INTRODUCTION:

Young adulthood, spanning approximately ages 18 to 26, addressed as 'emerging adults', is a transitional period during the life course. Individual health behavioral patterns developed during this transition often persist into later life influencing their own health. The promotion and sustained behavioral change are best achieved from a targeted approach, by identifying transition points in the life course when individuals are at a higher risk of weight gain. Despite this recognition, young adults between 18 and 25 years of age are a neglected age group compared with children or middle-aged adults and are hard to reach. The World Health Organization (WHO) defines obesity as a BMI greater than or equal to 30. "According to Global statistics in 2023, more than 1 billion people worldwide are obese – 650million adults, 340million adolescents and 39million children (about twice the population of New York).

The WHO is responding to the global obesity crisis. This includes monitoring global trends and prevalence, the development of a broad range of guidance adding the prevention and treatment of overweight and obesity. Thus, providing implementation support and guidance for the restriction of obesity globally. In 2016, Adults aged 18 years and over 39% were overweight, and 13% were obese. And according to an article by India today, the percentage of obese men between the ages of 15 and 49 increased to 23 percent from 19 percent. Among women, the number jumped from 21 percent to 24 per cent. The statistics by National Family Health Survey (NFHS) also declares that Kerala's obesity rate has even surpassed the national average. The survey found that 38.1 per cent of women and 36.4 percent of men from Kerala in the age group of 15 to 49 years were obese. As per WHO studies, over 4 million people are dying each year because of being overweight/obese in 2017. The role of overweight and obesity continues to grow in adults and 7 children. From 1975 – 2016, the prevalence of overweight/obese children and adolescents aged 5 – 19 years increased more than 4% - 18% globally.

Obesity is influenced by certain determinants which include family history, Food patterns, existing health problems, physical activity, stress etc. Nursing students should be aware proper lifestyle strategies for obesity helps them to be healthy as well as indirectly providing a health education to others around them on the importance of good health. When considering the increasing incidence of obesity and related issues, the researchers were interested to understand the determinants of obesity among nursing students.

OBJECTIVES OF THE STUDY:

Primary objective:

· To assess the determinants of obesity among nursing students.

· To determine the knowledge score among nursing students on lifestyle modifications strategies for obesity.

Secondary objective:

· To provide an awareness program on lifestyle modification strategies for obesity.

MATERIALS AND METHODS:

Operational Definition:

ASSESS: It refers to the process of obtaining information about the determinants of obesity and the knowledge regarding the lifestyle modification strategies for obesity among nursing students.

Knowledge:

It refers to response from nursing students on a structured questionnaire regarding lifestyle modification strategies on obesity.

Obesity:

Obesity is defined as abnormal or excessive fat accumulation that presents a risk to health. In this study, WHO classification of BMI above 30 is considered as obesity.

Determinants:

Determinants are factors or issues in the environment, social or political setting, or behavior of individuals that affects their health. In this study, the factors on prevalence of obesity among young adults were identified.

Lifestyle Modification Strategies:

It refers to the activities intended to change the practices of nursing students to promote healthy living.

Research Approach:

Quantitative approach.

Research Design:

Descriptive research design

Research Variable:

· Determinants of obesity among nursing students.

· Knowledge on lifestyle modification strategies for obesity.

Population:

Nursing Students.

Sample:

Second semester B.Sc. Nursing students of TMM College of Nursing, Thiruvalla were selected as the sample population.

Sampling Technique:

Non-probability convenient sampling technique.

Setting of the Study:

TMM College of Nursing, Thiruvalla.

Inclusion Criteria:

· Students who are present at the setting during time of data collection.

· Students with minimum awareness on obesity and lifestyle modification strategies.

Tools and Techniques:

TOOL I:

A Structured questionnaire consisting of two sections

SECTION A:

It contains demographic variables which comprises the items such as age, gender, type of family, physical activity per day, dietary habits, Practice of consuming junk Foods.

SECTION B:

A Self structured questionnaire on determinants of obesity such as height and weight.

