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CHAPTER ONE
INTRODUCTION
Background Of The Study
In affluent societies, obesity is the most common nutritional disorder. Obesity is a condition characterized by an abnormally excessive level of body fat (Edinburgh 1995). It is defined as abnormal adipose tissue growth caused by fat cell enlargement (hypertrophic obesity) or an increase in the number of fat cells (hyperplastic obesity) or a combination of the two (Park K 2005). Excess fat accumulates as a result of an imbalance in energy intake and expenditure. Obesity’s importance cannot be overstated because it is linked to increased morbidity and mortality. It predisposes to the development of serious diseases and reduces the efficiency and happiness of those who suffer from it.
Obesity is a chronic disease that affects both developed and developing countries, and it affects both children and adults. Obesity is now so common that it is displacing more traditional public health concerns, such as malnutrition (Park K 2005). It is now a worldwide phenomenon. It is extremely difficult to assess the size of the problem and compare prevalence rates across countries because no exact figures are available, and definitions of obesity are not standardized. However, it is estimated that 10 to 20% of children and adolescents in developed countries are affected (WHO 1995).
Overweight is defined as having an excess of body weight but not necessarily body fat; a body mass index (BMI) of 25 – 29.9 (www.Psychological, 2021). In children aged two years and older, the Body Mass Index (BMI) is acceptable for determining obesity (Deurenberg, Westrate & Seidell 1991). Although children and adults have the same BMI number, the criteria used to interpret the meaning of the BMI number for children and teens differ from those used for adults. BMI age and gender percentiles are used (www.cdc) The Centers for Disease Control and Prevention (CDC) has published tables to help determine this in children (www.cdc.gov). Overweight (but not obese) is defined as a BMI between the overweight and obesity cut-off values, whereas obese is defined as a BMI greater than the obesity cut-off value (www.cdc.gov). The BMI for normal weight is lower than the overweight cut-off value (www.cdc.gov).
Statement Of The Problem
Obesity is a health hazard and a detriment to one’s well-being, as evidenced by increased morbidity and mortality (Park K 2005). It plays an important role in the natural history of other chronic and noncommunicable diseases. Obesity in children is now recognized as a serious public health concern due to its rising prevalence and numerous negative health consequences (Kopelman 2005). Chronic disease incidence is rising much faster in developing countries than in developed countries. There is compelling evidence that childhood obesity is becoming more prevalent in low- and middle-income countries (Monteiro, Conde, Popkin 2002 & Monteiro, Conde, LUB 2004). In many developing countries, malnutrition and obesity coexist (Kelishadi 2007). Obesity has numerous health consequences. The first issues that arise in these obese children are usually emotional or psychological in nature (HCP 2003). Obesity in childhood can also lead to serious conditions such as diabetes, high blood pressure, heart disease, sleep problems, and cancer (en.wikipedia.org). Other disorders include liver disease, menarche or early puberty, eating disorders such as anorexia, skin infections, asthma, and other respiratory problems (Mayoclinic 2009). According to studies, overweight children are more likely to become overweight adults (adultsen.wikipedia.org). Obesity during adolescence has been linked to an increase in adulthood mortality rates (Must, Jacques PF, Dallal GE, Bajema CJ, Dietz WH. 1992). Obese students are frequently subjected to teasing, harassment, and ridicule at school (www.Obesity.Org). They may also face harassment, discrimination, and name-calling from family members and neighbors at home. These can result in anxiety, depression, low self-esteem, frustration, and even withdrawal (Falase & Akinkugbe OO, 2000). According to a study (Dessai MN, Miller, Staples, Bravender, 2008), college obesity is on the rise, and physical inactivity, disordered eating perceptions, and disordered behaviors are linked to higher rates of overweight and obesity. Obese children have carotid arteries that have aged prematurely by up to thirty years, according to a 2008 study, as well as abnormal cholesterol levels. A 15-year-old obese child has the carotid artery of a 45-year-old (Dessai MN, Miller, Staples, Bravender, 2008). According to World Health Organization projections, noncommunicable diseases will account for roughly three-quarters of all deaths in the developing world by 2020. (WHO 1997), and adolescent obesity is likely to be a major risk factor in this. This emerging public health issue of rising childhood obesity rates in developing countries will almost certainly impose a massive socioeconomic and public health burden on poorer countries in the near future (Freedman, Khan, Dietz 2001). Nigeria is a developing country in Africa.
