CHAPTER ONE
INTRODUCTION
1.1 Background of the Study
Body weight is the result of complex interactions involving genetic, environmental, and psychosocial factors, which influence the body's energy intake and expenditure mechanisms (Beynon, 2023; Gao et al., 2022). Overweight and obesity are characterized by an abnormal or excessive accumulation of body fat, which can have detrimental effects on one's health. Obesity, specifically, refers to the excessive buildup of fat or adipose tissue in the body, and it is linked to an increased risk of developing conditions such as diabetes mellitus, cardiovascular disease, hypertension, and hyperlipidemia (World Health Organization (WHO), 2021).
To gauge overweight and obesity in adults, the World Health Organization (WHO) utilizes a simple metric known as Body Mass Index (BMI), calculated by dividing a person's weight in kilograms by the square of their height in meters (kg/m2). According to WHO guidelines for adults, a BMI of 25 or higher is considered overweight, while a BMI of 30 or higher is classified as obesity. BMI is a widely adopted tool for assessing overweight and obesity on a population level, as it remains consistent across genders and age groups among adults. Nevertheless, it should be regarded as a general reference, as it may not accurately reflect the same level of fatness in all individuals. The relationship between BMI and body fat is curvilinear, and in certain populations, like Asians and elderly individuals, a normal BMI may obscure underlying excess fat. Additionally, alternate methods, such as measuring skin thickness in various areas like the triceps, biceps, subscapular, and supra-iliac regions, or conducting a DEXA scan (Dual-energy X-ray absorptiometry), can be employed to estimate fat mass (Panuganti et al., 2023).
Obesity is a complex condition with a multitude of contributing factors. It ranks as the second leading cause of preventable death, coming right after smoking (Panuganti et al., 2023). The global surge in overweight and obesity is a matter of increasing concern for the general populace, public health entities, and healthcare practitioners, primarily due to its profound and far-reaching health ramifications.
As per the World Health Organization (2021), the worldwide prevalence of obesity has nearly tripled since the mid-1970s. In 2016, over 1.9 billion adults aged 18 and older were identified as overweight, with more than 650 million of them being classified as obese. In 2016, 39% of adults aged 18 and over were deemed overweight, and 13% fell into the category of obesity.
While it is recognized that obesity significantly impacts the health of both men and women, it is essential to acknowledge that it affects the two genders differently. This discrepancy is primarily due to various biological, socioeconomic, cultural, and gender-related factors. Obesity presents gender-specific risks when it comes to the development of associated health issues (Pucci et al., 2017). Notably, obesity can be seen as a contributing factor to, as well as an outcome of, at least seven of the top 10 health concerns for women as outlined by the World Health Organization (WHO) in 2015. These concerns include cancer, reproductive health, maternal health, HIV infection, other sexually transmitted infections, violence against women, mental health, non-communicable diseases, and the challenges of youth and aging (WHO, 2017). This is because obesity is linked to breast and cervical cancer, sexual and reproductive health concerns, developmental and aging-related difficulties, mental health disorders, non-communicable diseases, including obesity itself and its metabolic consequences.
Research consistently demonstrates that obesity increases the risk of breast cancer in postmenopausal women and is associated with lower survival rates and a greater likelihood of cancer recurrence (Vaysse et al., 2017). Furthermore, a systematic review has established a positive correlation between BMI and the occurrence of endometrial, gallbladder, esophageal adenocarcinoma, and renal cancer in women. Concerning reproductive health, obesity exerts negative effects on both fertility and contraception due to hormonal and metabolic alterations, including hyperinsulinemia, hyperleptinemia, insulin resistance (IR), and hyperandrogenism. Abdominal obesity can worsen or even trigger the onset of Polycystic Ovarian Syndrome (PCOS), a widespread reproductive disorder in women of childbearing age and a primary cause of infertility (Delitala et al., 2017). Maternal health is also adversely affected by obesity or abnormal weight gain during pregnancy (Lindsay et al., 2018; White et al., 2017). Obesity is linked to early pregnancy loss, higher rates of cesarean (c-) section deliveries, high-risk obstetric conditions, increased maternal and neonatal mortality rates, and congenital malformations (Poston et al., 2016).
