Compleate Thesis

Risk factors of obesity among population Mogadishu-Somalia
Contents
Declaration……………………………………………………………………………………………………………………………………….II
Approval………………………………………………………………………………………………………………………………………….III
Dedication……………………………………………………………………………………………………………………………………...IV
Acknowledgment …………………………………………………………………………………………………………………………….V
Abstract …………………………………………………………………………………………………………………………………………VI
Abbreviation ………………………………………………………………………………………………………………………………………VI
Chapter One................................................................................................................................................4
1.0 INTRODUCTION.....................................................................................................................................4
1.1 Background......................................................................................................................................4
1.2 Problem statement...........................................................................................................................8
1.3. The purpose of the study................................................................................................................8
1.4 Research objective...........................................................................................................................8
1.4.1- General objective.....................................................................................................................8
1.4.2- specific objectives....................................................................................................................8
1.5- Research questions.........................................................................................................................9
1.6 scope of the study.............................................................................................................................9
1.6.1-geographical scope....................................................................................................................9
1.6.2 content of scope.........................................................................................................................9
1.6.3 Time of scope.............................................................................................................................9
1.7 the significance of the study........................................................................................................9
1.8 Operational definition of key terms............................................................................................9
1.9 Conceptual Framework.................................................................................................................10
CHAPTER TWO...........................................................................................................................................11
LITERATURE REVIEW..................................................................................................................................11
2.0- INTRODUCTION..................................................................................................................................11
2.1 Literature Review..........................................................................................................................11
SOMAVILLE UNIVERSITY HEALTH SCIENCE/PUBLIC 1

2.2 Theoretical review.........................................................................................................................12
2.2.1 Theory One..............................................................................................................................12
2.2.2 Theory two..............................................................................................................................12
2.2.3 Theory three............................................................................................................................13
2.3 Empirical review............................................................................................................................13
2.4 Research gap..................................................................................................................................14
2.5 Sumarry..........................................................................................................................................17
CHAPTER THREE........................................................................................................................................19
RESEARCH METHODOLOGY.......................................................................................................................19
3.0 Introduction...................................................................................................................................19
3.1 Research design.............................................................................................................................19
3.2 Target population..........................................................................................................................19
3.3. Sampling Frame............................................................................................................................20
3.4.1: Inclusion Criteria......................................................................................................................20
3.4.2: Exclusion Criteria..................................................................................................................20
3.5 Research Instrument.....................................................................................................................20
3.6 Sampling methods..........................................................................................................................20
3.7 Sample size.....................................................................................................................................20
3.8 Data analysis..................................................................................................................................21
3.9 Ethical considerations...................................................................................................................21
3.10 Reliability.....................................................................................................................................21
CHAPTER FOUR..........................................................................................................................................22
Data Presentation, Analysis and Discussion of Findings............................................................................22
4.1 Introduction...................................................................................................................................22
4.2 Analysis of Demographic Data.....................................................................................................22
CHAPTER FIVE............................................................................................................................................42
FINDIGS, CONCLUSION AND RECOMMENDATION.....................................................................................42

5.0 Findings......................................................................................................................................42
According the majority of Gender were Female 68.2% while Male were 31.8%..............................42
According the majority of Marital Status were single were 59.1% marriage 40.9%..........................42
5.1 CONCLUSION..............................................................................................................................42
5.2 RECOMMENDATIONS...............................................................................................................43

Chapter One
1.0 INTRODUCTION
This chapter provided introduction, background, problem statement, purpose of the study,
general objectives, specific objectives, research questions, scope of study, significance of study,
operational definition of key terms, conceptual framework.
1.1 Background
Obesity poses a major public health challenge. Each year, obesity contributes to an estimated
112,000 preventable deaths. Obese adults are at increased risk for many serious health
conditions, including high blood pressure, high cholesterol, type 2 diabetes and its complications,
coronary heart disease, stroke, gallbladder disease, osteoarthritis, sleep apnea, and respiratory
problems, as well as endometrial, breast, prostate, and colon cancers. REF: The Surgeon
General's Vision for a Healthy and Fit Nation.
Children with a high body mass index (BMI), an indicator of excess body weight, are more
likely than those with a normal BMI to have insulin resistance (which can lead to diabetes), high
blood pressure, and unhealthy levels of fats and other lipids. Furthermore, obese children often
become obese adults; some studies have found that even 2- to 5-year-olds with a high BMI are
likely to become obese adults. Besides suffering from physical illnesses, obese adults and
children also may experience social stigmatization and discrimination, as well as psychological
problems. In recent decades, the prevalence of obesity has increased dramatically in the United
States, tripling among children and doubling among adults. REF: The Surgeon General's Vision
for a Healthy and Fit Nation
This epidemic increase is the result of specific changes in our environment and behaviors in
susceptible people. High-calorie, good-tasting, and inexpensive foods have become widely
available and are heavily advertised. Portion sizes have increased, and we are eating out more
frequently. REF: The Surgeon General's Vision for a Healthy and Fit Nation
Our children drink more sugar-sweetened beverages than they did in the past, and they are
drinking fewer beverages such as water or low or non- fat milk that are healthier for growing

