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Original Article
Obesity among University Students and their Awareness of it with
Regards to Some Aspects and the Education they Receive
Fatma Genc, PhD
Assistant Professor, Institution and Department, Giresun University and Faculty of Health Sciences,
Giresun, Turkey
Cagla Yigitbas, PhD
Assistant Professor, Giresun University and Faculty of Health Sciences, Giresun, Turkey
Correspondence:
Fatma Genc. Giresun Universty Faculty of Health Sciences Giresun Turkey.
e-mail: fatma.ge[email protected]du.tr
Abstract
Background: Obesity is a current health problem which basically can be prevented, corrected and improved,
and the global prevalence of obesity is 11%, while around 30% in Turkey. In studies, it is reported that a high
rate of obesity develops in the transition from adolescent to youth and continues in later years.
Objectives: This study aims to investigate the obesity status and the awareness of the students who have normal
education at the undergraduate level in terms of some socio-demographic characteristics and the effects of
education.
Methods: The population of the study, which is in the descriptive and relational survey model, was composed
of the daytime university students in the academic year 2017-2018. In the sampling surveys 10% of the
participants were included in the sampling rate, and the research was carried out with 1441 people due to
possible losses. The data were collected with "Questionnaire" prepared by the researchers based on the
literatüre. The data were evaluated with statistical package program SPSS 22.0. Percentage, mean, chi-square,
Mann-Whitney-U, Kruskal Wallis tests and correlation analyses were performed.
Results: The mean age was 21.07 ± 2.03 (17-40) years. 15.7% of the participants were pre-obese, and 0.3%
were obese. Body mass index was higher in males, in those who received education outside the health field, in
those with a nuclear family, in those with a smoking habit and the family with obese individuals (p <0.001).
Women's perception of obesity as a disease, obesity detection according to body mass index and knowledge of
both types of obesity (men and women) were perceived to be equally harmful (p <0.001). The participants
interpreted obesity as increasing the relationship between hypertension, heart disease, stroke, diabetes, breast-
prostate and colon cancers, menstruation disorder, infertility, osteoarthritis, snoring and sleep apnea.
Conclusion: Efforts should be made to increase the awareness of obesity among university students.
Keywords: Undergraduate education, obesity, awareness
Introduction
Obesity is one of the most important health
issues of today it constitutes a priority field of
study of the health policies of Turkey and
various countries of the world with its constantly
increasing incidence (Yilmaz, 2017).
The primary cause of the disease is the disorder
of the carbohydrate metabolism, and it is
reported to be fully preventable, correctable and
curable (Kahraman, et al. 2015). The word has a
Latin origin and consists of the combination of
the words “ob” (because of) and “edere” (meal).
Obesity is defined by the World Health
Organization to be “abnormal or excessive fat
accumulation in the body deranging its health
(WHO). These chronic diseases are known to be
caused by genetic predisposition, lifestyle or
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environmental factors and causing the death of
35 million people every year with 80% of the
casualties taking place in countries with low and
medium income (Yilmaz,2017). According to the
2008 data of WHO, the obesity prevalence in the
world is around 11% (Obesity Diagnosis and
Treatment Guide,2017) Studies in Turkey report
that 30% of the people are obese
3
and the obesity
prevalence increased by 44% in the last 12 years
(Yilmaz, 2017; Turkey Obesity Program to
Combat and Control, 2010).
Obesity-induced health problems / risk factors:
insulin resistance-hyperinsulinemia, type 2
diabetes, hypertension, coronary artery disease,
hyperlipidemia-hypertriglyceridemia, metabolic
syndrome, gallbladder diseases, some types of
cancer (gallbladder, endometrium, ovarian and
breast cancers in women; colon and prostate
cancers in men), osteoarthritis, stroke, sleep
apnea, fatty liver, asthma, breathing difficulty,
pregnancy complications, menstrual
irregularities, excessive hair development,
increased risk of pre- and post-operative
complications, mental problems [anorexia
nervosa (not eating), bulimia nevroza (no benefit
of food by vomiting), binge eating, night-eating
syndrome, or trying to provide psychological
satisfaction by eating anything excessively,
social incompatibilities], skin infections, fungal
infections in the groin and feet due to excessive
subcutaneous adipose tissue as a result of
frequent weight loss and weight gain in
particular, and musculoskeletal
problems(Obesity Diagnosis and Treatment
Guide, 2010; Branca, et al. 2007; Tam & Cakir,
2012;Ata, et al. 2014).
