Impact of Diet on Obesity and Related Health Issues

The provided assignment is a collection of research papers and articles that examine the relationship between diet and obesity. It covers various aspects, such as the impact of diet on human intestinal microbiota, the effects of high-fat diets on bone mineral content, and the role of leptin resistance in diet-induced obesity. The assignment also touches upon the importance of exercise training in augmenting improvements in quality of life induced by energy restriction for obese populations. It appears to be a comprehensive review of existing research on the topic, providing a detailed analysis of the complex relationships between diet, obesity, and related health issues.

Running head: DIET AND OBESITY
Diet and Obesity
Name of the student
University name
Author’s note

1DIET AND OBESITY
Abstract
The current study focuses upon the impact of diet on obesity on the 40- 60 age group
in England. In this respect, focus has been shifted to a number of lifestyle habits and
approaches along with psychological perspectives which further govern the eating habit in
individuals. It has been seen that sedentary lifestyle along with homeostatic imbalance have
been seen to trigger development of obesgogenic conditions. At any pint of time less
expenditure compared to more intake of high calorific food can contribute towards the
development of obesogenic conditions. This is further influenced by a number of
psychosocial conditions such as self beliefs and perceptions along with environmental
stimulus.

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Table of Contents
Proposal..................................................................................................................................3
Rationale....................................................................................................................................3
Literature review:.......................................................................................................................6
Identification of gaps..................................................................................................................8
Methodology of the research:.....................................................................................................8
Dissertation:..........................................................................................................................12
Chapter 1: Introduction.........................................................................................................12
1.1 Background of the study....................................................................................................12
1.2 Rationale of the research....................................................................................................12
1.3 Aim of the research and research objectives......................................................................13
1.4 Significance of the research...............................................................................................14
1.5 Limitations of the research.................................................................................................14
1.6 Structure of the dissertation...............................................................................................15
1.7 Summary............................................................................................................................15
Chapter 2: literature review..................................................................................................16
2.1 Introduction........................................................................................................................16
2.2 Conceptual framework.......................................................................................................16
2.3 Sensory and cognitive aspects of food preference.............................................................17
2.4 Theories of weight and eating behaviour...........................................................................18
2.5 Impact of diet upon obesity within 46-60 age groups in England.....................................19

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2.6 Homeostatic and self –determination theory of obesity.....................................................19
2.7 Socio-ecological model of obesity focussing on the 40-60 age groups in England...........20
2.8 Gap analysis.......................................................................................................................22
2.8 Conclusion..........................................................................................................................23
Chapter 3: Research methodology........................................................................................24
3.1 Research philosophy..........................................................................................................24
3.2 Research onion...................................................................................................................25
3.3 Approach of the research...................................................................................................25
3.4 Research design..................................................................................................................26
3.5 Research strategy...............................................................................................................27
3.6 Data analysis tools..............................................................................................................27
3.7 Reliability and validity.......................................................................................................27
3.8 Ethical considerations........................................................................................................28
3.9 Summary............................................................................................................................28
Chapter 4: Data analysis.......................................................................................................29
Quantitative Data Representation and Interpretations.............................................................29
Qualitative data Interpretation..................................................................................................36
Thematic analysis:....................................................................................................................38
Theme 1: Effects of binge eating on obesity and health.........................................................38
Theme 2: factors contributing to an obesogenic environment.................................................38
Chapter 5: Conclusion and recommendations......................................................................39

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5.1 Conclusion..........................................................................................................................39
5.2 Linking with objectives......................................................................................................40
5.3 Recommendations:.............................................................................................................42
5.4 Research limitations...........................................................................................................43
5.5 Future scope of the study...................................................................................................44
References................................................................................................................................47

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Proposal
Rationale
The current research proposal focuses upon the issues of diet and obesity within the
age group of 40-60 in England. Obesity and binge eating are significant health issues across
all age groups. This is because carrying excess weight can have severe implications on the
physical and mental health of an individual (Munt et al. 2017). Diet has been significantly
linked with obesity where taking food with high calorific value can have negative
consequences such as triggering the development of plague or bad cholesterol in the blood
(Appleby and Key 2016). There were a couple of reasons for undertaking this research which
could be further supported with the help of facts and statistics. 63% adults within the age
group of 40-60 in England were classified as being overweight or obese with a BMI of over
30 (nhs.uk 2018). Additionally, there was a sharp increase in the rate of obesity from 13.2%
to 26.9% in men and 16.4 to 26.85 in women (ons.gov.uk 2018). Overall the prevalence of
obesity rose from 14.9% to 26.95 between 1993 to 2015 (nhs.uk 2018). The obese people
had 2.5 times more chances to develop high blood pressure (Neale et al. 2016). They also had
a 5 times more propensity for the development of type 2 diabetes. Therefore, a proper health
management plan was required to control the high rates of obesity within the adult population
of England. There are multiple causes of obesity which could be further divided into –
physiological, behavioural, psycho-social and environmental factors. Obesity can bring
along with it a number of health complications such as –type 2 diabetes, hypertension,
cancer, heart disease and stroke.
Objectives
The objectives of the research have been discussed as follows:

6DIET AND OBESITY
• To identify the factors which developed obesity within the age group of 40-60 in
England
• To identify the health implications of obesity within the age group of 40-60 in
England
• To critically analyse the relation between binge eating and obesity within the age
group of 40-60 in England
• To critically understand the contributory factors towards binge eating
• To identify the control methods for obesity management
Literature review:
The gain in weight could be related to a number of lifestyle and health habits within a
specific age group. Some of these factors are unhealthy diet and physical inactivity which
contribute towards the development of serious conditions such as cardiovascular diseases. As
mentioned by Tomlinson et al. (2016), smoking and alcohol have been seen to be
contributory factors in the development of obesity. The consumption of sugary and fat rich
diets can lead to the development of obesity. On the contrary as argued by Miller et al.
(2016), consumption of vegan diet which is rich in legumes, fruits and vegetables may
prevent the gain of weight. However, no specific evidences have been gained in this regard.
As commented by Mansoor et al. (2016), the lack of physical activity triggers obesity
within individuals. On the other hand, obesity makes physical activity difficult within the
population. TV watching is one of the sedentary activities associated with obesity.
Additionally, short sleep duration has also been seen to trigger obesity (Munt et al. 2017).
There are a number of factors governing obesity in men who tend to associate bigness with
being healthy and sturdy (Wang et al. 2016). Men tend to accumulate abdominal fat which

