PAPER

OBESITY IS RELETED TO LIFESTYLE

NAME : Ni Made Pasmiari

NIM: 17061008
CLASS : B
SEMESTER : V (FIVE)

FACULITY OF NURSING
CATHOLIC UNIVERSITY OF DE LA SALLE MANADO
2019
 CHAPTER 1
INTRODUCTION

A. Background
The problem of overweight and obesity is increasing rapidly in various parts of the
world towards epidemic proportions. This is due to an increase in a diet high in fat and sugar,
accompanied by a decrease in physical activity. In developed countries, obesity has become
an epidemic by contributing 35% to the morbidity rate and contributing 15-20% to mortality.
Recent reports indicate that the prevalence of obesity throughout the world in both
developing and developing countries has increased in an alarming amount. This can lead to
serious health problems because obesity can spur cardiovascular, kidney, metabolic,
prototombic, and inflammatory responses.
The prevalence of central obesity in patients with advanced CHD is very high. Central
obesity is associated with adiponectin levels which are cardioprotective factors. Differences
in blood adiponectin levels can also indicate the severity of acquired CHD. The higher the
level of central obesity will reduce levels of adiponectin in the blood and exacerbate the
manifestations of CHD that appear in these patients.
The increasing prevalence of central obesity has an impact on the emergence of
various degenerative diseases such as atherosclerosis, cardiovascular disease, type 2 diabetes,
gallstones, impaired pulmonary function, hypertension and dyslipidemia. Indonesia is a
developing country with a central obesity prevalence of 18.8% from 19.1% in general obesity
prevalence. Riskesdas 2016 reported that the three highest prevalence of central obesity,
namely North Sulawesi, Gorontalo and DKI Jakarta were 31.5%, 27%, and 27.9%
respectively. Based on research conducted by the Indonesian Obesity Study Association
(HISOBI) in 2014, it was found that the prevalence of central obesity was higher than general
obesity, with 11.2% of women and 9.6% of men suffering from general obesity. While a
higher prevalence was found in the central obesity group where in 41.2% of men and 53.3%
in women. The group with the highest central obesity characteristics in Indonesia is in the
vulnerable age group of 45 - 54 years as much as 27.4%. Based on the type of work, Civil
Servants (PNS) ranks first in the characteristics of obese people with the highest prevalence
of 27.3%, ABRI 26.4% and entrepreneurs by 26.5%. in his research found that abdominal
obesity 33% more in men who have temporary jobs (professional, manager, administration)
and only 6% in those who have high active jobs (farmers, fishermen, carpenters) .
Obesity during high-risk childhood becomes obese in adulthood and has the potential
to experience metabolic diseases and degenerative diseases in the future. The blood lipid
profile in obese children resembles the lipid profile in cardiovascular disease and obese
children have a greater risk of hypertension. Sharif's research found hypertension in 20-30%
of obese children, especially abdominal obesity. Thus obesity in children requires serious
attention and early treatment, by involving the participation of parents.
B. Risk Factor
Obesity can occur mainly due to increased food intake and decreased physical
activity. Various researchers found other risk factors for central obesity such as food
consumption, alcohol consumption, smoking history and physical activity. Besides
technological advances, socioeconomic status, sedentary life style are also important
determinants of risk factors. Many factors affect central obesity including environmental
factors such as the availability of access in the form of transportation, housing, local culture
or race and ethnicity are some of the many risk factors that can directly or indirectly trigger
central obesity. Research on central obesity internationally has done quite a lot, but in
Indonesia itself is still quite limited, and mostly carried out among housewives and in urban
areas. Central obesity is at a great risk of death, a person with a normal body mass index but
with an increase in abdominal circumference, a risk of death 20% greater than someone with
a normal body mass index and abdominal circumference.
Some of the factors causing obesity in children include excessive food intake that
comes from instant processed foods, soft drinks, snacks such as fast food (burgers, pizza, hot
dogs) and other fast foods that are available at food outlets. In addition, obesity can occur in
children who are babies who are not accustomed to consuming breast milk (ASI), but using
formula milk with the amount of intake that exceeds the portion needed by the baby / child.
As a result, children will become overweight when they are 4-5 years old. This is
compounded by the habit of consuming unhealthy snacks with high calorie content without
adequate consumption of vegetables and fruit as a source of fiber. Children aged 5-7 years are
a group that is vulnerable to over nutrition. Therefore, children in this age range need
attention from the point of view of changes in daily eating patterns because foods that are
consumed since childhood will form the next eating habits. The results of the Global Youth
Tobacco Survey (GYTS) in 2016 showed that more than 37.3% of students had smoked,
30.9% of them smoked for the first time before the age of 10. The Susenas results show that
the age of teenagers who are prone to start smoking is 15-19 years. Since 1970 until now, the
incidence of obesity has increased 2 (two) times in children aged 2-5 years and ages 12-19
years, even increasing three (3) times in children aged 6-11 years. In Indonesia, the
prevalence of obesity in children aged 6-15 years increased from 5% in 1990 to 50% until
now. Other factors causing obesity are lack of physical activity both daily activities and
structured physical exercise. Physical activity carried out from childhood to the elderly will
affect a lifetime of health. Obesity at the age of the child will increase the risk of obesity in
adulthood. The cause of obesity is rated as 'multicausal' and is very multidimensional because
it does not only occur in the high socio-economic class, but also often occurs in the middle to
lower socio-economic class. Obesity is influenced by environmental factors compared to
genetic factors. If obesity occurs in children before the age of 5-7 years, then the risk of
obesity can occur when growing up. Obese children usually come from families who are also
obese. Nutrition problems experienced by many nutrient-prone groups that require adequate
nutrients for growth. The group of children to early teens (around 10-14 years) is an age
group that is at risk of experiencing nutritional problems both under nutrition and over
nutrition.
C. Prenvention
As for the prevention that can be done to avoid obesity, namely:
1. Sports
Physical activity is defined as body movements, especially muscles that require
energy and exercise is a form of physical activity. Recommendations from Physical Activity
and Health state that 'moderate physical activity' should be done for about 30 minutes or more
a week. Moderate physical activity includes walking, jogging, swimming and cycling.
Physical activity carried out every day is beneficial not only to get a healthy body condition
but also beneficial for mental health, entertainment in preventing stress. Low physical activity
is a major factor affecting obesity.

