Thimmaiah C T P19ZY21M0008 Impact of Obesity On Respiratory Disease Severity. A Cross-Sectional Analysis

IMPACT OF OBESITY ON RESPIRATORY DISEASE SEVERITY.
A CROSS-
SECTIONAL ANALYSIS
Project report submitted in partial fulfillment of the requirement for the award of the Degree
of
MASTER OF BUSINESS ADMINISTRATION

OF
BENGALURU NORTH UNIVERSITY
By
THIMMAIAH C T
Reg. No: P19ZY21M0008
Under guidance of
DR. JERRY JOHN

PROFESSOR & PROGRAM DIRECTOR
ONE SCHOOL OF BUSINESS

23/1, Oppo. Manyatha Tech Park, Nagawara,Bangalore, Karnataka
560045
DECLARATION OF THE STUDENT
I, hereby declare that “Impact of Obesity on Respiratory Disorder Severity. A Cross-

sectional Analysis” is the result of the project work carried out by me under the guidance
of Dr Jerry John in partial fulfilment for the award of Master's Degree in Business
Administration by Bengaluru North University.
I also declare that this project is the outcome of my own efforts and that it has not been
submitted to any other University or Institute for the award of any other degree or Diploma
or Certificate.
Place: Bangalore Name: Thimmaiah C T
Date: Register Number: P19ZY21M0008

ONES3
Approved by AICTE, Recognized by Govt of Karnataka, Affliated to Bangalore North University
Ref: ONESB/OC-8/23 09.09.2023
CERTIFICATE OF ORIGINALITY
This is to certify that the Project report entitled "IMPACT OF OBESITY ON

RESPIRATORY DISORDER SEVERITY: A CROSS-SECTIONAL ANALYSIS" Is an
original work of Mr. THIMMAIAH C T bearing University Register Number
P19ZY21MO008 and is being submitted in partial fulfilment for the award of the Master's
Degree in Business Administration of Bengaluru North University. The report has not been
submitted earlier either to this University Institution for the fulfilment of the requirement of
any course of study. Mr. THIMMAIAH CT is guided by DR. JERRY JOHN who is the
Faculty Guide as per the regulations of Bengaluru North University.
lecccce
SIGNATURE AND SEAL OF DIRECTOR
23/1, aA RF ScOa
aros, tsorsed 560 045
+91 080 25443427

23/1, Opp. Manyata Tech Park
Nagawara, Bangalore-45, India info@onesb.edu.in
www.onesb.edu.in
ACKNOWDLGEMENT
I would like to express my special thanks of gratitude to the Chairman of One School of Business Mr.
C.M Faiz Mohammed for providing me with facilities to do my dissertation.
I am highly indebted to the Program Director Dr. Jerry John for his continuous Support and guidance
in completing my dissertation and for their valuable advice and cooperation for carrying out the
dissertation.
I owe my deep gratitude to my internal project guide Dr. Jerry John, professor and Program
Director, Department of management studies for his guidance till the completion of the dissertation.
I am thankful to and fortunate enough to get constant encouragement, support and guidance from all
MBA faculties which helped me in successfully completing the Dissertation.
At last, but not the least I want to thank my family and friends for their continuous help and support.
Place: Bangalore THIMMAIAH C T

ABSTRACT
This cross-sectional analysis delves into the intricate relationship between obesity and the
severity of respiratory disorders. Through a comprehensive survey, the study explores
demographics, respiratory health, lifestyle factors, and the perceived impact of obesity on
respiratory disorder severity. The findings underscore a robust association between obesity and
the severity of respiratory disorders, revealing a high prevalence of diagnosed respiratory
conditions, primarily asthma. The study encompasses a diverse range of participants, spanning
various age groups and genders, to provide a comprehensive understanding of the subject matter.
Notably, a significant number of respondents reported being diagnosed with respiratory disorders,
with asthma emerging as the most prevalent among them. Moreover, participants frequently
experienced high-severity symptoms, such as frequent coughing and wheezing episodes,
particularly among those who fell into the obesity category. The research brings attention to the
importance of family history and lifestyle factors. The study identifies a considerable proportion
of participants with a family history of obesity, suggesting a potential genetic predisposition to
obesity and its impact on respiratory health. Furthermore, physical inactivity emerged as a
contributing factor, as a substantial proportion of participants admitted to being physically
inactive. The perceived relationship between obesity and respiratory severity was a noteworthy
aspect. A majority of participants acknowledged the correlation between obesity and the severity
of respiratory disorders, highlighting the need for heightened awareness and education on this
matter. The implications of this study extend to the realm of public health. The findings
emphasize the urgency of interventions targeting both obesity and respiratory health. It
underscores the significance of early detection, personalized management plans, and
collaborative healthcare approaches that consider the intricate interplay between these factors. By
addressing these facets comprehensively, healthcare providers can offer more effective strategies
to manage and alleviate the impact of respiratory disorders among individuals with obesity,
ultimately enhancing their overall respiratory health and well-being.
Keywords: Obesity, respiratory disorder, family history, education and awareness.

TABLE OF CONTENT
SL.NO TITLE PAGE NO
Chapter 1: Introduction 1-13
1.1 Industry Profile 4
1. 1.2 Theoretical background of the study 5-11
1.3 Importance of the topic 11-12
1.4 Need to study the topic 12-13
Chapter 2: Review of Literature and Research design 14-25
2.1 Review of literature and Gaps 14-20
2.2 Statement of the Problem 21
2.3 Scope of the study 21
2. 2.4 Objectives of the study 21-22
2.5 Hypothesis 22
2.6 Sampling 22-23
2.7 Tools for data collection 23
2.8 Data analysis 23-24
2.9 Limitations of the study 24-25
3. Chapter 3: Profile of the selected organization and respondents 26-39
Chapter 4: Data Analysis and interpretation 40-76
4. 4.1 Descriptive Analysis and Interpretation 40-69
4.2 Hypothesis Testing 70-76
Chapter 5: Summary of findings, Conclusion and Suggestions 77-87
5.1Summary of findings 77-79

5.
5.2 Conclusion 80
5.3 Suggestions 81-87
6. Reference 88-90
7. Annexure 91-94
LIST OF TABLES
TABLE NO TITLE PAGE NO
4.1.1 Age 38
4.1.2 Gender 40
4.1.3 Presence of respiratory disorder 42
4.1.4 The type of respiratory disorders 44
Hospitalized or visited the emergency room due to

4.1.5 46
respiratory disorder in the past year
Experience of high severity coughing episodes in the past

4.1.6 48
month
Experience of high severity wheezing episodes in the past

4.1.7 50
month
4.1.8 Experience of shortness of breadth during physical activity 52
4.1.9 Diagnosed of obesity at some point in life 54
4.1.10 Physically active 56
4.1.11 Family history of obesity 58
4.1.12 Preference of smoking or drinking 60
Exposure to environmental factors that could impact

4.1.13 62
respiratory health
4.1.14 Respiratory disorder has impacted daily activities 64
There is a relationship between obesity and respiratory

4.1.15 66
disorder severity
4.2.1 Table of observed frequency 72
4.2.2 Table of expected frequency 72-73
4.2.3 Chi-square table 73-74

LIST OF FIGURES
TABLE PAGE
TITLE
NO NO
4.1.1 Age 39
4.1.2 Gender 41
4.1.3 Presence of respiratory disorder 43
4.1.4 The type of respiratory disorders 45
Hospitalized or visited the emergency room due to respiratory

4.1.5 47
disorder in the past year
4.1.6 Experience of high severity coughing episodes in the past month 49
4.1.7 Experience of high severity wheezing episodes in the past month 51
4.1.8 Experience of shortness of breadth during physical activity 53
4.1.9 Diagnosed of obesity at some point in life 55
4.1.10 Physically active 57
4.1.11 Family history of obesity 59
4.1.12 Preference of smoking or drinking 61
Exposure to environmental factors that could impact respiratory

4.1.13 63
health
4.1.14 Respiratory disorder has impacted daily activities 65
There is a relationship between obesity and respiratory disorder

4.1.15 67
severity
CHAPTER - 01
INTRODUCTION
IMPACT OF OBESITY ON RESPIRATORY DISEASE SEVERITY. A CROSS SECTIONAL ANALYSIS.
1 INTRODUCTION
Obesity has become a global epidemic and global health concern, with its prevalence increasing
significantly in recent decades. The World Health Organization (WHO) estimates that over 650
million adults worldwide are obese. Obesity is a complex multi-factorial condition characterized
by excessive fat accumulation in the body, resulting from an imbalance between energy intake
and expenditure. It is a major risk factor for numerous chronic diseases, including cardiovascular
disease, diabetes, and certain types of cancer.
In addition to its association with these well-known health conditions, obesity has also been
linked to respiratory disorders. Respiratory disorders encompass a range of conditions affecting
the lungs and airways, such as asthma, Chronic Obstructive Pulmonary Disease (COPD), and
obstructive sleep apnea (OSA). These disorders are significant causes of morbidity and mortality
globally, imposing a substantial burden on healthcare systems. These conditions are
characterized by chronic inflammation, airway hyper responsiveness, and impaired lung function.
The presence of obesity can further complicate the pathophysiology of respiratory disorders and
influence their clinical presentation, progression, and response to treatment.
Emerging evidence suggests that obesity may influence the severity and outcomes of respiratory
disorders. The excess adipose tissue in obese individuals can lead to mechanical changes in the
respiratory system, compromising lung function and respiratory muscle strength. Excess adipose
tissue in the thoracic and abdominal regions can restrict lung expansion, reducing lung volumes
and impairing respiratory mechanics. Decreased lung compliance and increased airway
resistance contribute to a reduced ability to exhale fully, resulting in air trapping and
hyperinflation. These mechanical alterations can lead to symptoms such as dyspnea (shortness of
breath), wheezing, and decreased exercise tolerance, thereby exacerbating respiratory disorder
severity. Furthermore, obesity is associated with chronic systemic inflammation and metabolic
dysregulation, which may contribute to the development and progression of respiratory disorders.
Furthermore, obesity disrupts the normal control of breathing during sleep, predisposing
individuals to sleep-disordered breathing, particularly obstructive sleep apnea (OSA). OSA is
characterized by recurrent episodes of upper airway collapse during sleep, resulting in
intermittent hypoxemia (low oxygen levels), fragmented sleep, and excessive daytime sleepiness.
The prevalence of OSA is markedly increased in obese individuals, mainly due to adipose tissue
ONE SCHOOL OF BUSINESS 1

deposition around the upper airway, leading to narrowing and obstruction. The combination of
obesity-related anatomical changes, including increased neck circumference and decreased upper
airway caliber, along with the presence of systemic inflammation, contributes to the severity of
OSA and its associated complications.
Obesity not only affects the mechanical aspects of respiratory disorders but also contributes to a
chronic pro-inflammatory state. Adipose tissue serves as an active endocrine organ, secreting
various bioactive molecules, including pro-inflammatory cytokines (such as tumor necrosis
factor-alpha and interleukin-6) and adipokines (such as leptin and adiponectin). These molecules
influence immune responses, oxidative stress, and airway inflammation. In the context of asthma,
obesity-related inflammation may augment airway hyperresponsiveness, compromise the
effectiveness of bronchodilators, and reduce the response to corticosteroid therapy. Similarly, in
COPD, obesity-related systemic inflammation is associated with accelerated disease progression,
increased frequency of exacerbations, and impaired lung function decline.
The Impact of obesity on respiratory disorder severity is not limited to asthma and COPD. Other
respiratory conditions, such as interstitial lung diseases, cystic fibrosis, and pulmonary
hypertension, may also be influenced by obesity. For example, obesity-related mechanical factors
can worsen respiratory compromise in interstitial lung diseases, while obesity hypoventilation
syndrome, a distinct entity characterized by daytime hypercapnia and hypoxemia in obese
individuals, is associated with both mechanical and inflammatory effects.
Despite the growing recognition of the complex relationship between obesity and respiratory
disorders, there is a paucity of research specifically investigating the impact of obesity on disease
severity and outcomes. Most studies have focused on the association between obesity and the
prevalence or incidence of respiratory disorders, rather than their severity. Consequently, a
comprehensive analysis examining the influence of obesity on respiratory disorder severity
across various conditions is lacking.
In this paper, we will provide an overview of the methodology employed in our analysis, present
the results obtained from the cross-sectional study, and discuss the implications of our findings.
By shedding light on the association between obesity and respiratory disorder severity, this study
aims to contribute to the development of evidence-based guidelines for the management and
treatment of respiratory disorders in the context of obesity.

To address this knowledge gap, this study aims to conduct a cross-sectional analysis to examine
the association between obesity and the severity of respiratory disorders using a large cohort of
patients. By including diverse respiratory disorders, ranging from asthma and COPD to sleep
apnea and other respiratory conditions, this study seeks to provide a comprehensive evaluation of
the impact of obesity on disease severity, symptomatology, and treatment response. By assessing
a large sample of individuals diagnosed with respiratory disorders, we will explore the
relationship between obesity status, as measured by body mass index (BMI), and various
indicators of disease severity, such as symptom severity, lung function, and quality of life.
Additionally, we will investigate potential mediators or confounders, such as age, gender,
smoking status, and comorbidities, to gain a comprehensive understanding of the relationship
between obesity and respiratory disorder severity.
Understanding the impact of obesity on respiratory disorder severity is crucial for several reasons.
Firstly, the prevalence of both obesity and respiratory disorders is increasing, which highlights
the need to elucidate the relationship between these conditions. Secondly, identifying the
mechanisms through which obesity influences respiratory disorders can inform targeted
interventions and management strategies. Lastly, recognizing the impact of obesity on respiratory
disorder severity has implications for public health policies, healthcare resource allocation, and
patient care.
The findings of this study have significant clinical implications. Understanding the Influence of
obesity on respiratory disorder severity can help healthcare professionals in risk stratification,
treatment decision-making, and the development of tailored interventions. It may facilitate the
identification of high-risk individuals who may require more aggressive management strategies,
such as weight loss interventions, to improve respiratory outcomes.
Furthermore, recognizing the impact of obesity on respiratory health can inform public health
initiatives aimed at obesity prevention and management. Strategies that emphasize weight
reduction, healthy lifestyle modifications, and early detection of respiratory disorders in obese
individuals may lead to improved outcomes and reduce the burden on healthcare systems.

1.1 INDUSTRIAL PROFILE
The healthcare industry is a large and critical field focused on providing medical services,
treatment and support to individuals for their well-being and quality of life. This includes various
components such as hospitals, clinics, pharmaceutical companies, medical device manufacturers
and healthcare professionals such as doctors, nurses, pharmacists and therapists.
Research and innovation is an integral part of the industry as it constantly strives to find new
treatments, medicines and medical technologies that improve patient care and outcomes. The
industry is heavily regulated by government agencies to ensure patient safety, data protection and
adherence to quality standards.
Health insurance companies are key players in the healthcare industry, providing financial
coverage for medical expenses and controlling healthcare costs for individuals and businesses.
Digital health technologies have transformed the industry, enabling telemedicine, electronic
health records (EHRs), wearables, health apps and data analytics, making healthcare easier and
more efficient.
The healthcare industry has a global impact, and access, affordability and equity of healthcare
services face challenges in different regions. It plays an important role in pandemics and health
crises, emphasizing the importance of preparedness, medical supply chains and international
cooperation.
Multiple stakeholders, including governments, nonprofits, and patient advocacy groups, work
together to shape health policies, regulations, and initiatives to achieve better health outcomes.
These activities aim to address public health problems, improve health infrastructure and
promote health education and disease prevention. As the industry evolves, it continues to be a
critical pillar of society, supporting the well-being of people and communities around the world.
The future of healthcare is likely to see the integration of artificial intelligence and machine
learning, personalized medicine, precision therapies, and an increased focus on preventive care
and public health. Through continuous development and the engagement of health professionals,
the industry strives to meet the changing health needs of the population and improve overall
health outcomes.

1.2 THEORETICAL BACKGROUND OF THE STUDY
The relationship between obesity and respiratory disorders has been widely studied, and there is
substantial evidence to suggest that obesity has a significant impact on the severity of respiratory
disorders. This theoretical background provides an overview of the key concepts and theories
relevant to understanding the relationship between obesity and respiratory disorder severity in a
cross-sectional analysis.
Obesity:
Obesity is a condition characterized by excessive accumulation of body fat, resulting in a high

body mass index (BMI). Obesity is a disease characterized by an excessive accumulation of body
fat, which can negatively affect a person’s health. It is usually defined by body mass index (BMI),
which is a measure of weight and height. A BMI of 30 or higher is generally considered obese.
It Is a complex problem influenced by genetic, environmental and behavioral factors. Some

common causes of obesity include: It is a complex, multifactorial disorder influenced by genetic,
environmental, behavioral, and socio-cultural factors. Obesity is a global health concern and has
reached epidemic proportions in many countries. It is associated with numerous health problems,
including respiratory disorders.
 Poor diet: Consuming foods high in calories, saturated fat, sugar and processed
carbohydrates can contribute to weight gain and obesity.
 Sedentary lifestyle: Lack of physical activity and a sedentary lifestyle can lead to weight
gain and obesity. Regular exercise is important for maintaining a healthy weight.
 Genetics: Certain genetic factors can contribute to obesity. However, genetics alone do
not determine whether a person becomes fat, as lifestyle choices also play a large role.
 Environmental factor: Factors such as the easy availability of unhealthy foods, larger
portion sizes and heavy advertising promoting unhealthy foods can contribute to
overeating and weight gain.

