Prevalence, Associated Factors and Psychological Determinants of Obesity among Adults in Selangor, Malaysia
Abstract
:1. Introduction
2. Materials and Methods
2.1. Study Design and Sampling Frame
2.2. Sample Size
2.3. Eligibility Criteria
2.4. Data Collection
2.4.1. Obesity
2.4.2. Depression
2.4.3. Anxiety
2.4.4. Perceived Stress
2.4.5. Self-Esteem
2.4.6. Stressful Life Events
2.4.7. Suicidal Ideation
2.4.8. Quality of Life
2.5. Statistical Analysis
2.6. Ethics Statement
3. Results
4. Discussion
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Acknowledgments
Conflicts of Interest
References
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Characteristics | Overall (N = 1380) | Male (N = 513) | Female (N = 867) |
---|---|---|---|
N (%)/Mean (SD) | |||
Age group (years) | |||
19 and below | 76 (5.5) | 41 (8.0) | 35 (4.0) |
20–29 | 509 (36.9) | 188 (36.6) | 321 (37.0) |
30–39 | 351 (25.4) | 124 (24.2) | 227 (26.2) |
40–49 | 221 (16.0) | 72 (14.0) | 149 (17.2) |
50–59 | 128 (9.3) | 42 (8.2) | 86 (9.9) |
60 and above | 95 (6.9) | 46 (9.0) | 49 (5.7) |
Ethnicity | |||
Malay | 954 (69.1) | 360 (70.2) | 594 (68.5) |
Chinese | 112 (8.1) | 52 (10.1) | 60 (6.9) |
Indian | 281 (20.4) | 87 (17.0) | 194 (22.4) |
Others | 33 (2.4) | 14 (2.7) | 19 (2.2) |
Residence | |||
Urban | 1285 (93.1) | 474 (92.4) | 811 (93.5) |
Rural | 95 (6.9) | 39 (7.6) | 56 (6.5) |
Marital status | |||
Single | 472 (34.2) | 221 (43.1) | 251 (29.0) |
Married | 851 (61.7) | 276 (53.8) | 575 (66.3) |
Widowed | 49 (3.6) | 14 (2.7) | 35 (4.0) |
Divorced | 6 (0.4) | 2 (0.4) | 4 (0.5) |
Separated | 2 (0.1) | 0 (0.0) | 2 (0.2) |
Education level | |||
Primary | 115 (8.4) | 27 (23.5) | 88 (76.5) |
Secondary | 681 (49.9) | 258 (37.9) | 423 (62.1) |
Tertiary | 568 (41.6) | 224 (39.4) | 344 (60.6) |
Employment status | |||
Employed | 702 (51.6) | 350 (69.0) | 352 (41.2) |
Unemployed | 599 (44.0) | 120 (23.7) | 479 (56.1) |
Retired | 60 (4.4) | 37 (7.3) | 23 (2.7) |
History of Medical Problems | |||
Yes | 325 (23.6) | 118 (23.0) | 207 (23.9) |
No | 1055 (76.4) | 395 (77.0) | 660 (76.1) |
History of Mental Health Problems | |||
Yes | 22 (1.6) | 11 (2.1) | 11 (1.3) |
No | 1358 (98.4) | 502 (97.9) | 856 (98.7) |
History of Mental Health Problems in the Family | |||
Yes | 35 (2.5) | 10 (1.9) | 25 (2.9) |
No | 1284 (93.0) | 478 (93.2) | 806 (93.0) |
Not sure | 61 (4.4) | 25 (4.9) | 36 (4.2) |
Disability | |||
Yes | 9 (0.7) | 5 (1.0) | 4 (0.5) |
No | 1371 (99.3) | 508 (99.0) | 863 (99.5) |
Perceived stress (PSS) (0–40) ± SD | 15.08 (4.77) | 15.07 (4.70) | 15.09 (4.81) |
Self-esteem (RSES) (0–40) ± SD | 19.65 (3.68) | 19.77 (3.66) | 19.58 (3.69) |
Depression (PHQ-9) ± SD | 3.53 (3.58) | 3.56 (3.85) | 3.52 (3.41) |
Present (PHQ-9≥10) | 98 (7.1) | 46 (9.0) | 52 (6.0) |