TOOL II:

This consisted of a Self- structured knowledge questionnaire regarding lifestyle modification strategies for obesity such as causes, complications and needed lifestyle changes. The questionnaire contains 20 multiple choice questions. Each question carries one mark.

Knowledge score was graded as:

Score	Criteria
0 - 5	Poor
6 - 10	Average
11 - 15	Good
16 - 20	Very good

Content Validity of the Instrument:

Validity is the appropriateness, completeness and usefulness of an attribute measuring research instrument. The content validity of the tool was obtained by presentation and submission of the tool to the subject.

Reliability:

Reliability of the tool was ascertained by the split half method. The tool was found to be reliable with a score of 0.99.

Pilot Study:

The pilot study was conducted among the 10 third year GNM students of TMM college of Nursing, Kaviyoor. The tool was found to be feasible.

Data collection:

The study was conducted in TMM College of Nursing, Kaviyoor on 27.06 2023 to 29.06.2023 among 2nd semester nursing students. Samples were drawn using non-probability convenient sampling techniques as per the inclusion criteria. The research group was introduced and explained the purpose of the study. The willingness of the nursing students to participate in the study was confirmed by getting consent from them. The height and weight of the students were checked and recorded. Structured questionnaire was administered among the nursing students. Subsequently a structured teaching programme was given on the same day for 1 hour on 29.06.2023. Data was planned to be analyzed based on objectives. The baseline characteristics determinants of obesity and the knowledge of students regarding lifestyle modification strategies for obesity were analyzed by using descriptive statistics (Frequency and percentage).

RESULT:

OBJECTIVE: 1

To assess the determinants of obesity among nursing students.

Section A:

Frequency and distribution of sample based on demographic data.

Table 1: Frequency and Percentage Distribution of Demographic Variables. n= 65

Variables	f	%
Age:
17-18	18	27.69%
19-20	47	72.31%
Gender:
Male	3	4.62%
Female	62	95.38%
Dietary pattern:
Vegetarian	2	3.08%
Mixed	63	96.92%
Snacking during study
Yes	47	72.30%
No	18	27.70%
Skipping breakfast
Yes	34	52.30%
No	31	47.70%
Drinking water
< 0.5 l	9	13.84%
1-2l	39	60%
3-4l	15	23.07%
>4.5l	2	3.09%
Frequency of fast food
Everyday	2	3.07%
Once a month	21	32.31%
Once a week	21	32.31%
Not very often	21
Reason for fast food
Advertisement	12	18.46%
Peer Pressure	9	13.84%
Variety of Menu	20	30.76%
Others	24	36.94%

Table 1 shows that, out of 65 samples, the majority (72.3%) were in the age group of 19-20 years among females following a mixed dietary pattern. The majority (72.30%) of samples snack during study time. 52.305 skip breakfast, 60% students drink 1-2 L of water daily. 32.31% order fast food at a frequency of once a month, once a week and not very often among 36.94% have other reasons for ordering fast foods.

Figure 1: - Frequency and Percentage of Bmi. n=65

Figure 1 shows that more than half (52.31%) of the samples have normal weight and less than half (23.08%) are overweight and 9.23% are obese.

Section II: Frequency and percentage distribution of determinants of obesity.

Table 2: Frequency and Percentage Distribution of Determinants.

Variables	f	%
Family History
Yes	4	6.15
No	61	93.85
Exercise
Yes	14	23.08
No	51	76.92
Health Problems
Menstrual irregularities	18 1	1.50
Thyroid problem	46	27.7
None		70.80
Preference to study
Sitting	52	80
Walking	13	20
Leisure Time
Reading books	8	12.30
Sleeping	23	35.38
Mingling with friends	31	47.69
Eating snacks	3	4.63
Hours of Sleep
<4 hrs	3	4.61
5 - 6 hrs	48	73.84
7 - 8 hrs	13	20
7 hrs	1	1.53

Table 2 shows that the majority (93.85%) of students have no family history of obesity. Less than a quarter (23.08%) are doing regular exercises along with 26.66% (4 students) walking, 13.33% (2 students) skipping and more than half of samples are doing pushups, jogging etc. More than three quarters (76.92%) are not doing any regular exercise. The majority (70.80%) have no health problems .61.54% have no pocket money influence while choosing fast food. 80% of samples have sitting as a preference of study and 47.69% use their leisure time by mingling with friends and more than half of the students are having 5 - 6 hours of sleep (73.84%).

