| Summary: | 碩士 === 臺北醫學大學 === 公共衛生學研究所 === 98 === The World Health Organization (WHO) indicated that the prevalence of obesity has tripled in many European countries since 1980s. As the world''s obese population has increased drastically, the WHO warns that obesity is a disease and has become a new epidemic illness worldwide. In Taiwan, the threats of obesity expand across lifespan, including childhood, adolescence, and adulthood.
Childhood obesity frequently persists into adulthood, with up to 42-63% of obese children and 80% of obese adolescents being reported to become obese adults. This is of great concern, given that many adverse effects on health are already found in obese adolescents, including physical (e.g., hypertension, type 2 diabetes) and psychosocial (e.g., depression) problems. As obesity has contributed to substantial medical burden and to many of the top ten causes of death, there is an imperative need to address the problem on adolescent obesity.
The purpose of this study was (1) to explore the distributions of weight status and psychological and physical conditions among overweight and obese high school students in Taipei across three different time points (i.e., Wave I (baseline), Wave II (3 months later), and Wave III (8 months later)); (2) to explore the effects of weight loss on the consequent change of psychological conditions in Wave II and Wave III; (3) to explore the effects of weight loss on the consequent change of physical conditions in Wave II. To the best of our knowledge, most of the previous reserches on adolescent weight loss in Taiwan were cross-sectional. Our study was designed to collect information on three time points to investigate if weight loss could improve both psychological and physical conditions on adolescents.
A total of 100 overweight and obese students who participated in the research project of “the Effectiveness of an Integrated Weight Management Intervention and its Consequences on Related Physical and Mental Indices for Taipei Municipal High School Students” starting from April, 2009 (Wave I) were recruited in our study. These students were selected among six municipal senior high schools in Taipei.
Three assessments of structured questionnaires (e.g., lifestyle, depression, and body image) and two measures of physical and laboratory examinations (e.g., weight, blood pressure, and 10c.c. blood for blood lipid and blood sugar measurements) were implemented at different time points. In addition, the change of body mass index (ΔBMI), the independent variable, was calculated. For the comparison between Wave I and Wave II status, we used 2% as a cut-off point (i.e., categorized into three groups of ΔBMI21＜-2%, 0%＞ΔBMI21≧-2%, and ΔBMI21≧0%), while for the comparison between Wave I and Wave III status, we used 3% as a cut-off point (i.e., categorized into three groups of ΔBMI31＜-3%, 0%＞ΔBMI31≧-3%, and ΔBMI31≧0%). The pair-T test ,one-way ANOVA and χ2 were adopted for analysis.
For the comparison between Wave I and Wave II status, we found that (1) there was no significant difference on psychological conditions within and between groups; (2) there was significant improvement on high density lipoprotein cholesterol (HDL-C) among male students. Specifically, the group of “ΔBMI21＜-2% (53.31±11.989 mg/dL)” is better than the group of ΔBMI21≧0% (44.24±6.53 mg/dL; P＝0.024).
For the comparison between Wave I and Wave III status, we found that (1) the group of “ΔBMI31≧0%” displayed significantly lower self-esteem. (P＜0.05); (2) among female students, students in the group of “ΔBMI31＜-3%” reported significantly lower scores on depression, compared to those in the group of “0%＞ΔBMI31≧-3%” and “ΔBMI31≧0%” (P＝0.009).
In conclusion, for male students with weight loss in about 3 months, the HDL-C might be improved accordingly. On the other hand, for female students with weight loss in about 8 months, depressive scores might be improved. It might be helpful to conduct longer-term intervention and qualitative researches in the future to further address the effects of change of weight status on the consequent modification of physical and psychological conditions among adolescents. Because abnormal biochemical values were observed on some of these obese students, the design and administration of the prevention and intervention programs on adolescent obesity have remained a major public health issue to concern for.
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