Psychological factors associated with body weight status among overweight and obese children in Kedah, Malaysia
Childhood obesity was a growing global phenomenon. In Malaysia, 29.8% children and adolescents aged between five to seventeen, were OW or obese (National Health and Morbidity Survey, 2019). Obesity was a multifactorial disorder, associated with biological, environmental and psychological factors...
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| Format: | Thesis |
| Language: | English |
| Published: |
2021
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| Subjects: | |
| Online Access: | http://psasir.upm.edu.my/id/eprint/103856/1/THESIS%20B5%20NURUSSABAH%20-%20IR2.pdf |
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| Summary: | Childhood obesity was a growing global phenomenon. In Malaysia, 29.8%
children and adolescents aged between five to seventeen, were OW or obese
(National Health and Morbidity Survey, 2019). Obesity was a multifactorial
disorder, associated with biological, environmental and psychological factors
which were the prominent variables that plays roles in its pathogenesis. Many
studies have been conducted in Malaysia to identify the causes of the childhood
obesity. However, there was lack of studies that based on psychological, beliefs
or perceived factors that caused the obesity among children. Thus, the crosssectional
study was carried out to determine the association of socio
demographic factors, psychological factors towards weight reduction and body
weight status (BWS) among overweight (OW) and obese children in Kedah,
Malaysia.
The list of OW and obese children from standard 4 and 5 were provided by
respective school teachers taken from the National Physical Fitness Standard
(SEGAK) test. A total of 398 children aged 10 to 11 years participated in this
study, consisting of 221 boys and 117 girls. The proportion of children recruited
from the urban and rural school was 61.6% and 38.4% respectively. Based on
body mass index (BMI) classification, 24% of participants were identified as OW
and 76% obese. Majority of participants (64.6%) were classified under B40
category where 70% of their parents had at least secondary education.
The children were measured for weight, height, waist circumference, hip
circumference. They also required to complete the self-administered
questionnaire in group guided by researcher, covering socio-demographic
profiles and psychological factors of perceived body image, perceived benefits
of weight reduction, perceived barriers to weight reduction, perceived self efficacy in dietary practice and exercise. The body image perception was
adapted from ‘The seven male and female child figure rating scale’ and the
psychological factors scale instrument from the Health Belief Model (HBM).
Overall, 5.8% of the respondents perceived their BWS as underweight and 41%
of obese respondents perceived they were not in the obese category. As for
socio-demographic factors showed that school locality and father’s education
level were associated with BMI (x2 = 8.49, p = 0.004, x2 = 6.61, p = 0.037), WC
(x2 = 11.05, p = 0.001, x2 = 10.04, p = 0.007) and WHtR (x2 = 4.97, p = 0.026, x2
= 15.31, p < 0.001). Meanwhile, psychology factors such as self-efficacy in
exercise (BMI: x2 = 8.768, p = 0.012) and perceived BWS (BMI: x2 = 15.71, p <
0.001) showed association with children BWS. The study also revealed that
household income (x2 = 15.70, p < 0.001), parent’s education level (mother: x2 =
11.59, p = 0.003, father: x2 = 12.14, p = 0.002) and parent’s occupation level
(mother: x2 = 19.36, p < 0.001, father: x2 = 9.97, p = 0.041) were associated with
school locality. Children perceived self-efficacy in exercise was significantly
higher in boys (t = 3.202, p = 0.001) and among urban (t = - 0.423, p = 0.001)
school children. In addition, there was no significant difference between body
image and sex.
Logistic regression analysis reported that sex was moderately associated with
obesity (BMI) and AO (WHtR), where girls were less likely to be obese than boys
and children where the fathers had secondary education level were less likely
(BMI (aOR) 0.34: 95% Cl 0.10, 1.16) to be obese or AO compared to father with
tertiary education level. There were associations between perceived self efficacy
in exercise, perceived BWS and BMI. For WC classification, the association was
found between perceived BWS and WC (p = 0.02, aOR 0.54: 95% Cl (0.32,0.91).
The results of multiple linear regression analysis showed perceived benefits of
weight reduction (BMI: F (3, 394) = 30.89, p = 0.01), perceived body image (BMI:
F (2, 395) = 42.36, p < 0.001), (WC: F (2, 395) = 31.03, p < 0.001), (WHtR: F (2,
395) = 4.93, p = 0.008) as well as body size discrepancy score (BMI : F (1, 396)
= 39.33, p < 0.001), (WC: F (1, 396) = 39.98, p < 0.001), (WHtR: F (1, 396) =
5.66, p = 0.018) and perceived self-efficacy in exercise (WC: F (3, 394) = 25.58,
p < 0.001) were the strongest psychological factors contributor towards children
BWS. Meanwhile, household income and household size were the most sociodemographic
factors contributor towards children BWS. There was association
between psychological factor with children BWS (BMI, WC and WHtR).
However, from the study, either one of the classifications was recommended to
be used to avoid confusion of main contributing factor. Which BWS
classifications is more accurate was not studied. According to the literature
review, the most widely used measure of weight status is BMI. BMI as dependent
variable to ease the comparison between countries. However, alternative health
screening methods such as WHtR showed their privilege which easier to conduct
and can apply for all ages, sex and locality. Further studies were needed to
confirm these findings among the OW and obese children. Effort to design health
promotion programs to achieve ideal BWS for OW and obese children should be
taken integrating with identified factors. |
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