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Table of Contents
ORIGINAL ARTICLE
Year : 2020  |  Volume : 8  |  Issue : 1  |  Page : 35-40

Prevalence of Sthoulya (obesity) and Karshya (underweight) in medical students with special reference to body mass index: An observational study


1 Intern, Wardha, Maharashtra, India
2 Department of Kayachikitsa, Mahatma Gandhi Ayurved College Hospital and Research Centre, Datta Meghe Institute of Medical Sciences (DU), Wardha, Maharashtra, India

Date of Submission08-Jan-2020
Date of Decision18-Feb-2020
Date of Acceptance16-Apr-2020
Date of Web Publication2-Jul-2020

Correspondence Address:
Dr. Aditya Manohar Tiwari
Intern, Mahatma Gandhi Ayurved College Hospital and Research Centre, Datta Meghe Institute of Medical Sciences (DU), Wardha, Maharashtra.
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/JISM.JISM_1_20

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  Abstract 

Background: Body mass index (BMI) is used for defining anthropometric weight/height characteristics in adults and for classifying (categorizing) them into groups. The common interpretation is that it represents an index of an individual’s physical health. It is also widely used as a risk factor for the development of or the prevalence of several health issues. Aims: The aim of this work was to study the BMI of college students of age group 18-25 years in Ayurveda College; a screening of underweight, overweight, normalcy, and obesity was carried out according to the “Body Mass Index cutoff.”Materials and Methods: BMI was calculated in hundred participants using the weight and height of the each student. They were categorized based on BMI cutoff according to Asian criteria for classification. Two groups were formed as overweight and underweight and separate questions were asked. Observation and Results: It represents that 38% participants have underweight BMI, whereas 34% participants are having normal BMI, 12% participants are overweight, 13% are pre-obese, and 3% are of type 1 obese. The screening of underweight rate is comparatively low in men. The overweight rate and underweight rate show a gender difference with the former favors male group and the latter favors female group. Conclusion: Underweight (Karshya) and obesity (Sthoulya) are very prevalent among medical students, which is quite alarming considering their role as future physicians. Hence, the study reinforces the need to make them aware about maintaining healthy lifestyle, healthy balanced diet, proper eating habits, stress management, and a physically active daily routine targeting the students at the beginning of their college career to prevent the risks of developing chronic degenerative diseases.

Keywords: Anthropometry, body mass index, Karshya, Sthoulya, survey


How to cite this article:
Tiwari AM, Ade V, Patle PM. Prevalence of Sthoulya (obesity) and Karshya (underweight) in medical students with special reference to body mass index: An observational study. J Indian Sys Medicine 2020;8:35-40

How to cite this URL:
Tiwari AM, Ade V, Patle PM. Prevalence of Sthoulya (obesity) and Karshya (underweight) in medical students with special reference to body mass index: An observational study. J Indian Sys Medicine [serial online] 2020 [cited 2020 Aug 14];8:35-40. Available from: http://www.joinsysmed.com/text.asp?2020/8/1/35/288802




  Introduction Top


Body mass index (BMI) recommended by World Health Organization (WHO) is a simple and convenient way to judge underweight and obesity of adults and has been proved to be more reliable than weight index. BMI has been useful in sample-based studies by virtue of its wide acceptance in defining specific categories of body mass as a health issue. BMI values indicate the nutritional status of adults. BMI is an estimate of body fat based on weight and height of adult men and women. Higher BMI is associated with morbidity and mortality especially that related to diabetes mellitus and cardiovascular diseases.[1] Difficulty in breathing even on slight exertion, thirst, delusion, sleep, sudden catching of breath, exhaustion, excessive hunger, bad smell of the body, and poor physical and sexual capacity gradually develop. As the abdomen and bones are chief depots of fat, the abdomen gets enlarged in such persons. Absence of physical activity, sleeping during day, and intake of foods that increase Kapha make the end product of digestion to become (abnormally) sweet, which in turn causes increase of Medas (fat).This obstructs the nutrient channels of the remaining tissues depriving them of nutrition. So only fat accumulates in large quantities in the body making the person incapable of all activities. The channels of Vata become obstructed by the increased fat inside the abdomen; Vata then begins to act fast inside the abdomen and increases the digestive activity, making for voracious hunger and craving for large quantity of food this is known as Sthoulya.[2],[3] However, “underweight person is a person whose weight is too low to be healthy.” Indulgence of food which increase Vata (impulse) along with excessive physical exercise, sexual intercourse, study, fear, grief, worry, keeping awake at nights, suppression of thirst and hunger, consumption of astringent taste food, less intake of food etc, leading to less formation and dryness of Rasadhatu (blood). The same Rasadhatu circulates all over the body, which fails to nourish the other Dhatus (tissue) because of its inadequate quantity. This is known as Karshya.[4]

Alarming conditions associated with obesity include the following:[5] coronary artery disease, type 2 diabetes mellitus and insulin resistance, hypertension, stroke, breast, endometrial, colon cancers, varicose veins, depression, dyslipidemia, cholelithiasis, sleep apnoea syndrome, and osteoarthritis.