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has been associated with cardiovascular disease and type 2 diabetes. The levels of
testosterone reduce from as early as the age of 30 years and have been related with increase
in fat mass (Mansoor et al. 2016). Evidences and study have linked obesity with family
hereditary and genetics. However, as supported by Golden et al. (2015), exercise and proper
diet can control the rate of deposition of adipose tissue. A total of 35,820 deaths in England
and Wales could be related to obesity (nhs.uk 2018). This is because overweight in females
have been further associated with the development of serious health conditions such as
polycistronic ovarian disorder. Obesity corresponds to 7.1 percent of the total deaths in a year
along with contributing towards the additional health costs (ons.gov.uk 2018). Additionally,
environmental and psycho-social factors have also contributed in the development of obesity
within the specified age group population of UK. Some of the factors such as peer pressure
can also contribute towards taking up of unhealthy habits such as alcohol and smoking in an
individual which contributes towards the development of body fats (Feeney et al. 2016).
Older Americans consume food with high levels of sodium and over seasoned foods which
contribute towards the development of excess body fats (Miller et al. 2016). As supported by
Feeney et al. (2016), old age has also been related to loneliness and isolation. Some of this
has been seen to contribute to the development of depressive conditions in the old gage
group. As a supported by Neale et al. (2016), binge eating have been further linked with the
development of obesogenic conditions . However, binge eating is a compulsive behaviour
which has often been linked to low mood and depression. As argued by Watson et al.
(2016), the lack of awareness within the population regarding healthy eating habits can also
result in the development of excess fat tissues in the body.

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Identification of gaps
There are a number of gaps within the literature sources as it failed to identify the
exact cause for the development of obese conditions within the population. The causes vary
with each and every individual and needs to be addressed. Apart from the environmental
conditions there are genetic factors which contribute equally towards the development of
obesogenic conditions in an individual. However as argued by Miller et al. (2016), no direct
link have been found between hereditary and obesity. Additionally, some of the research
conducted so far have failed to take into consideration the presence of different diseases,
which contributes equally towards the development of obesogenic conditions.
Methodology of the research:
Research approach
The research approach could be divided into two different types such as deductive and
inductive. The deductive approach tests the validity of the stated assumptions and helps in
arriving at a hypothesis. It helps in arriving at specific hypothesis from generalized facts and
theories. In this context, when the premises is true the conclusion is also expected to be true.
The deductive approach is best suited for secondary research design where already stated
facts and theories are used for the development of hypothesis (Smith 2015).
The inductive approach on the other hand is based upon observation and patterns for
arriving a suitable theory. The inductive approach is based upon finding the pattern through
observations and the development of explanations through observations (Lewis 2015). The
data collection through inductive approach is done using open-ended questionnaire. The open
ended questionnaire follows a qualitative and interview pattern of data collection.

9DIET AND OBESITY
For the current study the researcher will be following an inductive approach where the
data will be collected using interview questions. The researcher will get sufficient freedom to
alter the direction of the research using an inductive approach.
Data accessibility
Depending on the kind of data collection method used, the researcher will face data
accessibility issues. If the researcher uses a primary method of data collection getting
consent from the participants of the survey process is critically important. In this respect, the
participants will be informed beforehand regarding the objective and particulars of the survey
process. As commented by Creswell and Creswell (2017), inability in getting sufficient
cooperation from the participants of the research process can result in hindrances in achieving
sufficient data.
Sampling approach
The researcher will use a simple random probability sampling which will provide
every subject equal amount of opportunity for participating in the data collection process.
The simple random probability sampling will help in removing the biasness of the selection
process (Merriam and Tisdell 2015).
Validity and reliability
The validity and reliability of the data collection process can be questioned depending
upon the type of data collection process that will be used by the researcher. The validity and
reliability of secondary data will be ensured by the researcher based upon a number of facts.
For secondary research, only journals belonging to the last five years will be selected.
Additionally, only articles printed in English will be selected for review by the researcher.

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The search will be generated using specific keywords which will help in finding the right
articles.
Limitation
The researcher will have to face a number of limitations in conducting the research.
One of the major limitations which will be faced by the researcher over here is limited access
to secondary articles and journals which are necessary to conduct the research study by the
researcher. Additionally not being able to get sufficient cooperation and support from the
participants of the research process can result in further limitations in the process of data
analysis (Cooper 2015).
Intended approach to data analysis
The data analysis approach used by the researcher could be divided into two main
types- primary and secondary method. The primary method of data collection could be
further divided into quantitative and qualitative methods. In the secondary method of data
collection the researcher will be gathering sufficient data from articles and journals.
For the current research, the researcher will be using mixed methods of data
collection. The researcher here will conduct both survey and interview for gathering
sufficient data. This will be used by the researcher for the purpose of data collection. The
researcher will get in touch with some of the patients admitted in the UK based hospitals who
had been receiving treatment for cardiovascular diseases and type 2 diabetes. The participants
will be divided into focus groups and they will be asked questions pertaining to their eating
and lifestyle habits. The responses will help the researcher in understanding the contribution
of diet towards development of obesity. The researcher will conduct a comparative analysis

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using qualitative and quantitative methods which will help them in arriving at important
results and data.