Absent (PHQ-9<10) | 1282 (92.9) | 467 (91.0) | 815 (94.0) |
Anxiety (GAD-7) ± SD | 1.94 (2.67) | 1.80 (2.66) | 2.03 (2.68) |
Present (GAD-7 ≥ 8) | 69 (5.0) | 25 (4.9) | 44 (5.1) |
Absent (GAD-7 < 8) | 1311 (95.0) | 488 (95.1) | 823 (94.9) |
Suicidal Ideation | |||
Yes | 97 (7.0) | 49 (9.6) | 48 (5.5) |
No | 1283 (93.0) | 464 (90.4) | 819 (94.5) |
Stressful Life Event ± SD | 3.56 (1.74) | 3.59 (1.84) | 3.54 (1.67) |
No | 37 (2.7) | 9 (1.8) | 28 (3.2) |
Low (1 stressful life event) | 152 (11.0) | 68 (13.3) | 84 (9.7) |
Moderate (2 stressful life events) | 182 (13.2) | 78 (15.2) | 104 (12.0) |
High (≥3 stressful life events) | 1009 (73.1) | 358 (69.8) | 651 (75.1) |
Quality of Life (WHOQOL-BREF-26) ± SD | |||
Physical Health (4–20) | 14.79 (2.16) | 14.84 (2.12) | 14.76 (2.18) |
Psychological Health (4–20) | 14.56 (2.09) | 14.49 (2.20) | 14.60 (2.03) |
Social Relationships (4–20) | 15.28 (2.42) | 15.38 (2.50) | 15.22 (2.38) |
Environment (4–20) | 14.66 (1.97) | 14.59 (2.04) | 14.70 (1.93) |
Weight (kg) Mean ± SD | 65.77 (15.42) | 70.85 (14.81) | 62.77 (15.00) |
Height (cm) Mean ± SD | 161.25 (9.39) | 167.60 (8.97) | 157.49 (7.40) |
Body mass index (kg/m2) Mean ± SD | 25.34 (5.79) | 25.26 (5.14) | 25.38 (6.15) |
Characteristics | Obesity N (%) | ||
---|---|---|---|
Overall (N = 1380) | 256 (18.6) | ||
Male (N = 513) | 73 (14.2) | ||
Female (N = 867) | 183 (21.1) | ||
Male | Female | Overall | |
Age group (years) | |||
19 and below | 7 (17.1) | 3 (8.6) | 10 (13.2) |
20–29 | 30 (16.0) | 44 (13.7) | 74 (14.5) |
30–39 | 15 (12.1) | 64 (28.2) | 79 (22.5) |
40–49 | 10 (13.9) | 39 (26.2) | 49 (22.2) |
50–59 | 4 (9.5) | 20 (23.3) | 24 (18.8) |
60 and above | 7 (15.2) | 13 (26.5) | 20 (21.1) |
Ethnicity | |||
Malay | 50 (13.9) | 120 (20.2) | 170 (17.8) |
Chinese | 5 (9.6) | 11 (18.3) | 16 (14.3) |
Indian | 18 (20.7) | 50 (25.8) | 68 (24.2) |
Other | 0 (0.0) | 2 (10.5) | 2 (6.1) |
Residence | |||
Urban | 70 (14.8) | 170 (21.0) | 240 (18.7) |
Rural | 3 (7.7) | 13 (23.2) | 16 (16.8) |
Marital status | |||
Single | 38 (17.2) | 29 (11.6) | 67 (14.2) |
Married | 33 (12.0) | 140 (24.3) | 173 (20.3) |
Widow/widower | 2 (14.3) | 11 (31.4) | 13 (26.5) |
Divorced | 0 (0.0) | 1 (25.0) | 1 (16.7) |
Separated | 0 (0.0) | 2 (100.0) | 2 (100.0) |
Education level | |||
Primary | 3 (11.1) | 29 (33.3) | 32 (27.8) |
Secondary | 33 (12.8) | 109 (25.8) | 142 (20.9) |
Tertiary | 36 (16.1) | 42 (12.2) | 78 (13.7) |
Employment status | |||
Employed | 51 (14.6) | 72 (20.5) | 123 (17.5) |
Unemployed | 17 (14.2) | 104 (21.7) | 121 (20.2) |
Retired | 4 (10.8) | 4 (17.4) | 8 (13.3) |
Characteristics | Obese | Non-Obese | Chi-Square | Crude OR (95%CI) | p Value |
---|---|---|---|---|---|
Gender | 10.09 | 0.001 *(0.086) | |||
Female | 183 (21.1%) | 684 (78.9%) | 1.61(1.20–2.17) | ||
Male | 73 (14.2%) | 440 (85.8%) | |||