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Objective Of The Study
Generally, the study is set to determine the pattern of overweight and obesity among secondary school students in Benue state, Nigeria. Specifically, the study is aimed at;
1. Identifying the factors influencing childhood overweight and obesity among secondary school students.
2. Identifying the age and gender differentials in the prevalence of overweight and obesity among secondary school students in Benue state.
3. Identifying the health risk factors associated with overweight and obesity among these students.
4. Suggesting ways to prevent overweight and obesity among students.
Research Question
The following questions will guide this study:
1) What are the causes of overweight and obesity among secondary school students in Benue state?
2) What are the age and gender differentials in the prevalence of overweight and obesity among these secondary school students in Benue state?
3) What are the health risk factors associated with overweight and obesity among these students?
Significance Of The Study
Since it has been demonstrated that interventions are usually ineffective once overweight and obesity have occurred (Pinhass-Hamiel O, Zietler P 2000), it is critical to generate and disseminate research information to policymakers, health care providers, parents, and the general public so that the problem can be identified in childhood and appropriate attention can be given at that early age. The emerging trends in the factors influencing childhood overweight and obesity among our students are definite health risks that necessitate definite studies and data for intervention planning. Because of the limited number of studies available in Nigeria (as in other developing countries), little is known about the prevalence of childhood overweight and obesity, particularly in the South Eastern States of Nigeria. More studies and data are needed in Nigeria to provide a reliable assessment of the problem of childhood overweight and obesity in Nigeria, as well as to compare its prevalence with that of other regions of the world. Studies like this one are therefore required to uncover this ostensibly hidden but critical public health issue. Because of a lack of studies, data, and publicity, the prevalence of childhood overweight and obesity, as well as their association with chronic diseases in adulthood, remains underappreciated in Nigeria. College years have a significant impact on adult behavior, particularly diet, physical activity, and other lifestyle habits. Interventions aimed at the college population may help reduce overweight and obesity during the adolescent-to-adult transition, thereby preventing some of the long-term health consequences of obesity, such as coronary heart disease, hypertension, type 2 diabetes, and dyslipidemia (Dessai MN, Miller, Staples, Bravender, 2008). Identification and clarification of these risk factors may aid in the development of multifaceted interventions that not only address weight loss but also target the associated disordered behaviors in the treatment of adolescent obesity (Dessai MN, Miller, Staples, Bravender, 2008). Until now, most national public health programs and policies, as well as national level research on children and adolescents in Nigeria, appear to have focused primarily on undernutrition and its effects on maternal and child survival, mortality, and development. Because childhood overweight and obesity, as well as their co-morbidities, will continue to increase the impact of a number of risk factors for adult diseases, it is reasonable and important to raise awareness and knowledge about the prevalence of these disorders in Nigeria, which is still grappling with the public health effects of malnutrition and micronutrient deficiencies. This research will serve as an additional impetus and contribution to these efforts. This study can equip stakeholders to make policies that will recognize and address the emerging challenges of childhood overweight and obesity in Nigeria in general during this period of Health Sector Reform. Seminars with evidence of this research data could be organized in Gwer West Local Government Area in particular, for students and parents to initiate and stir up voluntary preventive health measures for themselves against these emerging childhood problems.
Scope Of The Study
This study examines the patterns of overweight and obesity among secondary school students in Benue State. The study is set to cover only the factors influencing childhood overweight and obesity among secondary school students, the age and gender differentials in the prevalence of overweight and obesity among secondary school students in Benue state, the health risk factors associated with overweight and obesity among students, and finally, suggest ways of preventing overweight and obesity among students. Thus, to achieve an optimum result, the study is hence delimited to the Gwer West Local Government Area of Benue State.
Limitations Of The Study
This study is subject to the limitations and challenges that come with any research that uses questionnaires, such as noncompliance by some respondents and insufficient information about the problem under investigation. Finally, financial and time constraints were also some of the challenges that posed a lot of limitations on the scope of this study.
DEFINITIONS OF TERMS
Overweight: Being overweight or fat is having more body fat than is optimally healthy. Being overweight is especially common where food supplies are plentiful and lifestyles are sedentary.
Obesity: Obesity is a complex disease involving an excessive amount of body fat. Obesity isn’t just a cosmetic concern. It is a medical problem that increases risk of other diseases and health problems, such as heart disease, diabetes, high blood pressure and certain cancers.
Nutritional disorder: Nutrition disorders are diseases that occur when a person’s dietary intake does not contain the right amount of nutrients for healthy functioning, or when a person cannot correctly absorb nutrients from food.
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