Respiratory Disorders
Respiratory diseases are conditions that affect the organs and structures involved in breathing,
especially the lungs and the entire respiratory system. There are many types of breathing
problems, from mild to severe. Here are some common examples.
 Asthma: A chronic disease characterized by inflammation and narrowing of the airways,

resulting in frequent wheezing, shortness of breath, chest tightness and coughing.
 Chronic Obstructive Pulmonary Disease (COPD): a progressive lung disease that
includes chronic bronchitis and emphysema. This causes airflow obstruction, causing
symptoms such as coughing, wheezing, shortness of breath and difficulty breathing.
Pneumonia: an infection of the lung tissue, usually caused by bacteria, viruses or fungi.
This can cause symptoms such as fever, cough, chest pain, difficulty breathing and
sputum production.
 Chronic Bronchitis: A type of COPD characterized by prolonged cough and mucus
production for at least three months in two consecutive years. This causes inflammation
and narrowing of the airways.
 Pulmonary Embolism: a condition in which a blood clot (usually from the legs) travels to
the lungs and blocks the pulmonary arteries, reducing blood flow to the lungs. Symptoms
include sudden shortness of breath, chest pain, rapid breathing and coughing up blood.
 Sleep apnea: a sleep disorder characterized by repeated pauses in breathing or shallow
breathing during sleep. This can lead to excessive daytime sleepiness, loud snoring and
poor sleep quality.
 Tuberculosis (TB): an infectious disease caused by the bacterium Mycobacterium
tuberculosis. It mainly affects the lungs, but can also affect other parts of the body.
Common symptoms include cough, fever, night sweats, weight loss, and fatigue.
 Cystic fibrosis (CF): a genetic disease that affects the production and flow of mucus,
causing thick, sticky mucus to build up in the lungs and other organs. This can cause
recurrent lung infections, cough, shortness of breath and poor growth.
 Lung cancer: A type of cancer that starts in the lungs. This can cause symptoms such as
persistent cough, chest pain, wheezing, weight loss and difficulty breathing.

Obesity and Respiratory Function:
Obesity can seriously affect respiratory function. Excess body weight can cause various
respiratory complications and weaken the normal functioning of the respiratory system. Here are
some ways obesity can affect respiratory function:
 Reduced lung volume: Obesity can limit lung expansion and reduce overall lung volume.
Excess fatty tissue in the chest and abdomen can compress the lungs and limit their
ability to fully expand. This can cause a decrease in lung volume and breathing problems.
Increased breathing: Obese people often have increased breathing. Extra weight on the
chest and abdomen requires more effort to move air in and out of the lungs. This can
cause shortness of breath, especially during physical activity or exertion.
 Sleep apnea: Obesity is a major risk factor for sleep apnea, a condition characterized by
breathing disorders during sleep. Being overweight can cause the muscles and soft tissues
of the throat to collapse and block the airway, causing repeated breathing problems. Sleep
apnea can further contribute to daytime fatigue, decreased oxygen levels, and decreased
respiratory function.
 Asthma: Obesity is associated with an increased risk of asthma and can worsen existing
asthma symptoms. Inflammatory mediators produced by adipose tissue can promote
airway inflammation and hypersensitivity, making it difficult for asthmatics to breathe.
 Impaired gas exchange: obesity can interfere with the exchange of oxygen and carbon
dioxide in the lungs. Altered airway mechanics, such as decreased lung compliance and
increased airway resistance, can cause inadequate oxygenation and reduced removal of
carbon dioxide from the body. Increased risk of respiratory infections: Obese people may
be more susceptible to respiratory infections such as pneumonia and bronchitis. Being
overweight can weaken the immune system and reduce the body’s ability to effectively
fight infections.
Inflammatory Pathways:
Inflammation plays an important role in the development and progression of obesity. Chronic
low-grade inflammation is a hallmark of obesity and is thought to contribute to various metabolic

complications associated with the condition. Inflammation is linked to obesity in the following
ways:
 Inflammation of adipose tissue: In obesity, significant changes occur in adipose tissue

(adipose tissue). When adipose tissue expands to store excess fat, it can become
dysfunctional and release pro-inflammatory cytokines such as TNF-alpha, IL-6, and IL-
1β. These cytokines attract immune cells, especially macrophages, to the adipose tissue.
Infiltration of macrophages and other immune cells into adipose tissue leads to a chronic
inflammatory state.
 Systemic inflammation: In addition to localized adipose tissue inflammation, obesity-
induced inflammation can spread throughout the body, causing systemic inflammation.
Inflammatory mediators released from adipose tissue can enter the bloodstream and affect
various organs and tissues. Systemic inflammation is associated with insulin resistance,
dyslipidemia, and cardiovascular complications.
 Insulin resistance: Chronic inflammation in obesity can impair the normal function of
insulin, the hormone that regulates blood sugar. Inflammatory cytokines can disrupt
insulin signaling pathways, leading to insulin resistance. Insulin resistance impairs the
ability of cells to efficiently bind glucose, leading to increased blood sugar levels and
increased insulin production. Over time, this can contribute to type 2 diabetes.
 Metabolic disorders: inflammation in obesity is associated with disorders of fat
metabolism and the production of adipokines, which are hormones secreted by adipose
tissue. Adipokines such as leptin and adiponectin may influence obesity and contribute to
metabolic disorders. Dysfunctional adipose tissue and altered adipokine levels can disrupt
energy balance, appetite regulation, and fat metabolism.
 Comorbidities: Obesity-related inflammation has been implicated in the development of
various obesity-related diseases, including cardiovascular disease, nonalcoholic fatty liver
disease (NAFLD), and certain cancers. Inflammation can promote atherosclerosis,
inflammation of the liver and the proliferation of cancer cells.
Systemic Effects of Obesity:
Obesity is not just a localized condition affecting adipose tissue; it has systemic effects on
various physiological processes. Obesity-related comorbidities, such as insulin resistance,

metabolic syndrome, and cardiovascular disease, can further complicate respiratory disorders.
These systemic effects may contribute to increased respiratory disorder severity in obese
individuals.
Obesity is associated with many systemic effects on various organs and systems of the body.
Here are some of the main systemic effects of obesity:
 Cardiovascular system: Being overweight greatly increases the risk of cardiovascular

disease, including hypertension (high blood pressure), coronary heart disease, heart
failure and stroke. Excess body fat and obesity-related inflammation can cause fatty
plaque to build up in arteries, narrowing blood vessels and reducing blood flow.
 Metabolic system: Obesity is closely related to metabolic disorders such as insulin
resistance, type 2 diabetes and dyslipidemia (abnormal lipid levels). Insulin resistance
occurs when cells become less responsive to the effects of insulin, causing blood sugar
levels to rise. Obesity also disrupts the balance of various hormones involved in appetite
regulation and energy balance, such as leptin and ghrelin.
 Respiratory: Obese people are more prone to respiratory problems. Being overweight can
put pressure on the lungs and diaphragm, reduce lung capacity and cause breathing
problems. Conditions such as sleep apnea, asthma and obesity-hypoventilation syndrome
(OHS) are more common in overweight people. Musculoskeletal system: Being
overweight increases stress on the musculoskeletal system, which increases the risk of
joint problems, including osteoarthritis. Being overweight can also impair mobility,
balance and physical function, making it more difficult to perform daily activities.
 Digestive system: Obesity is associated with an increased risk of gastroesophageal reflux
disease (GERD), gallbladder disease, and fatty liver disease (nonalcoholic fatty liver
disease or NAFLD). NAFLD can progress to more severe conditions such as
nonalcoholic steatohepatitis (NASH) and cirrhosis.
 Endocrine system: obesity disrupts the normal functioning of the hormonal system
responsible for the production and regulation of hormones. This can cause hormonal
imbalances, such as increased estrogen levels in men and women, which can increase
the risk of certain cancers, such as breast and endometrial cancer.

 Psychological and mental health: Being overweight is associated with a range of

psychological and mental health problems, including depression, anxiety, low self-esteem
and body image dissatisfaction. Weight-related social stigma and discrimination may
further contribute to these psychological effects.
Cross-Sectional Analysis:
A cross-sectional analysis is an observational study design that examines a population at a

specific point in time. In the context of studying the impact of obesity on respiratory disorder
severity, a cross-sectional analysis involves assessing the relationship between obesity
(independent variable) and respiratory disorder severity (dependent variable) in a sample of
individuals. This analysis allows for the examination of associations and patterns, but it does not
establish causality.
Mechanisms:
Several theories have been put out to explain how obesity affects the severity of respiratory
disorders:
 Mechanical Factors: Excess body fat might result in an increase in the respiratory
system’s mechanical strain. A larger belly can compress the diaphragm, lowering lung
capacity and affecting breathing.
 Inflammatory factor: Adipose tissue, an active endocrine organ, releases a variety of
inflammatory chemicals known as adipokines. Chronic low-grade inflammation linked to
obesity can aggravate respiratory symptoms by causing airway inflammation.
 Metabolic Factors: Metabolic problems, such as insulin resistance and dyslipidemia,
frequently coexist with obesity.
 Hormonal Factors: Obesity is linked to changes in hormonal profiles, including higher
levels of leptin and lower levels of adiponectin. These hormonal abnormalities may affect
respiratory function and airway inflammation.

Previous research:
Previous research has looked into the connection between obesity and respiratory diseases in a
number of observational and experimental studies. The findings of these research provide
credence to the idea that obesity is linked to more severe respiratory symptoms, decreased lung
function, and a higher risk of respiratory exacerbations. Weight loss can result in improvements
in lung function and respiratory symptoms, according to certain research that looked into the
connection between weight loss and respiratory outcomes.
1.3 IMPORTANCE OF THE TOPIC
The importance of studying the impact of obesity on respiratory disorder severity lies in several
Key aspects:
 Public Health Burden: Obesity and respiratory disorders are significant public health
concerns globally. Both conditions have reached epidemic proportions and are associated
with substantial morbidity, mortality, and healthcare costs. Understanding the relationship
between obesity and respiratory disorder severity can help address this burden more
effectively.
 Clinical Management: Knowledge of how obesity affects the severity of respiratory
disorders is crucial for healthcare professionals involved in the diagnosis and treatment of
these conditions. It can inform decision-making regarding therapeutic interventions,
medication dosing, and patient monitoring. Tailoring treatment approaches to consider
the impact of obesity can lead to better outcomes and improved quality of life for
individuals with respiratory disorders.
 Risk Assessment and Screening: The association between obesity and respiratory disorder
severity can assist in identifying individuals at higher risk of developing or experiencing
more severe respiratory symptoms. By recognizing the impact of obesity, healthcare
providers can target high-risk populations for early detection, screening, and intervention.
This can aid in preventive efforts and facilitate timely management of respiratory
disorders.

 Intervention Strategies: Understanding how obesity influences respiratory disorder

severity can guide the development of targeted interventions. Lifestyle modifications,
weight loss programs, and exercise regimens tailored to obese individuals with
respiratory disorders can potentially alleviate symptoms, improve lung function, and
enhance overall respiratory health. Such interventions can also help prevent disease
progression and reduce the need for more intensive treatment measures.
 Health Policy and Public Health Initiatives: Findings from studies exploring the impact of
obesity on respiratory disorder severity can inform health policies and public health
initiatives. This information can guide the development of guidelines for healthcare
providers, shape preventive strategies, and facilitate the allocation of resources to address
the intertwined challenges of obesity and respiratory disorders effectively.
 Patient Education and Empowerment: Increased awareness of the impact of obesity on
respiratory disorder severity can empower individuals to take an active role in managing
their health. Patients can make informed decisions regarding lifestyle changes, adherence
to treatment plans, and seeking appropriate medical care. Educating patients about the
relationship between obesity and respiratory disorders can enhance self-management and
promote better respiratory health outcomes.
1.4 NEED TO STUDY THE TOPIC
Research has shown that obesity is associated with an increased risk and severity of several
respiratory disorders, such as asthma, chronic obstructive pulmonary disease (COPD), and sleep-
disordered breathing. Here are some key points highlighting the need to investigate the impact of
obesity on respiratory disorder severity:
 Prevalence: Obesity rates have been steadily rising worldwide, reaching epidemic
proportions. This increase in obesity prevalence has coincided with an increase in the
prevalence of respiratory disorders. Understanding the relationship between obesity and
respiratory disorders is crucial for effective management and prevention strategies.
 Asthma: Obesity is a risk factor for asthma development and is associated with worse
asthma control and increased asthma severity. Obese individuals with asthma often
experience decreased lung function, increased airway inflammation, and reduced

response to asthma medications. Exploring the mechanisms behind this association is

vital for improving asthma management in obese patient
 COPD: Obesity has been identified as a risk factor for the development and progression
of COPD. Obese individuals with COPD tend to have higher symptom burden, more
frequent exacerbations, and poorer response to treatment. Investigating the impact of
obesity on COPD severity can help optimize management approaches and improve
outcomes in this population.
 Sleep-disordered breathing: Obesity is a major risk factor for sleep-disordered breathing,
including conditions such as obstructive sleep apnea (OSA) OSA is characterized by
recurrent episodes of partial or complete upper airway obstruction during sleep, leading
to disrupted breathing patterns and oxygen deprivation. Obesity-related OSA has been
linked to increased disease severity, cardiovascular complications, and impaired quality
of life.
 Mechanisms: Understanding the underlying mechanisms by which obesity influences
respiratory disorder severity is crucial for developing targeted interventions. Potential
mechanisms include altered lung mechanics, systemic inflammation, adipose tissue
dysfunction, and hormonal imbalances. Investigating these mechanisms can pave the way
for novel therapeutic approaches and personalized medicine strategies.
 Public health implications: The impact of obesity on respiratory disorder severity has
significant public health implications. Effective management and prevention of obesity
could potentially reduce the burden of respiratory disorders, improve patient outcomes,
and decrease healthcare costs.

CHAPTER 02
REVIEW OF LITERAUTURE
AND RESEARCH DESIGN
2.1 REVIEW OF LITERATURE AND GAPS
Herkenrath et al. (2022) Researchers conducted a prospective study to explore hypoventilation

in obese patients with various sleep-related conditions, including OSA, ORSH, and OHS. They
utilized different diagnostic techniques and discovered that HCVR (hypercapnic ventilatory
response) emerged as the most significant predictor of hypoventilation, with the OHS group
exhibiting notably lower HCVR levels. Notably, this finding remained consistent even after
accounting for differences in BMI, respiratory mechanics, and airway obstruction severity across
the groups. The study’s identification of HCVR’s pivotal role in obesity-related hypoventilation
carries valuable implications for the development of future treatment approaches.
Di Palmo et al. (2021) The research investigated risk factors contributing to sleep-disordered
breathing (SDB) in children and adolescents, with a specific focus on obesity, race, and
respiratory conditions. The study encompassed 399 participants, aged 2-18 years, from 61
families. The findings revealed a significant association between moderate SDB and obesity, as
well as African American ethnicity. Additionally, sinus issues and persistent wheezing emerged
as independent predictors of SDB, even after accounting for other variables. The study
underscores the significance of maintaining upper and lower respiratory tract health and
addressing obesity as key risk factors for SDB in the pediatric and adolescent population.
Cortes-Telles et al. (2021) Obesity is a significant health concern affecting countries globally,
leading to respiratory issues and reduced lung volume. A study conducted in the Mexican
population focused on analyzing the prevalence and risk factors of obesity and respiratory
diseases. The observational study involved 1167 patients referred to the Department of
Respiratory and Thoracic Surgery at the Hospital Alta Specialidad de la Península de Yucatán
from 2015 to 2018. Approximately 39% of the population had an average BMI of 36.5 kg/m².
Among obese patients, there was a higher prevalence of obstructive sleep apnea (OSA) at 19%
and asthma at 15%. Logistic regression analysis revealed a direct association between obesity
and respiratory diseases, particularly OSAS and asthma, indicating that obesity acts as an
independent risk factor for these conditions.
López-Sánchez et al. (2021) Nonalcoholic fatty liver disease (NAFLD) is a condition

characterized by the buildup of liver fat in over 5% of hepatocytes, with no other apparent causes
of hepatic steatosis. This health issue is linked to several diseases such as type 2 diabetes,

cardiovascular disease, and respiratory conditions. Conducting additional research is crucial to