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Dissertation:
Chapter 1: Introduction
1.1 Background of the study
The current study focuses on the aspect of diet and obesity within the age group of 40-
60 in England. Obesity has been a global concern and one of the biggest contributors for the
deteriorating health in people worldwide. There can be a number of possible causes for
obesity including sedentary lifestyle, improper diet. Eating right along with active lifestyle
are some of the factors which can keep obesity in control (Evans et al. 2015). For the current
study, we will be focussing upon the age group of 40-60 in England who had been suffering
from a number of co-morbid health conditions owing to obesity. Obesity also affects the
mental and psychological well being of people (Sainz et al. 2015).
In the current study the discussion of obesity would be conducted with reference to
diet and presence and the affect of the same over the life of individual within the age group of
40-60 in England.
1.2 Rationale of the research
In the current chapter the effect of diet on obesity will be discussed and also the
manner in which the diet could be modulated to bring about positive health changes within
the population. The proportions of men who are obese within the age group of 40-60 have
increased from 66.7% to 76.8% by the year 2013, whereas for women the figures have risen
from 54.8% to 63.4% (nhs.uk 2018). Additionally, there has been a rise in the number of
reported cases of type 2 diabetes along with some of the other health issues such as cancer,
stroke etcOne of the basic causes is the consumption of high calorific food. The rate of

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intake of calorie for an averagely active man and woman ranges between 200-250 calories.
The additional burden at jobs, stress, low mood, less health concerns have resulted in people
making poor food choices. The rate of obese people with diabetes within the age group of 40-
60 has doubled over the past 20 years (Gao et al. 2017). As commented by Buettner et al.
(2016), type 2 diabetes can lead to a number of complications such as amputation, heart
attack, kidney disease, stroke and blindness etc. (Gao et al. 2017).
1.3 Aim of the research and research objectives
The research aims at finding out the link between diet and development of obesity
within 40-60 age groups in England.
Objectives of the research
A number of research objectives have been designed based upon which the research
questions have been further developed.
 To identify the factors which developed obesity within the age group of 40-60 in
England
 To identify the health implications of obesity within the age group of 40-60 in
England
 To critically analyse the relation between binge eating and obesity in the age group
of 40-60 in England
 To critically understand the contributory factors towards binge eating
 To identify the control methods for the management of obesity

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Research questions
The objectives of the research have been further used for the development of research
questions and have been entailed below:
 What are the factors which developed obesity within the age group of 40-60 in
England?
 What are the health implications of obesity within the age group of 40-60 in England?
 What is the relationship between binge eating and obesity within the age group of 40-
60 in England?
 What are the factors which contribute to binge eating?
 Which control methods could be employed for the management of obesity?
1.4 Significance of the research
Obesity is a global health concern and has been linked to the development of a
number of co-morbid conditions. From studies and evidences it has been found that around
11.9 million people are at an increased risk of developing type 2 diabetes owing to morbidly
obese conditions (nhs.uk 2018). It has been found that elevated levels of serum fatty acids
have been seen produce a negative feedback over the production of insulin.
1.5 Limitations of the research
There are a number of limitations of the research such as the research fails to take into
consideration the different genetic factors which contribute towards the development of
obesogenic conditions in individuals. The research objectives also fail to take into
consideration the food habits of the population in general

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1.6 Structure of the dissertation
Figure: structure of the research
(Source: Author)
1.7 Summary
The chapter discusses the background and the rationale of the current research issue.
The background has been provided in much detail which highlights the effect improper diet
can have upon the overall health of individual and community.
I N T R O
D U C T I
O N
L IT E R A T
U R E
R E V I E W
R E S E AR C
H
M E T H O D
O LO GY
D A T A
A N A L Y
S IS
C ON C L US IO N
A ND
R EC O M M E N D
A TIO N

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Chapter 2: literature review
2.1 Introduction
The study here discuses the impact of diet upon obesity and the factors which
influence the diet types in individuals. For the current study, people within 40-60 age groups
residing in England have been taken into consideration. Some of them have been seen to be
suffering from a number of co-morbid conditions such as asthma, type 2 diabetes and
cardiovascular diseases. By the year 2020, the rate of type 2 diabetes within the population is
expected to double. The occurrence of the same has been related to certain lifestyle behaviour
and approaches. The sedentary lifestyle and intake of calorie rich foods have been seen to
trigger obesogenic conditions and a number of health co-morbidities. The chapter here
discusses several theories and models relate diet preferences and obesity. The socio-
ecological model of obesity helps in looking at the bigger picture which has been further
discussed over here.
2.2 Conceptual framework
Figure: concept map for impact of diet on obesity
Attitudes/lifestyle/
health
Wants/preferences
Concept
formation Diet preferences Obesity
and co-
morbid

17DIET AND OBESITY
(Source: author)
2.3 Sensory and cognitive aspects of food preference
Research and evidences have suggested that a lot of the eating preferences are guided
by the sensory and cognitive aspects of an individual. The food preferences in an individual is
guided by a number of factors such as culture, development of food preference, emotional
relationship to food preference, perception to foods and gift markets. For example, the
British and the Scandinavian people do not prefer the addition of garlic in their cooking
recipes (McCrickerd and Forde 2016). However, garlic has been seen to serve as a rich
oxidant and also control the blood sugar level. Therefore, the omission of such an important
nutrient from the diet could be related to the lack of knowledge.
In addition, the upbringing and family circle of an individual also influences their
food habits. As mentioned by Lafraire et al. (2016), the people who are busy and constantly
moving have been seen to prefer to readymade foods more compared to homemade foods.
As mentioned by Forde (2018), the preferences towards certain foods are guided by the
sensory as well as the cognitive factors. The offering of certain kind of food in the early
developmental stages of childhood has been treated as a reward. For example in the early
developmental stages the parents would only agree to provide chips or fried foods to the
children on following their instructions and heaving in a decent manner. Therefore,
consumption of certain delicacies is considered as a reward befitting positive actions
(Lafraire et al. 2016). However, if the food tastes bitter in the very first attempt then one may
not develop liking for it in the future. Hence, both sensory and cognitive abilities guide the
food preferences in individuals.
The preference for certain kinds of food is further guided by emotions. Aroma
stimulations are stored in the memory processing centre of the brain. Thus, emotions can be