2. Consumption Habits Of Vegetables and Fruit

Vegetables and fruit are important sources of fiber for children in their infancy,
especially those associated with obesity. Overweight and obese children need high-fiber
foods such as Vegetables and fruit are important sources of fiber for children in their infancy,
especially those associated with obesity. Overweight and obese children need high-fiber
foods such as vegetables and fruit. Based on PUGS (General Guidelines for Balanced
Nutrition), consumption of vegetables and fruit is at least 3 servings / day. The pattern of
consumption of vegetables and fruit in the Indonesian population is still lower than the
recommended amount. The results of this study also showed that around 90% of children
consume vegetables and fruit with sizes <3 servings / day. In addition it turns out girls are
more likely to consume vegetables and fruit compared to boys. Consumption of linear fiber
will reduce fat and salt intake which will further reduce blood pressure and prevent weight
gain. Various interventions in preventing obesity including increasing consumption of
vegetables and fruit can replace foods with high energy density that are often consumed by
children and adolescents, so that it can indirectly lose weight. and fruit. Based on PUGS
(General Guidelines for Balanced Nutrition), consumption of vegetables and fruit is at least 3
servings / day. The pattern of consumption of vegetables and fruit in the Indonesian
population is still lower than the recommended amount. The results of this study also showed
that around 90% of children consume vegetables and fruit with sizes <3 servings / day. In
addition it turns out girls are more likely to consume vegetables and fruit compared to boys.
Consumption of linear fiber will reduce fat and salt intake which will further reduce blood
pressure and prevent weight gain. Various interventions in preventing obesity including
increasing consumption of vegetables and fruit can replace foods with high energy density
that are often consumed by children and adolescents, so that it can indirectly lose weight.
3. Energi and Protein Intake
Apart from being a source of energy, food is also needed to replace damaged body
cells and growth. Problems will arise if the food consumed exceeds the needs. The excess
energy will be stored in the body. If this situation occurs continuously will result in
accumulation of fat in the body so that the risk of obesity. Teenagers need a number of
calories to meet their daily energy needs both for activities and growth needs. Increased
energy requirements are in line with increasing age. In fulfilling their needs, teenagers are
encouraged to consume a variety of healthy foods including protein sources, low-fat dairy
products, cereals, fruits and vegetables. In principle, the nutritional needs of children aged
10-12 years are high in calories and protein, because at this time the body is experiencing
rapid growth.
 CHAPTER 2
DISCUSSION

A. Definition Obesity

Obesity is defined as a disorder or disease characterized by excessive accumulation of

body fat tissue.
Besit is a pathological condition with excessive fat accumulation than is needed for
bodily functions (Mayer, 2015). Obesity in terms of health is one of malnutrition, as a result
of food consumption that far exceeds its needs.
Obesity is one of the risk factors causing degenerative diseases such as Diabetes
Mellitus (DM), Coronary Heart Disease (CHD) and Hypertension (Laurentia, 2014). Obesity
generally causes fat accumulation in subcutaneous areas and other tissues. One method used
to measure subcutaneous fat in the upper arm is to measure the thickness of the triceps skin
fold. In children and adolescents of the same age and sex it is said to be obese if the thickness
of the triceps skin fold is above the 85th percentile. Then if the thickness of the triceps skin
fold shows above the 95th percentile of the child or adolescent is said to be super-obese
(Soetjiningsih, 2015).