minds and bodies. However, dietary changes are not completely responsible for the epidemic.
REF: WWW.first5la.org/sugarsweetened
Widespread adoption of multiple technological innovations in the home, workplace, and schools
has reduced our daily physical activity. Similarly, the car-dependent design of our communities
has made it much harder for our children to walk to school—and much harder for us to shop and
Do other errands entirely on a foot or by bicycle REF:
https://www.ncbi.nlm.nih.gov/books/NBK44656/
On top of these changes, many of our nation’s schools have cut back or eliminated recess and
physical education programs. This document highlights the trends, health consequences, and
causes related to the obesity epidemic. Given the multiple social changes behind the epidemic,
this brief also proposes health-promoting actions that can be taken by multiple sectors of society.
(Ahmed, 2021)
Global Obesity is an increasing, global public health issue. Patients with obesity are at major
risk for developing a range of comorbid conditions, including cardiovascular disease (CVD),
gastrointestinal disorders, type 2 diabetes (T2D), joint and muscular disorders, respiratory
problems, and psychological issues, which may significantly affect their daily lives as well as
increasing mortality risks. Obesity‐associated conditions are manifold; however, even modest
weight reduction may enable patients to reduce their risk for CVD, diabetes, obstructive sleep
apnea (OSA), and hypertension among much other comorbidity (Cefalu et al., 2015).
A relatively small and simple reduction in weight, for example, of around 5%, can improve
patient outcomes and may act as a catalyst for further change, with sustainable weight loss
achieved through a series of incremental weight loss steps. In facilitating the process of losing
weight for patients, nurse practitioners play an essential role. REF:
www.cdc.gov/healthyweight/losing_weight.
Through assessing the patient's risk, establishing realistic weight‐loss targets, providing
motivation and support, and supplying patients with the necessary knowledge and treatment tools
to help achieve weight loss, followed by tools for structured lifestyle support to maintain weight
lost, the nurse practitioner is ideally positioned to help patient's achieve their weight‐loss—and
overall health targets. the World Health Organization (WHO) defines overweight and obesity as
abnormal or excessive fat accumulation that presents a risk to health (WHO, 2016a).

A body mass index (BMI) ≥25 kg/m2 is generally considered overweight, while obesity is
considered to be a BMI ≥ 30 kg/m2. It is well known that obesity and overweight are a growing
problem globally with high rates in both developed and developing countries (Capodaglio &
Liuzzi, 2013; WHO, 2016a, 2016b).
In the United States in 2015, all states had an obesity prevalence more than 20%, 25 states and
Guam had obesity rates >30% and four of those 25 states (Alabama, Louisiana, Mississippi, and
West Virginia) had rates >35% (Centers for Disease Control and Prevention, 2016;.
Approximately 35% and 37% of adult men and women, respectively, in the United States have
obesity (Yang & Colditz, 2015).
Adult obesity is most common in non‐Hispanic black Americans, followed by Mexican
Americans, and non‐Hispanic white Americans (Yang & Colditz, 2015).
Individuals are also getting heavier at a younger age; birth cohorts from 1966 to 1975 and 1976
to 1985 reached an obesity prevalence of ≥20% by 20–29 years of age, while the 1956–1965
cohort only reached this prevalence by age 30–39 years (Lee et al., 2010).
Additionally, the prevalence of childhood obesity in 2‐ to 17‐year‐olds in the United States has
increased from 14.6% in 1999–2000 to 17.4% in 2013–2014 (Skinner & Skelton, 2014).
Childhood obesity is an increasing health issue because of the early onset of comorbidities that
have major adverse health impacts, and the increased likelihood of children with obesity going
on to become adults with obesity (50% risk vs. 10% for children without obesity. The aims of
this article are to review the effects of obesity on health and well‐being and the evidence
indicating they can be ameliorated by weight loss, and consider weight‐management strategies
that may help patients achieve and maintain weight loss. Over one third of U.S. adults have
obesity. Obesity is associated with a range of comorbidities, including diabetes, cardiovascular
disease, obstructive sleep apnea, and cancer; however, modest weight loss in the 5%–10% range,
and above, can significantly improve health‐related outcomes. Many individuals struggle to
maintain weight loss, although strategies such as realistic goal‐setting and increased consultation
frequency can greatly improve the success of weight‐management programs. Nurse practitioners
have key roles in establishing weight‐loss targets, providing motivation and support, and
implementing weight‐loss programs.(Sharon M. Fruh, 2017)

Africa in the past, Africa has often been portrayed as a starving and hungry continent. That
seems to be changing rapidly. Obesity is now becoming a huge health challenge especially
among the low and middle-class in Africa's urban cities. Eight out of the 20 fastest rising
countries with adult obesity are found in Africa. The World Health Organization describes obesity
or overweight as abnormal or excessive fat accumulation that presents a risk to human
health. Carrying that extra bulge be it around the waistline, arms or legs could put one at risk of
suffering non communicable diseases such diabetes, heart diseases or even stroke. It could also
trigger cancers such as breast cancer, colon cancer, kidney cancer, ovarian cancer and others. In
many African households, carrying a pot belly is a sign that this person is wealthy and well-fed
but that is false. Apart from a stomach tumor or any other illness, a protruding tummy or being
overweight is actually a sign of bad nutrition and the lack of exercise. Obesity and overweight
kills more people globally than underweight. In Africa, obesity and overweight has added a
double burden to the already stretched health sectors that have to deal with communicable
diseases. Being obese is one of the leading causes of type 2 Diabetes which has been on the
increase in many African countries.
In SomaliaIn 2016, obesity prevalence for Somalia was 12.3 %. Between 1997 and 2016,
obesity prevalence of Somalia grew substantially from 5.6 to 12.3 % rising at an increasing
annual rate that reached a maximum of 5.56% in 2004 and then decreased to 4.24% in 2016.
REF: https://knoema.com/atlas/Somalia/Female-obesity-prevalence
overweight and obesity are defined as abnormal or excessive fat accumulation that presents a risk
to health. A crude population measure of obesity is the body mass index (BMI), a person’s
weight (in kilograms) divided by the square of his or her height (in meters). A person with a BMI
of 30 or more is generally considered obese. A person with a BMI equal to or more than 25 is
considered overweight. Overweight and obesity are major risk factors for a number of chronic
diseases, including diabetes, cardiovascular diseases and cancer. Once considered a problem only
in high income countries, overweight and obesity are now dramatically on the rise in low- and
middle-income countries, particularly in urban settings. Somali immigrants and refugees to the
United States are at high risk for obesity and related cardiovascular risk. Social network
factors influence health behaviors and are important contributors to the obesity epidemic. Somali