Figure: 2 Frequency and Percentage of Stress.

Figure 2: shows that, 26.15% (17 students) is having no stress and 73.84% (48 students) is having stress along with 79.16% (38 students) is having academic stress, 14.5and (7 students) is having peer relationship, 2.08% (1 student) is having family stress and 4.16 % (2 students) is having financial stress.

Objective: 2 To determine the knowledge level of nursing students on lifestyle modifications strategies for obesity.

Figure:3-Percentage of Pretest Knowledge Scores.

Figure 3 shows that 1.53% (1 student) has poor knowledge, 53.84% (35 students) has average knowledge and 44.61% (29 students) have good knowledge.

DISCUSSION:

Report of findings is never sufficient to convey significance. The meaning that the researcher gives to the results plays a rightful and important role in the report. The discussion section is devoted to a thoughtful and insightful analysis of the finding leading to a discussion of clinical and theoretical utility.

Sadhu Charan et al (2017) conducted a comparative cross-sectional study conducted from December 2016 to April 2017 among 600 children of class VI to X of two government and two private schools using systematic sampling method. Pre-designed and pre-tested questionnaires were used to elicit information on demographic variables and lifestyle behaviors. The study results reveal that prevalence of overweight and obesity were 8.9%and 3.4% respectively. Obesity was found more among girls (3.8%) and more children from private school were obese.

Yashneil Singh Rautela et al (2018) conducted a study on community-based cross-sectional study in Sirkhot, Uttarakhand, in 2016. 155 adults systematically sampled, aged above 20 years. The result shows in the present study, 61.3%were females. The mean age of the study participants was 38.3(±13.6) years. The prevalence of overweight was 14.8% and obesity was 55.5%. A total of 92.9% of the study participants reported consumption of junk food.

Section A: Assessment of socio-demographic variable:

In the present study distribution of samples according to various demographic variables revealed that,

· Out of 65 2nd Semester nursing students, the majority (72.31%) were in the age group of 19-20 years. Among these, 95.8% are females and 96.92% are following a mixed diet.

· Half of the students have normal BMI, 23.08% (15 students) are overweight.

Section B: Assessing determinants affecting obesity:

The Factors of obesity under study revealed that,

· 93.85% have no family history of obesity.

· 23.08% (14 students) are doing regular exercises along with 26.66% (4 students) walking, 13.33% (2 students) skipping and 53.33% (8 students) doing pushups, jogging etc. 76.92% (51 students) are not doing any regular exercise.

· 26.15% (17 students) is having no stress and 73.84% (48 students) is having stress along with 79.16% (38 students) is having academic stress, 14.5 and (7 students) is having peer relationship, 2.08% (1 student) is having family stress and 4.16% (2 students) are having financial stress.

· 80% of students have sitting as a preference to study. 72.30% of students snack during study. time and 47.69% use their leisure time by mingling with friends.

· 73.84% (48 students) is having 5-6hours of sleep, 20% (13 students) is having 7-8hours of sleep, 4.61 % 9 3 students) is having < 4hours of sleep, 1.53% (1 student) is having 8 hours of sleep.

· 52.30% skips breakfast, 60% students drink 1-2 L of water daily and 70.80% has no health problems. 32.31% order fast food at a frequency of once a month, once a week and not very often. 36.94% have other reasons for ordering fast foods and 61.5 have no pocket money influence while choosing fast food.

· 1.53% (1 student) is having poor knowledge, 53.84% (35 students) is having average knowledge and 44.61% (29 students) is above average.

Section C: Assessment of Knowledge regarding obesity

Out of the 65 samples, 1.53% (1 student) is having poor knowledge, 53.84% (35 students) is having average knowledge and 44.61% (29 students) is above average.

