Comprehensive Analysis of Adolescent Obesity: A Biology Project

This project is an independent academic study in biology, focusing on adolescent obesity. It begins with a project plan, including a timeline and evidence-based database search to identify the research topic. The study investigates the prevalence of obesity in adolescents, particularly in the United Kingdom, and examines various risk factors and causes. A systematic review of 10 primary research articles from databases like CINAHL and PubMed is conducted, exploring factors such as genetics, lifestyle, child abuse, and weight misconceptions. The methodology involves a secondary research approach, utilizing inclusion and exclusion criteria to select relevant studies. The literature review synthesizes findings from selected articles, highlighting the impact of factors like diet, physical activity, and socioeconomic status. The project also provides recommendations for controlling obesity among adolescents. The assignment includes an acknowledgement to the advisor and an abstract summarizing the key findings and methodology, providing valuable insights into the complexities of adolescent obesity and potential avenues for intervention and prevention.

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Independent academic study biology
Name of the student
University Name
Author’s note

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Project planning
Time table
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Evidence
based
database
search to
decide on
the topic
Topic and
the aims
and the
objectives
identified
Literature
search
through
the
databases
Analysis
of the
data
Reporting
the
findings
Discussion
Progress
An evidence based literature research was necessary for the deciding on this topic. A large
number of government websites has been used to understand the trends in the obesity among the

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adults. However previously a large number of paper were retrieved with the initial search hits,
but narrowing down the expanders and using the limiters helped to find out the exact relevant
papers. However, some challenges has been faced with regarding the implementation the
findings and then concluding the same.

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Acknowledgement
Firstly, I would like to express my sincere gratitude to my advisor Prof. _______________ who
has provided an endless and relentless support to complete my Ph.D study and the related
research, for the patience, motivation and the immense knowledge. The guidance has helped me
in all kinds of research and writing of this dissertation proposal.
Besides my advisor, I would like to thank the rest of the dissertation committee. Prof
_______________ for their valuable comments and the encouragement but also for the hard
question which has incented me to widen my scope of research.

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Abstract
The occurrence of overweight and obesity among the children and the adolescents has been a
problem worldwide, rendering it as one of the most common chronic disorders particularly in
this age group. The main purpose of this study is to comprehend the effect of obesity on the
adolescent group of individuals. The study will examine the various risk factors and the causes of
obesity among the adolescents. In order to do find out the evidences a systematic review has
been conducted by selecting 10 primary research articles selected from the electronic databases
like the CINAHL and PubMed, by using appropriate keywords. The paper has highlighted the
some of the major factors that has contributed to obesity. The paper had also provided evidences
as of how child abuse is related to obesity, although there are very few evidences that proved,
connection between childhood and obesity. However, potential linkage had also been tried to be
established between the weight misconceptions among the adolescents that leads to wrong choice
of diets leading to obesity. Some of the most important aspect of this paper is that it contains
evidences against the causative factors of childhood obesity. Several avoidable lifestyle related
risk factors has been identified to be associated with obesity like the eating patterns, the
sedentary life style , the amount of physical activities , the screen viewing time , the ethnicity,
sex and the income of the family members . The studies have also explores how the westernized
mode of diet rich in cheese and butter might lead to obesity among the adolescents. The western
dietary habit is associated with high fat, high energy and SFA consumption with lower intake of

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fibers has been associated with adolescent obesity. Finally, the paper has also provided with a list
of recommendations that can be used to control obesity among the group of adolescents.

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Research topic: Obesity among the adolescent population
Methodology
Prevalence of obesity among the adolescents in United Kingdom is increasing day by
day. The frequency of overweight and obesity among the adolescent and the children has made it
as one of the common disorder of this age group. While there are valuable research works
available online, there are very few systematic reviews that has been conducted to comprehend
the worldwide prevalence of obesity among the adolescent population.
This section illustrates the steps while conduction of an extensive literature review. A
secondary research methodology has been employed in the conduction of this systematic review.
Lately, systematic review plays an important role in evidence based practice. This is due to the
fact that one can get access to the pre-filtered evidence. A pre-filtered indication is established as
a researcher, with the expertise in a substantive area has revised and has presented the strongest
methodological data in the field. A proper systematic review aims to synthesize the result of
multiple studies by the use of the methodologies that that delimits biasness.
A systematic literature search was conducted by the search engine Google scholar and
data bases like CINAHL and the PubMed. Different keywords like “obesity”, “adolescents’,
“prevalence” and Boolean operators like “overweight AND adolescents” are taken.
In total 93 articles have been selected for the systematic review. The data on the
incidence of obesity in the adolescent period was also investigated in the International obesity
Task Force Website. In order to find out the number of articles involved in the review, the
following inclusion criteria were followed- 1) Cross sectional studies that took place within the