fully comprehend its consequences and address any misinformation surrounding NAFLD.
Denson et al. (2021) COVID-19, caused by the severe acute respiratory syndrome coronavirus 2
(SARS-CoV-2), is a novel threat that appears to be exacerbated by the interaction between the
pandemic of this virus and the ongoing obesity-related metabolic disease pandemic. This
perspective explores emerging epidemiological, clinical, biological, and molecular evidence to
propose a developing paradigm, wherein aging, chronic metabolic diseases (like obesity, type 2
diabetes, and metabolic syndrome), and male biological sex contribute to an uncontrolled and
deadly symbiosis. This condition involves immunometabolism and chronic systemic
inflammation, which can intensify virus-induced hyper inflammation associated with SARS-
CoV-2 infection. The purpose of this viewpoint is to inspire novel avenues of research and
encourage funding to address this critical area of study.
Kuvat et al. (2020) Obstructive Sleep Apnea Syndrome (OSAS) and obesity are intricately
linked, driven by a complex interplay of biological and lifestyle factors such as oxidative stress,
inflammation, and metabolic disturbances. This study aims to explore this relationship, focusing
on the impact of “organ crosstalk” and its role in pathogenesis. By analyzing data from PubMed,
EMBASE, and Web of Science, the study seeks to contribute insights for diagnosis and treatment.
Recognizing the bidirectional causality, addressing mutual interactions among respiratory,
adipose, and intestinal systems is vital for effective intervention in both OSAS and obesity.
Comprehensive clinical trials are needed to assess treatment efficacy within this association.
Miethe et al. (2020) Research has demonstrated a connection between obesity in children and an
increased risk of developing asthma. However, limited information exists about the reverse
scenario where children with asthma are at a higher risk of developing obesity. A longitudinal
study conducted in the United States on early-stage asthma revealed a greater risk of obesity in
later childhood and adolescence. Similarly, a study in Europe highlighted that besides asthma,
childhood wheezing, and allergic rhinitis are also associated. Recent clinical, epidemiological,
and experimental evidence points towards a potential causal relationship between obesity and
asthma. Obesity is linked to metabolic disturbances involving sugar and lipid metabolites.
Adipose tissue plays a significant role in this context as it exhibits local and systemic subclinical
inflammation. This inflammatory response seems to contribute to airway inflammation, lung

dysfunction, and asthma exacerbations. The findings emphasize the importance of understanding
these connections to address and manage childhood asthma effectively.
Lampalo et al. (2019) Asthma is a common chronic disease, often associated with obesity as the
most common comorbidity. A study with 149 asthmatic patients and 153 healthy individuals
found that asthmatics had a significantly higher mean BMI compared to the control group. The
correlation between BMI and asthma was stronger in women than in men. Increased BMI was
strongly associated with non-allergic asthma in women. These findings suggest that BMI may be
a risk factor for asthma, with a more significant impact on women.
Peters et al. (2018) Obesity significantly increases the risk of asthma and asthmatic diseases in
both children and adults. While there are numerous pathophysiological and clinical similarities,
certain characteristics vary between the two age groups. This highlights the existence of a
complex and multifactorial condition known as the obesity asthma syndrome. Potential
underlying mechanisms encompass shared genetic factors, dietary and nutritional elements,
alterations in the gut microbiome, systemic inflammation, and metabolic disturbances.
Understanding these interactions is crucial for addressing and managing obesity-related asthma
effectively in both children and adults.
Xanthopoulos and Tapia (2017) Obesity is a prevalent condition and is often linked to common
respiratory diseases like asthma and obstructive sleep apnea syndrome (OSAS), among others.
Additionally, it can also be a symptom of the rare disease ROHHAD (Rapid-onset Obesity with
Hypothalamic Dysfunction, Hypoventilation, and Autonomic Dysregulation). Notably, recent
research indicates that individuals with obesity may have a diminished response to standard
treatments for asthma and OSAS. The exact cause of this phenomenon is not fully understood,
underscoring the significance of translational research in tailoring individualized therapies for
affected patients. By gaining a better understanding of these relationships, healthcare
professionals can develop more effective and personalized treatment approaches for individuals
with obesity and respiratory conditions.
Lambert et al. (2017) The study findings suggest that 35% of participants were obese, with 21%
classified as class I (BMI range, 30-34.9 kg/m2), 9% as class II (BMI range, 35-39.9 kg/m2), and
5% as class III (BMI ≥ 40 kg/m2). The research revealed that the number of comorbidities
increased with higher obesity class, and obesity was linked to worse respiratory-specific and

general quality of life, reduced 6-minute walk distance, increased dyspnea, and a higher
likelihood of severe acute exacerbation of COPD. These associations were independent of
comorbidities, except for SF-36 and severe exacerbations. The study emphasizes that obesity in
patients with COPD can exacerbate the course of the disease.
Zewari et al. (2017) The connection between obesity and chronic obstructive pulmonary disease
(COPD) has been receiving more attention due to the global rise in obesity rates. Studies have
indicated that obesity is more prevalent among COPD patients compared to non-COPD
individuals, but variations in data call for further research. This review specifically examines
how obesity impacts dyspnea, pulmonary function, exercise capacity, and exacerbation risk in
COPD patients.The impact of obesity on dyspnea in COPD patients remains inconclusive, with
no consensus on whether it has a negative or positive effect. Some theories suggest that obese
COPD patients might experience improved respiratory mechanics, but weight-bearing tests
indicate reduced exercise capacity. However, exercises that support body weight, such as cycling,
do not show any negative influence. Interestingly, obese COPD patients seem to have better
survival rates concerning severe exacerbations. Further studies are needed to better understand
the complex relationship between obesity and COPD and its effects on various aspects of the
disease.
Verberne et al. (2017) The research analyzed data from 380 Dutch general practices to explore
the correlation between obesity and overweight with coexisting conditions and treatment in
individuals with mild to moderate COPD. They identified 4938 COPD patients with a BMI less
than 21 kg/m² and compared outcomes for overweight and obese COPD patients to those with
normal weight. The study found positive associations between overweight and obesity with
diabetes, osteoarthritis, hypertension, and heart failure, while showing lower odds of developing
osteoporosis and anxiety disorders. No significant relationships were found for coronary heart
disease, stroke, insomnia, depression, and pneumonia. Obese patients were more frequently
prescribed medication for obstructive airway disorders. The research highlights the importance
of increasing awareness among general practitioners regarding excessive weight in individuals
with mild to moderate COPD.

Mafort et al. (2016) Obesity can lead to various respiratory complications as it mechanically
compresses the diaphragm, lungs, and chest, resulting in restrictive lung damage. Additionally,
excess fat weakens the adaptive capacity of the respiratory system, increases lung resistance, and
reduces the strength of respiratory muscles. Metabolic syndrome further impacts lung function
and, combined with excess weight, worsens the health of the respiratory organs. In overweight
and obese individuals, there is a strong correlation between lung function and body fat
distribution, with greater impairment observed when fat accumulates in the chest and abdomen.
While our understanding of the pulmonary and systemic complications and biochemical
abnormalities related to obesity has improved, longitudinal randomized trials are required to
evaluate the effects of weight loss on metabolic syndrome and lung function.
Gachelin et al. (2015) The study’s objective was to assess obese children referred to Timonen
Children’s Hospital. Among the 102 patients (mean age 10.5±3.3 years; BMI-Z score 4.52±1.5),
29.4% displayed symptoms of obstructive sleep apnea syndrome (OSAS), with nine cases
confirmed through polysomnography. Out of the nine, eight needed ventilation and four were
diagnosed with obesity hypoventilation syndrome (OHS). Detecting respiratory diseases early in
clinical practice and improving access to sleep breathing tests are crucial for effectively
managing these conditions, which are often overlooked in obese children.
Hanson et al. (2014) Obesity and diet are influential factors in the development and outcomes of
chronic obstructive pulmonary disease (COPD), a leading cause of death worldwide. They are
linked to reduced lung function and higher prevalence of lung diseases. Interestingly, obesity
appears to have a protective effect against mortality from severe COPD. To lessen the burden of
lung disease, public health campaigns should emphasize the importance of addressing obesity
and diet. Further research is necessary to explore these associations in diverse populations and
age groups, considering the complex interplay of behavior, environment, and genetics in the
development and progression of COPD.
O’Donnell et al. (2014) The rise in patients with combined obesity and COPD will impact
pulmonary healthcare practitioners. Understanding the effects of weight gain on respiratory
function in COPD is evolving. Consider lung volume reduction when interpreting pulmonary
function tests like FEV1/FVC ratio and DlCO/Va.Mild to moderate obesity in COPD patients has
little deleterious effect on peak oxygen uptake. Larger Inspiratory Capacity (IC) and lower lung

volumes in obese COPD patients offer a mechanical advantage for respiratory muscles, allowing
them to handle increased ventilatory requirements during tasks without discomfort. Non
pulmonary factors like high metabolic demand, musculoskeletal issues, and cardiocirculatory
impairment should be considered in moderately obese patients experiencing dyspnea and
exercise intolerance. However, severe obesity erodes Inspiratory Capacity (IC), compromises gas
exchange, and leads to respiratory failure. Clinicians should be mindful of sleep-disordered
breathing in obese COPD patients and its impact on survival.
Broström et al. (2012) A study on gender differences in COPD management involved surveys
administered to 295 female and 273 male COPD patients. Findings revealed that women reported
experiencing shortness of breath and poor health. However, no significant gender differences
were observed in health insurance, doctor visits, or spirometry. Nevertheless, women were more
likely to report delayed COPD diagnosis and difficulty accessing a doctor. Moreover, they
perceived insufficient time spent in the doctor’s office. Understanding these variations can
contribute to enhancing care for both male and female COPD patients.
Kauppert et al. (2013) In this prospective cross-sectional study, researchers analyzed 64

clinically stable obesity hypoventilation syndrome (OHS) patients who underwent
echocardiography and right heart catheterization after receiving noninvasive positive pressure
ventilation (NPPV) for a minimum of 3 months. The results indicated that 42.9% of patients had
pulmonary hypertension (PH) with a mean pulmonary arterial pressure (mPAP) of ≥ 25 mmHg.
The mPAP was negatively correlated with NPPV use and lung function, while positively
correlated with BMI. Both NPPV use and lung function independently predicted mPAP. Patients
with PH demonstrated worse sleepiness, functional class, and physical functioning. Despite
receiving NPPV, mild to moderate PH is still common in OHS patients, and its presence is linked
to various clinical outcomes. The study emphasizes the importance of further understanding the
impact of PH on OHS patients and the potential implications for their management.
Koo et al. (2014) Researchers studied the impact of sarcopenia and obesity on lung function and
quality of life (QOL) in male COPD patients using data from the Korea National Health and
Nutrition Examination Survey. Sarcopenia and obesity were measured, and patients were
categorized accordingly. Both sarcopenia and obesity were independent risk factors for worsened
lung function. Sarcopenia was linked to poorer QOL, while obesity correlated with better QOL.

GAPS
Obesity’s impact on respiratory disorders has been extensively studied, with existing literature
highlighting its association with increased severity of conditions in respiratory disorder. However,
there are some gaps in the current body of research. While many studies establish a link between
obesity and worsened respiratory symptoms, there’s a need for more comprehensive
investigations that delve into the mechanisms underlying this relationship.
The following are the gaps that were observed in the available research relating to the topic,
1. Diverse Respiratory Conditions: Many studies focus on specific respiratory disorders,

such as asthma or obstructive sleep apnea, but there is a lack of comprehensive research
that considers a broader spectrum of respiratory conditions. A cross-sectional analysis
could encompass conditions like chronic obstructive pulmonary disease (COPD),
interstitial lung diseases, and more.
2. Population Diversity: Many studies may not adequately represent diverse populations in
terms of age, gender, ethnicity, and socioeconomic status. This limits the generalizability
of findings and hinders a comprehensive understanding of how obesity impacts
respiratory disorder severity across different demographic groups.
3. Limited Focus on Non-Asthma Respiratory Disorders: The existing literature
predominantly emphasizes the impact of obesity on asthma, leaving a gap in
understanding how obesity influences other respiratory disorders such as chronic
obstructive pulmonary disease (COPD) and interstitial lung diseases.
4. Absence of Interventions Tailored to Respiratory Health: Research gaps exist in
investigating the effectiveness of specialized interventions that target both obesity and
respiratory disorder severity, beyond generic weight loss programs.
5. Inadequate Examination of Social Determinants: A gap exists in understanding how
socioeconomic factors influence the relationship between obesity and respiratory disorder
severity, including access to healthcare, environmental conditions, and lifestyle
disparities.
6. Unexplored Impact of Gender on Disease Burden: The literature lacks comprehensive
investigations into how gender might mediate the connection between obesity and the
severity of various respiratory disorders.

2.2 STATEMENT OF THE PROBLEM
The relationship between obesity and the severity of respiratory disorders, such as asthma and
chronic obstructive pulmonary disease (COPD), remains poorly understood. While obesity has
been identified as a potential risk factor for the development and progression of these respiratory
disorders, the impact of obesity on respiratory disorder severity requires further investigation.
Understanding the association between obesity and respiratory disorder severity is crucial for
developing effective public health strategies and clinical interventions to mitigate the burden of
respiratory disorders. Therefore, this study aims to explore the relationship between obesity and
the severity of respiratory disorders, considering various confounding factors, to address the
existing knowledge gap and provide valuable insights for healthcare professionals and
policymakers.
2.3 SCOPE OF THE STUDY
In this Cross-sectional analysis, the study aims to investigate the impact of obesity on the
severity of respiratory disorders. The study will focus on a specific population, such as adults or
children,
And include individuals diagnosed with various respiratory disorders, such as asthma, chronic
obstructive pulmonary disease (COPD), or sleep apnea.
The primary variables of interest will be obesity, measured using body mass index (BMI), and
respiratory disorder severity, assessed using validated scales or indices specific to each disorder.
Additionally, relevant demographic factors (age, gender), medical history (smoking,
comorbidities), and potential confounding variables (socioeconomic status, physical activity)
will be considered.
2.4 OBJECTIVES OF THE STUDY
1. To examine the association between obesity and the severity of respiratory disorders,
specifically focusing on respiratory disorders such as asthma and chronic obstructive
pulmonary disease (COPD).
2. To determine if there is a significant difference in the severity of respiratory disorders
between individuals with obesity and those without obesity.

3. To compare the severity of respiratory disorders among different levels of obesity (e.g.
normal weight, overweight, obese) to identify any dose-response relationship between
obesity and respiratory disorder severity.
4. To asses the influence of potential confounding factors, such as age, gender, smoking
status and comorbidities, on the association between obesity and respiratory disorder
severity.
5. To provide evidence supporting or refuting the alternative hypothesis that there is a
significant association between obesity and the severity of respiratory disorders, with
higher levels of obesity associated with greater respiratory disorder severity.
2.5 HYPOTHESIS
Null Hypothesis (H0): There is no significant association between obesity and the severity of
respiratory disorders.
Alternate Hypothesis (H1): There is a significant association between obesity and the severity
of respiratory disorders, with higher levels of obesity being associated with greater respiratory
disorder severity.
2.6 SAMPLING
To design a sampling strategy for a population of 200 people in the study of impact of obesity on
respiratory disorder severity, the following approach can be considered:
1. Define the Target Population: The target population consists of people who are
overweight. Cluster is based on gender, living style, working environment and age
category.
2. Determine Sample Size: The sample size is 200 no’s.
3. Sampling Technique: Stratified, Random Sampling can be utilized to ensure
representation from different strata within the population.
 Random sampling: Individuals are selected from the target population randomly,
giving each person an equal chance of being included in the study as per the
above cluster mentioned.

 Stratified sampling: Dividing the target population into distinct subgroups or

strata based on relevant characteristics (e.g., age, gender, BMI), and then
randomly selecting participants from each stratum in proportion to their
representation in the population.
4. Contact and Consent: Contact the selected participants through email, phone, or in-person
communication, explaining the purpose of the study and requesting their voluntary
participation. Obtain informed consent from those who agree to participate.
2.7 TOOLS OF DATA COLLECTION
 Questionnaires: Administer the survey questionnaire to the selected participants. This can
be done through online surveys, email attachments, or in-person interviews, depending on
the preferred method of data collection.
 Interview: Interviews involve direct interaction with the participant. They can be
conducted face-to-face, over the phone, or via video conferencing. Interviews allow for
more in-depth and qualitative data collection, enabling the researcher to explore complex
topics and probe for detailed responses.
2.8 DATA ANALYSIS
The objective of this data analysis is to investigate the impact of obesity on the severity of
respiratory disorders in a cross-sectional study. Respiratory disorders pose significant health
burdens worldwide, and obesity has been identified as a potential risk factor for their
exacerbation. By examining a dataset comprising information on body mass index (BMI) and
respiratory disorder severity scores, we aim to explore the relationship between obesity and the
severity of respiratory disorders. The findings of this analysis can provide insights into the role
of obesity in respiratory health and contribute to the development of targeted interventions for
individuals affected by these conditions.
Data for this analysis were collected from a diverse sample of respiratory disorder patients,
obtained from healthcare facilities across different regions. Variables of interest include body
mass response and respiratory disorder presence, which were assessed using validated clinical
measures. Additional demographic and clinical information, such as age, gender, and smoking
status, were also collected to account for potential confounding factors.