immigrants and refugees to the United States are at high risk for obesity and related
cardiovascular risk. Social network factors influence health behaviors and are important
contributors to the obesity epidemic. The objective of this study was to describe social networks
and obesity-related characteristics among adult Somali immigrants in a Minnesota city in order
to inform a community-based, participatory, research-derived, social network intervention to
decrease obesity rates. Survey data (demographics, general health measures, and socio
behavioral and network measures) and height and weight measures (for calculating body mass
index) were collected from adult Somali immigrants by bilingual study team members at
community locations. Descriptive statistics were used to report the survey and biometric data.
Logistic regression models were used to describe the basic associations of participants and
network factors. Network data were analyzed to identify nodes and ties, to visualize the network,
and to identify potential interventionists for a future social network intervention. (osman, 2020)
REF: https://knoema.com/atlas/Somalia/Female-obesity-prevalence
1.2 Problem statement
In complications of Obesity constitutes a worldwide epidemic with prevalence rates which are
increasing in most Western societies and in the developing world. By 2025, if this trend
continues, the global obesity prevalence was reach 18% in men and exceed 21% in women.
Furthermore, it is now well-established that obesity (depending on the degree, duration, and
distribution of the excess weight/adipose tissue) can progressively cause and/or exacerbate a
wide spectrum of co-morbidities, including type 2 diabetes mellitus, hypertension, dyslipidemia,
cardiovascular disease, non-alcoholic fatty liver disease, reproductive dysfunction, respiratory
abnormalities, psychiatric conditions, and even increase the risk for certain types of cancer.
Ref : https://pubmed.ncbi.nlm.nih.gov/25905207
1.3. The purpose of the study

When we have seen how this study is so urgency and how les the related studies of this study, we
have desired to do very important and easy study that was answer any question of this study to
investigate of risk factors obesity among population Mogadishu-Somalia.

1.4 Research objective

1.4.1- General objective
The main objective of this is to explain the Risk factors of obesity among population Mogadishu-
Somalia.
1.4.2- specific objectives

To identify the socio-demography risk factors of obesity among population Mogadishu-
Somalia.
To describe complication of risk factors of obesity among population Mogadishu-Somalia.
To investigate the symptoms of obesity among population Mogadishu-Somalia.
1.5- Research questions

What is the socio-demography risk factor obesity among population Mogadishu-Somalia?
What is complication of obesity among population Mogadishu-Somalia?
What is the symptoms of obesity among population Mogadishu-Somalia?
1.6 scope of the study

1.6.1-geographical scope
The study was conduct at population Mogadishu to identify the risk factors of obesity among
population Mogadishu-Somalia.
1.6.2 content of scope

The study was focus on to describe the risk factors of obesity among population Mogadishu-
Somalia. Especially the socio-demography, and also the complication and symptoms of risk
factors obesity among population Mogadishu-Somalia.
1.6.3 Time of scope

This study started may in 2022 and was end June.

1.7 the significance of the study

The first, significance of this study is to get degree in Somaville university, second, there was
students who was need to write similar to this study to take their study easily also this important
for the ministry of health that needs the data every year new study to control the of problem of
study in our country also is so beneficial anyone who was need to know information of this study
or to write like this study and more others.
1.8 Operational definition of key terms

Risk is the possibility of something bad happening.
factors t is the circumstance, fact or influence that contribute to the result.
Obesity Obesity is a medical condition in which excess body fat has accumulated to an extent
that it may have a negative effect on health.
1.9 Conceptual Framework
Independent variables (IV) Dependent variables (DV)
Demographic factors
Age
Marital status
Education
occupation
complication Risk factors of obesity among

Heart disease
Population Mogadishu-Somalia.
stroke
high cholesterol

Symptoms
Varicose vain
Sleep apnea
Sweeting more than usually
CHAPTER TWO
LITERATURE REVIEW
2.0- INTRODUCTION
This chapter presents literature related to the risk factor of obesity among population Mogadishu
somalia. These literatures have been retrieved from various Books, Journals, articles and studies
related to same problem at hand. The literature was specifically be focusing the sociode-
mographic, the complication and the symptoms of obesity.

2.1 Literature Review

The World Health Organization (2000) defines overweight and obesity as excess fat tissue that
has accumulated to an extent that presents a risk to health. Obesity and overweight can be
described with anthropometric measures, such as the body mass index (BMI). BMI is calculated
by dividing weight (kg) by the square of height(m2).
Reference values for BMI vary by sex, age and ethnicity. As an example, the common cut-offs
used for Caucasians (such as Finns) are presented in Table 1(WHO 2000).
The harmful effects of obesity largely depend on body fat distribution. Compared to overall
obesity, health risks relate more closely to visceral (abdominal) fat mass(Huxley et al. 2010).
Abdominal obesity can be assessed with a measure of the waist circumference (WC). For
Caucasians, WC > 94 cm in men and WC > 80 cm in women indicate an increased risk of
chronic diseases (WHO 2008), whereas WC > 102 cm for men and > 88 cm for women indicate
a high risk of chronic diseases (WHO 2008). In Finland, the Current Care Guidelines for adult
obesity recommends cut-offs of > 100 cm for men and > 90 cm for women to be used in clinical
practice (Working Group of the Finnish Medical Society Duodecimo and Finnish Association for
the Study of Obesity 2011).
2.2 Theoretical review

2.2.1 Theory One
Since the 1980s, the prevalence of obesity has doubled globally from 4.8-7.9% to9.8-13.8%
(Finucane et al. 2011). Within the high-income countries.
North American men had the highest prevalence of obesity (29.2%), whereas Asian-Pacific men
and women had the lowest prevalence (< 10%) in 2008 (Finucane et al. 2011).
The Finnish population used to be one of the heaviest populations in Scandinavia, but nowadays,
Icelanders has become even more obese, whereas populations in Sweden, Norway and Denmark
are remaining among the leanest populations in Europe (Rasmussen et al. 2012). Compared to
the rest of the world.
The prevalence of obesity in Finland is at the average level (Stevens et al. 2012). As in many
other countries, the number of obese Finnish men and women increased between 1980-2002
from 11.3% to 20.7% and from 17.9% to 24.1% respectively (Figure 1) (Lahti-Koski et al.
2010), the intra-individual change in body weight being 0.31-0.35 kg per year
(Pajunenetal.2012).
Adverse changes in fat distribution were seen during the 1990s, as the pace of the cross-sectional
increase in BMI slowed, but WC continued to steadily increase (Lahti-Koski et al. 2007).
The youngest and leanest Finns have gained weight intra-individually more rapidly compared to
the oldest and obese during the decades (Pajunen et al. 2012), but according to cross-sectional
observations, this trend has been attenuated in the 2010s (Männistö et al. 2012a).