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last 15 years, if the original study did not the inform the survey year then it was not taken in to
consideration. (2) Peer reviewed research articles (3) studies, where both the weight and height
has been measured objectively. Full text studies written in English were used in the study. The
previous inclusion and the exclusion criteria brought back, a number of articles and hence the
inclusion and the exclusion criteria was revised. The date of publication was revised from the last
15 years to last 10 years, to get recent relevant literatures.
Literature review
A total of 10 articles were found to be eligible as per the inclusion and the exclusion
criteria of this report. Obesity is the major and one of the rising problem in adolescent of United
Kingdom. Lifschitz (2015) has done a widespread research where he has highlighted the major
factor that has contributed to obesity. The factor are genetic cause, race, and economic condition
of the people, cesarean birth and use of perinatal antibiotics. The author in his paper has talked
about high protein diet in infant as the other reason for weight gain that leads to obesity. The
author has conducted the research where he stated that people with BMI of more than 30 are
considered to be obese. In the study of genetic cause, he said that polymorphism in the genes of
human that is known to control the appetite has is genetic reason of obesity while he also added
use of antibiotic and cesareans birth which disturbs the metabolism and lead to obesity. lastly he
concluded by saying that overall reduction of high protein diet in children to 1.8g/100kcal is the
safe way to prevent obesity. The author has clearly highlighted the reason for obesity in
adolescent however, the major limitation is that he has not given relevant data in support of such.
Hawton et al. (2018) has done a population cohort study where he has evaluated the child
abuse as the reason for adolescent obesity. The author has exploited the data from the Avon

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Longitudinal study of children and parents where total of 4205 children of age 13 to 165 years
was included in the evaluation. The author has analyzed the body mass index of them and
investigated about the child abuse from their parents. They have categorized the abuse as
emotional, sexual and physical categories. Among 4205, total of 3429 has recorded their BMI at
age of 18 years. The author has used linear and logistic regression analysis to study the
association between child abused and high BMI. The author recognized that there is no
connection between the child abuses obesity in adolescent. The study conducted by the author
has used the anonymous parental report of abuse of their child which has not given the relevant
information. The major limitation of the study was lack of authenticity of data, as there is the
chance that parent might have not given accurate data. Though, the author has presented the
study in clear format and design, it is hard to believe in finding.
Sonneville et al. (2016) has researched that whether the potential linkage between the
weight misunderstanding and its gain among the obese adolescent is helpful or harmful. Author
said that weight misconception is the common among the people who are obese however,
research was lacking in evaluating its connection with weight gain. To study such author has
used the sample of “National Longitudinal Study of Adolescent to Adult Health Wave II
Cohort”. He has employed the use of linear regression, literacy of parents, poverty to analyses
the strong connection between misconception and weight gain. The total sample size in his study
was of 2738 obese individual. The author has taken good sample size for the evaluation. The
author founded in his research that 57% and 80% male and females respectively has correctly
taken themselves as obese. He further founded that the misunderstanding of weight was linked
with less BMI among the people who are obese. Therefore, he said that such people was often
known to have lower future gain in weight. The major strength of their study is the method used

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to draw the conclusion which has given accurate result, however, the presentation of their study
was not recognizable and was limited in proper expression of result with lack of graphs and
charts.
Gibson et al. (2015) has studied the Non- Alcoholic fatty liver disease (NAFLD) as the
cause of chronic liver disease which often lead to adolescent obesity in United Kingdom. The
study has highlighted the effect of the habitual diet and the activities of the adolescent individual
who are suffering from the NAFLD. He has done a comparative analysis with people who do not
have NAFLD. Total sample taken for this evaluation was 24 individual with NAFLD and 8
healthy one who are obese with the disease for 24 hrs. The author has conducted the
questionnaire regarding physical activity, eating behavior, daily activities with association with
examining them with pedometer. He founded that people with NAFLD had limited eating habit
and less number of people were known to have inadequate dietary and prevalence of physical
activities. The author also recognized that obese people have high BMI than the one who are
having NAFLD, thus high body weight is the only reason for it. The paper was well presented
with graphs and chart however, the sample size taken was less in number which might have not
given reliable data.
Johnson, Kuh and Hardy (2015) done conducted research on age related progression of
overweight with time among the people of participant of United Kingdom of five birth cohorts.
He has taken total of 56,632 participant which included data from 1946 NSHD, 1958 NCDS,
1970 BCS, and 1991 ALSPAC 2001 MCS who are of various age group. The author has made
critical evaluation of their BMI. He founded that the recent born people tends to develop the
incidence of overweight. It is more common in NCDS than the NSHD. People of BCS was
known to have even more tendency. The author has said that his study has established how