2.9 LIMITATIONS OF THE STUDY
The study on the impact of obesity on respiratory disorder severity through cross-sectional
analysis has limitations that need to be acknowledged. The cross-sectional design restricts the
ability to establish causality or temporal relationships. Reverse causality, selection bias, reliance
on self-reported data, limited generalizability, confounding variables, and potential limitations in
assessing severity are factors to consider. Awareness of these limitations ensures a cautious
interpretation of the findings and highlights the scope of the study.
1. Cross-Sectional Design: Cross-sectional studies capture data at a single point in time,

making it difficult to establish causal relationships. The temporality between obesity and
respiratory disorder severity cannot be determined, as it is possible that either variable
could precede the other. Longitudinal studies would be needed to better understand the
temporal relationship.
2. Confounding Factors: Despite efforts to control for confounding variables through
statistical analysis, it is possible that unmeasured or residual confounding factors may
influence the relationship between obesity and respiratory disorder severity. Factors such
as physical activity level, socioeconomic status, and comorbidities (e.g., diabetes) could
impact both obesity and respiratory health.
3. Generalizability: The generalizability of the study findings may be limited to the specific
population or setting from which the data were collected. Factors such as geographic
location, cultural differences, and healthcare access could impact the applicability of the
results to other populations.
4. Measurement of Respiratory Disorder Severity: The assessment of respiratory disorder
severity is crucial to the study but may vary depending on the specific respiratory
disorders being investigated. The use of different measurement tools or scoring systems
across studies could introduce inconsistencies or measurement errors, limiting
comparability.
5. Reverse Causality: The study may not account for the possibility of reverse causality,
where individuals with more severe respiratory disorders may be less physically active,
leading to weight gain and obesity. This bidirectional relationship between respiratory
disorders and obesity should be considered when interpreting the results.

6. Limited Variables: The study’s analysis may be limited to a specific set of variables, such
as BMI and respiratory disorder severity scores. Other relevant factors, such as dietary
habits, medication use, or environmental exposures, may not be included, potentially
impacting the comprehensive understanding of the relationship between obesity and
respiratory disorder severity.

CHAPTER 03
PROFILE OF THE SELECTED ORGANISATION
AND
RESPONDENTS
3 PROFILE OF SELECTED ORGANISATION AND RESPONDENTS
INTRODUCTION TO AROGYA SOUDHA
Arogya Soudha, an imposing and remarkable building located at Ananda Rao Circle in
Bengaluru, Karnataka, stands as a symbol of healthcare governance and innovation in the
region. Serving as the administrative headquarters of the Department of Health and Family
Welfare, Government of Karnataka, this iconic structure was inaugurated on November 15,
2009, by the then Chief Minister B. S. Yeddyurappa. Arogya Soudha exemplifies Karnataka’s
unwavering dedication to ensuring the health and well-being of its citizens.
The architecture of Arogya Soudha blends modern aesthetics with traditional South Indian
influences, creating an architectural marvel that reflects the state’s rich heritage and
progressive vision for healthcare. Situated in the heart of Bengaluru, the building symbolizes
the government’s commitment to providing accessible, equitable, and high-quality healthcare
services to its diverse population.
Beyond its physical grandeur, Arogya Soudha plays a pivotal role in shaping healthcare
governance and policy-making in Karnataka. It serves as a strategic hub where healthcare
experts, policymakers, and stakeholders converge to formulate innovative health initiatives,
address pressing health challenges, and allocate resources effectively. The building’s well-
organized departments facilitate seamless coordination and collaboration, enabling a
streamlined approach to healthcare issues across the state.
Arogya Soudha is not merely an administrative building; it stands as a testament to the state’s
dedication to public health. It has been instrumental in launching numerous healthcare
programs that positively impact the lives of millions of people in Karnataka. From maternal
and child health initiatives to disease control and prevention campaigns, the building serves
as the epicenter of change and progress in the healthcare sector.
In this project, we will delve deeper into various aspects of Arogya Soudha, shedding light on
its historical significance, architectural brilliance, role in governance, healthcare initiatives,
and collaborations that have contributed to elevating the overall healthcare landscape in
Karnataka. By studying this iconic institution, we gain valuable insights into how

government-led efforts and infrastructure play a pivotal role in improving public health
outcomes and building a healthier, more resilient society.
History
Arogya Soudha’s historical background dates back to the early 2000s when the Karnataka
state government recognized the necessity for a centralized administrative center to oversee
healthcare governance and initiatives. Prior to the establishment of Arogya Soudha, different
departments related to health and family welfare were spread across various locations,
leading to operational inefficiencies and coordination challenges.
The concept of constructing a dedicated headquarters for health administration gained

momentum in the mid-2000s, as the government aimed to streamline healthcare governance,
policy-making, and service delivery. The vision was to create a state-of-the-art building that
would symbolize the state’s unwavering commitment to providing accessible and quality
healthcare services to its citizens.
The construction of Arogya Soudha commenced in the late 2000s, and the design
incorporated both modern architectural elements and traditional South Indian influences.
Emphasis was placed on integrating green building concepts and sustainable features to align
the project with eco-friendly practices.
On November 15, 2009, a significant inauguration ceremony was held for Arogya Soudha.
The event was attended by prominent government officials, healthcare experts, and
dignitaries, with the then Chief Minister of Karnataka, B. S. Yeddyurappa, officially opening
the building.
Since its inception, Arogya Soudha has been actively involved in healthcare governance,
policy formulation, and the implementation of various healthcare initiatives. It serves as a
central hub for healthcare-related decision-making, coordination, and collaboration among
different departments, agencies, and stakeholders.
Over the years, Arogya Soudha has become an iconic symbol of healthcare administration
and innovation in Karnataka. Its historical significance lies in the transformative impact it has

had on healthcare governance and service delivery in the state, further reaffirming the
government’s dedication to enhancing public health and well-being.
Architecture and design
Arogya Soudha, situated in Bengaluru, Karnataka, is a remarkable architectural marvel that

skillfully fuses modern aesthetics with traditional South Indian influences. The building’s
façade presents a striking blend of glass and sandstone cladding, resulting in a unique and
visually captivating appearance. Inside, a central atrium allows ample natural light to
permeate the space, creating a welcoming and vibrant atmosphere. The design is not only
aesthetically pleasing but also highly functional, facilitating seamless movement between
different floors and departments.
Arogya Soudha is equipped with modern facilities, including conference halls and meeting
rooms, catering to the needs of healthcare administrators, policymakers, and visitors.
Furthermore, the building embraces energy-efficient features such as solar panels and LED
lighting, underscoring its commitment to sustainability and reducing its environmental
impact.
Beyond its architectural brilliance, Arogya Soudha serves as a symbol of the government’s
unwavering dedication to healthcare governance and public health. The incorporation of
traditional elements pays homage to the state’s rich cultural heritage, adding a touch of
timeless elegance to the contemporary structure. As a prominent landmark in Bengaluru’s
skyline, Arogya Soudha stands as a symbolic testament to Karnataka’s vision for providing
accessible and high-quality healthcare services, ultimately making a profound impact on the
well-being of its citizens.
Department and facilities
1. Department of Health and Family Welfare

Function: Responsible for devising and implementing healthcare policies and programs
across Karnataka. This department focuses on public health, family welfare, and ensuring
the effective delivery of healthcare services.
2. Directorate of Health Services:

Function: Overseeing the provision of medical and health services throughout the state,
including the management of hospitals and health centers. It also plays a key role in
implementing various health-related initiatives.
3. Directorate of Medical Education:
Function: Regulating medical education institutions, including medical colleges and
postgraduate training centers, to ensure the quality of medical education in Karnataka.
4. Directorate of Ayurveda, Yoga & Naturopathy, Unani, Siddha, and Homoeopathy
(AYUSH):
Function: Promoting traditional Indian systems of medicine, such as Ayurveda, Yoga,
Naturopathy, Unani, Siddha, and Homoeopathy, alongside modern healthcare practices.
5. Directorate of Medical Services:
Function: Overseeing the management and administration of medical services, including
hospitals and specialized medical facilities.
6. Directorate of Health and Family Welfare Services:
Function: Responsible for the effective implementation and monitoring of various health
and family welfare programs, including initiatives for maternal and child health.
7. Directorate of Health and Family Welfare Education:
Function: Focusing on health education and awareness programs to disseminate health-
related information among the public.
8. Directorate of Health and Family Welfare Training
Function: Providing training to healthcare professionals and personnel to enhance their
skills and knowledge.
9. Karnataka State Health System Resource Centre:
Function: Concentrating on health system strengthening, research, and providing
technical support to the Department of Health and Family Welfare.
10. Karnataka State Health and Family Welfare Society:
Function: Implementing various health projects and schemes by coordinating efforts
between government and non-governmental organizations.
11. Other Supportive Departments and Offices:

These may include departments or offices responsible for finance, administration, human
resources, and public relations, ensuring the smooth functioning of Arogya Soudha and
supporting the core healthcare departments.
Role in Healthcare Governance
Arogya Soudha plays a central and crucial role in healthcare governance in Karnataka. As the
headquarters of the Department of Health and Family Welfare, it serves as the focal point for
healthcare administration, policy formulation, and decision-making processes within the state.
One of its primary functions is to develop and implement healthcare policies and strategies that
address the specific health needs and challenges of the population. By collaborating with various
departments, healthcare experts, and stakeholders, Arogya Soudha ensures that policies are
evidence-based and tailored to effectively tackle health issues such as maternal and child health,
disease control, and healthcare accessibility.
Additionally, Arogya Soudha plays a vital role in allocating resources for healthcare initiatives. It
assesses the healthcare requirements of different regions and communities in Karnataka,
channeling funds to areas in need of more support and attention.
Furthermore, the building fosters coordination and collaboration among different healthcare
entities, providing a platform for stakeholders to share ideas, expertise, and best practices. This
collective approach ensures a cohesive and integrated healthcare system in the state.
Arogya Soudha also monitors and evaluates the effectiveness of healthcare programs and
initiatives. By analyzing the impact of interventions, the building identifies successful
approaches and areas requiring improvement, leading to data-driven decision-making.
During public health emergencies or disease outbreaks, Arogya Soudha acts as a central
coordination center, facilitating rapid response actions, resource mobilization, and effective crisis
management.
Overall, Arogya Soudha’s influence on health policies and decision-making stems from its role
as a hub for healthcare governance. It actively shapes the state’s healthcare agenda by

incorporating evidence-based research and data analysis, ultimately working towards improving
the health and well-being of the people of Karnataka.
Healthcare Initiatives and Programs
Arogya Soudha has played a crucial role in launching several impactful healthcare initiatives and
programs in Karnataka, aiming to enhance public health and well-being. Some of these notable
initiatives include:
1. Maternal and Child Health Programs:

Arogya Soudha has implemented comprehensive programs focused on improving
maternal and child health outcomes. These initiatives emphasize prenatal care, safe
deliveries, immunizations, and providing proper nutrition to mothers and children.
2. Disease Control and Prevention Campaigns:
The building actively supports campaigns for disease control and prevention, particularly
targeting communicable diseases like malaria, tuberculosis, and HIV/AIDS. These efforts
encompass awareness drives, testing, treatment, and preventive measures.
3. Universal Healthcare Access:
Arogya Soudha is committed to providing universal healthcare access to all citizens of
Karnataka. Various health insurance schemes and initiatives have been launched to ensure
that every individual can access essential medical services without facing financial
barriers.
4. Health Education and Awareness:
The building places significant emphasis on health education and awareness campaigns
to promote healthy living and disease prevention. These initiatives aim to educate the
public on hygiene, sanitation, nutrition, and making informed lifestyle choices.
5. Mental Health Programs:
Recognizing the importance of mental health, Arogya Soudha has initiated programs to
address mental health challenges. These efforts focus on destigmatizing mental health
issues, providing counseling services, and increasing access to mental healthcare.
6. Non-Communicable Disease Management:

Arogya Soudha has taken proactive steps to combat the rising burden of non-
communicable diseases. It has implemented programs for early detection, management,
and prevention of conditions like diabetes, hypertension, and cardiovascular diseases.
Impact assessment on public health
The implementation of these healthcare initiatives and programs from Arogya Soudha has
significantly impacted public health in Karnataka. Some key assessments include:
1. Improved Maternal and Child Health Outcomes:

The maternal and child health programs have led to a reduction in maternal and infant
mortality rates, resulting in improved health outcomes for mothers and children.
2. Reduced Disease Burden:
Disease control and prevention campaigns have effectively contained outbreaks and
reduced the prevalence of communicable diseases, leading to improved public health
indicators.
3. Enhanced Access to Healthcare:
Efforts towards universal healthcare access have expanded the number of people
receiving medical services, resulting in better healthcare coverage and equity in
healthcare provision.
4. Healthier Lifestyles:
Health education and awareness initiatives have empowered the public to make informed
decisions about their health, leading to healthier lifestyle choices and disease prevention.
5. Improved Mental Health Support:
The implementation of mental health programs has increased awareness and accessibility
to mental healthcare services, effectively addressing mental health issues and promoting
overall well-being.
6. Better Management of Non-Communicable Diseases:
Programs targeting non-communicable diseases have contributed to better management
and control of chronic conditions, ultimately improving the quality of life for affected
individuals.

Collaborations and Partnerships
Arogya Soudha actively engages in collaborations and partnerships with diverse healthcare
organizations, both governmental and non-governmental, to enhance healthcare practices and
promote better public health outcomes in Karnataka. These collaborative efforts foster synergy,
knowledge exchange, and resource-sharing, ultimately leading to more effective healthcare
initiatives and programs.
1. Governmental Collaborations:
Arogya Soudha collaborates with other government departments at the state and national
levels to align healthcare policies and strategies. It works closely with the Department of
Medical Education, Department of Ayush, and other health-related departments to ensure
a coordinated approach to healthcare governance and service delivery.
2. Non-Governmental Organizations (NGOs):
The building partners with NGOs specializing in specific healthcare areas. These
partnerships enable the implementation of grassroots-level initiatives, reaching
underserved communities and vulnerable populations. NGOs often contribute valuable
expertise, community engagement, and innovative solutions.
3. Medical Colleges and Research Institutions:
Arogya Soudha collaborates with medical colleges and research institutions to promote
medical education, research, and evidence-based policymaking. These partnerships help
in developing a skilled healthcare workforce and conducting research to address public
health challenges.
4. International Collaborations:
Arogya Soudha forms collaborations with international health organizations,
governments, and institutions. These partnerships facilitate the exchange of best practices,
technical expertise, and access to global health knowledge, contributing to the
improvement of healthcare practices in Karnataka.
Benefits of Collaborations in Improving Healthcare Practices:
1. Resource Sharing:

Collaborations allow for the sharing of resources, expertise, and knowledge. By pooling
together resources and expertise from various partners, Arogya Soudha can efficiently
address healthcare challenges and implement initiatives on a larger scale.
2. Enhanced Technical Expertise:
Partnerships with medical colleges and research institutions bring advanced technical
expertise and research capabilities. This collaboration results in evidence-based
policymaking and the implementation of best practices in healthcare.
3. Community Reach:
Collaborations with NGOs enable Arogya Soudha to reach remote and underserved
communities effectively. NGOs often have a strong presence at the grassroots level,
aiding the successful implementation of healthcare initiatives in those areas.
4. Innovation and Learning:
Partnering with international health organizations and institutions exposes Arogya
Soudha to innovative healthcare practices and the latest medical advancements. This
fosters a culture of continuous learning and adaptation, enhancing healthcare practices
within the state.
5. Synergy and Coordination:
Collaborations ensure better coordination among various stakeholders involved in
healthcare. By working together, partners can avoid duplication of efforts and focus on
complementary areas of expertise, maximizing the impact of healthcare programs.
6. Scalability and Sustainability:
Collaborative efforts often lead to scalable and sustainable healthcare initiatives. By
combining resources and expertise, Arogya Soudha can develop programs that are both
effective and sustainable in the long run, even after the initial collaboration ends.
Community engagement and outreach
Arogya Soudha actively organizes various community engagement programs to raise health
awareness and promote healthy living among the public in Karnataka. These initiatives aim to
empower communities with knowledge, encourage preventive healthcare practices, and foster a
sense of ownership and responsibility towards their health and well-being.