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closely related to aromas of different kinds of food. Psychology often relates binge eating
with different kinds of emotions such as the desire for crunchy food arises when one is angry,
bored or frustrated (Piqueras-Fiszman and Spence 2018). On the other hand, soups have been
related to being sad or lonely, wine and gourmet foods could be further related to emotions
and love.
2.4 Theories of weight and eating behaviour
There are different theories guiding weight and eating behaviour within individuals.
It also depends upon the individual ideas and perceptions related to weight which further
influences their eating habit. Some people hold and incremental view of weight whereas
others hold and entity view of weight. The incremental view states that weight is changeable
through diet and exercise whereas the entity view states that one’s weight is fixed owing to a
number of genetic factors and could hardly be changed (Curtis et al. 2015).
The implicit theory helps in the establishment of the relationship between the self
efficacy and healthy eating behaviour. As mentioned by Piqueras-Fiszman and Spence
(2015), the view of weight as malleable has been seen to promote healthy eating behaviours
in an individual. On the other hand people who thought weight was guided by genetic
factors were seen to indulge into binge eating more. The binge eating would often stem from
negative self or social image resulting in the development of depressive disorder. As
reported by Lafraire et al. (2016), the implementation of incremental theory further
supported the development of healthy eating in an individual by down regulating the
consumption of high calorie and high fat snack. It promotes self motivation within people to
reduce the excessive fat or body weight.

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2.5 Impact of diet upon obesity within 46-60 age groups in England
Some of the factors which have been contributing to the obesity within are the
mid-life crisis faced by old age people. Most people in their old age often lose hope of losing
weight or lack the enthusiasm for participating in weight loss programs. They are guided by
the notion that weight is guided by genetic factors and therefore nothing could be done
regarding it. Additionally, the presence of a number of co-morbid conditions further triggers
increase in weight in old age. The presence of a number of conditions such as type 2
diabetes makes people dependent upon steroidal drugs, which further increases the weight
gain problem within the population (Brownell and Walsh 2017). The dietary approach to
weight loss states that the total intake should be less than expenditure. However, as supported
by Nurkkala et al. (2015), old age is marked by sedentary lifestyle which results in much of
the energy being stored in the body which increases the overall intake of calorie. One of the
biggest challenges which are faced over here is convincing the person suffering from obesity
that they are eating too much. NICE guidelines 2014 have recommended diet with a 600kcal
deficit (nice.org.uk 2018). Self awareness and setting reality expectations are the basic
aspects of cognitive structuring. However as argued by Montano and Kasprzyk (2015),
amidst mid life crisis faced by people within the age group of 40-60 is there is an increased
tendency to indulge in binge eating characterised by low mood disorders. There is more
dependence upon readymade or packet foods within the age group 40-52 as most of the times
people are travelling.
2.6 Homeostatic and self –determination theory of obesity
The obesity could be further explained with the help of the homeostatic theory. The
homeostatic obesity imbalance could be further supported with the help of circle of
discontent, which is a system feedback loop linking weight gain to negative image about

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body. The homeostasis theory states that over-consumption of high-calorie, low-nutrient
food along with a stressful environment can contribute to weigh gain (Forde 2018).
Additionally, gaining sufficient amount of weight can lead to body dissatisfaction which
triggers continued over consumption. Therefore, weight gain individuals are guided to a
greater extent by environmental factors.
The obesity could be further explained with the help of the self determination theory.
As peer the theory, the consumer buying behaviour is guided much my intrinsic motivation
rather than external influences (Lafraire et al. 2016). In this regard, people express their
nutritional choices depending upon the amount of autonomy they express in their personal
life. As mentioned by Deliens et al. (2014), a more controlled motivation behaviour is often
associated with pressure and guilt. Therefore, individuals with a stronger control over self
tend to be more affirmative regarding weight loss.
2.7 Socio-ecological model of obesity focussing on the 40-60 age groups in England
The socio-ecological model can be used further for explaining the prevalence of
obesity within 40-60 age groups in England. The model emphasises upon behaviour changes
at individual level. It further establishes a relationship between behaviour and environment.
The model explains weight gain through obesity depending upon a number of factors which
are – intrapersonal factors, interpersonal factors, organizational factors, community factors
and public policies. Most of the health promotion programs are aimed at bringing about
changes at the intrapersonal level by modifying individual values, beliefs and knowledge
(Furukawa et al. 2017). Therefore, the delivery of community level health education
programs can encourage the obese people within the age bracket of 40-60 for further losing
weight. The interpersonal processes focus upon the effect of family friends and peers in
bringing about positive health behaviour changes within an individual. At this stage

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counselling activities are undertaken to increase the self confidence in an individual. As
mentioned by Montano and Kasprzyk (2015), the family and circle of an individual can
control to a greater extent the kind of diet followed by them. For example, exercise with peers
and community walking groups can further encourage the weight loss programs. The
organizational factors include encouraging healthy food options at workplace. This is
particularly useful for people within the 40-55 age group as they spend most of their times
either in their offices or are either engaged in the family burdens. The community factors
focuses upon providing healthy food options to the obese age group and also educate the
particular age bracket with the help of social media campaigns (Conlon and Bird 2014). The
public factors are more focussed upon implementing policies which could help in controlling
the rate of obesity within the community. Some of the policies which had been developed in
this regard were- ‘healthy weight, healthy lives’, ‘a call to action on obesity’. These were
invented for tackling the rate of obesity within the population.
An increased focus on policy, legislation and guidance on the nutritional intake has
been seen to control the rate of obesity within the general population. However, as argued by
Lafraire et al. (2016), sole focus on policy level action can neglect the behavioural
approaches that have important the dietary intake of the 40-60 age groups. It had been found
that food policies and interventions could be maximised by understanding the exploitation of
the interdependence between the different levels of the socio-ecological framework.
The socio-ecological model can be used as an intervention to mitigate obesogneic
factors. The framework helps in understanding the relation between different political,
socioeconomic and biological factors towards triggering unhealthy dietary intake resulting in
obesity and co-morbid health conditions. It has been seen that lack of sufficient health
awareness initiatives on the part of the government have further led to increase in the
consumption of junk foods. Therefore, organising health campaigns or health education

