Overweight among Medical Students in a Tertiary Care Center: A Descriptive Cross-sectional Study

ABSTRACT Introduction: Today's generation is facing an increased prevalence of overweight and obesity. It may be genetic or habitual due to overeating of junk foods and sedentary lifestyle. It directly affects an individual personality and health. The main aim of this study is to find out the prevalence of overweight among medical students in a tertiary care center. Methods: This is a descriptive cross-sectional study done in 385 students in a tertiary care hospital from 25th January 2020 to 28th February 2021. The sample was collected by simple random sampling method after the approval from the Institutional Review Committee of Kathmandu Medical College and Teaching Hospital. Height in meter and weight in kilogram of students were measured to calculate body mass index. Data were analyzed by using Statistical Package of Social Science software version 16. Point estimate at 95% confidence interval was calculated along with frequency and proportion for binary data. Results: Among 385 students, 75 (19.48%) (95% Confidence Interval= 15.53%-23.44%) were overweight. Fifty-seven (14.85%) males and 18 (4.69%) females were overweight respectively. In total, there were 197 (51.01%) males and 188 (48.99%) females. Conclusions: The current study shows the prevalence of overweight among medical students is slightly higher than in studies done in similar settings.


INTRODUCTION
Overweight is the most common health problem leading to a marked increase in mortality and morbidity in the entire world. The body condition with excessive or abnormal fat accumulation is overweight and obesity. 1 A person is considered overweight if his/her body mass index (BMI) is 25-29. 9, and obese BMI is over 30. 2 Based on the revised guidelines for the Asian population, individuals are classified as overweight if their BMI is 23-24.9, pre-obese ≥25-29.9 and obese ≥ 30. 3 Overweight is not just aesthetic consideration. The metabolic changes can lead to serious health problems and increase risk of diseases like diabetes mellitus, hypertension, orthopedic complications, psychological disorders etc. 4 Nowadays, people with any age group, gender, ethnicity and socio-economic background are equally affected. 5 But, there are insufficient data of overweight among Nepalese medical students.
Overweight and obesity are common physical problems. So, the objective of this study is to find out the prevalence of overweight among medical students in a tertiary care center.

METHODS
A descriptive cross-sectional study was carried out among undergraduate healthy medical students, aged between 17 to 25 years, in the Department of Physiology of Kathmandu Free Full Text Articles are Available at www.jnma.com.np Medical College and Teaching Hospital. The study was started from 25 th Jan 2020 to 28 th Feb 2021 with approval of the Institutional Review Committee (IRC) of Kathmandu Medical College and Teaching Hospital (reference number: 130120204). The sample was selected by a simple random sampling method. The sample size was calculated by using the following formula, n= Z 2 x p x q / e 2 = (1.96) 2 x 0.5 x 0.5 / (0.05) 2 = 385 where, n= sample size, Z= 1.96 for 95% Confidence Interval (CI), p = prevalence of overweight for maximum sample size, 50% q = 1-p e = margin of error, 5% Based on the above formula, the minimum sample size was 385.
Height in meter and weight in kilogram (kg) of students were measured to calculate Body Mass Index (BMI) by Prestige height and weight measuring scale (Stadiometer). The formula, weight in kg divided by height in meter square was used to calculate the BMI and unit is kg/m 2 . According to WHO (World Health Organization), "Asian Criteria" for BMI cut off point 23-24.99 is overweight, pre-obese ≥25-29.9 and obese ≥ 30. This "Asian Criteria" is used to analyze overweight and obesity in this study.
Data was analyzed by using Statistical Package of Social Science (SPSS) software version 16. Point estimate at 95% CI was calculated along with frequency and proportion and subgroup analysis was done on the basis of gender.

DISCUSSION
In our findings, the prevalence of overweight was slightly higher than a study done by Kishore S, the study showed 14.6% medical students were overweight. 6 Another study by Deotale M. had much less prevalence of overweight (9.3%) in medical students. 7 A study by Rui Wang showed higher range of overweight (32.3%) than present study which was done in adult population. But the gender specific result was similar higher among male (34.3%) than female (30.2%). 8 Kumar A. study showed contrast result of overweight in fifth batch male students, low (1%) than female students (4.9%) but similar finding was there in IV th batch students, overweight male (12.15%) and females were (4.9%). 9 Similar result was reported by Thomas E 39.8% overweight in boys and 25.5% in girls. Male showed more prevalence with overweight than girls. 10 In contrast to the current study, the prevalence of overweight is higher in females by Gopalkrishnan 15.7% and 13.7% males. 1 Magda Antal 19.6% in girls and 18.1% boys. 11 A study by Gabriel L has similar result of overweight 20.26%. 12 Rabanales-Sotos J study showed a bit higher overweight 26.5% than current study 13

CONCLUSIONS
The current study shows the prevalence of overweight students is a bit higher than other similar studies in students. The male students show a higher rate of overweight than female students. It suggests that the prevalence of overweight is gender specific. But a person's age factors, stress level, day to day habits like exercise and eating can influence it. Overweight can lead to serious health problems and can increase the risk of many diseases like diabetes mellitus, hypertension, JNMA I VOL 59 I ISSUE 240 I AUGUST 2021 psychological disorders and many more. If the students can be counseled about the importance of normal BMI and healthy habits, many serious health issues can be avoided.