There are two different measurement methods
used in evaluating obesity: central and abdominal
measurements: In central evaluation, Body Mass
Index (BMI) is taken into consideration, while
abdominal evaluation focuses on waist/hip
circumference ratio (WHR). According to the
WHO criteria, a WHR of 0.85 and above in
women and a WHR of 1.00 and above are
accepted to be abdominal obesity (=android
type=male type obesity). Studies support the
argument that WHR type obesity causes
complications (Tanyolac, 2004).
Several cross-sectional studies determined
obesity by BMI. BMI is grouped by WHO as
follows (Figure 1) (Ozbahar Acar, 2015).
Studies reveal that 50% of the people who are
obese in the adolescence period are also obese in
their adult ages( Yilmaz, 2017).
In developed countries, obesity ratio was
determined to be 31% in adults, 15.3% in
children and 15.5% in adolescents. This
increasing ratio of obesity causes an alarm due to
emerging health problems. As mentioned above,
evidence suggests that obesity is a result of a
number of complex factors, including genetics,
environment, socioeconomic status, and
behaviors (National Institutes of Health, 2017).
One important cause of the increase in obesity in
the last 10 to 20 years is the transition of lifestyle
due to industrial developments from the one that
is based on power to the one that is based on
inactivity and to the unhealthy fast-food based
eating style. These factors are observed among
university students when they start their
university education (Ozbahar Acar, 2015).
Adult obesity rates are highest in the United
States, Mexico, New Zealand, and Hungry and
lowest in Japan and Korea (OECD, 2017). In the
United States, 36% of adults and 17% of youth
meet the criteria for obesity (Ogden, et al. 2017).
In Europe as a whole, estimates for 2008
indicated that 50% of both men and women in
the WHO European Region were overweight,
and roughly 23% of women and 20% of men
were obese (WHO, 2014).
The years at a university is a period that shapes
life habits particularly including nutrition,
physical activity and stress. Studies show that a
high ratio of obesity develops among late
adolescents and that their obesity is permanent
which is an important risk (Racette, et al. 2005;
Sert, et al. 2016).
Obese individuals are usually stigmatised to be
unattractive, weak-willed, lazy, inert, slow,
selfish, loving eating, frail, lacking motivation,
worthless, worried, shapeless, lacking self-
confidence and having negative body perception.
They are blamed for their weights and subjected
to extreme behaviours. In such situations are
experienced in every part of life including
family, life, education and health and the obese
people encounter problems including
stigmatisation, social exclusion and
discrimination by society in addition to
psychological problems including anxiety and
depression due to these behaviours they are
subject to (Sert, et al. 2016).
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Public organisations and agencies are not
sufficient in fighting against/protection from
obesity. The persons themselves need to be
willing to preventing obesity and tending
towards preventing health behaviour. In other
word, doctors are decisive in obesity treatments
while the active participation of individuals in
health-related recommendations and
arrangements (Racette, et al. 2005; Gordon-
Larsen, et al.2004)
The study aims to examine the obesity and
awareness among university students who have
undergraduate education during daytime hours
with regards to some qualities and the effect of
the education that is received.