Age (years) | 12.84 | 0.025 * (0.096) | |||
Below 19 | 10 (13.2%) | 66 (86.8%) | 0.65 (0.33–1.29) | 0.213 | |
20–29 | 74 (14.5%) | 435 (85.5%) | 0.64 (0.48–0.87) | 0.003 * | |
30–39 | 79 (22.5%) | 272 (77.5%) | 1.40 (1.04–1.88) | 0.027 * | |
40–49 | 49 (22.2%) | 172 (77.8%) | 1.31 (0.92–1.86) | 0.131 | |
50–59 | 24 (18.8%) | 104 (81.3%) | 1.02 (0.64–1.62)) | 0.951 | |
60 and above | 20 (21.1%) | 75 (78.9%) | 1.19 (0.71–1.98) | 0.516 | |
Ethnicity | 11.03 | 0.012 * (0.089) | |||
Malay | 170 (17.8%) | 784 (82.2%) | 0.86 (0.64–1.14) | 0.296 | |
Chinese | 16 (14.3%) | 96 (85.7%) | 0.71 (0.41–1.23) | 0.226 | |
Indian | 68 (24.2%) | 213 (75.8%) | 1.55 (1.13–2.12) | 0.006 * | |
Others | 2 (6.1%) | 31 (93.9%) | 0.28 (0.07–1.17) | 0.062 | |
Residence | 0.20 | 1.13 (0.65–1.98) | 0.657 | ||
Urban | 240 (18.7%) | 1045 (81.3%) | |||
Rural | 16 (16.8%) | 79 (83.2%) | |||
Marital status | 18.57 | 0.001 * (0.116) | |||
Single | 67 (14.2%) | 405 (85.8%) | 0.63 (0.46–0.85) | 0.003 * | |
Married | 173 (20.3%) | 678 (79.7%) | 1.37 (1.03–1.83) | 0.031 * | |
Widowed | 13 (26.5%) | 36 (73.5%) | 1.62 (0.85–3.10) | 0.143 | |
Divorced | 1 (16.7%) | 5 (83.3%) | 0.88 (0.10–7.55) | 0.691 a | |
Separated | 2 (100.0%) | 0 (0.0%) | - | 0.034 a,* | |
Education level | 17.71 | <0.001 * (0.114) | |||
Primary | 32 (27.8%) | 83 (72.2%) | 1.80 (1.17–2.78) | 0.007 * | |
Secondary | 142 (20.9%) | 539 (79.1%) | 1.37 (1.04–1.81) | 0.024 * | |
Tertiary | 78 (13.7%) | 490 (86.3%) | 0.57 (0.43–0.77) | <0.001 * | |
Employment status | 2.66 | 0.256 | |||
Employed | 123 (17.5%) | 579 (82.5%) | 0.87 (0.66–1.15) | 0.330 | |
Unemployed | 121 (20.2%) | 478 (79.8%) | 1.22 (0.93–1.60) | 0.156 | |
Retired | 8 (13.3%) | 52 (86.7%) | 0.67 (0.31–1.42) | 0.290 |
Characteristics | Obese | Non-Obese | Chi-Square | Crude OR (95%CI) | p Value |
---|---|---|---|---|---|
Chronic disease | 19.00 | <0.001 * (0.117) | |||
Yes | 87 (26.8%) | 238 (73.2%) | 1.92 (1.43–2.56) | ||
No | 169 (16.0%) | 886 (84.0%) | |||
Heart disease | 0.25 | 0.620 | |||
Yes | 6 (22.2%) | 21 (77.8%) | 1.26 (0.50–3.16) | ||
No | 250 (18.5%) | 1103 (81.5%) | |||
Diabetes | 10.37 | 0.001 * (0.087) | |||
Yes | 33 (30.0%) | 77 (70.0%) | 2.01 (1.31–3.10) | ||
No | 223 (17.6%) | 1047 (82.4%) | |||
Stroke | 0.20 | 0.546 a | |||
Yes | 1 (12.5%) | 7 (87.5%) | 0.63 (0.08–5.11) | ||
No | 255 (18.6%) | 1117 (81.4%) | |||
Hypertension | 22.80 | <0.001 * (0.129) | |||
Yes | 52 (32.3%) | 109 (67.7%) | 2.37 (1.65–3.41) | ||
No | 204 (16.7%) | 1015 (83.3%) | |||
Arthritis | 2.72 | 0.099 | |||
Yes | 10 (29.4%) | 24 (70.6%) | 1.86 (0.88–3.95) | ||
No | 246 (18.3%) | 1100 (81.7%) | |||
Cancer | 0.69 | 0.408 a | |||
Yes | 0 (0.0%) | 3 (100.0%) | - | ||
No | 256 (18.6%) | 1121 (81.4%) | |||
Asthma | 3.99 | 0.046 * (0.054) | |||