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programs could be beneficial in educating the community regarding the ill effects of
consumption of food with high calorific value. For example, educating employees at
workplace to consume healthy food and adopt healthy lifestyle options can help in generating
sufficient awareness at individual as well as group level.
Figure: socio-ecological model
(Source: Evans et al. 2014)
2.8 Gap analysis
The current study focuses upon the impact of diet on obesity within 40-60 age groups
in England. A number of theories and models have suggested that there exists a direct link
between improper diet and development of obesogenic conditions in individuals. There
have been a number of studies in the past which focuses mainly upon BMI index and
psychosocial factors for explaining the prevalence of obesity within a certain section of the
population. However, there has been a dearth of research which provides much detailed
explanation on the energy expenditure relating them to dietary habits. The study had tried to

23DIET AND OBESITY
provide a detailed interpretation of the manner in which psychosocial factors influence both
the dietary habits and energy expenditure.
2.8 Conclusion
Therefore, the development of obesity is dependent much on dietary and lifestyle
habits. The lifestyle and eating habits are influenced much by a number of psychosocial
factors such as individual attitude and perception. The perceptions are further guided by
exposure to a particular kind of social circle. Therefore, health education along with lifestyle
changes can further impact the resting calorie count of the body which can bring about
sufficient changes in weight structure.

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Chapter 3: Research methodology
The current chapter describes the different methods and approaches used for
conducting the research. The methodology used by the researcher plays a crucial role in
determining the success of the research.
3.1 Research philosophy
The philosophy of the research describes the manner in which the data could be
collected, analysed and used. There are four different types of research philosophy such as –
pragmatism, positivism, realism and interpretivism.
The positivism research philosophy is based upon the view that only factual
knowledge gained through observations and measurement could be trusted (Taylor et al.
2015). The researcher mainly uses quantifiable observations leading to statistically significant
results. The positivism relies on experience as a reliable source of knowledge. The
interpretivist philosophy states that access to reality is only through social constructs such as
language, consciousness, shared meanings and instruments (Flick 2015). Pragmatism on the
other hand believes in looking at the larger picture (Brinkmann 2014). The realism aspects
help in establishing relationship between individual, group and organization.
Justification of the chosen research philosophy
In the current study the researcher had used a positivist research philosophy as it will
help the researcher in developing knowledge through sufficient facts and data. Additionally,
adopting a positivist research philosophy had helped the researcher in conducting the
quantitative estimations.

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3.2 Research onion
The research onion gives an idea in a nutshell regarding the important attributes
which are to be taken into consideration by the researcher during the process of executing the
research.
Figure: Research onion
(Source: Saunders et al. 2015)
3.3 Approach of the research
Research approach refers to the plan and procedure used by the researcher for the
purpose of the collection and the analysis of the data. The kind of research approach adopted
depends upon the nature of the research problem being addressed. The approach of the
research could be further divided into data collection and data analysis. Based upon the type
of data analysis the approach of the research is further divided into deductive and inductive
approach.
The deductive approach is based upon moving from the particular to the general
(Humphries 2017). This type or research approach is more appropriate to be used in
secondary study design where existing literature sources are tampered for gathering data.

26DIET AND OBESITY
The inductive approach starts with observations and theories are proposed at the end
of the research. The hypothesis is developed based on similar patterns. The inductive
approach is particularly useful in quantitative study design.
Justification of the chosen research approach
In the current study the research had followed both a deductive and an inductive
approach. The researcher had used both primary and secondary data for the collection of
data. For collecting data through primary research design an inductive approach had been
used by the researcher where the theories are framed by the researcher based upon the
observations from practical scenario. The researcher will use a deductive approach for doing
detailed case study analysis. Here, the hypothesis will be developed based upon existing
theory.
3.4 Research design
The design of the research refers to strategy chosen to integrate different components
of a study in a logical and coherent manner. It serves as a blue print for the collection,
measurement and analysis of the data (Maxwell et al. 2015). The research design could be
further divided into explanatory, exploratory and descriptive. The descriptive research design
is based upon shedding light upon the current issue through a process of data collection
(Mertens 2014). It helps the researcher in analysing the characteristics or behaviour of the
sample population. The exploratory research design intends to explore the mere questions of
the research (Bernard 2017). The explanatory research is based upon quantitative methods of
data collection (Creswell 2014).

27DIET AND OBESITY
Justification of the chosen research design
For the current study, the researcher had used a descriptive research design where the
researcher had employed a number of data collection methods for the collection of
quantitative and qualitative data. Additionally, the researcher had used survey methods for
the collection of data, which is in accordance with the descriptive study design.
3.5 Research strategy
In the current study, the researcher had used all the different methods for the
collection of data which are – interviews, case studies and surveys. The research had used
both primary and secondary methods of data collection over here. The data collected through
surveys and interviews are further compared through longitudinal case studies.
3.6 Data analysis tools
The researcher had designed an open ended questionnaire where he had collected
varied responses on different aspects of obesity management and treatment from the
healthcare staffs such as nurses and doctors. The ideas expressed by the participants of the
interview process were used by the researcher for further analysis. The responses collected
through the interview were used for doing a thematic analysis.
The researcher had also used case study analysis for the collection of data where the
ideas presented through different articles and journals were used for the development of
proper themes. The themes were further analysed for arriving at a conclusive result.
3.7 Reliability and validity
The reliability and validity of the research is one of the important parameters which
further guarantees the authenticity of the research conducted. Research reliability is the

28DIET AND OBESITY
degree to which research methods produce stable and consistent results (Hughes and
Sharrock 2016). The methodology applied for the research is proved to be reliable when they
produce the same results on repeated application (Noble and Smith 2015).
In the current study the data had been collected through both survey and interview.
For the case study analysis the data has been collected through a number of online books and
journals. For ensuring that only valid journals and articles are selected a number of secondary
databases are used such as Pubmed and NCBI are used.
3.8 Ethical considerations
The research ethics forms a very significant part of the research which ensures that the
right measures and means are followed for the process of data collection. Therefore, sharing
the private details of the participants will be violation of the research ethics (Smith 2015). It
should be ensured that the data is only collected for academic purpose and not commercial a
purpose (Krosnick 2018). The researcher had also ensured that the outcome of the researcher
is not tampered with as it could hamper the end result of the research.
3.9 Summary
In this chapter the researcher describes the different approaches to research which
had been employed by the researcher for the collection and analysis of data. However, the
researcher had to face a number of accessibility issues owing to less support and cooperation
from the participants. The lack of time and resources were some of the additional
constraints.