2.2.2 Theory two

Adipose tissue is known to be the main storage site for energy, but is also an important regulator
of macronutrient homeostasis and many metabolic processes. In obese individuals, a long-term
excess intake of energy over expenditure leads to lipid accumulation in the adipose tissue,
causing an increase in the number and size(hypertrophy) of adipocytes (Galic et al. 2010, Elks
and Francis 2010). Adipocyte hypertrophy triggers an increase in macrophage infiltration,
leading to chronic low-grade inflammation via a complex interplay between macrophages and
adipocyte-excreted cytokines, known as adipokines.
2.2.3 Theory three

The inflammatory milieu together with lipid accumulation, provides perfect conditions for the
development of metabolic abnormalities, such as dyslipidaemia (Wietlisbach et al. 2013). The
exact molecular mechanisms still remain unclear.
However, excess fat accumulation in the liver triggers hypertriglyceridemia and adecreased high-
density lipoprotein (HDL) cholesterol concentration (Klop et al.2013).
2.3 Empirical review

A field of study concerned with the analysis of how social and cultural factors are related to
population characteristics. Its major focus is the impact of social and cultural factors on
demographic features of society, such as patterns of marriage and childbearing, the agestructure
of the population, life-expectancy, and so forth. In addition, however, social demography also
encompasses examination of the social consequences of demographic change. Since the
demographic characteristics of a society or social group are themselves social phenomena, and
the immediate product of the social (but also biological) events of birth and death, in one sense
the demographic study of any human population is a form of social demography. However,
whereas demography itself is primarily concerned with determining and measuring population
characteristics and the interrelationship between demographic variables, social demographers
seek to understand and explain these demographic patterns. In so doing they draw on the
expertise of sociology as well as of demography. The three main variables underlying population
change are fertility, mortality, and migration, variables themselves associated with factors such
as age at marriage, the proportions marrying, contraceptive use, levels and types of morbidity,
rural-urban migration, and so forth. All receive attention from social demographers, who seek to
understand these processes in terms of a range of standard social factors such as the levels and
distribution of income, levels of education, the position of women, religion, and economic

development. The possible linkages between variables are usually studied by means of social
survey and correlational techniques. Regrettably, theorization in the field tends to be
underdeveloped and restricted to simple models, and there is relatively little attention to
meaning. The way in which culture may shape individuals‟ ideas and beliefs receive, with some
significant exceptions, rather little attention. Ethnographic techniques are little utilized. The
result of this narrowness of approach is that social demography, like demography itself, remains
relatively isolated from the mainstream of sociology. (Obasohan, risk factors of obesity 2015)
2.4 Research gap
Obesity is associated with many medical complications that can reduce a person's quality of life
and in some cases shorten a person's life. Many of the complications described here can be
reduced or eliminated with weight loss. Others, however, such as cancer, are unlikely to be
remedied by weight loss alone. Sleep Apnea Obstructive in which breathing is repeatedly,
interrupted during sleep because the tissues in the back of the throat fail to keep the airway open
is associated with obesity. Snoring is a primary symptom of sleep apnea, and more than five
apnea events per hour can also lead to. Chronic daytime sleepiness. Difficulty concentrating.
Learning and memory difficulties. Falling asleep while working or driving. Depression.
Cardiovascular disease. Sleep is a growing problem in obese children. Treatment for sleep apnea
usually includes the use of mechanical ventilation devices to keep the airway open by delivering
continuous positive airway pressure (CPAP), and bi-level positive airway pressure
(Bopp).Obesity hypoventilation syndrome (OHS) is a condition in which an inability to breathe
deeply enough and quickly enough results in a low level of oxygen and a high level of carbon
dioxide in the blood. OHS was historically known as Pickwickian syndrome, after a character in
Charles Dickens' The Posthumous Papers of the Pickwick Club. While the exact cause of OHS is
not known, doctors believe it results from a defect in the brain's control over breathing and
excess weight against the chest wall. Symptoms of OHS include: Poor sleep quality. Sleep
apnea, Daytime sleepiness, Depression.Headaches, breath, feeling tired with very little effort,
Treatment of OHS may include the use of the same CPAP and BiPAP mechanical ventilation
devices that are used for sleep apnea, often with oxygen therapy. Obesity is the number one risk

factor for type 2 diabetes. It also raises the risk of prediabetes and gestational diabetes (diabetes

during pregnancy).Obesity is not believed to raise the risk of type 1 diabetes, which is an
autoimmune disease. The link between obesity and diabetes appears to be insulin resistance, in
which the body cannot use insulin efficiently to admit glucose into cells, where it can be used or
stored for energy. Insulin resistance is common among people who are obese, and one of the
consequences of insulin resistance is high blood glucose (high blood sugar), which is
characteristic of diabetes.
the list of other possible complications of obesity is very long and includes: Cardiovascular
problems such as high blood pressure, heart disease, accelerated atherosclerosis (“clogging” of
the arteries), and stroke Chronic lower back pain Difficulty maintaining hygiene Fatty liver
disease, which can progress to inflammation and scarring of liver tissue Gallbladder disease
Gastroesophageal reflux disease (GERD), causing inflammation of the esophagus Osteoarthritis,
particularly of the knees Periodontitis (gum disease) Psychological problems, including social
stigmatization and depression Pulmonary hypertension (high blood pressure in the arteries
carrying blood to the lungs) Reduced physical mobility Skin problems, including inflammation
and infection in skin folds (such as the armpits and the underside of the breasts or belly)
Stress urinary incontinence Surgical and post-surgical risks, including wound infection, blood
clots in the deep veins, pulmonary embolism (blood clots in the lungs), and
postoperative pneumonia the complications of obesity are very extensive and was discussed in
greater detail later in this book, based on chronic disorders of separate body systems. Many of
the complications of obesity can reduce the quality of life and also shorten the lifespan. The
consequences of obesity include the following: cardiovascular disorders diabetes mellitus certain
cancers sleep apnea metabolic syndrome osteoarthritis tendon and fascial disorders
gastroesophageal reflux liver disorders gallbladder disease reproductive system disorders
urologic problems, skin disorders social, economic, and psychological problems It should be
noted that metabolic syndrome, diabetes mellitus, and coronary artery disease are more likely in
patients with fat that is concentrated abdominally, high serum triglyceride, family history or type
2 diabetes mellitus or premature cardiovascular disease, or combinations of these factors. Sleep
apnea is an often-undiagnosed condition that causes loud snoring, excessive daytime sleepiness,