Material and methods
Study design and setting: The study is planned
in a descriptive cross-sectional type. The
population of the study consists of the university
students in a city centre in the academic year of
2017 to 2018 having daytime education (total
10.523 people). The students who attend the
school between 17:00 and 23:00 hours within the
scope of evening education were excluded from
the study as they are more exposed to the risk of
obesity. The sample included the group of 10%
with an ideal sampling ratio in the survey (1052
people), and the study was conducted with 1441
people to increase the representative power of the
sample for the population. Since the study
intends to compare the students who do and
don’t take health education, it was planned to
have the participants consisting of the students
who do and don’t take undergraduate education.
In this context, the students who take
undergraduate health education consisted of the
students in the fields of nursing and midwifery
and voluntary participation were used among the
students of different faculties other than health
education.
Data collection: In this study, survey form that
was developed by the literature knowledge (1-
12) was used as the data collection instruments
and the data was collected by the face-to-face
interview method by the researchers. The survey
form covers the questions to measure some
socio-demographic qualities, health history and
health behaviours of the university students.
With regards the obesity, central method
technique was used in screening, WHR
measurement was not conducted, and the WHR
awareness of the university students was
recorded according to their statements. In
measurements, inflexible tape measure with a
standard length was used to determine the height
while a digital scale did the weight monitoring at
the same time of the day.
Statistical analyses: Both BMI and WHR were
analysed both quantitative and categorical ways
in this study. WHO’s classification method was
used for the classifying BMI. On the other hand,
all of the three obese groups (class I, Class II,
Class II) defined by WHO (see figure 1) was
transformed as a single group for statistical
analyses. All findings were summarised by
statistical methods such as mean, standard
deviation, frequency, percentage, etc. The
independent sample Mann Whitney U test, one
of the parametric hypothesis tests, was used to
test the significance of the mean differences of
the two group independent variables in the study.
The Kruskal Wallis test was used to test the
significance of the mean differences between
groups when the number of groups was higher
than double. Spearman correlation test was used
to determine the relationship between continuous
numerical variables. In all analyses, statically
significance level was accepted as p <0.05.
Ethical Issues: Ethics committee and authority
permissions were obtained before the study,
participants were informed within the scope of
the Helsinki Declaration Criteria, and voluntary
participation principle was used.
Results
The average age in this study is 21.07±2.03 (17-
40). 34.4% of the participants in the study are
students in the field of health. 74.3% of the
university students have a nuclear family, 23.5%
of them have an extended family, and the
remaining has a fragmented family. The ratio of
smokers is 23.6% while 70.1% stated that they
never smoked before and 6.3% stated that they
smoked before but quitted. The ratio of those
consuming alcohol is 7.1% while 88.5% stated
that they never drank alcohol before and 4.3%
stated they drank alcohol before but quitted now.
89.5% of the university students stated that they
don’t have the habit of using any pleasure-
inducing substance and 10.5% (151 people)
stated that they use. With regards to using a
pleasure-inducing substance, almost all of the
university students (140 people) stated they
smoked water pipe and one person mentioned
about the use of marijuana. The ratio of those
with the habit of using the non-prescription drug
is 11.7%, and painkiller is the most frequently
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used medicine. 21.5% of the university students
in this study stated that they had professional
assistance for losing weight and 87.8% stated
they managed to lose weight through this
assistance.
61.6% of the university students in this study are
women, 79.5% of them have a perception of low
income and 63,1% find themselves to be in
normal weight (Table 1).
As shown in Table 2, 82.5% of university
students consider obesity to be a disease. 74.7%
of them believe that BMI determines obesity.
11% replied with "I don't know" to the question
about the type of fat to be preferred in food
preparation. The ratio of those who don't want to
receive any information about obesity is
46.8%.The participants in the study were asked
whether they know the connection between
obesity and the other health conditions it may
cause and they replied that they didn’t know
whether obesity causes hypertension (15.1%),
stroke (30.1%), breast cancer (49.8%), prostate
cancer (51.6%), intestinal cancer (51.6%),
menstrual irregularity (37.6%),
infertility/impaired fertility (36.2%), arthrolith
(25.5%), snoring (20.5%) and sleep apnea
(18.5%).