29DIET AND OBESITY
Chapter 4: Data analysis
Quantitative Data Representation and Interpretations
1) Mention your age
Options Response
Frequency
Total
Respondents
Percentage of
Responses (%)
40-45yr 10 21 47.6
45-50 yr 7 21 30
50-60yr 4 21 19
Most of the survey participants are of age category 40 to 45 years followed by that of
age category of 45 to 50 years. Hence, most of the participants are within the middle aged
category. The risk of obesity is considered maximum within this age category.
2) What do you think is the cause of obesity within you
Options Response
Frequency
Total
Respondents
Percentage of
Responses (%)

30DIET AND OBESITY
Lack of physical
exercise
8 21 38.09
Excessive calorie
intake within food
8 21 38.09
Genetic factors
causing metabolic
imbalance
3 21 14.28
Age related disease 1 21 4.7
Other lifestyle
factors like
excessive drinking
1 21 4.7

31DIET AND OBESITY
From the above collected data it can be said that lack physical exercise and excessive
intake of calories in take in the food are two of the major Causes of obesity within the people
of England. There is an also genetic factor which also plays as a major cause of obesity.
Nearly 15% of the respondents had suffered in obesity due to genetic factors. 10% of the
respondents have suffered obesity due to age-related and other Lifestyle habits factors.

32DIET AND OBESITY
3) What are the major health implications and symptoms that you faced due to obesity
Options Response
Frequency
Total
Respondents
Percentage of
Responses (%)
Breathlessness 4 21 19.09
Excessive sweating 7 21 33.33
Fatigue 6 21 28.57
Cardiac Disorders 3 21 14.28
Hepatic Disorders 1 21 4.7

33DIET AND OBESITY
Excessive sweating and fatigue are two of the major symptoms that occur within
individual, who have been diagnosed with obesity. Nearly 60% of the respondents suffer
from these two symptoms. Breathlessness is another common symptom, which is found
among 20% of the participants. These symptoms are evident among 18% of the total
respondents.

34DIET AND OBESITY
4) How are you able to diagnose the occurrence of obesity
Options Response
Frequency
Total
Respondents
Percentage of
Responses (%)
Calculation of BMI 8 21 39.09
Excessive Tiredness
while performing
the daily activities
6 21 28.6
General physical
exam like
measuring heart
rate, BP and
temperature
4 21 19
Blood tests like
cholesterol test,
liver function tests,
a fasting glucose, a
thyroid test and
others
3 21 14.3

35DIET AND OBESITY
Diagnosing obesity is considered to be highly critical factor as it can help in the further
the treatment process. There are several advanced processes that are used in diagnosing the
symptoms of obesity. From the above finding section, it is evident that calculation of body
mass index is useful among nearly 40% of the survey participants for diagnosing the
symptoms of obesity. Another common ways of diagnosing obesity that has been agreed by
nearly 29% of the survey participants is excessive tiredness in performing normal day – to
day activities. This has been followed by 19% of the survey participant responding to the
option of physical examination like measuring of heart rate and blood pressure. And other
14% have responded to the Diagnostic method of blood test.
5) How far do you agree that binge eating is responsible for the cause of obesity
Options Response
Frequency
Total
Respondents
Percentage of
Responses (%)
Strongly agree 8 21 38.09
Agree 5 21 23.8

36DIET AND OBESITY
Neutral 5 21 23.8
Disagree 1 21 4.8
Strongly Disagree 2 21 9.5
From the above collected data, it can is clear that nearly 60% of the survey participants
have agreed and strongly agreed with the fact that binge eating is responsible for cause
obesity among the people of 40 to 60 years. Nearly 24% of the people have been neutral
about the given fact. There are also 14% of the people, who has disagrees with the given fact.
Hence, there are certain groups of people, who do not give priority to causes of binge eating
as a causative factor the obesity among the mid-aged and older people within the society of
England, which could be attributed to the lack of sufficient awareness.

37DIET AND OBESITY
6) What are the factors that are preventing you to recover from the consequences of
obesity
Options Response
Frequency
Total
Respondents
Percentage of
Responses (%)
Lack of awareness 6 21 28.6
Lack of proper
healthcare service
10 21 47.6
Lack of initiative to
perform physical
exercise
10 21 47.6
Other age related
physical disorders
3 21 14.3
Daily lifestyle habits 8 21 38.1

38DIET AND OBESITY
Prevention of obesity is one of the major issues that are currently faced by the middle
aged individual in the society of England. Two of the major reasons that prevent the recovery
process of obesity include lack of proper Healthcare service and lack of initiative from the
individual to conduct physical exercise in their daily routine.
Qualitative data Interpretation
This section is analysis of the interview data that has been obtained from the three
professional nurses and two medical practitioners, who have wide experience in the medical
field of obesity
1) How do you think that the matter of binge eating is related to the increased cases
of obesity among the population of 40-60yr old in England?
According to two of the nurses, most of the obesity patients that they have encountered
have irregular diet plan in the earlier part of their life. Both the nurses have shared their
experience about the laxative disorders that are common symptoms with the patients who
have higher body mass index (BMI). The issue of binge eating however is not limited to the
obesity patients as most due to the unhygienic food processing units in UK are also
responsible for the same.
The third nurse has highlighted about the DSM IV diagnostic tool that has been widely
used in most of the healthcare service centre in UK to deal with the issue of eating disorder.
The medical professionals however focused upon the fact that in most cases, to provide
treatment just with proper diet and physical exercise could be beneficial.
2) What are the initiatives that can be taken to raise the awareness among the people
about the consequences of binge eating?

