The prevalence, risk factors and perception of overweight and obesity in kuwaiti children: a mixed methods approach

The prevalence of overweight and obesity among children has reached epidemic proportions across the world. Overweight and obesity in children is associated with an increased risk of chronic diseases. This study seeks to provide an understanding of the prevalence and the risk factors of overweight and obesity among school children aged 11 to 14 years in Kuwait and to explore how children and their parents perceive these issues. In addition, the study examines the perceptions and attitudes of school teachers and government officials toward this serious public health issue.<br><br>Methods: A mixed method study surveyed 635 parents and children aged 11–14 years (males and females) in 12 selected public schools. Questionnaires were developed to elicit information on parents’ and children’s perceptions of weight status, physical activities, sedentary activities, daily food intake and their attitudes toward overweight and obesity in general. The children’s BMIs were measured according to the World Health Organization’s guidelines. Focus group discussions and face-to-face interviews with the school teachers and government officials were conducted to explore their perceptions of overweight and obesity. Survey data was analysed using descriptive and inferential statistics, and content analysis was used for qualitative data.<br><br>Results: One quarter of the surveyed children (25.5%) were overweight. An additional one third of the participants (36.5%) were classified as obese. The nurses’ measurements of BMI disagreed with the children’s perceptions of their own weight and obesity. The children’s perceptions were better aligned with their parents’ perceptions of overweight and obesity. Multiple regression models found that the BMI of male children increased significantly with age, if they had overweight siblings, spent time on sedentary activities, or regularly ate food from fast food restaurants. The BMI of female children also increased significantly with age, if they had overweight siblings, ate at fast food restaurants, and for who not walk to and from school.<br><br>Focus group and interview results revealed the following key themes: (a) obesity is described as a non-normal or disease condition (b) unhealthy diets and lack of exercise were contributing factors to obesity (c) schools do not appropriately address these issues, and (d) there is a need for schools, school nurses, home, and community cooperation to promote healthy lifestyles.<br><br>Conclusion: With the diagnosis of overweight or obesity rising across the world, the need for early interventions is critical. There is a clear need for the collective effort of government officials, parents and teachers to provide measures that enhance prevention, control and management of overweight and obesity among Kuwaiti school children. School nurses could make substantial changes by assessing, monitoring and providing health teaching for parents and their children.