As shown in Table 4, 73.3% of university
students have normal BMI ratios. However, 2.4%
of them was found to be 1
st
grade obese. This
study compares some features on whether
obesity is perceived to be a disease or not. It was
determined that no difference was created by the
variants including age range, civil status, type of
the parent family, place where majority of life is
spent, current employment in a job with income,
income level perception, smoking habit, alcohol
habit, habit of using pleasure inducing substance,
having any chronic disease and presence of obese
individuals in the family (p>0.05). However, as
shown in Table 5, those who received health
education, who have both parents to be primary
school graduates and who don't try to lose weight
have a higher ratio of considering obesity to be
disease (p<0.05). This study examined some
aspects of the university students with regards to
BMI scores and determined that there was no
statistical difference caused by the variants
including employment, having a chronic disease,
civil status, place where majority of life is spent,
income level perception, mother’s education
level, father’s education level, current way of
accommodation, perception on whether obesity
is a disease and feeling oneself knowledgeable
about obesity (p>0.05). However, as shown in
Table 6, average BMI ranks are higher with a
statistical difference in those who have education
in a field other than health, in men, in those who
are 26 years and older, who smoke, who use
pleasure inducing substance (marijuana, cocaine
etc.), who don’t make any effort to lose weight,
who want to be informed about obesity and who
have obese individuals in the family (p<0.05).
Figure 1. BMI Classification by WHO
Classification BMI
Thin (underweight)
• severe thinness
• moderate thinness
• mild thinness
<18.50
<16.00
16.00-16.99
17.00-18.49
Normal 18.50-24.99
Pre-obese 25.00-29.99
Obese
Class I
Class II
Class III
> 30.00
30.00-34.99
35.00-39.99
> 40.00
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Table 1. Some Defining Features and Health Features of the University Students (N=1441)
Features Number %
Age Groups Under 25
26 and above
1409
32
97.8
2.2
Sex Female
Male
887
554
61.6
38.4
Civil Status Married
Single
Informal marriage
Unwilling to reply
18
1408
7
8
1.2
97.7
0.5
0.6
Place where they lived for
a long time
Village
District-Town
City centre
247
486
708
17.2
33.8
49.0
The current type of
residence
With family
Rented flat with friends
Public dormitory
Private dormitory
Alone in a rented flat
With relatives
Unwilling to reply
143
264
527
453
34
10
10
9.9
18.3
36.6
31.4
2.4
0.7
0.7
Employment status No
Yes
1393
48
96.7
3.3
Mother’s education level
(n=1383)
Illiterate
Literate (no graduation)
Primary school
Secondary school
High school
University
87
23
730
231
236
76
6.3
1.7
52.8
16.7
17.0
5.5
Father’s education level
(n=1380)
Illiterate
Literate (no graduation)
Primary school
Secondary school
High school
University
18
11
479
277
387
208
1.3
0.8
34.7
20.1
28.0
15.1
Perception of income level Low income
Moderate income
251
1145
17.4
79.5
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High income 45 3.1
Perception of weight Thin
Normal
Overweight
Obese
218
909
276
38
15.1
63.1
19.2
2.6
Use of alcohol Yes
Never used
Used but quitted
103
1276
62
7.1
88.5
4.3
The habit of using the non-
prescription drug
No
Yes
1273
168
88.3
11.7
Table 2. Some Aspects of the University Students Regarding their Awareness of Obesity
(N=1441)
Some Aspects of Obesity Awareness Number %
Is obesity a disease? Yes
No
I don’t know
1189
149
103
82.5
10.3
7.1
How is obesity determined? Per weight
Per dimension
Per BMI score
Per WHR score
I don’t know
294
8
933
83
123
20.4
0.6
64.7
5.8
8.5
Which fat is preferable in food
preparation?
Margarine
Butter
Vegetable oil
I don’t know
I don't matter
14
564
692
159
12
1.0
39.2
48.0
11.0
0.8
Which food preparation method is
healthier?