B. Factors Causing Obesity

Based on thermodynamic laws, obesity is caused by a positive energy balance, as a

result of an imbalance between energy intake and energy output, resulting in excess energy
stored in the form of fat tissue. Most of these energy balance disorders are caused by
exogenous / nutritional factors (primary obesity) while endogenous factors (secondary
obesity) due to hormonal disorders, syndromes or genetic defects are only around 10%.
The cause of obesity is not known with certainty. Obesity is a multifactorial disease
which is suspected that most of the obesity is caused by interactions between genetic factors
and environmental factors, including activities, lifestyle, socio-economic and nutritional that
is eating behavior and feeding solids too early in infants.

1. Genetic Factor
Parental fatness is a genetic factor that plays a big role. If both parents are obese, 80%
of children become obese; if one parent is obese, the incidence of obesity is 40% and if both
parents are not obese, the prevalence is 14%.

2. Environmental Factor

a. Phsical Activity
Physical activity is a major component of energy expenditure, which is about 20-50%
of total energy expenditure. Research in developed countries found a relationship between
low physical activity and the incidence of obesity.
b. Nutritional Factor
The role of nutritional factors begins in the womb where the amount of body fat and
baby growth is influenced by maternal weight. Weight gain and fat of children is influenced
by: when they first get solid food, high calorie intake from carbohydrates and fats5 and the
habit of consuming foods that contain high energy.

c. Social Economi Factor

Changes in knowledge, attitudes, behaviors and lifestyles, eating patterns, as well as
increased incomes influence the choice of types and amounts of food consumed. The data
shows that the last few years seen lifestyle changes that lead to a decrease in physical
activity, such as: to school by driving and lack of play activities with friends and the home
environment that does not allow children to play outside the home, so that children are more
happy to play computer / games, watching TV or video instead of doing physical activities. In
addition, the availability and price of easily affordable junk food will risk obesity.

C. Diagnosa

Clinically obesity can be recognized easily because it has signs and symptoms that are
typical, among others (Juanita, 2016):
1. Rounded face
2. Chubby cheeks
3. Double chin
4. Neck is relatively short
5. Bulging chest with enlarged breasts containing fat tissue
6. The stomach bulges and the stomach wall folds and the legs are generally x-shaped with
the two inner groin stuck together and cause blisters.
7. In boys the penis looks small because it is buried in fatty tissue.

D. Conceptual Framework

The problem of obesity in school children is not only a problem in developed

countries where the economy has prospered, but the problem of obesity has become a global
problem that has befallen people in developing countries.
 Response Characteristics:

 Age
 Gender

Characteristics Of The Respondent’s Parents :

 Perent Education
 Mother’s Employment Status

Frequency Of Food Consumption :

Obesity
 Frequency Of Snacks
 Frequency Of Consumtion
Of Fast Food

Physical Activits :

 Sleping Time
 Time Watching TV and
Playing Games
 Sports Habits

Media Exposure

Informatian :

= Variabel Independen

= Variabel Dependen
 CHAPTER 3
CONCLUDES

A. Conclusion
Obesity is a pathological condition where there is excessive accumulation of fat than
is needed for bodily functions. Obesity in terms of health is one of malnutrition, as a result of
food consumption that far exceeds its needs. Obesity is one of the risk factors causing
degenerative diseases such as Diabetes Mellitus (DM), Coronary Heart Disease (CHD) and
Hypertension.
Factors Causing Obesity:
a. Genetic Factors
b. Environmental factor
 physical factor
 nutritional factor
 social economic factors

Obesity can occur mainly due to increased food intake and decreased physical
activity. Various researchers found other risk factors for central obesity such as food
consumption, alcohol consumption, smoking history and physical activity (Lathi Koski,
2002). In addition, technological progress, socioeconomic status, sedentary life style are also
important determinants of risk factors.
 REFERENCES

Apriadji, W.H. 2014. Gizi Keluarga. PT. Penebar Swadaya Anggota IKAPI. Jakarta

Brodbenner. C., B dalam Wardlaw & Hampl (2015). Perspsective in Nutrition, Seventh
Edition & Diet in Obesity. Therapeutic Nutrition and Dietetics.
Fukuda, S., Takeshita, T., Morimoto,K. Obesity and Lifestyle. Asian Med.J.