Some of the community engagement programs include health camps and awareness drives,
health education workshops, school health programs, community health meetings, health
awareness campaigns, and mobile healthcare units. These programs are designed to reach
different segments of the population, including rural and underserved areas.
The effectiveness of these community engagement programs can be observed through several
key outcomes. They have led to increased health awareness among communities, empowering
individuals to make informed health-related decisions. Early detection of health issues through
screenings and camps has facilitated timely intervention and improved health outcomes.
Furthermore, the programs have encouraged behavioral changes among the community, with
individuals adopting healthier habits and lifestyle choices. By fostering a sense of solidarity and
support within communities, the programs have strengthened the overall healthcare ecosystem
and enhanced healthcare access for marginalized communities in remote areas.
In conclusion, Arogya Soudha’s community engagement and outreach programs have proven to
be effective in raising health awareness and promoting healthy living. Through active
involvement and education, these initiatives have positively impacted public health outcomes,
empowering individuals to take charge of their health and contributing to the overall
improvement of healthcare practices in Karnataka.
Impact on Public Health
The impact of Arogya Soudha on public health in Karnataka has been significant, as it serves as
the central hub for healthcare governance and the implementation of various healthcare
initiatives. While specific data-driven evidence may vary based on individual programs and
initiatives, some general observations can highlight the building’s contributions to improving
public health in the state.
1. Increased Access to Healthcare Services:

Arogya Soudha’s efforts towards universal healthcare access have resulted in improved
access to medical services for a larger segment of the population. By implementing health
insurance schemes and outreach programs, more individuals can now avail essential
healthcare services, leading to better health outcomes.
2. Reduction in Maternal and Infant Mortality Rates:

The building’s focused maternal and child health programs have played a role in reducing
maternal and infant mortality rates in Karnataka. Timely and improved healthcare
services, along with awareness campaigns, have positively impacted maternal and child
health indicators.
3. Control and Prevention of Communicable Diseases:
Arogya Soudha’s disease control and prevention campaigns have been effective in
containing outbreaks and reducing the prevalence of communicable diseases like malaria,
tuberculosis, and HIV/AIDS. This has contributed to a decline in the overall disease
burden in the state.
4. Health Education and Awareness Impact:
The health education workshops and awareness campaigns organized by Arogya Soudha
have increased health awareness among communities. This heightened awareness has led
to better health practices, early detection of health issues, and increased utilization of
healthcare services.
5. Improved Mental Health Support:
The building’s initiatives focused on mental health have led to increased awareness and
accessibility to mental healthcare services. This has played a role in addressing mental
health issues and reducing stigma associated with mental health conditions.
6. Non-Communicable Disease Management:
Arogya Soudha’s efforts in addressing non-communicable diseases have contributed to
better management and control of chronic conditions like diabetes, hypertension, and
cardiovascular diseases, leading to enhanced health outcomes.
Future Plans and Challenges:
Arogya Soudha, as a vital healthcare governance hub, likely has future plans to address the
evolving healthcare needs in Karnataka and overcome challenges faced in its functioning. Some
potential future plans could include:
1. Infrastructure Expansion:
Arogya Soudha may consider expanding its infrastructure to accommodate the increasing
demand for healthcare services and administrative functions. This could involve adding

more wings or floors to the building or constructing additional buildings within the
complex.
2. Technological Upgrades:
Given the significance of technology in modern healthcare, Arogya Soudha might invest
in advanced technological upgrades. This could include the implementation of digital
health records, telemedicine facilities, and advanced medical equipment.
3. Sustainable and Green Initiatives:
Future plans may also include incorporating sustainable and eco-friendly features into the
building’s design. This could involve the installation of renewable energy sources, water-
saving technologies, and green building materials.
4. Enhancing Research Facilities:
Arogya Soudha could prioritize the development of research facilities and collaborations
with research institutions to promote evidence-based policymaking and medical
advancements.
Challenges Faced in Functioning and Potential Solutions:
1. Healthcare Infrastructure Demand:

Meeting the increasing demand for healthcare services in a populous state like Karnataka
can strain existing infrastructure and resources. To address this challenge, Arogya Soudha
can focus on expanding healthcare infrastructure and investing in advanced medical
technologies. Additionally, strengthening primary healthcare centers and community-
based healthcare services can alleviate the burden on the main building.
2. Human Resource Management:
Attracting and retaining skilled healthcare professionals and administrative staff can be
challenging due to competition from the private sector. To address this, Arogya Soudha
can implement competitive incentive packages, professional development opportunities,
and create a supportive work environment.
3. Healthcare Funding:
Ensuring adequate funding for healthcare initiatives and programs is crucial for their
successful implementation. Arogya Soudha can advocate for increased healthcare funding

from the state government and explore public-private partnerships to supplement

financial resources
4. Health Disparities and Access:
Addressing health disparities and ensuring equitable access to healthcare across all
regions and communities in Karnataka. Focusing on targeted healthcare programs for
underserved areas, vulnerable populations, and marginalized communities can help
reduce health disparities and improve access to healthcare services.
5. Policy Implementation and Monitoring:
Effectively implementing and monitoring healthcare policies to ensure their successful
execution. Strengthening the monitoring and evaluation mechanisms within Arogya
Soudha can help assess the impact of healthcare policies and make data-driven decisions
to refine and improve their implementation.
6. Technological Integration:
Integrating advanced healthcare technologies into the existing healthcare system and
ensuring seamless connectivity. Investing in technology infrastructure and providing
necessary training to healthcare professionals can aid in the successful integration and
utilization of technology in healthcare practices.
PROFILE OF RESPONDENTS
The cross-sectional analysis includes respondents between the ages of 18 and 80, reflecting
adiverse group of individuals with varying experiences and health characteristics related to
respiratory disorders. Here is a general profile of the respondents:
1. Age Distribution:
 Young Adults (18-29): This group includes individuals in their late teens and
twenties, who may be students, young professionals, or starting families.
 Adults (30-49): This age group comprises individuals in their thirties to forties,
often experiencing career advancements and family responsibilities.
 Middle-aged Adults (50-64): This group consists of individuals in their fifties to
early sixties, potentially facing midlife changes and transitioning to retirement.

 Older Adults (65-80): This category includes individuals aged 65 and above, who
may be retirees or senior citizens.
2. Gender Representation:
The respondents may consist of both males and females, providing a balanced
representation across genders.
3. Body Mass categories
 Normal Weight: Some respondents may fall within the normal weight range
according to their response and age.
 Overweight: Others may be categorized as overweight based on their response
 Obese: A subset of respondents may fall into the obese category based on their
response, highlighting the interest in studying the impact of obesity on respiratory
disorder severity.
4. Respiratory Disorder Diagnosis:
The respondents would have been diagnosed with various respiratory disorders, such as
asthma, chronic bronchitis, emphysema, or chronic obstructive pulmonary disease
(COPD)
5. Smoking and drinking Status:
Smoking habits would be recorded, distinguishing between current smokers, former
smokers, and non-smokers, as smoking is a major risk factor for respiratory disorders.

CHAPTER 04
DATA ANALYSIS AND INTERPRETATION

4.1 DESCRIPTIVE ANALYSIS AND INTERPRETATION
Age Group No of Respondents Percentage
Below 20 4 1.96%
21-30 48 23.53%
31-40 67 32.84%
41-50 36 17.65%
51-60 25 12.25%
Above 60 24 11.76%
Total 204 100.00%
Table 4.1.1. Age Source: Primary data
Analysis: From the table above, it is evident that the majority of respondents fall within the age
groups of 21-40, suggesting that this age range might have a higher association with respiratory
disorder severity. The distribution of respondents across various age groups, as depicted in Table
4.1, reveals notable insights. The preponderance of participants within the 21-40 age range
(56.37%) suggests a concentration of adults in their prime years. This age group’s prominence
sparks the idea of a possible connection between this range and respiratory disorder severity.
However, any such correlation requires rigorous analysis beyond this preliminary observation.
Importantly, the diversity in respondent ages—from those under 20 (1.96%) to those above 60
(11.76%)—adds nuance to the understanding of the population.

Figure 4.1.1. Age Source: Primary data
Interpretation: From the Figure above, it seems that individuals in the age range of 31-40 have
the highest representation among those with respiratory disorders, indicating a potential link
between this age group and increased respiratory disorder severity. The visualization presented in
Figure 4.1 unveils valuable insights into the interplay between age and respiratory disorder
severity. The conspicuous prominence of individuals aged 31-40, representing the highest
percentage of respondents (32.84%) with respiratory disorders, strongly hints at a potential
connection between this age group and heightened respiratory disorder severity. This focal point
draws attention to the critical Impact of middle-aged years on susceptibility to such disorders.

Gender No of Respondents Percentage
Male 128 62.75%
Female 75 36.76%
Prefer not to say 1 0.49%
Total 204 100.00%
Table 4.1.2. Gender Source: Primary data
Analysis: The table above shows a higher prevalence of respiratory disorder respondents among
males, suggesting that males might experience more severe respiratory issues.The gender
distribution data presented in the table indicates a significant divergence in the prevalence of
respiratory disorders, with males accounting for a substantial majority at 62.75%, compared to
females at 36.76%. This gender-based variation raises intriguing questions about potential
underlying factors. Biologically influenced differences in respiratory physiology, along with
possible occupational exposures and lifestyle choices, could contribute to the observed pattern.

Figure 4.1.2. Gender Source: Primary data
Interpretation: According to the Figure above, males constitute a significant majority among
those with respiratory disorders, hinting at a possible connection between male gender and
greater respiratory disorder severity. The Figure illustrates a substantial gender imbalance among
those with respiratory disorders, with males accounting for 62.75% compared to females at
36.76%. This suggests a possible connection between male gender and heightened respiratory
disorder severity. Biological differences, occupational exposure, lifestyle choices, and sampling
biases could contribute to this observation. While the Figure implies a correlation,
comprehensive investigation is needed to understand the underlying factors before establishing a
direct link between gender and disease severity.

Response No of Respondents Percentage
Strongly Agree 136 66.67%
Agree 51 25.00%
Neutral 5 2.45%
Disagree 5 2.45%
Strongly Disagree 7 3.43%
Total 204 100.00%
Table 4.1.3. Presence of respiratory disorder. Source: Primary data
Analysis: The majority strongly agree to having a diagnosed respiratory disorder, suggesting a
high proportion of respondents with confirmed respiratory issues. The dominant “strong
agreement” response (66.67%) signifies a substantial number of respondents with diagnosed
respiratory disorders. This prevalence underlines the presence of confirmed respiratory issues
within the surveyed group. However, variations in agreement levels—agreement (25.00%),
neutral (2.45%), disagree (2.45%), strongly disagree (3.43%)—show diverse perspectives.

Figure 4.1.3. Presence of respiratory disorder. Source: Primary data
Interpretation: As per the Figure above, a significant number of participants strongly agree with
having a diagnosed respiratory disorder, indicating a considerable proportion of the sample
population experiencing respiratory disorders. The Figure underscores a significant majority
(66.67%) of participants strongly agreeing to having diagnosed respiratory disorders. This robust
response suggests a noteworthy prevalence of confirmed respiratory health issues within the
sample. While this insight sheds light on a considerable portion of the population, factors like
reporting bias and medical validation should be considered. The varied agreement levels
(25.00% agree, 2.45% neutral, 2.45% disagree, 3.43% strongly disagree) highlight diverse
perceptions among participants.

Not Applicable 16 7.84%
Asthma 112 54.90%
COPD 30 14.71%
Allergy 32 15.69%
Other 14 6.86%
Total 204 100.00%
Table 4.1.4. The type of respiratory disorder: Source: Primary data
Analysis: The table illustrates that asthma is the most common diagnosed respiratory disorder
among respondents, potentially indicating its higher prevalence and impact on severity. The table
showcases asthma as the most prevalent diagnosed respiratory disorder (54.90%), followed by
COPD (14.71%) and allergies (15.69%). The prominence of asthma aligns with its recognized
commonality. The "Other" category (6.86%) underlines diverse, less common disorders. While
asthma’s prevalence is notable, each category offers insights into potential contributors to
respiratory health issues. Healthcare implications include tailored interventions and resource
allocation.

Figure 4.1.4. The type of respiratory disorder: Source: Primary data
Interpretation: The Figure above highlights asthma as the prevailing diagnosed respiratory
disorder, potentially suggesting its strong association with the severity of respiratory issues in
this sample. The Figure highlights asthma as the prevalent diagnosed respiratory disorder
(54.90%), followed by COPD (14.71%) and allergies (15.69%). This triad offers a
comprehensive glimpse into the spectrum of respiratory health issues within the sample. While
asthma’s prominence might imply an association with severity, establishing causation requires
more in-depth analysis. Factors like genetics, environment, and lifestyle likely contribute to each
disorder’s prevalence. Healthcare implications include tailored interventions. The “Other”
category (6.86%) underscores diversity in less common conditions.

Strongly Agree 22 10.78%
Agree 30 14.71%
Neutral 75 36.76%
Disagree 59 28.92%
Strongly Disagree 18 8.82%
Total 204 100.00%
Table 4.1.5. Hospitalized or visited the emergency room due to respiratory disorder in the past
year. Source: Primary data
Analysis: The table displays a significant proportion of respondents who have visited the
hospital or ER due to their respiratory disorders, suggesting a notable impact on their severity.
The table reveals diverse responses regarding hospitalization or ER visits due to respiratory
disorders. A combined 25.49% (Strongly Agree + Agree) indicate such visits within the past year,
underlining the significant impact of these disorders. The prevalence of “Neutral” responses
(36.76%) suggests varying interpretations of severity. Conversely, “Disagree” and “Strongly
Disagree” responses (28.92% + 8.82%) reflect those who haven’t experienced such visits.

Figure 4.1.5. Hospitalized or visited the emergency room due to respiratory disorder in the past
year. Source: Primary data
Interpretation: The Figure above indicates that a substantial portion of participants have agreed
or strongly agreed to having visited a hospital or ER due to their respiratory disorders, implying
a substantial influence on the severity of their conditions. The Figure demonstrates a
considerable number of participants (25.49% combined from “Strongly Agree” and “Agree”)
who confirm visiting hospitals or emergency rooms due to their respiratory disorders. This
suggests a substantial impact on the severity of their conditions, prompting the need for
professional medical attention. Additionally, a substantial percentage (36.76%) adopt a neutral
standpoint, showcasing diverse interpretations of when such visits are appropriate. Conversely,
“Disagree” and “Strongly Disagree” responses (28.92% + 8.82%) indicate a portion of
participants who haven’t experienced respiratory disorder-related hospitalization or ER visits.

Strongly Agree 35 17.16
Agree 124 60.78
Neutral 31 15.20
Disagree 3 1.47
Strongly Disagree 11 5.39
Total 204 100.00
Table 4.1.6. Experience of high severity coughing episodes in the past month.
Source: Primary data
Analysis: The data suggests that a significant proportion (78.94%) of respondents either
“Strongly Agree” or “Agree” that they experienced high severity coughing episodes in the past
month. This points to a widespread consensus regarding the severity of the coughing episodes.
The “Neutral” responses (15.20%) indicate some uncertainty or mixed feelings, while a small
percentage (1.47%) “Disagreed” and 5.39% “Strongly Disagreed.” This variation in responses
underscores the diverse perceptions of the severity of the coughing episodes among participants.
The analysis is based on a sample of 204 respondents.

Figure 4.1.6. Experience of high severity coughing episodes in the past month.
Interpretation: The data presented in the Figure strongly suggests a notable connection between
the experience of high severity coughing episodes and respondents leaning towards agreement.
The significant number of respondents who indicated agreement, either by “Strongly Agree” or
“Agree,” could be indicative of a potential correlation between the severity of coughing episodes
and certain factors, notably obesity.
The emphasis on agreement responses, totaling 78.94%, implies a considerable proportion of

individuals who acknowledge the presence of high severity coughing episodes in their recent
experiences. This is a noteworthy finding, especially considering that only a small percentage
expressed disagreement.
In summary, the strong alignment of respondents towards agreement highlights the prevalence of
high severity coughing episodes among them.

Agree 113 55.39
Neutral 28 13.73
Disagree 9 4.41
Total 204 100.00
Table 4.1.7. Experience of high severity wheezing episodes in the past month.
Analysis: The data suggests that a majority (73.53%) of respondents either “Strongly Agree” or
“Agree” that they experienced high severity wheezing episodes in the past month. The
substantial percentages of “Strong Agreement” (18.14%) and “Agreement” (55.39%) point to
both intense and general instances of wheezing episodes. Around 13.73% responded neutrally,
indicating uncertainty, while 4.41% disagreed and 8.33% strongly disagreed. This diversity in
responses highlights varied perceptions of wheezing severity among participants. The analysis
considered a sample of 204 respondents.

Figure 4.1.7. Experience of high severity wheezing episodes in the past month.
Interpretation: The graphical representation strongly suggests a notable correlation between

experiencing high severity wheezing episodes and respondents leaning towards agreement. The
substantial percentage of respondents indicating agreement, encompassing both “Strongly
Agree” and “Agree,” provides valuable insight into the potential relationship between the
severity of wheezing episodes and specific factors, notably obesity.
The emphasis on agreement responses, totaling 73.53%, highlights a significant portion of

individuals acknowledging the presence of high severity wheezing episodes within their recent
experiences. This is a substantial finding, particularly considering the comparatively smaller
percentages of neutral, disagree, and strongly disagree responses.
In summary, the prevailing trend of respondents leaning towards agreement underscores the
prevalence of high severity wheezing episodes among them.

Agree 131 64.22
Neutral 22 10.78
Disagree 9 4.41
Total 204 100.00
Table 4.1.8. Experience of shortness of breath during physical activity. Source: Primary data
Analysis: The data indicates that a significant majority (82.36%) of respondents agree or
strongly agree that they experience shortness of breath during physical activity. With 18.14%
“Strongly Agreeing” and 64.22% “Agreeing,” it’s clear that this issue is prevalent. About 10.78%
responded neutrally, while 4.41% disagreed and 2.45% strongly disagreed. These varied
responses offer insights into differing perceptions and experiences of shortness of breath during
physical activity. The analysis is based on a sample of 204 respondents.

Figure 4.1.8. Experience of shortness of breath during physical activity. Source: Primary data
Interpretation: The graphical representation strongly highlights a notable correlation between

experiencing shortness of breath during physical activity and respondents leaning towards
agreement. The significant percentage of respondents indicating agreement, encompassing both
“Strongly Agree” and “Agree,” offers valuable insights into the potential relationship between
the severity of breathlessness and specific factors, notably obesity.
The emphasis on agreement responses, totaling 82.36%, underscores a substantial portion of

individuals acknowledging experiencing shortness of breath during physical activity in their
recent experiences. This finding is significant, particularly considering the relatively smaller
percentages of neutral, disagree, and strongly disagree responses.
In summary, the prevailing trend of respondents leaning towards agreement underscores the
common experience of shortness of breath during physical activity among them.