CONCLUSION:

The focus of the study is to assess the determinants of obesity and knowledge on lifestyle modification strategies for obesity among nursing students in TMM College of nursing Thiruvalla. Quantitative Descriptive research approach is used here in the study. 65 students were selected using Convenient sampling technique. The data was processed using Microsoft Excel and were analyzed and interpreted by applying descriptive statistical methods. The major findings of the study were identified as inactivity, academic stress, absence or regular exercise and more than half of the students were having an average knowledge on lifestyle modification.

CONFLICT OF INTEREST:

The authors have no conflicts of interest regarding this investigation.

ACKNOWLEDGEMENTS:

The authors would like to thank the 2^nd semester B.Sc. nursing students of TMM College of Nursing for their kind support during the study.

REFERENCE:

1. Sayyed Salar Gaffar. Quadrilateral Figure Method: An Innovation in Probability Sampling Method. International Journal of Indian Psychology. 2018 Oct 29; 6(4).

2. International Journal of Nursing Education and Research [Internet]. 2014 Mar 28 [cited 2023 Dec 16];2(1):43–9. Available from: https://ijneronline.com/AbstractView.aspx?PID=2014-2-1-10

3. Fruh SM. Obesity: Risk factors, complications, and strategies for sustainable long-term weight management. Journal of the American Association of Nurse Practitioners. 2017 Oct 12; 29(1): S3–14

4. Kadam, A., and Shinde, M. B. Effectiveness of Structured Education on Caregivers Knowledge and Attitude Regarding Colostomy Care. International Journal of Science and Research 2014; 3(4): 586-593.

5. Babu, R. L., Mali, N., and Shinde, M. Effectiveness of Planned Teaching Programme on Knowledge Regarding Non-Curative Care of Terminally ILL Cancer Patients among Caretakers. International Journal of Science and Research. 2014; 3(4): 198-205.

6. Shinde M, Desai A, Pawar S. Knowledge, Attitudes and Practices among Caregivers of Patients with Schizophrenia in Western Maharashtra. International Journal of Science and Research. 2014; 3(5): 516- 22.

7. Obesity in India: 2007 Available from URL: http://en.wikipedia.org/wiki/Obesity_in_India

8. Hormis N, D‟silva F. Obesity among Adolescents of urban and rural schools of Mangalore. The Nursing Journal of India. 3: 106

9. Kotian MS., et al. Prevalence and determinants of overweight and obesity among adolescent school children of South Karnataka, India. Indian Journal of Community Medicine. 2010; 35(1): 176-178.

10. Sujit Kumar., et al. To study the risk factors associated with overweight and obesity among adolescents in Patna, Bihar. International Journal of Contemporary Medical Research. 2018; 5(9): 11-13.

11. Xue B, Zhang X, Li T, Gu Y, Wang R, Chen W, et al. Knowledge, attitude, and practice of obesity among university students. Annals of Palliative Medicine [Internet]. 2021 Apr 1; 10(4): 4539546–4534546. Available from https://apm.amegroups.com/article/view/68416/html

12. Salam RA, Padhani ZA, Das JK, Shaikh AY, Hoodbhoy Z, Jeelani SM, et al. Effects of Lifestyle Modification Interventions to Prevent and Manage Child and Adolescent Obesity: A Systematic Review and Meta-Analysis. Nutrients. 2020 Jul 24; 12(8): 2208.

13. Moreshwar S. A Study to Evaluate the Effectiveness of Planned Teaching Programme on Obesity and its Consequences among Adolescents in Selected Private High Schools.

14. Obesity [Internet]. World Heart Federation. Available from: https://world-heart-federation.org/what-wedo/obesity/.

Received on 22.05.2025 Revised on 01.07.2025

Accepted on 02.08.2025 Published on 13.08.2025

Available online from August 20, 2025

Asian J. Nursing Education and Research. 2025;15(3):149-154.

DOI: 10.52711/2349-2996.2025.00031

This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License. Creative Commons License.