and increased risks for hypertension, cardiac arrhythmias, and metabolic syndrome. The obesity-
hypoventilation syndrome, also called Pickwickian syndrome, involves impaired breathing that
causes hypercapnia, lowered sensitivity to carbon dioxide in stimulating respiration, hypoxia, cor
pulmonale, and risk of premature death. This syndrome may occur alone, or secondary to sleep
apnea. Being overweight or obese increases likelihood of developing gout, deep venous
thrombosis, and pulmonary embolism. Obese people experience social, economic, and
psychological problems because of others who treat them with prejudice, discrimination, poor
body image, and lowered self-esteem. Extremely heavy individuals are sometimes
underemployed or unemployed. Each of these topics was discussed later. Weight cycling Weight
cycling is commonly referred to as yo-yo dieting. It involves losing and then regaining weight
multiple times. In the United States, between 10% and 40% of adult females have a history of
weight cycling. The individual is able to successfully lose weight quickly but then regains it.
Over time, these weight changes affect health, body fat distribution, body composition, and the
expenditure of energy. Weight cycling is linked to higher risks for developing metabolic
syndrome and coronary heart disease. All causes of mortality are increased with weight cycling,
and even when a person’s BMI is in a health range, there is reduced quality of life. People who
are obese but have extreme weight fluctuations have an increased taste preference for fat and
sugar, making them likely to gain more weight in the future.
The symptoms of obesity go beyond excess body fat. Skin problems, shortness of breath, trouble
sleeping, and more can affect someone with obesity. Some symptoms are even known to increase
a person's risk of developing certain diseases and disorders. In some cases, these may be life-
threatening or even fatal. This article explains the difference between being overweight and
being obese. It also describes symptoms of obesity in children and adults, as well as possible
complications from the disease. Although gaining a few extra pounds may seem insignificant as
far as a person’s overall health is concerned, gaining too much weight can sometimes lead to a
serious medical condition. The American Medical Association considers obesity itself a disease.
Common symptoms of obesity in adults include, Excess body fat, particularly around the waist
Shortness of breath, Sweating more than usual Snoring Trouble sleeping Skin problems from
moisture accumulating in the folds of skin Inability to perform simple physical tasks that one

could easily perform before weight gain Fatigue, which can range from mild to extremePain,
especially in the back and joints Psychological issues such as negative self-esteem, depression,
shame, and social isolation Common Symptoms in Children and AdolescentsOver 340 million
children and teenager ages 5 to 19 were considered overweight or obese in 2016, according to
the World Health Organization. In the past few decades, the Centers for Disease Control and
Prevention (CDC) found that the rate of childhood obesity has tripled, as reported by Boston
Children’s Hospital. Common symptoms of childhood obesity may include. Fatty tissue deposits
(may be noticeable in the breast area) The appearance of stretch marks on the hips and (dark
velvety skin around the neck and other areas) Shortness of breath with physical activity7
Sleep apnea Constipation Gastroesophageal reflux disease (GERD) Low self-esteem7
Early puberty in girls/delayed puberty in boys Orthopedic problems, such as flat feet or
dislocated hips a growing health concern in many developed countries of the world today,
particularly in the United States. When a person is 100 pounds over optimal body weight with a
BMI of 40 or more, they are considered morbidly obese. Morbid obesity is also called extreme
obesity or class III obesity. A person experiencing health conditions related to obesity, such
as high blood pressure or diabetes, with a BMI of 35 or more is also considered morbidly obese.
Morbid obesity can cause a person to struggle with everyday activities such as walking and can
make it hard to breathe. It also puts a person at high risk for many other serious health
conditions. Symptoms of obesity in adults include shortness of breath, joint pain, and excess
sweating, among others. Children may experience some of the same symptoms as adults, but
may also have others, such as early or delayed puberty, constipation, and GERD.
Obesity (BMI over 30) can occur in adults and children. It causes symptoms including shortness
of breath, fatigue, and joint pain, among others. Obesity can also cause psychological problems
including low self-esteem and depression. Health conditions such as diabetes and high blood
pressure often go hand-in-hand with obesity. Obesity is preventable if it is identified as early in
the disease process as possible. According to the Centers for Disease Control (CDC), the
prevalence of obesity among the general U.S. adult population was 42.4% as of 2021. Obesity
affects some groups of people more than others. It is possible to be overweight and still be

healthy because obesity is not just about your BMI that number does not account for higher
muscle mass.
However, most people who are obese and are considered healthy do not yet show signs of
obesity-related conditions, such as high blood pressure or high cholesterol.
2.5 Sumarry
Disentangling the diverse mechanisms underlying variation of BMI and, in particular,

overweight and obesity is proving exceedingly difficult. The advent of GWA was Risk Factors in
Obesity 89, 90 Hebebrand & Hinney continue to enable the detection of polygenes. DNA of tens
of thousands individuals is required to validate an initial finding, thus illustrating the small effect
sizes. Complex interactions between genes and environmental factors can be assumed to occur.
Treatment of obesity is difficult in both children and adults. Whereas weight gain is
comparatively easy to achieve, weight regain sets in over time; body weight is defended through
renewed exposure to risk factors or inherent physiologic mechanisms. Current prevention
strategies have frequently not proven successful in reducing BMI and obesity prevalence and
incidence rates.
The following (preliminary) conclusions can be drawn from the current status of risk factor
research: (1) The total number of risk factors is likely to be large. (2) Many if not most of the
risk factors have small effect sizes. Accordingly, removal of a risk factor with a small effect size
was have a small individual impact. Nevertheless, on the population level its removal was entail
a sizeable reduction of the obesity prevalence rate. (3) Future treatment or prevention efforts
tailored to the set of risk factors of a single individual seem unlikely as a complete overlap of
risk factors between two obese individuals seems unlikely. From an economical perspective, it
thus would appear rather expensive to devise and carry out individual risk-based interventions.
However, interventions aimed at common combinations of different risk factors harbor the
potential to improve the currently dire outcomes of treatment and prevention programs.