Agree 77 37.75
Neutral 9 4.41
Disagree 16 7.84
Total 204 100.00
Table 4.1.9. Diagnosed of obesity at some point in life. Source: Primary data
Analysis: The data indicates that a substantial proportion (73.53%) of respondents agree that
they have received an obesity diagnosis at some point in their lives. With 35.78% “Strongly
Agreeing” and 37.75% “Agreeing,” there’s a clear acknowledgment of this diagnosis. A small
percentage (4.41%) responded neutrally, while 7.84% disagreed and 14.22% strongly disagreed.
These diverse responses offer insights into different perceptions of obesity diagnoses. The
analysis is based on a sample of 204 respondents.

Figure 4.1.9. Diagnosed of obesity at some point in life. Source: Primary data
Interpretation: The visual representation strongly underscores a significant correlation between

respondents having received an obesity diagnosis and a notable number leaning towards
agreement. The substantial percentage of respondents indicating agreement, comprising both
“Strongly Agree” and “Agree,” raises important implications about the potential link between
obesity diagnosis and certain health outcomes, such as respiratory symptoms.
The emphasis on agreement responses, totaling 73.53%, highlights a substantial portion of

individuals acknowledging that they have received an obesity diagnosis at some point in their
lives. This finding is substantial and carries implications for both individual health and broader
health trends.
In summary, the prevailing trend of respondents indicating obesity diagnoses underscores the
widespread nature of this condition.

Agree 36 17.65
Neutral 80 39.22
Disagree 63 30.88
Total 204 100.00
Table 4.1.10. Physically active. Source: Primary data
Analysis: The data indicates that a significant portion (45.29%) of respondents disagree or
strongly disagree with considering themselves physically active. While 6.37% “Strongly Agree”
and 17.65% “Agree,” a substantial percentage (39.22%) responded neutrally. A notable number
(30.88%) disagree, and 5.88% strongly disagree. These responses suggest diverse perceptions of
physical activity levels among participants. The analysis involved 204 respondents.

Figure 4.1.10. Physically active. Source: Primary data
Interpretation: The graphical representation strongly highlights a notable correlation between

respondents not considering themselves physically active and a significant number leaning
towards disagreement. The substantial percentage of respondents indicating disagreement,
including both “Disagree” and “Strongly Disagree,” provides valuable insights into the potential
relationship between physical inactivity and specific health outcomes, particularly the prevalence
of obesity.
The emphasis on disagreement responses, totaling 36.76%, underscores a considerable portion of

individuals acknowledging that they are not physically active. This finding is significant,
especially considering the relatively smaller percentages of agreement and neutral responses.
In summary, the prevailing trend of respondents not considering themselves physically active
emphasizes the need to address physical inactivity as a potential contributor to health issues.

Agree 83 40.69
Neutral 15 7.35
Disagree 4 1.96
Total 204 100.00
Table 4.1.11. Family history of obesity. Source: Primary data
Analysis: The data indicates that a substantial majority (85.79%) of respondents acknowledge
having a family history of obesity. With 45.10% “Strongly Agreeing” and 40.69% “Agreeing,”
there’s clear recognition of this familial influence. A smaller percentage (7.35%) responded
neutrally, while 1.96% disagreed and 4.90% strongly disagreed. These responses offer insights
into diverse perceptions of family history. The analysis is based on a sample of 204 respondents.

Figure 4.1.11 Family history of obesity Source:Primary data
Interpretation: The visual representation strongly underscores the significant presence of

participants acknowledging a family history of obesity. The substantial proportion of respondents
indicating that they either “Strongly Agree” or “Agree” with having a family history of obesity
holds crucial implications for understanding potential contributors to health issues, particularly in
relation to respiratory disorder severity.
The emphasis on agreement responses, totaling 85.79%, highlights a considerable portion of

individuals who recognize the influence of family history on obesity. This finding is substantial
and carries implications for both individual health and broader health trends.
In summary, the prevailing trend of participants acknowledging a family history of obesity

underlines the significance of genetic and familial factors in health outcomes.

Agree 21 10.29
Neutral 58 28.43
Disagree 96 47.06
Total 204 100.00
Table 4.1.12. Preference of smoking or drinking Source: Primary data
Analysis: The data indicates that a majority (53.35%) of respondents do not currently smoke or
drink, suggesting potential healthier habits. While 7.35% “Strongly Agree” and 10.29% “Agree,”
a significant percentage (28.43%) responded neutrally. A notable number (47.06%) disagreed,
and 6.86% strongly disagreed. These responses provide insights into diverse smoking and
drinking perceptions. The analysis involved 204 respondents.

Figure 4.1.12. Preference of smoking or drinking Source: Primary data
Interpretation: The visual representation strongly underscores the noteworthy percentage of

participants who indicate that they do not currently smoke or drink. This finding carries
important implications for both individual health and broader health trends, particularly in the
context of respiratory health and the potential relationship between obesity and respiratory
disorders.
The emphasis on non-engagement with smoking and drinking, which totals to 60.41% (Disagree
+ Strongly Disagree), is a significant observation. This indicates a substantial portion of
individuals who prioritize avoiding these habits, which can have a positive impact on their
overall well-being.
In summary, the prevailing trend of participants not currently smoking or drinking indicates a
promising commitment to healthier habits.

Agree 70 34.31
Neutral 82 40.20
Disagree 26 12.75
Total 204 100.00
Table 4.1.13. Exposure to environmental factors that could impact respiratory health.
Analysis: The data indicates that a substantial proportion (43.62%) of participants agree that they
are exposed to environmental factors that could impact their respiratory health. While 9.31%
“Strongly Agree” and 34.31% “Agree,” a significant percentage (40.20%) responded neutrally. A
smaller portion (12.75%) disagreed, and 3.43% strongly disagreed. These responses highlight
diverse perceptions of environmental influences on respiratory health. The analysis involved 204
respondents.

Figure 4.1.13. Exposure to environmental factors that could impact respiratory health
Interpretation: The visual representation strongly underscores the substantial percentage of

participants who acknowledge being exposed to environmental factors that could potentially
impact their respiratory health. This observation holds important implications for understanding
the potential complexities of respiratory health outcomes, particularly in relation to the interplay
between environmental factors, obesity, and respiratory disorder severity.
The emphasis on agreement responses, which totals 43.62%, highlights a significant portion of
individuals who recognize the influence of environmental factors on their respiratory health. This
finding is crucial, as it underscores the awareness of external elements that could contribute to
respiratory health issues.
In summary, the trend of participants acknowledging exposure to environmental factors adds

complexity to the understanding of respiratory health outcomes.

Agree 149 73.04
Neutral 15 7.35
Disagree 2 0.98
Total 204 100.00
Table 4.1.14. Respiratory Disorder has impacted daily activities. Source: Primary data
Analysis: The data indicates that a substantial majority (89.71%) of respondents report that
respiratory disorders impact their daily activities. While 16.67% “Strongly Agree” and 73.04%
“Agree,” a notable percentage (7.35%) responded neutrally. A smaller portion (0.98%) disagreed,
and 1.96% strongly disagreed. These responses highlight diverse experiences of the impact of
respiratory disorders on daily life. The analysis involved 204 respondents.

Figure 4.1.14. Respiratory Disorder has impacted daily activities. Source: Primary data
Interpretation: The visual representation strongly highlights the considerable percentage of

participants who indicate that respiratory disorders have indeed impacted their daily activities.
This observation underscores the significance of these health conditions and their potential
implications for individuals’ overall well-being, particularly in relation to the context of obesity.
The emphasis on agreement responses, which totals 89.71%, underscores a substantial portion of
individuals who acknowledge the impact of respiratory disorders on their daily activities. This
finding carries important implications for both individual experiences and broader health trends.
In summary, the trend of participants acknowledging the impact of respiratory disorders on daily
activities reinforces the significance of these health challenges.

Agree 99 48.53
Neutral 7 3.43
Disagree 3 1.47
Total 204 100.00
Table 4.1.15. There is a relationship between obesity and respiratory disorder severity.
Analysis: The data indicates that a substantial majority (92.65%) of respondents recognize a
relationship between obesity and respiratory disorder severity. With 44.12% “Strongly Agreeing”
and 48.53% “Agreeing,” there’s a clear acknowledgment of this connection. A small percentage
(3.43%) responded neutrally, while 1.47% disagreed and 1.96% strongly disagreed. These
responses highlight diverse perceptions of the relationship. The analysis involved 204
respondents.

Figure 4.1.15. There is a relationship between obesity and respiratory disorder severity.
Interpretation: The visual representation strongly highlights the significant portion of

participants who acknowledge the existence of a relationship between obesity and respiratory
disorder severity. This observation underscores the importance of recognizing the interplay
between these health factors and their potential implications for both individual health and
broader health trends.
The emphasis on agreement responses, which totals 92.65%, underscores a substantial portion of
individuals who recognize the connection between obesity and respiratory disorder severity. This
finding carries important implications for understanding the potential role of obesity in
influencing the severity of respiratory disorders.
In summary, the trend of participants acknowledging a relationship between obesity and

respiratory disorder severity underscores the significance of considering obesity as a potential
contributor to the severity of respiratory health issues.

4.2. HYPOTHESIS TESTING
Step 1: Defining the Hypothesis:
Null Hypothesis (H0): There is no significant association between obesity and the severity of
respiratory disorders.
Alternate Hypothesis (H1): There is a significant association between obesity and the severity
of respiratory disorders, with higher levels of obesity being associated with greater respiratory
disorder severity.
Step 2: Defining the level of significance:
Level of Significance = 5%, α = 0.05
Step 3: Testing the hypothesis:
In my current research project, I am employing the Chi-square statistical analysis to investigate

the relationship between obesity and respiratory disorders. Utilizing a “Strongly Agree,”
“Agree,” “Neutral,” “Disagree,” and “Strongly Disagree” format, I am assessing participants’
responses to better understand the potential connection between these two variables. By
analyzing the distribution of responses across these categories, I aim to uncover any significant
associations between levels of obesity and the severity of respiratory disorders. This approach
will allow me to explore the nuances of opinions and attitudes while shedding light on the impact
of obesity on respiratory health.
The following responses to the Likert scale questions were considered to test the hypothesis,
1. Do you have a diagnosed respiratory disorder?

 Strongly Agree-136
 Agree-51
 Neutral-5
 Disagree-5
 Strongly Disagree-7
2. "I have received a diagnosis of obesity at some point in my life."
 Strongly Agree-73

 Agree-77
 Neutral-9
 Disagree-16
 Strongly Disagree-29
3. “I experienced high severity coughing episodes in the past month.”

 Strongly Agree
 Agree
 Neutral
 Disagree
 Strongly Disagree
4. “I experienced high severity wheezing episodes in the past month.”

 Strongly Agree
 Agree
 Neutral
 Disagree
5. Is there a family history of obesity?
 Strongly Agree
 Agree
 Neutral
 Disagree

Strongly Strongly
Agree Neutral Disagree TOTAL
Agree Disagree
Presence of 136
51 5 5 7 204
respiratory disorder
73 77 9 16 29 204
Presence of obesity
Severe coughing
episodes in the past 35 124 31 3 11 204
month
Severe wheezing
episodes in the past 37 113 28 9 17 204
month
Family history of
92 83 15 4 10 204
obesity
TOTAL 373 448 88 37 74 1020
4.2.1 Table of Observed frequency
Row total∗Column total

Expected frequency (column, row) = Table total
204∗373 204∗448 204∗88 204∗37 204∗74

E(1,1) = 1020
= E(2,1) = 1020
= E(3,1) = 1020
= E(4,1) = 1020
= E(5,1) = 1020
=
74.6 89.6 17.6 7.4 14.8

204∗373 204∗448 204∗88 204∗37 204∗74
E(1,2) = 1020
= E(2,2) = 1020
= E(3,2) = 1020
= E(4,2) = 1020
= E(5,2) = 1020
=
74.6 89.6 17.6 7.4 14.8

204∗373 204∗448 204∗88 204∗37 204∗74
E(1,3) = 1020
= E(2,3) = 1020
= E(3,3) = 1020
= E(4,3) = 1020
= E(5,3) = 1020
=

74.6 89.6 17.6 7.4 14.8

204∗373 204∗448 204∗88 204∗37 204∗74
E(1,4) = 1020
= E(2,4) = 1020
= E(3,4) = 1020
= E(4,4) = 1020
= E(5,4) = 1020
=
74.6 89.6 17.6 7.4 14.8

204∗373 204∗448 204∗88 204∗37 204∗74
E(1,5) = 1020
= E(2,5) = 1020
= E(3,5) = 1020
= E(4,5) = 1020
= E(5,5) = 1020
=
74.6 89.6 17.6 7.4 14.8
4.2.2 Table of Expected frequencies
Observed Expected (� − �)�

(O-E) (O-E)2
Frequency (O) Frequency (E) �
136 74.6 61.4 3769.96 50.53
73 74.6 -1.6 2.56 0.03
35 74.6 -39.6 1568.16 21.02
37 74.6 -37.6 1413.76 18.95
92 74.6 17.4 302.76 4.05
51 89.6 -38.6 1489.96 16.62
77 89.6 -12.6 158.76 1.77
124 89.6 34.4 1183.36 13.20
113 89.6 23.4 547.56 6.11
83 89.6 -6.6 43.56 0.48
5 17.6 -12.6 158.76 9.02
9 17.6 -8.6 73.96 4.20
31 17.6 13.4 179.56 10.20
28 17.6 10.4 108.16 6.14
15 17.6 -2.6 6.67 0.38
5 7.4 -2.4 5.76 0.77
16 7.4 8.6 73.96 9.99
3 7.4 -4.4 19.36 2.61
9 7.4 -1.6 2.56 0.34
4 7.4 -3.4 11.56 1.56

7 14.8 -7.8 60.84 4.11

29 14.8 14.2 201.64 13.62
11 14.8 -3.8 14.44 0.97
17 14.8 2.2 4.84 0.32
10 14.8 -4.8 23.04 1.55
∑= ��. ��
4.2.3 Chi-square Table
χ² = Σ ((O - E)² / E)
Where:
 χ² (chi-square) is the test statistic.

 Σ represents summation, indicating the need to calculate the sum of all values
for all categories or cells.
 represents the observed frequency in each category or cell.
 E represents the expected frequency in each category or cell under the
assumption of independence between the variables.
Hence, χ²= Σ ((O - E)² / E) = 198.54.
In order to test the null hypothesis, we need to find the degree of freedom. The degree of
freedom will be :(number of columns -1) (number of rows-1)
= (5-1) (5-1)
= 4*4
ν = 16

For ν = 16, for 5% level of significance α = 0.05, using the Chi-square distribution table
χ ²0.05 = 26.30.
Step 4: Interpretation:
In the course of this study, we investigated the potential relationship between obesity and the
severity of respiratory disorders. Our analysis involved employing a chi-squared test to
determine whether there exists a statistically significant association between these two variables.
The null hypothesis(H0) stated that no such association exists, while the alternative
hypothesis(H1) posited the presence of a significant relationship.

Upon performing the chi-squared test, we computed a chi-squared value (χ²) of 198.54. To
evaluate the significance of this result, we compared it to the critical value from the chi-squared
distribution table, specifically χ²₀.₀₅, which amounted to 26.30 for a significance level of 0.05.
The calculated χ² value significantly exceeded the critical value, indicating a profound outcome.
As a result, we rejected the null hypothesis(H0) and accept alternate hypothesis(H1) implying
that there is indeed a meaningful association between obesity and the severity of respiratory
disorders. The data strongly supports the notion that higher levels of obesity are correlated with
greater severity of respiratory disorders.

CHAPTER 05
SUMMARYOF FINDINGS,
CONCLUSION AND SUGGESTION
5.1 SUMMARY OF FINDINGS:
The primary objective of this cross-sectional analysis was to delve into the connection between
obesity and the extent of respiratory disorders. The study employed questionnaires to gather data,
concentrating on multiple facets such as participant demographics, respiratory health conditions,
levels of physical activity, family medical history, lifestyle choices, and participants' perceived
associations between obesity and the seriousness of respiratory disorders.
By examining these comprehensive aspects, the analysis aimed to uncover potential patterns and
correlations that might exist between obesity and the severity of respiratory issues. The
utilization of questionnaires allowed for a comprehensive exploration of participants' experiences
and perspectives, contributing to a more nuanced understanding of the interplay between
these variables.
Here are the key findings:
1. Demographics:
 The majority of respondents fell within the age range of 31-60, with a relatively even
distribution among age groups.
 Gender distribution leaned slightly towards males, with 128 male respondents compared
to 75 female respondents.
2. Respiratory Health:
 A significant number of participants (136) reported having a diagnosed respiratory

disorder, with asthma being the most prevalent (112 respondents).
 A substantial portion of respondents (52) reported being hospitalized or visiting the
emergency room due to their respiratory disorder in the past year.
3. Symptoms:
 High severity coughing episodes were reported by a majority of participants (159).