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younger generation are more probable to accumulate high influence to become overweight in
their lifespan and this often increases the chance of chronic disease such as heart stoke and
diabetes mellitus among the adolescents. The research conducted was relevant with the data. The
major strength of the paper was great sample size which has included the people of various age
groups and the critical observation of their BMI was well presented making it understandable.
However, the study has incurred huge investment and took long time to draw conclusion based
on the research.
Obesity can be considered as an abnormal accumulation of body fat to that extent such
that it might have adverse effect on health. It is a chronic disorder and this often considered as a
disease and is defined as a body mass index of about 30 kg/m2 or more. Obesity among the
adolescent population is now a common public health problem, affecting many countries
throughout the world because of the prevalence cost and the health effects.
There are several risk factors related to obesity. Siddarth (2013) have identified the risk
factors related to obesity in children and the adults. Siddarth (2013) have studied about the some
lifestyle factors such as the eating patterns, physical activity, the viewing time of the computer
screen, ethnicity , sex, socio-income status were linked with obesity in pedriatics and the adults.
Data collection was done from the National Health and the Nutrition examination survey 2009-
2010. A multivariate logistic regression analysis was performed with the obesity for the adults
and 95th percentile for the children were selected as the outcome variable. As per the results the
screen viewing time for the adolescents, food habits were found as the only noteworthy
predictor. Exercise has always been associated with glycemic control. No exercise are also
associated with obesity. Hence, people having obesity due to lack of physical activities are more
likely to have poor glycemic control. This paper has been cross referenced by papers containing

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information about the different life style interventions to control obesity among the adolescent
population. Like any other researches. This paper has also certain limitations that is the small
sample size decreasing the generalizability of the results.
Eating habits has been long been the important predisposing factors. Diet plays a
significant role in the origin of obesity. Individual choices, food advertisements , social customs,
food advertising as well as the obtainability of food, plays a crucial role in the obesity. As stated
by Naja et al, (2015), obesity in the adolescent is associated with both the immediate and long
term implications. This study has identified how western dietary patterns can lead to obesity and
overweight in some Lebanese adolescents. A cross sectional study was performed with 446
Lebanese adolescents. Survey was conducted and the data included socio-demographic and
lifestyle characteristics, the anthrometric, eating habits as well as the assessment of the dietary
intake. Smoking status and the physical status and smoking status of the adolescents were also
considered. The anthropometric measurements included height and weight. The measurements
included the standardized techniques. In order to address the dietary patterns the food were
divided in to nineteen food groups on the basis of the similarity of the ingredients, nutrient
profile and the culinary usage. Butter and ghee has been chosen as one of the main ingredients of
the westernized food.
Standard deviation was used to measure the socio-demographic, eating habits and the
anthropometric measures. Stieger based equations were used for the measurement of the
correlation coefficient. The dependent variable in the regression model were the factor scores of
the identified patterns. In the current study the western pattern of food rich in Mayonese and
cheese has been found to be linked with obesity and obesity in the Lebanese young adult
population. In relation to this Tate et al. (2017) has conducted a study where Western dietary