39DIET AND OBESITY
The first nurse has shared the experience about attending an awareness
program that is aimed to overcome the issues of diet planning. The second and the
third nurse have also expressed their views about the management care program that
are needed to deal with the dietary issues. Both the medical experts have also
expressed their opinions about the management of the dietary plan that is needed as
the primary elements of the awareness program. In most of the cases, the age related
factors are responsible for increase the levels of body mass index. The experts have
said that awareness level needs to be raised from the earlier stage of life that will help
to deal with the issues of obesity at the middle and late stage of life.
What is your opinion about the obesity management program that can be
applied in the society of England?
The medical experts said that in the primary steps, it is essential to identify the cause of
obesity that can differ highly among the every patient. In case the severity of the obesity, the
medical experts need to take extra precautions. This will ensure that further complications
related to the cardiac and other consequences can be prevented. The medical experts also
empathizes that regular healthcare checkups are needed to ensure that there is no further
worsening in the weight management program.
Thematic analysis:
Theme 1: Effects of binge eating on obesity and health
In this particular aspect, we have tried to draw a link between diet and obesity in
England. The most common diseases which could be linked with obesity are metabolic
disorders and type 2 diabetes. Additionally, the relationship between obesity and high blood
pressure advances through old age. The waist circumference of older adults further serves as

40DIET AND OBESITY
a predictor over here. Research has further correlated the development and progression
through type 2 diabetes based upon waist circumference. The problem is much more
developed in men with waist circumference greater than 102 and BMI greater than 30 kg/m2
(Brownell and Walsh 2017). The morbid obesity has been associated with a number of severe
and lethal health consequences such as hypogonadism in men with a waist circumference
greater than 102 cm and development of endometrial cancer in post-menopausal women
(Curtis et al. 2015).
Theme 2: factors contributing to an obesogenic environment
As reported by Cani et al. (2017), the desk jobs and the sedentary lifestyles makes it
difficult to lead a healthy life for the target age group In the deprived areas due to differential
access to knowledge resources people have been seen to practice worst health behaviours
which further contributes in the development of co-morbid conditions (Pucci et al. 2018). In
the current research light had been shed upon implementing and educating regarding the right
kind of diet within the daily life of an individual. It also analyses the myths regarding eating
habits which contributes to obesity.
Chapter 5: Conclusion and recommendations
5.1 Conclusion
The current study focuses on the concept of diet and obesity within 40-60 age groups
in England. Obesity is a global concern and has been associated with a number of co-morbid
health conditions. Evidences and studies have suggested that by the year 2020, the rate of
diabetes within the older adult population of UK is expected to double. Studies have
suggested that there is a direct link between diabetes and obesity and vice versa. The

41DIET AND OBESITY
excessive levels of fatty acids within the blood serum have been seen to down regulate
insulin secretion. Additionally, lifestyle, health perceptions and beliefs has also been seen to
affect the dietary preferences of an individual. In this respect, obesity has often been
considered to a genetic problem over which an individual has no control. This results in the
development of a negative self and social image within the individual. This further results in
the development of negative self-esteem in an individual. Additionally, individuals in the age
bracket of 40-60 often suffer from mid-life crisis and have little or no hope for considerable
weight loss. Additionally, the sedentary lifestyle also results in misbalance in energy storage,
where the calorific intake is far exceeding the expenditure resulting in abnormal weight gain.
However, the research fails to address some of the myths present within the society which are
the sole reason for growing obesity concerns within the society. For example, many people
are of the opinion that obesity is an inherited problem. Therefore, one cannot do much to
control obesity. However, this is a false notion and could only be changed with sufficient
health education.
5.2 Linking with objectives
Objective 1: To identify the factors that developed obesity within the age group of 40-60
in England
The objective 1 can be linked with question number 2 of the survey questionnaire
and the question 1 of the interview questions which focuses upon the causes of obesity
within 40-60 age group in England and the associated factors. Most of the participants of
the survey and the interview process have highlighted excessive calorie intake in food to be
one of the contributory factors.
Further study has shown that the adults living in the derived areas are 46% more
likely to develop obesity compared to the ones living in the less developed areas (Dewhurst et

42DIET AND OBESITY
al. 2017). In the least deprived quintile, 22% have been found to be obese and 35%
overweight (gov.uk 2018). This is because they are more addicted to activities such as
drinking alcohol which could trigger the development of fatty liver disease. This could be
further attributed to inequitable distribution of privileges to the people living in the
downtrodden areas such as lack of job, employment opportunities or access to education.
The lack of quality education and less knowledge about proper lifestyle management further
affects their health and eating behaviours resulting in obesity and weight gain. As reported by
Wohl et al. (2014), and obesogenic environmental factors such as TV, computers, desk
jobs, high calorie food , clever food marketing have all contributed towards the development
of inactivity and overeating.
Objective 2: To identify the health implications of obesity within the age group of 40-60
in England
The second objective could be linked with question no 3 of both the survey and the
interview process. The survey question focuses upon the health effects of obesity on the
overall health of the community. The interview question on the other hand emphasize upon
the needs of different policies and programs for controlling morbid obesity within the
community. The medical experts do strongly believe that stepwise monitoring of patient
health records along with implementing strict diet control and regular physical exercises have
been seen to reduce the co-morbidities associated with obesity by 12.3%. Nevertheless, the
experts also agreed upon the fact that altering the habits of binge eating is quite challenging
owing the lifestyle habits of the modern society in England (Salonen and de Vos 2014). The
lack of awareness and initiative skills among the people is considered to be the major
obstruction in the due process. Additionally, the obesogenic conditions could lead to the
development of health conditions such as heart disorders and diabetes, as some of these have
been directly linked with excess obesity. Increased body weight have been associated with