Frying
Boiling
Grilling
I don’t know
52
1052
200
137
3.6
73.0
13.9
9.5
Which food group has a lower
calorie content?
Meat, milk, egg
Vegetable, fruit
Bread, pasta, biscuits
I don’t know
193
1113
60
75
13.4
77.2
4.2
5.2
Does exercise have any benefit Yes 1320 91.6
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other than weight control? No
I don’t know
41
80
2.8
5.6
Which type of obesity is more
harmful?
Female type
Male type
Both
I don’t know
245
224
786
186
17.0
15.5
54.5
12.9
Do you want to be informed about
obesity? (n=684)
Yes
No
I don’t know
556
674
211
38.6
46.8
14.6
Do you feel knowing obesity? Yes
No
Partly
414
343
684
28.7
23.8
47.5
Source of information about
obesity*
Family
Friend
Printed media
Visual media
Internet
Health personnel
Other
268
351
451
504
936
515
73
18.6
24.4
31.3
35.0
65.0
35.7
5.1
Do you have any obese person in
the family?
Yes
No
I don't want a reply
128
1180
78
9.2
85.1
5.7
*Multiple responses
Table 3. Knowledge of University Students on the Relation between Obesity and Various Health
Conditions (N=1441)
In obesity
Increase Decrease No change I don’t know
S % S % S % S %
Frequency of hypertension 1180 81.9 15 1.0 28 1.9 218 15.1
Frequency of cardiac diseases 1247 86.5 18 1.2 29 2.0 147 10.2
Frequency of stroke 861 59.8 20 1.4 126 8.7 434 30.1
Frequency of diabetes 1200 83.3 20 1.4 47 3.3 174 12.1
Frequency of breast cancer 427 29.6 22 1.5 275 19.1 717 49.8
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Frequency of prostate cancer 435 30.2 24 1.7 238 16.5 744 51.6
Frequency of intestinal cancer 435 30.2 24 1.7 238 16.5 744 51.6
Frequency of menstruation irregularity 696 48.3 63 4.4 140 9.7 542 37.6
Frequency of infertility 721 50.0 64 4.4 135 9.4 521 36.2
Frequency of arthropathy 979 67.9 23 1.6 71 4.9 368 25.5
Frequency of snoring 1040 72.2 27 1.9 79 5.5 295 20.5
Frequency of sleep apnea 1102 76.5 22 1.5 50 3.5 267 18.5
Table 4. Conditions of University Students according to BMI and WHR Classifications
(N=1441)
Some Descriptive and Health Features Number %
BMI Thin <18.50
Normal 18.50-24.99
Pre-obese 25.00-29.99
Obese >30
1
st
grade obese 30.00-34.99
2
nd
grade obese 35.00-39.99
3
rd
grade obese > 40.00
111
1056
226
5
34
7
2
7.7
73.3
15.7
0.3
2.4
0.5
0.1
WHR* Women (n=187) Low
High
89
98
47.6
52.4
Men (n=110)
Low
High
72
38
65.5
34.5
This calculation includes only those who provide their WHR ratios.
