Factors associated with overweight/obesity among secondary school students in Batang Padang District, Perak, Malaysia

Overweight and obesity are the fifth leading risk for global deaths and approximately 300,000 people die each year of ailments related to obesity. Overweight and obese adolescents are at increased risk of significant health problems such as hypertension, diabetes, heart disease, stroke and cancer. The objective of this study was to determine the prevalence of overweight and obesity and factors associated among secondary school students in Batang Padang District, Perak. An analytic cross sectional study was conducted in selected secondary schools in Batang Padang district, Perak, Malaysia. Sample size was calculated using two proportion formula. Systematic random sampling followed by cluster sampling method was used for selecting the schools. A validated selfadministered questionnaire was used to obtain information on sociodemographic factors, lifestyle factors and psychosocial factors. Physical activity questionnaire for adolescents (PAQ-A), which was modified and adapted from Kowalski et al. (2004), was used to assess general level of physical activity. Rosenberg self-esteem Scale was used to measure selfesteem. Body parts satisfaction scale and body size perception scale were used to measure body Image. Anthropometrics measurements of height and weight were measured for each respondent. Body mass index (BMI) was calculated (weight in kg/height in m2). Data collection was done after getting approval from University Ethics Committee for Research Involving Human, University Putra Malaysia and permission from the Ministry of Education. Data analysis was carried out using Statistical Package for Social Sciences version 22 (SPSS Inc, Chicago, IL, USA).Variables that was significantly associated with overweight/obesity were entered into logistic regression model. Simple logistic regression was used to determine the crude odd ratio. Variables with p value < 0.25 were entered into the multivariable logistic regression to determine the adjusted odd ratio. P value < 0.05 in the multivariable logistic regression was considered statistically significant. The overall response rate was 86%. The results showed that majority were females (53.1%) and Malays (55.9%). The mean age was 14.73 (95%CI = 14.70, 14.77). The overall prevalence of overweight and obesity was 16.0% and 11.5% respectively. It was seen that the prevalence was higher among male (29.8%) compared to female (25.3%).Obesity/overweight was significantly associated with gender (χ2=16.0, p=0.0001), age (χ2=40.3,p=0.0001), ethnicity (χ2=21.3, p=0.0001), education level of father (χ2=8.0, p=0.045) education level of mother (χ2=8.0, p=0.045), physical activity (χ2=4.0, p=0.044),disordered eating (χ2=25.4, p=0.0001),smoking status (χ2=13.3, p=0.001), body size perception (χ2=348.9, p=0.0001) and body part satisfaction (χ2=117.4, p=0.0001). Multivarible logistic regression was used to determine the predictors of overweight/obesity and it showed that the significant predictors of overweight/obesity were gender, physical activity, body parts satisfaction, body perception, and disordered eating. The odds of developing overweight/obesity is 1.5 times higher in male than in females (OR=1.545, 95% CI = 1.4, 1.8, p<0.001). Those with lower physical activity are 1.3 times more likely to develop overweight/obesity (OR=1.254, 95%Cl 1.1-1.5, p=0.005).The odds of developing obesity is 1.9 times higher in those who was dissatisfied with their body parts (OR=1.964, 95%CI =1.7, 2.3, p<0.001). Those who was dissatisfied with their body size were 4.2 times more likely to develop overweight/obesity (OR=4.233, 95%CI= 3.6, 5.0, p<0.001). Those who are at risk of having eating disorders are 1.4 times more likely to develop overweight/obesity (OR=1.401, 95%CI= 1.2, 1.6, p<0.001). In conclusion the overall prevalence of overweight and obesity was high (overweight (16.0%) and obesity (11.5%). The findings from this study can be used by policy makers to plan an integrated intervention program to tackle the increasing prevalence of obesity.

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