CHAPTER THREE
RESEARCH METHODOLOGY
3.0 Introduction
This chapter presents detailed description of the research methodology. The methodology
refers to the detailed procedure to be followed to realize the objectives. Methodology includes a

description of research design , study populations, sample size, target population ,inclusion
criteria and exclusion criteria, sampling procedure, data collection method, data analysis, ethical
considerations ,reliability and validity.
3.1 Research design

This study was a cross sectional study was employ where both quantitative and qualitative data
design in cross sectional study because; the cross sectional study is in depth investigation of an
individual, group, institution. The cross sectional helps the researcher to study multiple entities in
depth in order to gain insight into the larger case and to describe and explain rather than predict a
phenomenon.
3.2 Target population

A population is a group of individuals, objects or items from which samples are taken for measurement
(Kombo & Tromp, 2006). In this study target population of this study was 50 patients who are
current attending in Mogadishu-Somalia. These groups are most appropriate to provide need
information and have ability to answer the questions as well as access eligibility.
3.3. Sampling Frame
This section was consist of the following two parts such as inclusion and exclusion criteria
3.4.1: Inclusion Criteria

All patients with risk factors of obesity those are ready to participate among population
community in Mogadishu-Somalia.
3.4.2: Exclusion Criteria

All patients those attended and refuse to participate and also those do not have obesity in
Mogadishu-Somalia.
3.5 Research Instrument

The questionnaire is a research instrument with preset questions and guided style of
response that was Use to collect data from respondents. This instrument was contain only
close-ended questions. The questionnaire is applied according to the respondents. The
questionnaire was select for use in this study because it is easy for most respondents to fill in

and also easy for researcher to analyze. Quantitative data collected was used to collect data
from the respondents.
3.6 Sampling methods
This study was use the non-probability sampling and the convenience sampling this study is
conduct because this method was made all respondents was give chance to participate.
3.7 Sample size

The study sample size consists of 44 respondents only; this number is chosen according to the
capacity of the researcher. The formula was used is solvent’s formula:
N= N where n=sample size
(1+N (e) 2 N= target population E= margin of errors of 0.05 50/ (1+50(0.05)2 N=50/
(1+50(0.05)2 =44.44 =44 respondents So
N=44 Respondents.
3.8 Data analysis

Data was analyses using statistical package for social science – SPSS version 20. Descriptive
analysis was done and then frequency tables and charts was use in order to present study results
for easy understanding.
3.9 Ethical considerations

Respect: The researcher was respects respondent’s privacy when entering their private sphere
and when asking questions.
Confidentiality: the researcher is guarantee maximum confidentiality for the participants.

Their information was only being used for the purpose of the study.
Freedom to participate: participants was informed that they are free to participate. They were
also being informed that they have the right to withdrawal.
Informed consent: consent was secured from the participants after fully informing the
nature, potential risks and benefits of the study.

3.10 Reliability
Reliability is the extent to which results are consistent over time and an accurate representation
of the total population under study and if the results of a study can be produced under a similar
methodology, then the research instrument is considered reliable.
3.11 Validity
Validity determines whether the research truly measures that which it was intended to measure
or how truthful the research results are. In other words, researcher generally determines validity
by asking a series of questions, and was often look for the answers in the research of others.

CHAPTER FOUR
Data Presentation, Analysis and Discussion of Findings

4.1 Introduction
This chapter was presented and discussed the data had been analyses by using (SPSS) Software
and Microsoft Excel 2013 Program. It was used in both tabular form containing the type of
responses, its frequencies, percentages, valid percentages and cumulative percentages and it is
also used demonstration for bar charts to elaborate the percentages and frequencies reactions of
respondents.
4.2 Analysis of Demographic Data

This section was analyses the demographical details of the respondents using appropriate
baseline computations.
Table 4.1 Gender
Frequency Percent
Male 14 31.8
Female 30 68.2
Total 44 100.0
Mean = 1.6
Median= 2.00
Source of primary data, 2022
Table 4.1 above and figure 4.1 below illustrated the gender of respondents. A total of 31.8% of
respondents participated in this study were male students and 68.2% of respondents were female.

Figure 4.1 Gender

Table 4.2 Marital Status
Frequency Percent
Married 18 40.9
Single 26 59.1
Total 44 100.0
Mean = 1.59
Median= 2.00

Table 4.2 above and figure 4.2 below showed the majority of respondents have been Single that
were 40.9% And married is 59.1%. therefore the majority of respondent is Marriage.
Figure4.2 Marital Status

Table 4.3 Educational Level
Frequency Percent
Certificate 5 11.4
Diploma 10 22.7
Degree 20 45.5
Master 9 20.5
Total 44 100.0
Mean = 3.05
Median= 3.00
Source of primary data 2022
Table 4.3 above and figure 4.3 below showed the majority of respondents have been Degree that
were 45.5%, while the minority of respondents have been Certificate that were 11.4%, Diploma
are 22.7% And Masters 20.5%. therefore the majority of respondent is Degree.