 A similar trend was observed with high severity wheezing episodes, with 150 respondents
indicating their occurrence in the past month.
 Shortness of breath during physical activity was reported by 168 participants.

4. Obesity and Lifestyle:
 A considerable number of respondents (150) received a diagnosis of obesity at some

point in their lives.
 Physical activity levels were relatively low, as a majority of respondents (155) either
disagreed or strongly disagreed with being physically active.
 A substantial portion of participants (175) had a family history of obesity.
5. Lifestyle Factors:
 Smoking and drinking were generally less common, as a majority of respondents (110)
disagreed with currently engaging in these behaviors.
 The majority of participants (152) agreed that they were exposed to environmental factors
that could impact their respiratory health.
6. Impact on Daily Activities:
 The impact of respiratory disorders on daily activities was significant, with 183
respondents agreeing or strongly agreeing that it affected their lives.
7. Perceived Relationship between Obesity and Respiratory Disorder Severity:
 The majority of respondents (189) agreed or strongly agreed with the statement that there
is a relationship between obesity and respiratory disorder severity.
This cross-sectional analysis of the survey data conducted indicates a substantial presence of
diagnosed respiratory disorders within the surveyed population, with asthma being the most
prevalent among them. Notably, a significant number of participants reported experiencing high-
severity symptoms like persistent coughing, wheezing, and shortness of breath, particularly
during physical activities. Interestingly, the analysis also highlighted a noteworthy prevalence of
obesity among the respondents.
What's particularly striking is that a considerable percentage of the participants perceived a direct
correlation between obesity and the severity of their respiratory disorders. This perception adds
an intriguing layer to the findings, suggesting a potential interplay between these two health
factors. To address these concerning trends, there arises a clear need for further in-depth research,

exploring the intricate relationship between obesity and respiratory health. Additionally, these
findings underscore the importance of implementing targeted public health interventions to raise
awareness and mitigate the impact of obesity on respiratory well-being.

5.2 CONCLUSION:
This cross-sectional analysis aimed to investigate the impact of obesity on the severity of
respiratory disorders. The study gathered responses from a diverse group of participants,
spanning various age groups and genders. The survey encompassed aspects related to
respiratory health, physical activity, smoking or drinking habits, family history of obesity,
exposure to environmental factors, and the perceived relationship between obesity and
respiratory disorder severity.
The results indicate a strong correlation between obesity and the severity of respiratory
disorders. A significant number of participants reported being diagnosed with respiratory
disorders, particularly asthma and COPD, and also experienced high-severity coughing and
wheezing episodes in the past month. Shortness of breath during physical activity was a
common complaint among participants as well. This underscores the potential respiratory
challenges faced by individuals with obesity.
The study illuminated an interesting connection between family history of obesity and its
prevalence among the participants, suggesting a genetic predisposition to obesity. A
considerable proportion of participants admitted to being physically inactive, which could
contribute to the exacerbation of respiratory symptoms.
The majority of participants also acknowledged the impact of respiratory disorders on their
daily activities, reflecting the profound influence of these conditions on overall quality of life.
Importantly, a strong consensus emerged regarding the relationship between obesity and
respiratory disorder severity, further supporting the notion that obesity contributes to the
worsening of respiratory symptoms.
These findings emphasize the need for comprehensive interventions targeting both obesity
and respiratory health. Public health initiatives should focus on promoting physical activity,
healthy lifestyle choices, and awareness of the interplay between obesity and respiratory
disorders. By addressing these factors holistically, healthcare providers can effectively
manage and mitigate the impact of respiratory disorders in individuals with obesity,
ultimately improving their respiratory health and overall well-being.

5.3 SUGGESTIONS:
1. Promote Healthy Lifestyle Choices:

Promoting healthy lifestyle choices involves educating individuals about the benefits of
maintaining a balanced diet rich in nutrient-dense foods such as fruits, vegetables, lean
proteins, and whole grains. Portion control, reducing processed foods, staying hydrated, and
dietary diversity are emphasized. Alongside diet, regular physical activity tailored to
individual abilities is encouraged. Activities range from aerobic exercises like walking and
cycling to strength training and flexibility routines. The goal is to gradually progress while
ensuring safety, consulting healthcare professionals as needed. By adopting these practices,
individuals can manage their weight and improve respiratory health, contributing to an
enhanced overall quality of life.
2. Raise Awareness of Respiratory Health:
Raising awareness about respiratory health involves informing the public about the potential
interplay between obesity and respiratory disorders, aiming to enhance comprehension and
encourage early intervention. This can be achieved through public awareness campaigns,
educational workshops, online resources, and collaboration with healthcare professionals. By
sharing personal stories, integrating lessons into school curricula, and participating in
community events, the goal is to foster understanding, prompt timely medical attention, and
promote healthier lifestyle choices. Through these efforts, individuals can gain the
knowledge needed to take proactive steps towards preserving their respiratory health and
overall well-being.
3. Individualized Management Plans:
Developing individualized management plans involves tailoring treatment approaches for
individuals with respiratory disorders, accounting for their obesity status and unique lifestyle
factors. This process begins with a comprehensive assessment of medical history, respiratory
symptoms, and obesity-related considerations. By understanding the individual's specific
needs, healthcare professionals can design interventions that encompass medical treatments,
dietary guidance, exercise regimens, and behavioral strategies. These personalized plans also
set achievable goals, prioritize safe weight management, and emphasize healthy lifestyle
adjustments. Regular monitoring and interdisciplinary collaboration ensure ongoing progress
and optimization of the individual's respiratory and overall well-being.

4. Screening and Early Detection:

Implementing routine screenings for obesity and respiratory disorders, with a particular focus
on individuals with a family history of obesity, serves as a proactive strategy for early
detection and intervention. Regular assessments of body weight, composition, and lung
function allow healthcare providers to identify potential health risks and establish tailored
management plans. By considering family history, these screenings can help uncover genetic
predispositions and prompt targeted interventions. Educating individuals about the
importance of screenings and collaborating with primary care providers ensure a
comprehensive approach to preventive care. The integration of obesity and respiratory
screenings facilitates the identification of potential connections between these conditions,
contributing to improved health outcomes and enhanced well-being.
5. Counseling and Support:
Providing counseling and support services to individuals diagnosed with both obesity and
respiratory disorders is essential for a comprehensive approach to managing their health.
These services encompass personalized guidance on lifestyle modifications, including weight
management strategies, dietary adjustments, and physical activity plans tailored to their
unique needs. Addressing the emotional and psychological aspects of living with chronic
conditions, such as stress management and coping strategies, is equally vital. By combining
education, behavioral interventions, and psychosocial support, individuals are empowered to
navigate the complexities of their health, make informed decisions, and work towards better
overall well-being.
6. Encourage Smoking Cessation and Reduced Alcohol Consumption:
Encouraging individuals to quit smoking and reduce alcohol consumption is paramount for
mitigating respiratory issues, particularly when compounded by obesity-related conditions.
By offering tailored programs and resources, healthcare providers facilitate positive changes
in behavior that directly impact respiratory health. Structured smoking cessation initiatives,
including counseling and nicotine replacement therapy, empower individuals to overcome
nicotine addiction. Educational workshops underscore the connection between smoking,
alcohol consumption, and exacerbated respiratory symptoms, while personalized plans
consider obesity status for greater efficacy. Collaborative efforts involving healthcare
professionals, support groups, and behavioral interventions ensure a holistic approach to

addressing both habits. Ultimately, these measures contribute to improved respiratory

function, enhanced overall health, and a better quality of life for those navigating obesity-
related respiratory challenges.
7. Environmental Risk Mitigation:
Environmental risk mitigation involves identifying and addressing factors that can
negatively impact respiratory health due to exposure to pollutants. Common pollutants
include particulate matter, ozone, and volatile organic compounds. Strategies for mitigation
include promoting cleaner energy sources, reducing vehicle emissions, enhancing indoor air
quality, and raising public awareness about these issues through educational campaigns and
community initiatives. By taking these actions, we can minimize the adverse effects of
environmental pollutants on respiratory health and overall well-being.
8. Integrated Healthcare Approach:
An integrated healthcare approach that encourages collaboration between respiratory
specialists and obesity experts is beneficial for patients with overlapping conditions. This
collaborative effort allows for a more comprehensive understanding of the patient's health, as
well as the development of tailored treatment strategies. Since conditions like obesity can
impact respiratory health, and vice versa, a combined approach can lead to improved patient
outcomes by addressing both aspects simultaneously. This might involve personalized
lifestyle modifications, exercise plans, dietary interventions, and possibly medical treatments,
all under the guidance of a coordinated team of specialists.
9. Physical Activity Promotion:
Promoting physical activity among individuals with respiratory disorders involves a careful
and personalized strategy. Collaborating with healthcare professionals is crucial to determine
suitable exercises based on the person's condition and fitness level. Activities like walking,
swimming, and yoga, adapted to individual needs, can enhance cardiovascular health without
straining the respiratory system. Breathing techniques and gradual progression aid in
managing symptoms, while consistency and emotional support contribute to long-term
adherence. This multidisciplinary approach, encompassing specialists and exercise
professionals, ensures a holistic strategy that addresses both the respiratory condition and the
individual's physical well-being, ultimately leading to improved overall health and
quality of life.

10. Research and Education:

Supporting research initiatives focused on the interplay between obesity and respiratory
disorders is pivotal for deepening our comprehension of this intricate connection.
Disseminating research findings to healthcare professionals is imperative, equipping them
with updated insights to enhance patient care through informed diagnosis and tailored
treatments. Simultaneously, raising public awareness through informative campaigns and
events can empower individuals to grasp the importance of managing obesity for better
respiratory health. The synergy of research, education, and multidisciplinary collaboration
holds the potential to drive evidence-based guidelines, fostering a healthier society by
addressing the nuances of the obesity-respiratory disorder relationship.
11. Nutrition Education:
Providing targeted nutritional education to individuals with respiratory disorders is a crucial
step toward improving their respiratory health and overall quality of life. This education
involves understanding the impact of various nutrients on lung function and inflammation.
By emphasizing a balanced diet rich in antioxidants, lean proteins, whole grains, and healthy
fats while minimizing processed foods and sugary options, individuals can better manage
their condition. Guidance on proper hydration, weight management, and the identification of
potential food sensitivities further equips them with the knowledge needed to make informed
dietary choices. Collaborating with experts such as registered dietitians ensures that this
education is personalized and effective, ultimately leading to enhanced respiratory well-being
and lasting positive health outcomes.
12. Telehealth Services:
Introducing telehealth services for individuals with respiratory disorders offers a
transformative solution, catering to those who face challenges accessing in-person care. By
enabling remote monitoring and consultations, telehealth eliminates geographical barriers
and enhances healthcare accessibility. Patients can conveniently discuss symptoms, receive
treatment guidance, and undergo assessments without the need for travel. Regular virtual
check-ins facilitate early intervention, continuous monitoring, and adherence to treatment
plans. Additionally, telehealth provides valuable educational resources for self-management,
all while maintaining patient privacy and confidentiality. While it doesn't replace all in-
person care, the implementation of telehealth represents a promising avenue for

comprehensive and patient-centric respiratory management, optimizing health outcomes and

quality of life.
13. Community Engagement:
Creating community-based programs that focus on physical activity, healthy eating, and
overall well-being holds immense potential for addressing obesity and respiratory health at a
grassroots level. These programs not only educate participants about the connections between
lifestyle and health but also provide accessible resources and support networks. By tailoring
interventions to the community's needs and collaborating with local organizations, these
initiatives can instill lasting behavioral changes. The intergenerational impact, coupled with
partnerships and a sense of community ownership, contributes to the sustainability of such
programs. As they engage individuals in proactive health management, community-based
efforts become a driving force for improved well-being, benefiting both individuals and the
larger population.
14. School and Workplace Initiatives:
Incorporating health-promoting activities like wellness programs and ergonomic
improvements in schools and workplaces can have a positive impact on respiratory health.
These initiatives can include activities like exercise routines, stress management workshops,
and proper ventilation systems. Ergonomic improvements could involve designing
workspaces that prioritize good posture and breathing, which can contribute to better
respiratory health for students and employees alike. Such collaborative efforts can lead to a
healthier and more productive environment overall.
15. Medication Management:
Managing medications for individuals with obesity and respiratory disorders requires a
tailored approach. Healthcare providers must be aware of potential interactions between
medications, adjust dosages based on weight and condition, and consider the complexity of
polypharmacy. Personalized plans, regular monitoring, patient education, and collaborative
care among healthcare providers are key. Lifestyle changes and risk assessments should be
integrated, while staying updated with research and guidelines ensures effective and safe
medication management..

16. Peer Support Groups:

Peer support groups play a pivotal role in the lives of individuals confronting both obesity
and respiratory disorders. By fostering connections with those who share similar challenges,
these groups offer a platform for sharing experiences, trading coping strategies, and
celebrating successes. The sense of community diminishes feelings of isolation, while the
exchange of practical advice and emotional support empowers members to navigate their
conditions with resilience and optimism. Through the camaraderie and shared knowledge
within these groups, individuals find not only solace but also motivation to manage their
health effectively.
17. Public Policy Advocacy:
Public policy advocacy plays a pivotal role in enhancing respiratory health and overall well-
being. By championing initiatives that promote clean air, reduce pollution, and create
environments conducive to healthy lifestyles, we can significantly impact the burden of
respiratory diseases and obesity. These efforts encompass advocating for cleaner industries,
green spaces, active transportation, tobacco control, indoor air quality regulations, and
increased healthcare access. By working collaboratively to drive policy changes, we can
create a healthier future for individuals and communities, preventing respiratory illnesses and
fostering a culture of well-being.
18. Screening for Mental Health:
Recognizing the intricate relationship between obesity, respiratory disorders, and mental
health is paramount for comprehensive care. Integrating mental health screenings and support
into treatment plans is a vital step towards addressing the holistic well-being of individuals
facing these challenges. By routinely screening for mental health concerns, tailoring
interventions, fostering collaborative care, and educating patients, healthcare providers can
create a more inclusive and effective approach to managing these conditions. This not only
improves the overall quality of care but also acknowledges the profound impact that mental
health has on the journey towards better health outcomes.
19. Collaboration with Fitness Professionals:
Collaborating with fitness professionals to develop tailored exercise programs for individuals
managing respiratory disorders and obesity is a proactive strategy that marries medical
insights with expert fitness knowledge. By combining the expertise of healthcare providers

and fitness experts, these programs can be carefully designed to accommodate physical
limitations, address respiratory challenges, and promote overall health. This collaboration not
only ensures safety and efficacy but also empowers individuals to engage in exercise routines
that align with their unique needs and goals, fostering a holistic approach to well-being.
20. Long-Term Follow-Up:
Incorporating a system of long-term monitoring and follow-up procedures is a cornerstone of
effective healthcare for individuals managing respiratory disorders and obesity. These
practices ensure that progress is consistently tracked, allowing healthcare providers to make
timely adjustments to treatment plans, exercise regimens, and interventions. By addressing
emerging issues proactively and tailoring care to evolving needs, long-term follow-up not
only prevents complications but also empowers individuals to actively engage in their health
management. This patient-centered approach contributes to improved outcomes, enhanced
quality of life, and the ongoing success of managing both conditions.

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organ crosstalk. The clinical respiratory journal, 14(7), 595–604.
11. Lambert, A. A., Putcha, N., Drummond, M. B., Boriek, A. M., Hanania, N. A., Kim, V.,
Kinney, G. L., McDonald, M. N., Brigham, E. P., Wise, R. A., McCormack, M. C.,
Hansel, N. N., & COPDGene Investigators (2017). Obesity Is Associated With Increased
Morbidity in Moderate to Severe COPD. Chest, 151(1), 68–77.
12. Lampalo, M., Majer, M., Ferara, N., Milošević, M., Barišić Kutija, M., & Jukić, I. (2019).
Gender Differences in Relationship between Body Mass Index and Asthma. Psychiatria
Danubina, 31(Suppl 5), 786–791.
13. López-Sánchez, G. N., Dóminguez-Pérez, M., Uribe, M., Chávez-Tapia, N. C., & Nuño-
Lámbarri, N. (2021). Non-alcoholic fatty liver disease and microRNAs expression, how it
affects the development and progression of the disease. Annals of hepatology, 21, 100212.
14. Mafort, T. T., Rufino, R., Costa, C. H., & Lopes, A. J. (2016). Obesity: systemic and
pulmonary complications, biochemical abnormalities, and impairment of lung function.
Multidisciplinary respiratory medicine, 11, 28.
15. Miethe, S., Karsonova, A., Karaulov, A., & Renz, H. (2020). Obesity and asthma. The
Journal of allergy and clinical immunology, 146(4), 685–693.
16. O’Donnell, D. E., Ciavaglia, C. E., & Neder, J. A. (2014). When obesity and chronic
obstructive pulmonary disease collide. Physiological and clinical consequences. Annals
of the American Thoracic Society, 11(4), 635–644.
17. Peters, U., Dixon, A. E., & Forno, E. (2018). Obesity and asthma. The Journal of allergy
and clinical immunology, 141(4), 1169–1179.
18. Verberne, L. D. M., Leemrijse, C. J., Swinkels, I. C. S., van Dijk, C. E., de Bakker, D. H.,
& Nielen, M. M. J. (2017). Overweight in patients with chronic obstructive pulmonary
disease needs more attention: a cross-sectional study in general practice. NPJ primary
care respiratory medicine, 27(1), 63.

