthy life styles TEEN program

journal of pediatric health care, vol 21 (5), 315 22.


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23.Michele gronder et al. (1996)Foundation and clinical applications

of nutrition Missouri Mosby by publication. Pp. 259 268.

24.Nancy Burns (1999) Understanding Nursing Research

Philadelphia, W.B. Saunders publications.

25.Nelson (1999) Text book of pediatrics California, W.B. Saunders

company.

26.Pillitteri adele, (1999) Child health nursing care of the child and

family Philadelphia, Lippincott publications.

27.Polit and Hungler (1999) Nursing Research principles and

methods phicadelphia, lippincott publication.

28.Rao sundar (1996) An introduction to Biostatistics New Delhi,

Hall of India Pvt ltd.,

29.Regber S (2007) Parenting styles and treatment of adolescents with

obesityjournal of pediatric nursing vol. 33 (1); 21 8.

30.Scott K. power et al. (2001) Exercise physiology 4th

edition

London, MC Grawttill publication 339 42.

31.Shaya FT (2008) School based obesity interventionsjournal school

health, vol 78 94), 189 96.

32.Shubhagini A. Joshi, (2002) Nutrition and dietetics New Delhi,

Tata Mc graw Hill publishing co Ltd.

33.Sukhpaul kaur, (2008) Role of nurses in Assessment and prevention

of obesity Indian journal of continuing nursing education, vol

9, 16 18.

34.Sumitra chakrabory (2009) Child hood obesity A negated vial issue

The nursing journal of India, vol XIII, 180 82.

35.Swaminathan M, (1995) Essentials of food and Nutrition

Bangalore. The Bangalore printing & publishing co ltd, 64 8.


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36.Tarek Tawfik et al (2008) Overweight and obesity and their

association with dietary habits Indian journal of community

medicine, vol 33, 172 81.

37.Wachter etal (1997) Nursing care of children Edinburg, mosby

publication.

38.Walker & Watkins (197) Nutrition in Pediatrics 2nd

edition,

London, B.C. Decker INC publisher, 716 28.

39.William. D. et (2003)Exercise physiology 4th

edition, Philadelphia,

lippincott publication, 160 70.

40.Wongs (2002) Nursing care of infants and children 7th

edition,

Missouri, mosby publication.


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DEMOGRAPHIC VARIABLES

1. Age

a) 12 yearsb) 13 years

c) 14 years

d) 15 years

2. Educational Status

a) 6th

Std

b) 7th

Std

c) 9th

Std

d) 10th

std

3. Sex

a) boys

b) girls

4. Fathers Occupation

a) Farmer

b) Coolie

c) Private employee

d) Government employee

5. Family Income

e) Rs 5000

f) Rs. 5000-7000g) Rs. 5000

h) Rs. 7000 above


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6. Types of family

a)Joint family

b) Nuclear family

7. Total No of Children

d) 1

e) 2

f) 2 above

8. Religion

e) Hindu

f) Muslim

g) Christian

h) Other

9. Food habits

a)Vegetraian

b)Non-Vegetraian

10. BMI Calculation

d) 25 27

e) 27- 30

f) >30


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Knowledge Question on Obesity

1. What is obesity ?

1. Increased Calcium 2. Increased fat

3. Increased Carbohydrate 4. Increased protein2. What is the reason for obesity ?

1. Decreased intake of food 2. Over Eating

3. Disease Condition 4. Fasting.

3. What is the dietary pattern of obesity ?

1. Vegetables 2 Water & Carbohydrate foods

3. Fatty and tinned food 4. Fruits & Fruit juices

4. Who are all more prone to get obesity ?

1. Childhood 2. Old age

3. Women 4. Men

5. Except dietary pattern what are all the other factors that you think as a

cause

of obesity ?

a. Running b. Studying

c. Not doing exercise d.. Travelling

6.What is the risk to get obesity ?

a. Water b. Watching TV

c. Reading Books d. Drugs

7.What are all the factors you will consider to calculate obesity ?

a. Height only b. Weight only

c. Both height & Weight d. Muscle strength

8.What is the formula to calculate BME ?1. Weight 2. Weight

Height in metre (Height)2

in M

3. Weight2

4. Height2

9. What is the abbreviation of BMI ?

A. Bare Mass Index B. Body Mass Index

C. Body Mass Instrument D. Bare Mass Instrument

10. How Will you reduce the weight?1. Exercise of controlled diet 2. Medication

3. Deceased intake of food 4. Increased intake of food

11. What is the signs of obesity ?

1. Very active 2. Palpitation of less activity

3. Happiness 4. Anemic


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12. How does the Mentality of obesity / overweight child ?