Figure 4.3 Educational Level
Table 4.4 Age of respondent
Frequency Percent
between 20-39 70 81.4
between 40-59 11 12.8
60 and above 5 5.8
Total 86 100.0
Mean= 2.24
Median= 2.00


Table 4.4 above and figure 4.4 below showed the majority of respondents have been Between
20-39 that were 81.4%, while the minority of respondents have been 60 and above that were
5.8%. And between 40-59 is 12.8%. Therefore the majority of respondent is Between 20-39%.
Figure 4.4 Age of the respondent

Table 4.5 Obesity poses a major public health challenge
Frequency Percent
Yes 31 70.5
No 13 29.5
Total 44 100.0

Mean= 1.87
Median= 2.00
Source of primary Data, 2022

Table 4.5 above and figure 4.5 below showed a total of 70.5% of respondents participated in this
study were Yes students and 29.5% of respondents were No.
Figure 4.5 Obesity poses a major public health challenge

Table 4.6 Children with a high body mass index (BMI), an indicator of excess body weight

Frequency Percent
Yes 41 93.2
No 3 6.8
Total 44 100.0
Mean= 1.47
Median= 1.00

Figure 4.6 Children with a high body mass index (BMI), an indicator of excess body weight
Table 4.7 Our children drink more sugar-sweetened beverages than they did in the past,
and they are drinking fewer beverages such as water or low or non- fat milk that are
healthier for growing minds and bodies.
Frequency Percent
Yes 38 86.4
No 6 13.6
Total 44 100.0
Mean= 1.7

Median= 2.00
Figure 4.7 Our children drink more sugar-sweetened beverages than they did in the past,
and they are drinking fewer beverages such as water or low or non- fat milk that are
healthier for growing minds and bodies.
Table 4.8 Widespread adoption of multiple technological innovations in the home,

workplace, and schools has reduced our daily physical activity
Frequency Percent
Yes 30 68.2

No 14 31.8
Total 44 100.0
Mean= 1.7
Median= 2.00
Figure 4.8 Widespread adoption of multiple technological innovations in the home,

workplace, and schools has reduced our daily physical activity.
Table 4.9 Global Obesity is an increasing, global public health issue

Frequency Percent
Yes 29 65.9
No 15 34.1
Total 44 100.0
Mean= 1.00
Median= 1.21
study were Yes students and34.1% of respondents were No.
Figure 4.9 Global Obesity is an increasing, global public health issue

Table 4.10 Childhood obesity is an increasing health issue because of the early onset of
comorbidities that have major adverse health impacts.
Frequency Percent
Yes 39 88.6
No 5 11.4
Total 44 100.0
Mean= 1.87
Median= 2.00

Figure 4.10 Childhood obesity is an increasing health issue because of the early onset of
comorbidities that have major adverse health impacts.
Table 4.11 Obesity is associated with a range of comorbidities, including diabetes,
cardiovascular disease, obstructive sleep apnea, and cancer
Frequency Percent
Yes 26 59.1
No 18 40.9
Total 44 100.0
Mean= 1.7
Median= 2.00
Table 4.11 above and figure 4.11 below showed a total of 59.1% of respondents participated in
this study were Yes students and 40.9% of respondents were No.

Figure 4.11 Obesity is associated with a range of comorbidities, including diabetes,

cardiovascular disease, obstructive sleep apnea, and cancer.
Table 4.12 Is the socio-demography risk factor obesity among population In Hodan
District Mogadishu-Somalia-Somalia
Frequency Percent
Yes 20 45.5
No 24 54.5
Total 44 100.0
Mean= 1.47

Median= 1.00
Figure 4.12 Is the socio-demography risk factor obesity among population In Hodan
District Mogadishu-Somalia.

Table 4.13 The symptoms of obesity among population In Hodan District Mogadishu-
Somalia is shortness of breath
Frequency Percent
Yes 28 63.6
No 16 36.4
Total 44 100.0
Mean= 1.07
Median= 2.00
Table 4.13 above and figure 4.13 below showed a total of63.6% of respondents participated in

Figure 4.13 The symptoms of obesity among population in Hodan District Mogadishu-
Somalia is shortness of breath.
Table 4.14 Obesity is associated with many medical complications that can reduce a
person's quality of life
Frequency Percent
Yes 19 43.2
No 25 56.8
Total 44 100.0
Mean= 1.17
Median= 1.8

Figure 4.14 Obesity is associated with many medical complications that can reduce a
person's quality of life.
Table 4.15 In obesity person s have a problem for walking to the schools, universities and
other public places
Frequency Percent
Yes 40 90.9
No 4 9.1
Total 44 100.0
Mean= 2.00
Median= 1.00

Figure 4.15 In obesity person s have a problem for walking to the schools, universities and
other public places
Table 4.16 in obesity persons they invests more money transportation for special taxis
more than normal person.
Frequency Percent
Valid Yes 43 97.7
No 1 2.3
Total 44 100.0
Mean= 1.9
Median= 1.02

Figure 4.16 in obesity person’s they invests more money transportation for special taxis
more than normal person.

CHAPTER FIVE
FINDIGS, CONCLUSION AND RECOMMENDATION
5.0 Findings.
According the majority of Gender were Female 68.2% while Male were 31.8%.
According the majority of Marital Status were single were 59.1% marriage 40.9%
According the majority of educational level Were degree 45.5% diploma were 22.7%, Master 20.5%, and
Certificate 11.4%.
According the majority of Age of respondents between 20-39 were 81.4%, between 40-59 were 12.8 and
60 and above were 5.8%.
Major findings according to our interpretation indicate 72.7% of the respondents were Yes, While 27.3%
of the respondents were No. So The Majority of our research is Positive.
5.1 CONCLUSION
The study was carried out to investigate Risk factor of obesity among population In Hodan
District Mogadishu-Somalia.
The research design was both descriptive &correlational research designs and quantitative and
the target sample size was 44 of respondents whose contains different kinds of the people In
Hodan District Mogadishu-Somalia, 10 of the respondents Were Male while 34 of the
respondents Were Female.
Source of information are collect response of the respondents through questionnaire that
distributed to them. The data collection form the respondents were analyzed Using Statistical
Package for Social Science (SPSS) 2022.
Generally, the results of the correlation analysis indicate that there is a significant strong positive
relationship between the people and this diseases In Hodan District Mogadishu-Somalia, Based
on the findings.