19. Xanthopoulos, M., & Tapia, I. E. (2017). Obesity and common respiratory diseases in
children. Paediatric respiratory reviews, 23, 68–71.
20. Zewari, S., Vos, P., van den Elshout, F., Dekhuijzen, R., & Heijdra, Y. (2017). Obesity in
COPD: Revealed and Unrevealed Issues. COPD, 14(6), 663–673.
Websites
1. https://medlineplus.gov/ency/article/000085.htm
2. https://mrmjournal.biomedcentral.com/articles/10.1186/s40248-016-0066-z
3. https://thorax.bmj.com/content/63/7/649
4. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2990395/
5. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6311385/
6. https://www.news-medical.net/health/Obesity-and-respiratory-disorders.
7. https://www.spectrumhealthlakeland.org/lakeland-pulmonology/our-services/obesity
hypoventilation-syndrome

ANNEXURE
Questionnaires
Dear participants,
This questionnaire is part of an MBA dissertation research on the topic of impact of obesity on
respiratory disorder severity. A cross-sectional analysis.
Your responses will provide essential insights into this critical issue and to find out the
relationship between obesity and respiratory disorder severity. All information shared will
remain confidential. Your valuable input will be instrumental in contributing to the academic
understanding of this subjectmatter.
Thank you for your participation.
Questions
1. Age:
2. Gender: [Male/Female/Other]
3. Do you have a diagnosed respiratory disorder?

 Strongly Agree
 Agree
 Neutral
 Disagree
4. If yes, please specify the type of respiratory disorder:

 Not applicable
 Asthma
 COPD

 Allergy
 Other
5. “I have been hospitalized or visited the emergency room due to my respiratory disorder in
the past year.”
 Strongly Agree
 Agree
 Neutral
 Disagree
6. “I experienced high severity coughing episodes in the past month.”

 Strongly Agree
 Agree
 Neutral
 Disagree
7. “I experienced high severity wheezing episodes in the past month.”

 Strongly Agree
 Agree
 Neutral
 Disagree
8. “I experience shortness of breath during physical activity.”

 Strongly Agree
 Agree
 Neutral

 Disagree
9. “I have received a diagnosis of obesity at some point in my life.”

 Strongly Agree
 Agree
 Neutral
 Disagree
10. “I am physically active.”

 Strongly Agree
 Agree
 Neutral
 Disagree
11. Is there a family history of obesity?

 Strongly Agree
 Agree
 Neutral
 Disagree
12. To what extent do you agree or disagree with the statement: “I currently smoke or drink?”
 Strongly Agree
 Agree
 Neutral
 Disagree

13. To what degree do you agree with the statement: “I am exposed to environmental factors
that could impact my respiratory health?”
 Strongly Agree
 Agree
 Neutral
 Disagree
14. To what extent do you agree or disagree with the statement: “espiratory Disorder has
impacted my daily activities”.
 Strongly Agree
 Agree
 Neutral
 Disagree
15. To what extent do you agree or disagree with the statement: “There is a relationship
between obesity and respiratory disorder severity” .
 Strongly Agree
 Agree
 Neutral
 Disagree

Thimmaiah
ORIGINALITY REPORT
17 %
SIMILARITY INDEX
11%
INTERNET SOURCES
10%
PUBLICATIONS
5%
STUDENT PAPERS
PRIMARY SOURCES
1
Christopher G. Slatore, Philip Harber,
Margaret C. Haggerty. "An Official American
3%
Thoracic Society Systematic Review: Influence
of Psychosocial Characteristics on Workplace
Disability among Workers with Respiratory
Impairment", American Journal of Respiratory
and Critical Care Medicine, 2013
Publication
2
www.science.gov
Internet Source 2%
3
Submitted to University of Leicester
Student Paper 1%
4
worldwidescience.org
Internet Source <1 %
5
www.esp.org
6
Denis E. O’Donnell, Casey E. Ciavaglia, J.
Alberto Neder. "When Obesity and Chronic
<1 %
Obstructive Pulmonary Disease Collide.
Physiological and Clinical Consequences",
Annals of the American Thoracic Society, 2014
Publication
7
www.researchgate.net
8
www.omicsdi.org
9
www.mdpi.com
10
mrmjournal.biomedcentral.com
11
Submitted to Harper Adams University
College
<1 %
Student Paper
12
Sarah Miethe, Antonina Karsonova, Alexander
Karaulov, Harald Renz. "Obesity and asthma",
<1 %
Journal of Allergy and Clinical Immunology,
2020
Publication
13
S. Zewari, P. Vos, F. van den Elshout, R.
Dekhuijzen, Y. Heijdra. "Obesity in COPD:
<1 %
Revealed and Unrevealed Issues", COPD:
Journal of Chronic Obstructive Pulmonary
Disease, 2017
Publication
14
Systems Biology of Free Radicals and
Antioxidants, 2014.
<1 %
Publication
15
archives.actx.edu
16
repository.up.ac.za
17
web.up.ac.za
18
www.abrmr.com
19
vocal.media
20
journals.lww.com
21
entokey.com
22
Submitted to Tower Hamlets College
Student Paper <1 %
23
Submitted to University of Southern
Queensland
<1 %
Student Paper
24
citeseerx.ist.psu.edu
25
Submitted to University of Glamorgan
Student Paper <1 %
26
eurjmedres.biomedcentral.com
27
wiredspace.wits.ac.za
28
"42nd EASD Annual Meeting of the European
Association for the Study of Diabetes",
<1 %
Diabetologia, 2006
Publication
29
academic.oup.com
30
www.univadis.co.uk
31
eclass.uniwa.gr
32
Submitted to Southwestern Oklahoma State
University
<1 %
Student Paper
33
eprints.soton.ac.uk
34
www.frontiersin.org
35
Submitted to United Colleges Group - UCG
Student Paper <1 %
36
www.hindawi.com
37
Submitted to Indus International School
Student Paper <1 %
38
Submitted to Technological University Dublin
Student Paper <1 %
39
Submitted to Higher Education Commission
Pakistan
<1 %
Student Paper
40
pubmed.ncbi.nlm.nih.gov
41
websta.me
42
www.ejeph.com
43
www.whymilk.com
44
Devraj Jindal, Ambuj Roy, Vamadevan S. Ajay,
Shailesh Kumar Yadav, Dorairaj Prabhakaran,
<1 %
Nikhil Tandon. "Strategies for Stakeholder
Engagement and Uptake of New
Intervention", Global Heart, 2019
Publication
45
gwinnettlung.com
46
ndl.ethernet.edu.et
47
www.thenews.com.pk
48
you.stonybrook.edu
49
Sue C. Bodine, Heddwen L. Brooks, Hilary A.
Coller, Ana I. Domingos et al. "An American
<1 %
Physiological Society cross-journal Call for
Papers on "The Physiology of Obesity"",
American Journal of Physiology-Lung Cellular
and Molecular Physiology, 2022
Publication
50
Submitted to University of Hong Kong
Student Paper <1 %
51
ap-st01.ext.exlibrisgroup.com
52
cellregeneration.springeropen.com
53
Submitted to CTI Education Group
Student Paper <1 %
54
Jongseok Hwang. "Unraveling the
Contributing Factors of Sarcopenia in Young
<1 %
Korean Male Adults: A Study of Occurrence,
Somatometric, Biochemical, and Behavioral
Characteristics", Journal of The Korean
Society of Physical Medicine, 2023
Publication
55
docplayer.net
56
Submitted to British International School
Student Paper <1 %
57
Submitted to Miami Dade College
Student Paper <1 %
58
estia.hua.gr
59
trap.ncirl.ie
60
www.cdt.unb.br
61
www.coursehero.com
62
www.tandfonline.com
63
Tsaroucha, Agori, Zoe Daniil, Foteini Malli,
Panagiotis Georgoulias, Markos Minas,
<1 %
Konstantinos Kostikas, Alexandra Bargiota,
Elias Zintzaras, and Konstantinos I.
Gourgoulianis. "Leptin, Adiponectin, and
Ghrelin Levels in Female Patients with Asthma
during Stable and Exacerbation Periods",
Journal of Asthma, 2013.
Publication
64
Submitted to University of Northumbria at
Newcastle
<1 %
Student Paper
65
patents.google.com
66
refills.umms.org
67
repec.its.waikato.ac.nz
68
rtmagazine.com
69
utpedia.utp.edu.my
70
uwspace.uwaterloo.ca
71
www.science.org
72
Submitted to RMIT University
Student Paper <1 %
73
coek.info
disesasesdictonary.blogspot.com
<1 %
Internet Source
74
75
eprints.univ-batna2.dz
76
lungdiseases.conferenceseries.com
77
orbi.uliege.be
78
www.warrdental.com
79
Bhavna Dhingra, Ashok Kumar Dutta.
"National Rural Health Mission", The Indian
<1 %
Journal of Pediatrics, 2011
Publication
80
Nuray Kuvat, Hakan Tanriverdi, Ferah
Armutcu. "The relationship between
<1 %
obstructive sleep apnea syndrome and
obesity: A new perspective on the
pathogenesis in terms of organ crosstalk",
The Clinical Respiratory Journal, 2020
Publication
81
Simon D. Herkenrath, Marcel Treml, Lars
Hagmeyer, Sandhya Matthes, Winfried J.
<1 %
Randerath. "Severity stages of obesity-related
breathing disorders – a cross-sectional cohort
study", Sleep Medicine, 2022
Publication
82
scholar.lib.vt.edu
83
www.asterhospitals.in
84
www.cdc.gov
85
www.ncbi.nlm.nih.gov
86
Karifala Marah, Antony Fute, Mohamed
Oubibi, Binghai Sun et al. "Parental
<1 %
abusiveness experienced in childhood and
premarital sexual permissiveness during
adolescence", Heliyon, 2023
Publication
87
feature1-researchprotocols.jmir.org
88
link.springer.com
89
open.alberta.ca
90
rgu-repository.worktribe.com
91
s3-eu-west-1.amazonaws.com
92
timesofindia.indiatimes.com
93
tr.aegeanconference.com
94
www.foxnews.com
95
www.semanticscholar.org
96
"The Molecular Targets and Therapeutic Uses
of Curcumin in Health and Disease", Springer
<1 %
Nature, 2007
Publication
97
Babeș-Bolyai University
Publication <1 %
98
Biswaranjan Bhola, Raghvendra Kumar,
Ishaani Priyadarshini, Chakchai So-In,
<1 %
Tusharkanta Padhy, Adam Slowik, Amir H.
Gandomi. "Internet of Things based Sensor
Module for Respiratory Tracking System",
IEEE Sensors Journal, 2023
Publication
99
Bright, J.J.. "Targeting autoimmune diseases
through nutraceuticals", Nutrition, 200401
<1 %
Publication
100
Sapna Bhatia, Akshay Sood. "Obesity and
obstructive lung disease: An epidemiologic
<1 %
review", Elsevier BV, 2019
Publication
101
Submitted to Universidad Europea de Madrid
Student Paper <1 %
102
cefe.ekf.tuke.sk
103
es.scribd.com
104
etheses.saurashtrauniversity.edu
105
gssrr.org
106
hdl.handle.net
107
info.elitelearning.com
108
moam.info
109
oftalmoloji.org
110
pure.bond.edu.au
111
pure.tue.nl
112
repository.gij.edu.gh
113
repository.smuc.edu.et
114
researchonline.jcu.edu.au
115
researchspace.ukzn.ac.za
116
sandag.org
117
www.kokilabenhospital.com
118
www.lib.ysu.am
119
www.tara.tcd.ie
120
www.utupub.fi
121
Angiogenesis in Adipose Tissue, 2013.
Publication <1 %
122
Lisa D. M. Verberne, Chantal J. Leemrijse, Ilse
C. S. Swinkels, Christel E. van Dijk, Dinny H. de
<1 %
Bakker, Mark M. J. Nielen. "Overweight in
patients with chronic obstructive pulmonary
disease needs more attention: a cross-
sectional study in general practice", npj
Primary Care Respiratory Medicine, 2017
Publication
123
Valentina Fainardi, Lucrezia Passadore,
Marialuisa Labate, Giovanna Pisi, Susanna
<1 %
Esposito. "An Overview of the Obese-Asthma
Phenotype in Children", International Journal
of Environmental Research and Public Health,
2022
Publication
124
"Poster Presentation - Tuberculosis :
Abstract", Respirology, 2014.
<1 %
Publication
125
Anindo Banerjee, Emily Heiden. "Obesity and
the Effects on the Respiratory System",
<1 %
Elsevier BV, 2018
Publication
126
Branched Chain Amino Acids in Clinical
Nutrition, 2015.
<1 %
Publication
127
dergipark.org.tr
128
ltr.edu.au
ONESB
Approved by AICTE, Recognised by Govt of Karnataka, Afiliated to Bangalore North University
Ref: ONESB CL-06/23 09/09/2023
TO WHOM IT MAY CONCERN
This is to certify that Mr. ThimmaiahCI, a dedicated student of One School of Business
(ONESB), has successfully collected data for his dissertation on the topic, "Impact of obesity
onrespiratory disorder severity: Across-sectional analysis" The data collection took place with
the help of Arogya Soudha, Bangalore.
ONESB can confim that Mr. Thimmaiah C T has fulfilled all the necessary requirements for
data collection and has shown dedication and integrity throughout his research activities. His
work is expected to contribute significantly to the field of Health Care.
We wish Mr. Thimmaiah C T the best of luck in completing his dissertation, and we are
confident that his findings will be of great benefit to the healtheare community.
Sincerely.
aro, dorsoa: 560 045
23/1, Opp. Manyata Tech Park +91 080 25443427

Nagawara, Bangalore-45, India info@onesb.org
www.onesb.org

Thimmaiah C T P19ZY21M0008 Impact of Obesity On Respiratory Disease Severity. A Cross-Sectional Analysis

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Thimmaiah C T P19ZY21M0008 Impact of Obesity On Respiratory Disease Severity. A Cross-Sectional Analysis

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IMPACT OF OBESITY ON RESPIRATORY DISEASE SEVERITY.

MASTER OF BUSINESS ADMINISTRATION

DR. JERRY JOHN

ONE SCHOOL OF BUSINESS

I, hereby declare that “Impact of Obesity on Respiratory Disorder Severity. A Cross-

Place: Bangalore Name: Thimmaiah C T

Date: Register Number: P19ZY21M0008

Ref: ONESB/OC-8/23 09.09.2023

This is to certify that the Project report entitled "IMPACT OF OBESITY ON

+91 080 25443427

Place: Bangalore THIMMAIAH C T

Keywords: Obesity, respiratory disorder, family history, education and awareness.

SL.NO TITLE PAGE NO

Chapter 1: Introduction 1-13

1.1 Industry Profile 4

1. 1.2 Theoretical background of the study 5-11

1.3 Importance of the topic 11-12

1.4 Need to study the topic 12-13

Chapter 2: Review of Literature and Research design 14-25

2.1 Review of literature and Gaps 14-20

2.2 Statement of the Problem 21

2.3 Scope of the study 21

2. 2.4 Objectives of the study 21-22

2.6 Sampling 22-23

2.7 Tools for data collection 23

2.8 Data analysis 23-24

2.9 Limitations of the study 24-25

3. Chapter 3: Profile of the selected organization and respondents 26-39

Chapter 4: Data Analysis and interpretation 40-76

4. 4.1 Descriptive Analysis and Interpretation 40-69

4.2 Hypothesis Testing 70-76

Chapter 5: Summary of findings, Conclusion and Suggestions 77-87

5.1Summary of findings 77-79

5.3 Suggestions 81-87

TABLE NO TITLE PAGE NO

4.1.3 Presence of respiratory disorder 42

4.1.4 The type of respiratory disorders 44

Hospitalized or visited the emergency room due to

Experience of high severity coughing episodes in the past

Experience of high severity wheezing episodes in the past

4.1.8 Experience of shortness of breadth during physical activity 52

4.1.9 Diagnosed of obesity at some point in life 54

4.1.10 Physically active 56

4.1.11 Family history of obesity 58

4.1.12 Preference of smoking or drinking 60

Exposure to environmental factors that could impact

4.1.14 Respiratory disorder has impacted daily activities 64

There is a relationship between obesity and respiratory

4.2.1 Table of observed frequency 72

4.2.2 Table of expected frequency 72-73

4.2.3 Chi-square table 73-74

4.1.3 Presence of respiratory disorder 43

4.1.4 The type of respiratory disorders 45

Hospitalized or visited the emergency room due to respiratory

4.1.6 Experience of high severity coughing episodes in the past month 49

4.1.7 Experience of high severity wheezing episodes in the past month 51

4.1.8 Experience of shortness of breadth during physical activity 53

4.1.9 Diagnosed of obesity at some point in life 55

4.1.10 Physically active 57

4.1.11 Family history of obesity 59

4.1.12 Preference of smoking or drinking 61

Exposure to environmental factors that could impact respiratory