1. Active 2. Happy

3. Stress 4. Palpitation

13. What is the complication of obesity ?

a. Increased morbidity rate b. Loss of Appetitec. Eye disease d. Malnutrition

14.What is the simple method to calculate the obesity ?

a. Height b. Weight

c. BMI d. Muscle Strength

15. How does the obesity calculate other tan BMI ?

a. Skin fold thickness & waist circumference

b. Height only c. Weight only

d. Muscle strength

16.What is the normal weight of school going student?

a. 50-60 kg b. 16.5 to 37 Kgc. 35-45 Kg c. 10-15 Kg

17. How will you prevent obesity ?

a. Excessive sleeping b. Exercise and dietary control

c. Taking Medications d. Excess intake of food

18. What is the normal weight of school going adolescence?

a. 40-45 b. 30-35

c. 60-70 d. 50-60

19.What are all the disease condition caused by obesity ?

a. Bone & heart disease b. Head ache

c. Visual deficit d. Hearing deficit20. What is the incident rate of obese among school going student?

a. 1-10% b. 80-90 %

c. 10-20% d 50-60 %


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APPENDIX III

AWARNESS PROGRAMME ON OBESITY

Place : Dhanalakshmi Srinivasan Higher Secondary

School.

Group : School age Children between 12 15 Years.

Teaching Method : Lecture cum Discussion.

A.V.Aids : Poster.

Teacher : Ms. A. Anis Fathima Kani,

Ms. J. Anne Grace,

Ms. S. Aruna,

Ms. Aswathy Prasad,

Ms. D. Baby Santhiya.


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CONTENT

INTRODUCTION

Obesity is perhaps the most prevalent form of malnutrition. As a

chronic disease, prevalent in both developed and developing countries,

and affecting children as well as adults. Early childhood overweight that

persists into adulthood is associated with more severe obesity among

adults. Among adolescents self image communication problems and

difficulties both in School and home obesity.

DEFINITION OF OBESITY

Obesity is defined as a high percentage of body fat, usually >25%

for men and >32% for women.

INCIDENCE

Obesity has been estimated to affect 20 to 40 percent of the adults

and 10 to 20 percent of children and adolescents in developed countries


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Subramanian etal have reported that the prevalence of overweight and

obesity among the affluent adolescent school children in Chennai,

Tamilnadu was about 15% There are evidences that children and

adolescents of affluent families are increasingly becoming

overweight/obese in recent times, because of decreased physical activity.

Secondary lifestyle and changes in dietary habits.

Epidemiological determinants of obesity.

a) Age : Obesity generally occurs at any age and increases with age.

b) Sex: Women generally have higher rate of obesity than men

c) Genetic factors: There is a genetic Components in the etiology of

obesity. Twins Studies have shown a close correlation between the

weights of identical twins even when they are reared in dissimilar

environments.

d) Physical inactivity : Regular Physical activity is protective against

unhealthy weight gain. Physical inactivity may cause obesity which

in turns restricts activity.

e) Socio economic States: Obesity has been found to be more

prevalent in the lower socio economic groups.

f) Eating habits: Eating habits (eg: Eating in between meals,

preference to sweets, refined foods and fats/ are established in early

life. The Composition of the diet, the periodicity with which it is


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eaten and the amount of energy derived from at are all relevant to

the etiology of obesity.

g) Psychosocial factors: Psychosocial factors (eg, emotional

disturbances are deeply involved in the etiology of obesity.

Overeating may be a symptom of depression, anxiety, frustration

and loneliness in childhood as it is in adult life.

h) Familial Tendency: Obesity frequently seen in families Obese

parents frequently having obese children.

i) Alcohol: The relationship between alcohol consumption and

adiposity was generally positive for men and negative for women.

j) Education: There is an universe relationship between educational

level and prevalence of obesity.

k) Drugs : Use of certain drugs, Eg: Cortico Steroids, contraceptives,

insulin, beta adrenergic blockers etc., can promote weight gain.

ASSESSMENT OF OBESITY

Body mass index

Skin fold thickness

Waist circumference and Waist Hip ratio (WHR)

Others

Body mass index = Weight in Kilograms

(Height in meter)2


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Normal BMI 18 to 24.9

Over Weight 25 to 27.9

Obese >30

2) Skin fold thickness

It is a rapid and non invasive method for assessing body fat.

Several varieties of calipers (eg:- Harpenden skin calipers) are available

for the purpose. The measurement may be taken at all four sites-mid

triceps, biceps, subscapular and suprascapular regions. The sum of the

measurements should be less than 40mm in boys and 50mm in girls.