43DIET AND OBESITY
breathing difficulties as one would get easily fatigued or tired in performing the day to day
activities. Therefore, obesity could reduce the functionality within an individual.
Objective 3: To critically analyse the relation between binge eating and obesity in the
age group of 40-60 in England
The objective number 3 could be related to question no. 5 of the survey and question
no. 1 and 2 of the interview question. Majority of the respondents have strongly agreed with
the aspect of binge eating to be one of the contributory factors towards development of
morbid obesity in individuals. The healthcare professionals have also confirmed in the
interview responses that there exists a direct relationship between binge eating and higher
BMI and the same had been confirmed through a range of diagnostic tools. In this respect,
binge eating could be further associated with psychological issues such as stress and anxiety.
Therefore, stress and obesity could be linked in a number of ways. Therefore, adopting a
holistic way of life could help in stress management and dealing with obesity.
Objective 4: To critically understand the contributory factors towards binge eating
The objective 4 relates to survey question number 5 and the interview questions 1 and
2. Equal percentage of responses have been obtained for strongly agree and neutral
responses. That is 50% of the population believe that binge eating can be harmful and 50%
have given neutral responses which means that preferences and passion of individual and
community govern their food choices. Additionally, the influences of peers further affect
their food choices. Stress and depression have also been seen to trigger incidences of binge
eating.
Objective 5: To identify the control methods for the management of obesity

44DIET AND OBESITY
The objective 5 relates with question no 3 of the interview question. It focuses upon
the importance of weight management programs for controlling morbid obesity where stress
have been imposed upon planning of individual health assessment needs depending upon the
co-morbid health conditions. The control methods could range from light physical exercises
to change in diet plan.
5.3 Recommendations:
Recommendation 1
Cutting down of food inducing development of obesity
For reducing weight and individual needs to be particularly careful regarding the
nature and the type of food substances which they are having on a regular basis. Some of the
food substances have been seen to trigger obesogenic conditions such as nuts, dried fruits,
high fat diary, extra virgin olive oil, avocado oil etc. Therefore, an individual needs to
measure the exact amount of the food substances taken on a daily basis such that the
expenditure is not lesser than the intake.
Additionally, one needs to be physically agile as being sedentary can result in accumulation
of high calories which further contributes to the increase in weight.
Recommendation 2
Indulge in more and more physical activities
The people within the age group of 40-60 are the ones who have entered their mid-
life and are facing a number of challenges owing to the management of their health and co-
morbid health conditions. Additionally, work life and stress does not allow them to
participate in physical activities and exercises. Therefore, community based exercise
programs could be useful in controlling obesity induced health issues.

45DIET AND OBESITY
Recommendation 3
Education on appropriate diet
Diet serves as one of the important factors for controlling and managing obesity
within the community. In this respect, reducing the calorie intake by 600kcal everyday can
contribute psotively towards the weight loss program. Therefore, community based diet
education along with lifestyle effective counselling sessions could be helpful in this respect.
5.4 Research limitations
The researcher had faced a number of limitations in conducting the research due to the
lack of time and effective resources. The researcher had used a combinatorial research
design where he had used both primary and secondary methods of data collection. However,
small size of focus groups interfered with the test results. Additionally, the lack of sufficient
amount of journal and academics also affected the quality of the comparisons made.
Moreover, unwillingness of the respondents to share the required amount of information also
affected the quality of the results.
5.5 Future scope of the study
The study conducted over here will provide further future scope for understanding the
effect of lifestyle and dietary interventions on the management of overall health condition in
individuals. The study conducted will serve as a basis of correspondence for relating to
biopsychosocial determinants of obesity.

46DIET AND OBESITY
Chapter 6: critical reflection
The current research studies the impact of diet on diet on obesity within 40-60 age groups in
England. Though, obesity has been linked with diet there are a number of other factors which
contributed towards the development of obesity in individual. It also consists of the various
psychosocial factors such as s society, community, group and peer influence which influences
the diet patterns within an individual. In my opinion, the additive factors such as stress or
poor life conditions also forces an individual in choosing poor dietary habits. I also think that
the diet preference of an individual is guided more by instincts, which is further influenced by
sensory and cognitive stimulus. However, the presence of obesity has been seen to trigger a
number of co-morbid health adversities. Therefore, effective health education and self
management strategies needs to be developed over here.
Therefore, I think sufficient health education programs or campaigns organized by
government on regular basis along with regular visit to poor and downtrodden areas could
positively affect in controlling the rate of obesity. I have also felt that majority of the
incidences of obesity could be attributed to false notions or ideas present within the
population that obesity is genetically inherited. However, obesity could be mainly attributed
to excessive deposition of calorie in the body. Obesity had a complex relation with the
development of co-morbid health conditions, whereas the co-morbid health conditions could
further result in the development of obesity. For example, high diabetic patients often have
the risk of development of obesity. Additionally, the presence of diabetes can make losing
weight difficult. Some of the attributes which could contribute towards gaining weight in an
individual have been further divided into physiological, behavioural, psychosocial and
environmental factors. Some of the psychosocial factors contribute towards ill health habits
such as binge eating. The binge eating habit or too much dependence upon high calorific food
can further contribute towards the development of obesity.

47DIET AND OBESITY
As mentioned by Dewhurst et al. (2017), the consumption of red meat diet can contribute
towards significant weight gain within an individual. In an attempt to reduce the
consumption of red meat the UK government had introduced a number of health education
programs. Some of these were aimed at generating awareness within the population
regarding the cons of the consumption of red meat. However as argued by Brinkmann (2014),
the food preferences of individuals are also governing factors in limiting the consumption of
a particular diet. In my opinion, community based health education program which could
encourage the uptake of vegan diets could be beneficial in this aspect. Additionally,
limitation of sedentary approaches to life and engaging more in physical activities could also
reduce the propensity for obesity.

48DIET AND OBESITY
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