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pattern has been found to be allied with the metabolic condition risk factors which included
obesity and overweight in the young adults. The western dietary pattern is linked with fat, high
energy and the SFA consumption, with lower intake of the fibrous food. This might partially
explain the relationship between the adherence to the patterns and increased adiposity among the
adolescents.
Again, the incidence of the non-communicable disease has been found to be associated to
obesity. Piryani et al., (2016) have performed a cross sectional descriptive studies on the higher
secondary school students. A random sample of 360 students has been take for the study. A
multistage random sampling was used for decreasing the bias. A self-administered and a
structured questionnaire was used by the researcher to measure the validity of the research. SPSS
was used to do the statistical analysis. Multivariate binary logistic regression analysis was used
for the determination of association between the dependent and the independent variables. The
variables having the body mass index for the age was above +1SD. The prevalence of obesity
among the adolescent students was found to be 12.2% (95% CI 8.9 to 15.5). Watching television
and the socio-economic status, consuming less fruit has been considered to be one of the major
risk factors for overweight among the adolescent population. Some of the strengths and the
weaknesses of the study is that the findings of the study is made on the basis of self-reported
data, which might suffer from over or underreporting and recall bias. Again due to the cross
sectional nature, the study restricts the drawing of the inferences about causation.
Several physical complications have been found to be associated with obesity among the
adolescents. In relation to this, Twig et al, (2016) have grouped some data on BMI of the
adolescents as per the age and the sex specific percentiles from the U.S Centers for the Disease
Control and Prevention. Obesity in early life has been considered to be a risk factor for the death

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due to the cardiovascular complications. The primary outcome that has been chosen are deaths
attributing to coronary heart disease, stroke and mortality due to obesity. The study has also
evaluated the deaths from the non-cardiovascular deaths. The BMI of the weight and the height
was measured by via beam balance and stadio meter. A cox proportional hazards model has been
used for the estimation of the hazards ratio and 95 % confidence intervals for the cardiovascular
specific outcomes. PHREG procedures were used for the calculation of the competing risks by
the use of the Cox proportional hazards model. After the multivariate adjustment it was found
that the risk of the death from coronary heart disease has already found to have been higher in
people with higher BMI. Cardiovascular specific deaths has also been found in people having
BMI ranging from 17.5 to 19.9 (hazard ratio, 1.2; 95% CI, 1.1 to 1.4). One of the limitation of
this paper is the absence of any adult measures of the BMI, thus the researches could not
independently assess the autonomous effect of adolescent BMI on the cardiovascular health.
Again the Mendelian randomization that was undertaken showed effects of the BMI that were
independent of the confounding (Twig et al.2016).
Apart from the prevalence of cardiovascular risk, obesity in younger generation is again
associated with the type 2 diabetes. The paper by Kushiyama et al. (2013) have hypothesized that
that obesity is related to poor control of the blood glucose level in patients having type 2
diabetes. A cross sectional, single centered study and time series was conducted. Data from the
patients with type 2 diabetes at their first visit to the Marunouchi Hospital. The measurement of
the blood glucose level was conducted by using the diabetes analyzers. Statistical analysis was
used by JMP-8.0 software and univariate and multivariate logistic analysis were applied for the
estimation of the risk of the glucose level. As per the findings of the analysis, the number of
younger obese adults with an undiagnosed type 2 diabetes visiting the hospital for the first time,

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had shown high glycemic level. Age has been found to be a string factor for the occurrence of
diabetes. It is known from the study that obesity has been linked to some environmental factors
like the short sleep, socioeconomic status and a conceded intrauterine environment, noexercise,
changes in the dietary factors especially carbohydrates. The glycemic control has been found to
be deteriorated by the emergency of obesity in the younger patients. The limitation of the study
is that the study has been carried out in the single Tokyo hospital, thus it might be difficult for
extrapolating the results.
Limitations
The most important limitation of this study is small number of papers has been collected
for the conduction of the systematic review due to shortage of time. The comparison of obesity
and overweight prevalence required interpretation with a caution because of the difference
between the survey sampling methods, the sample sizes , age range of the subject and quality of
the prevalence and the trends of obesity or over weight.
Findings /Conclusion
In conclusion it can be said that obesity has been an import issue globally. In order to
research the areas, a systematic review has been conducted. The entire assignment has used
PubMed and Google scholars for getting the relevant papers with. 10 articles relevant to the topic
were used. As per the table findings, obesity has been found to be associated with the several risk
factors like the cardiovascular risks, diabetes and the chronic diseases. Risk of the modifiable
life style had also been an important factors for obesity and adolescent population. Many clinical
complications like obesity, diabetes and communicable diseases. Watching phones and
televisions, has been found to be associated with the prevalence of obesity. The paper had also

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emphasized on the fact that diet had always played an important role in the prevalence of
obesity. Carbohydrates and fats has always been associated with obesity. One of the papers had
provided information about the association between the westernized food and the prevalence of
obesity among the adolescents. One of the important part that has been explored from this paper
is that the weight misunderstanding and weight misconception can be one of the important
factors for obesity among the adolescent people. Surprisingly, child abuse has also been found to
be one of the reason for the childhood obesity. One of the paper had also informed about the
genetic predisposing factor that contributes to obesity. However, as a part of the
recommendation, focus should be given on the consumption of healthy diets, following certain
exercises that can be really useful to reduce obesity. However, low fat, low protein and fibrous
diet along with a daily exercise regimen would not only help in maintaining the weight, but will
also help in the prevention of other chronic conditions like diabetes and cardiovascular diseases.