3. Waist circumference and waist: Hip ration (WHR)

Waist circumference is measured at the mid point between the

lower border of the ribcage and the iliac crest. It is a convenient and

simple measurement that is unrelated to height. Correlates closely with

BMI and WHR and is an approximate index on intra abdominal fat mass

and total body fat. A change in waist circumference reflects changes in

risk factor for cardio vascular disease.

4. Others:


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In addition to the above, three well established and more accurate

measurements are used for estimation of body fat. They are measurement

of total body water, of total body potassium and of body density

Obesity Associated disorders:

i.Cardiovascular Disease: Childhood obesity has been associated

with the development of risk factors for cardio vascular disease.

ii. Hyper tension:

Obesity is related to hypertension, increased heart rate and

increased cardiac output.

iii. Diabetes and carbohydrate metabolism: There is an increased

level of insulin and abnormal glucose tolerance tests in the obese. Further

insulin resistance is present in the obese and may increase renal sodium

retention, also increasing blood pressure of obese adolescents.

iv. Respiratory and sleep disorders: Obesity is believed to alter

respiratory function so that abdominal and thorasic fat are mechanical

obstacles to breathing.

v. Skeletal disorders: Slipped capital femoral epiphysis, which

occurs in adolescence as a result of increased stress at the growth plate.

vi. Mortality: The mortality risk of adolescent obesity was greater

than that of adult obesity.


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vii. Psychological and social distress; Severely obese adolescents

suffer from greater level of depression, low self concept and binge eating

disorder.

ii. Nutritional Counseling: Green foods: Foods low in fat and

calories, which may be eaten at reasonable quantities.

Yellow foods: are low in fat and moderate in calories (yellow means eat

but with moderation)

Red foods: are high in calories and fat. (Red means limi t these and eat

just a few red foods a week, usually outside the home). For example, an

adolescent would be prescribed a naturally balanced menu plan of 1200 to

1500 calories per day.

Protein: 20% of the total kilocalories from protein. (50 to 60 gm). Fat:

Minimum of 20% fat of total kilocaloricdiet (27 to 33gm) Carbohydrate:

Minimum of 20% of the kilocalories from carbohydrate.

Fibers: Another strategy to increase satiety is through high fiber intake.

(0.7 gm/kg of body wt). This provides bulk with low caloric density

foods.

A weight reduction die should satisfy the following criteria

i. Meet all nutrient needs except energy

ii. Suit clients tastes and habits

iii. Minimum hunger and fatigue

iv. Be accessible and Socially acceptable


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v. Encourage a change in eating pattern

Favor improvement in overall health.

Role of exercise: The effectiveness of regular exercise in achieving

weight loss is linked to ones degree of obesity. Generally, persons who

are obese lose weight and fat more readily with exercise then their

counterparts of normal weight.

Aerobic exercise: even without dietary restriction, provider a significant

positive.

When exercise: is used for weight loss, factors such as frequency,

intensity, duration, and the specific form of exercise must be considered.

Continuous, big muscle, aerobic: activities having moderate to high

caloric costs, such as walking, running, rope skipping, stair stepping,

cycling, and swimming, are ideal. Aerobic exercises also: stimulate lipid

metabolism, establish favorable blood pressure responses, and generally

promote cardiovascular fitness.

There generally is no selective: effect of running, walking of bicycling,

each is equally effective in promoting fat loss. An extra 300 kcal daily

caloric expenditure induced by moderate jogging for 30 minutes, for

example causes a 0.45 kg fat loss in about 12 days.

General guidelines for an exercise weight loss program:


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i. Start slowly: The initial stage of an exercise weight loss

program for a previously sedentary, over fact person

should be developmental in nature and should not include

an initial high total energy output.

ii. During the initial stage: the individual should be urged

to adopt long term goals, personal discipline and a

restructuring of both eating and exercise behavior.

iii. Regal city is the key: exercise frequency is important

when using exercise for weight reduction. It appears that

at least 3 days of training per wells is required to bring

about meaning feel changes in body composition through

exercise and more frequent exercise is even more

effective.

Diet flues exercise: the ideal combination benefits of adding exercise to

dietary restriction for weight loss.

i. Increases the overall size of the energy deficit

ii. Facilitates lipid mobilization and oxidation, especially

from visceral adipose tissue depots.

iii. Increases the relative loss of body fat by preserving the

fat free body mass.

iv. Contributes to the long term success of the weight loss

effort.

v. Provides unique and significant health related benefits.


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Summary & Conclusion:

Till now, we have seen about meaning of obesity definition,

etiology, measurement of obesity, compilation, management by diet

exercise. I hope you all have gained knowledge on obesity management

& you will apply this in practice.


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health should mean a rot more than escape from death or for that matter, escape from disease

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