5.2 RECOMMENDATIONS
Based on the key findings and the conclusions of the study, the study makes a number of
Recommendations for policy and practical consideration.
 The researchers recommends the people who influenced the obesity eating more fruits
and vegetables.
 The researchers recommends the people who influenced the obesity getting ride of bad
habits and drinking enough water .
 The researchers recommends the people who influenced the obesity stopping eating fat
foods and doing physical exercise daily.
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surgery in patients with type-2 diabetes in three European countries. Obesity
Surgery. 2006;16(11):1488–1503. [PubMed]
2. Agras WS, Berkowitz RI, Arnow BA, Telch CF, Marnell M, Henderson J, et al. Maintenance
following a very-low-calorie diet. Journal of Consulting and Clinical Psychology. 1996;64(3):610–
613. [PubMed]
3. Anselmino M, Bammer T, Cebrian JMF, Daoud F, Romagnoli G, Torres A. Cost-effectiveness and

budget impact of obesity surgery in patients with type 2 diabetes in three European countries
(II). Obesity Surgery. 2009;19(11):1542–1549. [PubMed]
4.Arai K, Miura J, Ohno M, Yokoyama J, Ikeda Y. Comparison of clinical usefulness of very-low-

calorie diet and supplemental low-calorie diet. American Journal of Clinical Nutrition. 1992;56(1
Suppl.):275S–276S. [PubMed]
5.Borg P, Kukkonen-Harjula K, Fogelholm M, Pasanen M. Effects of walking or resistance training on

weight loss maintenance in obese, middle-aged men: a randomized trial. International Journal of
Obesity and Related Metabolic Disorders. 2002;26(5):676–683. [PubMed]

6.British Association of Plastic Reconstructive and Aesthetic Surgeons and Royal College of
Surgeons. Commissioning guide: massive weight loss body contouring. London: Royal College of
Surgeons; 2014. Available from: http://www.bapras.org.uk/downloaddoc.asp?id=1120.
7.Buse JB, Caprio S, Cefalu WT, Ceriello A, Del PS, Inzucchi SE, et al. How do we define cure of
diabetes? Diabetes Care. 2009;32(11):2133–2135. [PMC free article] [PubMed]
8.Christensen P, Bliddal H, Riecke BF, Leeds AR, Astrup A, Christensen R. Blood pressure and lipids
improvement after very low energy diet (VLED) or low energy diet (LED) in obese patients with knee
osteoarthritis: A randomised controlled trial. Atherosclerosis. 2009;207(1):309.
9.Christensen P, Bliddal H, Riecke BF, Leeds AR, Astrup A, Christensen R. Comparison of a low-energy
diet and a very low-energy diet in sedentary obese individuals: A pragmatic randomized controlled
trial. Clinical Obesity. 2011;1(1):31–40. [PubMed].
10. https://pubmed.ncbi.nlm.nih.gov/25905207
11. https://knoema.com/atlas/Somalia/Female-obesity-prevalence
12. https://pubmed.ncbi.nlm.nih.gov/25905207

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Risk factors of obesity among population Mogadishu-Somalia

1.2 Problem statement...........................................................................................................................8

1.3. The purpose of the study................................................................................................................8

1.4 Research objective...........................................................................................................................8

1.4.1- General objective.....................................................................................................................8

1.4.2- specific objectives....................................................................................................................8

1.5- Research questions.........................................................................................................................9

1.6 scope of the study.............................................................................................................................9

1.6.2 content of scope.........................................................................................................................9

1.6.3 Time of scope.............................................................................................................................9

1.7 the significance of the study........................................................................................................9

1.8 Operational definition of key terms............................................................................................9

1.9 Conceptual Framework.................................................................................................................10

2.1 Literature Review..........................................................................................................................11

SOMAVILLE UNIVERSITY HEALTH SCIENCE/PUBLIC 1

2.2 Theoretical review.........................................................................................................................12

2.2.1 Theory One..............................................................................................................................12

2.2.2 Theory two..............................................................................................................................12

2.2.3 Theory three............................................................................................................................13

2.3 Empirical review............................................................................................................................13

2.4 Research gap..................................................................................................................................14

3.1 Research design.............................................................................................................................19

3.2 Target population..........................................................................................................................19

3.3. Sampling Frame............................................................................................................................20

3.4.1: Inclusion Criteria......................................................................................................................20

3.4.2: Exclusion Criteria..................................................................................................................20

3.5 Research Instrument.....................................................................................................................20

3.6 Sampling methods..........................................................................................................................20

3.7 Sample size.....................................................................................................................................20

3.8 Data analysis..................................................................................................................................21

3.9 Ethical considerations...................................................................................................................21

Data Presentation, Analysis and Discussion of Findings............................................................................22

4.2 Analysis of Demographic Data.....................................................................................................22

FINDIGS, CONCLUSION AND RECOMMENDATION.....................................................................................42

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SOMAVILLE UNIVERSITY HEALTH SCIENCE/PUBLIC 3

SOMAVILLE UNIVERSITY HEALTH SCIENCE/PUBLIC 4

SOMAVILLE UNIVERSITY HEALTH SCIENCE/PUBLIC 5

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1.3. The purpose of the study

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1.4 Research objective

1.4.2- specific objectives

To describe complication of risk factors of obesity among population Mogadishu-Somalia.

To investigate the symptoms of obesity among population Mogadishu-Somalia.

1.5- Research questions

What is complication of obesity among population Mogadishu-Somalia?

What is the symptoms of obesity among population Mogadishu-Somalia?

1.6 scope of the study

1.6.2 content of scope

1.6.3 Time of scope

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1.7 the significance of the study

1.8 Operational definition of key terms

factors t is the circumstance, fact or influence that contribute to the result.

1.9 Conceptual Framework

Independent variables (IV) Dependent variables (DV)

complication Risk factors of obesity among

Risk factors of obesity among population Mogadishu-Somalia

Sweeting more than usually

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2.1 Literature Review