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References
Agha, M., and Agha, R. 2017. The rising prevalence of obesity: part A: impact on public
health. International journal of surgery. Oncology, 2(7), e17.
Gibson, P., Lang, S., Gilbert, M., Kamat, D., Bansal, S., Ford-Adams, M., Desai, A., Dhawan,
A., Fitzpatrick, E., Moore, J. and Hart, K., 2015. Assessment of diet and physical activity in
paediatric non-alcoholic fatty liver disease patients: a United Kingdom case control
study. Nutrients, 7(12), pp.9721-9733.
Hawton, K., Norris, T., Crawley, E. and Shield, J.P., 2018. Is child abuse associated with
adolescent obesity? A population cohort study. Childhood obesity, 14(2), pp.106-113.
Johnson, W., Li, L., Kuh, D. and Hardy, R., 2015. How has the age-related process of
overweight or obesity development changed over time? Co-ordinated analyses of individual
participant data from five United Kingdom birth cohorts. PLoS medicine, 12(5), p.e1001828.
Kushiyama, A., Yoshida, Y., Kikuchi, T., Suzawa, N., Yamamoto, M., Tanaka, K., … Kawazu,
S. 2013. Twenty-year trend of increasing obesity in young patients with poorly controlled type 2
diabetes at first diagnosis in urban Japan. Journal of diabetes investigation, 4(6), 540–545.
Lifschitz, C., 2015. Early life factors influencing the risk of obesity. Pediatric gastroenterology,
hepatology & nutrition, 18(4), pp.217-223.
Naja, F., Hwalla, N., Itani, L., Karam, S., Sibai, A.M. and Nasreddine, L., 2015. A Western
dietary pattern is associated with overweight and obesity in a national sample of Lebanese

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adolescents (13–19 years): a cross-sectional study. British Journal of Nutrition, 114(11),
pp.1909-1919.
Piryani, S., Baral, K.P., Pradhan, B., Poudyal, A.K. and Piryani, R.M., 2016. Overweight and its
associated risk factors among urban school adolescents in Nepal: a cross-sectional study. BMJ
open, 6(5), p.e010335.
Siddarth, D., 2013. Risk factors for obesity in children and adults. Journal of Investigative
Medicine, 61(6), pp.1039-1042.
Sonneville, K.R., Thurston, I.B., Milliren, C.E., Kamody, R.C., Gooding, H.C. and Richmond,
T.K., 2016. Helpful or harmful? Prospective association between weight misperception and
weight gain among overweight and obese adolescents and young adults. International journal of
obesity, 40(2), p.328.
Tate, E.B., Spruijt-Metz, D., O'Reilly, G., Jordan-Marsh, M., Gotsis, M., Pentz, M.A. and
Dunton, G.F., 2013. mHealth approaches to child obesity prevention: successes, unique
challenges, and next directions. Translational behavioral medicine, 3(4), pp.406-415.
Twig, G., Yaniv, G., Levine, H., Leiba, A., Goldberger, N., Derazne, E., Ben-Ami Shor, D.,
Tzur, D., Afek, A., Shamiss, A. and Haklai, Z., 2016. Body-mass index in 2.3 million
adolescents and cardiovascular death in adulthood. New England Journal of Medicine, 374(25),
pp.2430-2440.

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Appendices
Table 1
Inclusion and Exclusion Criteria
Inclusion Exclusion
Primary research papers Systematic reviews or Meta analyses
Language: English Nil
Publication year: 2012 to 2018 Older than 2012
Peer reviewed journal article Nil
Table: List of the Initial inclusion and exclusion criteria
Source: Created by author
Table 2
Keywords Thesaurus terms
Adolescents Obesity
Young individuals Obese
Young adults Overweight
Source: Created by author