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Table 5. Distribution of University Students According to Some Aspects with regards to Obesity
Awareness (N=1441)
Some Aspects
n
Is Obesity a disease?* Test value
Yes
n (%)
No
n (%)
Don’t
know
n (%)
Group Health
Non-health
496
945
429 (86.5)
760 (80.4)
44 (8.9)
105 (11.1)
23 (4.6)
80 (8.5)
χ
2
=9.70
p=0.008
Sex Female
Male
887
554
757 (85.3)
432 (78.0)
76 (8.6)
73 (13.2)
54 (6.1)
49 (8.8)
χ
2
=12.87
p=0.002
Mother’s
education
level
(n=1383)
Illiterate
Literate
Primary school
Secondary school
High school
University
87
23
730
231
236
76
74 (85.1)
19 (82.6)
620 (84.9)
190 (82.3)
186 (78.8)
60 (78.9)
8 (9.2)
1 (4.3)
64 (8.8)
29 (12.6)
35 (14.8)
5 (6.6)
5 (5.7)
3 (13.0)
64 (8.8)
29 (12.6)
35 (14.8)
5 (6.6)
χ
2
=19.90
p=0.03
Father’s
education
level
(n=1380)
Illiterate
Literate
Primary school
Secondary school
High school
University
18
11
479
277
387
208
10 (55.6)
8 (72.7)
408 (85.2)
232 (83.8)
319 (82.4)
167 (80.3)
6 (33.3)
3 (27.3)
44 (9.2)
30 (10.8)
43 (11.1)
18 (8.7)
2 (11.1)
0 (0.0)
27 (5.6)
15 (5.4)
25 (6.5)
23 (11.1)
χ
2
=24.58
p=0.006
Trying to
lose weight
No
Yes
924
517
743 (80.4)
446 (6.3)
104 (11.3)
45 (8.7)
77 (8.3)
26 (5.0)
χ
2
=8.52
p=0.014
* Row percentage is taken.
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Table 6. Distribution of the BMI Scores of the University Students with regards to Some of
Their Aspects (N=1441)
Some Aspects
n
BMI MW U/KW
Test value
Mean Rank
Group Health
Non-health
496
945
672.76
746.32
MW U= 210434.0
p=0.001
Sex Female
Male
887
554
631.79
863.84
MW U= 166566.5
p=0.001
Age range Under 25 years
26 years and above
1409
32
716.09
937.36
MW U=15620.5
p=0.003
Smoking (n=1350) Yes
No
340
1010
742.13
653.07
MW U=149045.5
p=0.001
Alcohol habit (n=1379) Yes
No
103
1276
762.27
684.17
MW U=58270.0
p=0.056
Using pleasure inducing
substance
Yes
No
151
1290
851.71
705.71
MW U=77676.0
p=0.001
Trying to lose weight Yes
No
924
517
612.77
914.43
KW=138852.5
p=0.001
Presence of obese
individuals in the family?
Yes
No
128
1180
820.18
636.53
MW U=54312.5
p=0.001
Weight perception Thin
Normal
Weight
Obese
218
909
276
38
302.52
a,b,c
680.63
a,d,e
1111.25
b,d,f
1252.96
c,e,f
KW=533.8
p=0.001
Family type Nuclear
Extended
Fragmented
1071
338
32
709.00
a,b
775.54
a,c
546.69
b,c
KW=12.3
p=0.002
Willing to be informed
about obesity?
Yes
No
I don’t know
556
674
211
754.88
a
685.45
a
745.28
KW=9.323
p=0.009
a,b,c,d,e,f
Indicates the groups causing difference.
Discussion
Looking at the studies conducted in the world
and Turkey, obesity continues to be increasingly
present in all age groups. Every person is
considered to be a candidate for obesity. When
looking into the aetiology of obesity, studying
specific groups will be a better approach. Life
conditions and styles of people with common
features are similar. University students who
usually live on their resources and away from
their families are an ideal group to study to
determine the eating habits and obesity
prevalence of young people. The purpose of the
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study is to examine the obesity level and
awareness of undergraduate university students
with daytime education with regards to some
aspects, and to the education they receive.
Only 73.3% of university students in the study
were found to have normal BMI values. The
remaining students were found to be thin (7.7%),
pre-obese (15.7%) and obese (50.3%). Studies on
the obesity levels of university students in
Turkey have different prevalence with
remarkable increases in the ratios of pre-obese or
obese. The ratio of those who are pre-obese was
found to be 21.7% in men and 16.8% in women
in the study
of Dulger and Mayda (2016), 12.7%
in the study by Sert et al. (2016), 7.9% in women
and 26.5% in men in the study by Aydogan
Arslan et al. (2016) and 15.1% in the study by
Uluoz (2016). The world data indicates that the
ratio of overweight men is higher. For example,
in a study in Bahrain by Nizer Jaouna et al.