Numerous physical health issues, including obesity, are closely linked to severe mental disorders like anxiety and depression, often causing feelings of shame, guilt, and social anxiety, especially in individuals with Binge Eating Disorder (Albohn-Kuhne and Rief, 2011). Surprisingly, obesity is also prevalent among those dealing with mental health issues not typically associated with disordered eating, such as schizophrenia (Bradshaw and Mairs, 2014), and depression (Chauvet-Gelinier et al., 2019).
However, it's worth noting that deliberate weight loss efforts in individuals grappling with overweight and obesity can significantly enhance their health, reducing the risk of co-morbid conditions and mortality (Rueda-Clausen et al., 2015). Achieving a weight loss of 5 to 10% is considered clinically significant and can lead to improvements in vital metabolic parameters like blood glucose levels, blood pressure, and lipid profiles (Ryan and Yockey, 2017).
Furthermore, it's important to recognize that beyond the positive impacts weight loss can have on physical health and overall well-being, the patterns and trajectories of weight loss may also influence mental health. Consequently, this research aims to delve into the intricate relationship between weight loss and mental well-being among women aged 30 to 60 years in FCT Abuja.
1.2 Statement of the Problem
Research underscores a bidirectional relationship between obesity and mental health, as individuals carrying excess weight are at higher risk for experiencing mental health challenges, and those already grappling with mental health issues face an elevated likelihood of weight gain and subsequent obesity (Geiker et al., 2018; Bak et al., 2014; Fruh et al., 2017). Numerous studies have observed positive changes in mental health outcomes following weight loss interventions (Alhalel et al., 2018; Webber et al., 2016; Fuller et al., 2017; Janney et al., 2018; Young et al., 2018). Nonetheless, there are valid concerns regarding interventions that emphasize dietary restriction in weight management, as they might potentially contribute to disordered eating patterns and worsen mental health issues (Peckmezian and Hay, 2017).
Given these complexities, it is crucial to delve deeper into how weight management interventions influence mental health to enhance care and mitigate potential risks. This study aims to address this problem by identifying the specific challenges faced by women in the specified age group in FCT Abuja regarding weight loss and their mental well-being.
1.3 Aim of the Study
The aim of this study is to investigate the relationship between weight loss efforts and the mental health of women aged 30 to 60 years in the Federal Capital Territory (FCT) Abuja.
1.4 Objectives of the Study
The specific objectives of this study include:
- To assess the weight loss practices and behaviors of women aged 30 to 60 years in FCT Abuja.
- To explore the effects of intentional weight loss on mental health outcomes in women aged 30 to 60 years in FCT Abuja.
1.5 Research Questions
This study will address the following research questions:
- What are the weight loss practices and behaviors of women aged 30 to 60 years in FCT, Abuja?
- How does intentional weight loss impact the mental health outcomes of women aged 30 to 60 years in FCT, Abuja?
1.6 Research Hypothesis
H0: There is no significant relationship between weight loss practices and mental health outcomes among women aged 30 to 60 years in FCT, Abuja.
Ha: There is a significant relationship between weight loss practices and mental health outcomes among women aged 30 to 60 years in FCT, Abuja.
1.7 Justification of the Study
This study holds significant relevance to various stakeholders, including researchers, healthcare professionals, policymakers, and the women in the age group being studied. Understanding the relationship between weight loss and mental health in this demographic can inform more targeted and effective interventions and support systems. It can also contribute to a broader understanding of the complex interplay between physical and mental well-being.
1.8 Scope of the Study
This study will focus on women aged 30 to 60 years residing in the Federal Capital Territory (FCT) of Abuja, Nigeria. It will investigate their weight loss practices and behaviors, as well as the potential effects of intentional weight loss on their mental health. The study will utilize both quantitative and qualitative research methods to gather comprehensive data on this topic.