Yes | 20 (27.4%) | 53 (72.6%) | 1.71 (1.00–2.92) | ||
No | 236 (18.1%) | 1071 (81.9%) | |||
Kidney Failure | 0.56 | 0.499 | |||
Yes | 0 (0.0%) | 2 (100.0%) | |||
No | 256 (18.6%) | 1122 (81.4%) | |||
Thyroidism | 5.27 | 0.043 a,* (0.062) | |||
Yes | 4 (50.0%) | 4 (50.0%) | 4.44 (1.10–17.89) | ||
No | 252 (18.4%) | 1120 (81.6%) |
Psychological Variables | Simple Linear Regression | Multiple Linear Regression | ||||
---|---|---|---|---|---|---|
B | t | p | B | t | p | |
Perceived stress (PSS) (0–40) | −0.075 | −1.559 | 0.120 | −0.107 | −2.046 | 0.041 * |
Self-esteem (RSES) (0–40) | 0.077 | 1.235 | 0.217 | |||
Depression (PHQ-9) | −0.090 | −1.526 | 0.128 | |||
Anxiety (GAD-7) | 0.050 | 0.584 | 0.559 | |||
Suicidal Ideation | −2.062 | −2.686 | 0.007 | −2.423 | −3.031 | 0.003 * |
Stressful Life Event | 0.088 | 0.712 | 0.477 | |||
Quality of Life (WHOQOL-BREF-26) | ||||||
QOL—Physical Health (4–20) | −0.158 | −1.470 | 0.142 | −0.350 | −2.945 | 0.003 * |
QOL—Psychological Health (4–20) | −0.167 | −1.621 | 0.106 | |||
QOL—Social Relationships (4–20) | −0.012 | −0.135 | 0.893 | |||
QOL—Environment (4–20) | 0.050 | 0.451 | 0.652 |
Psychological Variables | Simple Linear Regression | Multiple Linear Regression | ||||
---|---|---|---|---|---|---|
B | t | p | B | t | p | |
Perceived stress (PSS) (0–40) | 0.017 | 0.403 | 0.687 | |||
Self-esteem (RSES) (0–40) | 0.122 | 2.167 | 0.031 | |||
Depression (PHQ-9) | 0.055 | 0.899 | 0.369 | |||
Anxiety (GAD-7) | −0.004 | −0.049 | 0.961 | |||
Suicidal Ideation | 0.043 | 0.047 | 0.962 | |||
Stressful Life Event | 0.703 | 5.730 | <0.001 | 0.711 | 5.869 | <0.001 * |
Quality of Life (WHOQOL-BREF-26) | ||||||
QOL—Physical Health (4–20) | −0.427 | −4.511 | <0.001 | |||
QOL—Psychological Health (4–20) | −0.469 | −4.618 | <0.001 | −0.478 | −4.789 | <0.001 * |
QOL—Social Relationships (4–20) | −0.207 | −2.363 | 0.018 | |||
QOL—Environment (4–20) | −0.195 | −1.807 | 0.071 |
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Mohd-Sidik, S.; Lekhraj, R.; Foo, C.N. Prevalence, Associated Factors and Psychological Determinants of Obesity among Adults in Selangor, Malaysia. Int. J. Environ. Res. Public Health 2021, 18, 868. https://doi.org/10.3390/ijerph18030868
Mohd-Sidik S, Lekhraj R, Foo CN. Prevalence, Associated Factors and Psychological Determinants of Obesity among Adults in Selangor, Malaysia. International Journal of Environmental Research and Public Health. 2021; 18(3):868. https://doi.org/10.3390/ijerph18030868
Chicago/Turabian StyleMohd-Sidik, Sherina, Rampal Lekhraj, and Chai Nien Foo. 2021. "Prevalence, Associated Factors and Psychological Determinants of Obesity among Adults in Selangor, Malaysia" International Journal of Environmental Research and Public Health 18, no. 3: 868. https://doi.org/10.3390/ijerph18030868