(2018), the proportion of overweight people was
21.9% in women and 29.4% in men. Karabulut et
al. (2018) found higher BMI values in men than
women in their study conducted in the USA. The
cause of the differences is attributed to the
differences in sample groups. A21.5% of the
university students in this study stated that they
received professional support for losing weight
and 87.8% of them stated that managed to lose
weight after assistance. A 82.5% of university
students consider obesity to be a disease. 74.7%
of them believe that BMI determines obesity.
11% replied with "I don't know" to the question
about the type of fat to be preferred in food
preparation. The ratio of those who don't want to
receive any information about obesity is 46.8%.
The participants in the study were also asked
whether they know the connection between
obesity and the other health conditions it may
cause and they replied that they didn’t know
whether obesity causes hypertension (15.1%),
stroke (30.1%), breast cancer (49.8%), prostate
cancer (51.6%), intestinal cancer (51.6%),
menstrual irregularity (37.6%),
infertility/impaired fertility (36.2%), arthrolith
(25.5%), snoring (20.5%) and sleep apnea
(18.5%). The fat tissue caused by obesity affects
the production of various adipokinines and plays
an important role in carcinogenesis. Some
substances that are produced are essential in the
progress and reoccurrence of cancer. Therefore,
it is necessary to ensure that individuals have
healthy eating and physical activity habits to
prevent obesity-related cancers (Urhan&Akbulut,
2017).
Those who received health education, who have
both parents to be primary school graduates and
who don't try to lose weight have a higher ratio
of considering obesity to be disease (p<0.05).
Average BMI ranks are higher with a statistical
difference in those who have education in a field
other than health, in men, in those who are 26
years and older, who smoke, who use pleasure
inducing substance (marijuana, cocaine etc.),
who don’t make any effort to lose weight, who
want to be informed about obesity and who have
obese individuals in the family (p<0.05). Similar
to the present study, the study by Uluoz (2016)
has higher BMI scores in men and in those who
have obese individuals in the family. Another
study conducted in Turkey found that female
university students have a more negative attitude
towards obesity which supports these findings
(Usta, et al. 2015). In a study by Jiang et al.
(2018) including the students in 50 universities in
China, men have a higher ratio of being pre-
obese and obese than women. Similarly, the
study by Chengi et al. (2018) found higher ratios
of pre-obesity and obesity in men.
Acknowledgements: We thank older adults who
participated in this study.
References
Ata A, Vural A, Keskin F. (2014). Body Perception
and Obesity. Ankara Med J, 14(3),74 -84
Aydogan Arslan S, Daskapan A, Çakır B. (2016).
Specification of nutritional and physical activity
habits of university students. TAF Preventive
Medicine Bulletin, 15(3),171-180.
Chenji SK, Rao
CR, Sivanesan
S, Kamath
V, Kamath
A. (2018). Cross-sectional analysis of obesity and
high blood pressure among undergraduate students
of a university medical college in South India.
Family medicine and Community Health, 6(2), 63-
69.
Dulger H, Mayda AS. (2016). Nutritional Habits and
Obesity Prevalence of Students at Bartin
University Vocational School of Health Services.
Journal of Duzce University Health Sciences
Institute, 6(3), 173-177.
Gordon-Larsen P, Adair LS, Nelson MC, Popkin BM.
(2004). Five year obesity incidence in the
transition period between adolescence and
adulthood: the National Longitudinal Study of
Adolescent Health. Am J Clin Nutr, 80, 569–575.
Jaoua N, Woodman A, Amini M. (2018). Abnormal
Weight Among University Students in the
Kingdom of Bahrain: Prevalence, Factors,
International Journal of Caring Sciences January-April 2021 Volume 14 | Issue 1| Page 569
www.internationaljournalofcaringsciences.org
Predictions, and Recommendations. American
Journal of Internal Medicine, 6(6), 152-160.
Jiang S, Peng S, Yang T, Cottrell RR, Li L. (2018).
Overweight and Obesity Among Chinese College
Students: An Exploration of Gender as Related to
External Environmental Influences. American
Journal of Men’s Health, 12(4), 926–934.
Kahraman G, Bas T, Akbolat M. (2015). The Effect of
Health Programs on The Development Of
Attıtudes and Beliefs in Obesity. Acibadem
University Journal of Health Sciences, 6(2), 89-
98.
Karabulut US, Romero Z, Conatser P, Karabulut M.
(2018). Assessing Overweight/Obesity, Dietary
Habits, and Physical Activity in Hispanic College
Students. Exercise Medicine, 2(5), 1-5.
National Institutes of Health, National Heart, Lung,
and Blood Institute. Risk factors. (2017).
Retrieved from:
https://www.nhlbi.nih.gov/health/health-
topics/topics/obe/risks.
Obesity Diagnosis and Treatment Guide. Turkey
Endocrinology and Metabolism Society.
http://www.temd.org.tr/files/file/OBEZITE_TTK_
web.pdf E.T. 03.10.2017 A.D.03.10.2017.
Ogden CL, Carroll MD, Fryar CD & Flegal KM.
(2015). Prevalence of obesity among adults and
youth: the United States, 2011–2014. NCHS Data
Brief, vol. 219. Retrieved 10/2/2017 from
https://www.cdc.gov/nchs/data/databriefs/db219.p
df)
Organisation for Economic Co-operation and
Development (OECD). OECD Obesity Update
2017. Retrieved from
http://www.oecd.org/health/obesity-update.htm)
Ozbahar Acar Z. (2015). Obesity and life behaviours
of university students. Thesis, On Dokuz Mayis
University, Faculty of Medicine, Department of
Public Health, Samsun.
Racette SB, Deusinger SS, Strube MJ, Highstein GR,
Deusinge RH. (2005). Weight changes, exercise,
and dietary patterns during freshman and
sophomore years of college. J Am Coll Health, 53,
245–251.
Republic of Turkey Ministry of Health Primary
Health Services General Directorate of Turkey
Obesity Program to Combat and Control (2010-
2014), Ankara, 2010.
Sert H, Seven A, Cetinkaya S, Pelin M, Aygin D.
(2016). Evaluation of prejudice against obesity in
health high school students. Online Turkish
Journal of Health Sciences 1(4), 9-17.
Tam AA, Cakir B. (2012). Approach of Obesity in
Primary Health Care. Medical Journal, 12(1), 37-
41.
Tanyolac S, Sertkaya Cikim A, Ozbey N, Orhan Y.
(2004). Waist circumference warning and action
limits in overweight and obese women. Istanbul
Medical Faculty Journal, 67(4), 205-209.
The challenge of obesity in the WHO European
Region and the strategies for response, Ed.
Francesco Branca, Haik Nikogosian ve Tim
Lobstein, WHO, Denmark, 2007.
Uluoz E. (2016). Overweightness and obesity
prevalence among university students in 2015-
2016 educational season. Journal of Human
Sciences, 13(3), 5884-5900.
Urhan M, Akbulut G. (2017). Obesity and Cancer
Relationship: Is Leptin a Carcinogenic Adipokine?
İzmir Kâtip Çelebi University Journal of Faculty
of Health Sciences, 2(3), 35-43.
Usta E, Acar K, Aygin D. (2015). The Attitudes of
Students Towards Obesıty in The Vocational
College of Health Services. Electronic Journal of
Vocational Colleges- December 2015. UMYOS, 4,
46-53.
World Health Organization (2014). The challenge of
obesity-quick statistics. Retrieved from:
http://www.euro.who.int/en/health-topics/
noncommunicable-diseases/obesity/data-
andstatistics.
Yilmaz A. The Effect of Education Given to Obese
High School Students According to Health
Promotion Model on Healthy Lifestyle Behavior
and Quality of Life. Atatürk University Public
Health Nursing PhD Thesis. https://tez.yok.gov.tr
A.D. 03/10/2017