Alarming conditions associated with underweight include the following:[6] malnutrition, vitamin deficiencies, anemia, osteoporosis, decrease immune function, increased risk for complication from surgery, fertility issues caused by irregular menstrual cycles, and growth and development issue especially in children and teenagers. Severely underweight individuals may have poor stamina and weak immune system leaving open to infection. In women, being severely underweight can result in amenorrhea and infertility. Being an underweight is an established risk factor for osteoporosis even for young people.[7]

In previous studies,[8],[9],[10] it is observed that prevalence of obesity and emaciation is increasing in college students. This article conducts a survey of the BMI of 100 students of Mahatma Gandhi Ayurveda College, Hospital and Research Centre, Salod (H), Wardha, Maharashtra to study the distribution of underweight, overweight, normalcy, and obesity so as to put forth some valuable suggestions for public physical education and some counter measures, that is, counseling to prevent potential health problems. Also to check the prevalence and awareness of obesity and underweight in the student of Mahatma Gandhi Ayurveda College, Hospital and Research Centre, Salod (H), Wardha, hence this study was undertaken.

Aims and Objectives

The objectives of this study were as follows:

  1. To calculate the BMI of student from Mahatma Gandhi Ayurveda Medical College, Hospital and Research Center, Salod (H), Wardha, Maharashtra.


  2. Assessment of prevalence of Sthoulya (obesity) and Karshya (underweight) on the basis of BMI in students.


  3. Counselling of students and make them aware to prevent health problems.



  Materials and Methods Top


The materials used in this study were weighing machine, wall-mounted measuring tape, and structured questionnaire, as shown in Annexures 1 and 2. The study was conducted among the students of Mahatma Gandhi Ayurveda Medical College, Hospital and Research Center, Salod (H), Wardha, Maharashtra. A total of 100 students were selected for the study. Informed consent was taken from each student. Formal approval for the study was obtained from the Institutional Ethical Committee, Datta Meghe Institute of Medical Sciences (DU) with approval Ref. no. DMIMS(DU)/IEC/Sept-2019/8456. Students were assessed on the basis of their height and weight. The height was measured in cm and the weight in kg. BMI was calculated using the weight and height of the student (BMI = W/H², where W is weight in kg and H2 is height in m2). BMI was calculated for each student. The values were compared with standard cutoff [Table 1].[11],[12] The students were categorized based on BMI cutoff according to Asian criteria for classification. Two groups were formed as overweight (BMI >23) and underweight (BMI <18.5), then separate questionnaires were asked from both groups. On the basis of observation, data were analyzed and correlated, and result was drawn.
Table 1: Standard BMI cutoff range used for assessment criteria

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Inclusion Criteria

The inclusion criteria of the study included the students having age in between 18 and 25 years with both the genders.

Exclusion Criteria

The exclusion criteria of the study included students who were not available during study period, those having chronic illness, and those who were not willing to participate.

Observation and Result

Of 100 students, majority of participants were female, that is, 70%, whereas male participants were 30%. Observations based on Asian criteria of BMI cutoff are depicted in [Table 2]. It represents that 38% participants have underweight BMI in which 21.05% are men and 78.95% are women, whereas 34% participants are having normal BMI, 12% participants are overweight, 13% are pre-obese, and 3% are of type 1 obese.
Table 2: Observation based on Asian criteria of BMI cutoff

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Approximately 28% participants are having their BMI greater than 23 in which 35.71% are men and 64.29% are women. Hence, it can be understood that the screening of underweight rate is comparatively low in men. The overweight rate and underweight rate show a gender difference with the former favors male group and the latter favors female group.


  Discussion Top


Even though the study was conducted at a single institute located in Wardha, the findings give a hint about the need to understand the problem of underweight in this group of students and design effective interventions to address the issue. The total number of study subjects considered for this study analysis was 100. Participation of female students were more in number compared to male students, that is, 70% women and 30% men, which is similar to most other studies.[13],[14],[15] This is may be because women are more sincere than men in such task.

It is observed that of 70 females, approximately 30 female students are underweight (42.85%). Erratic eating habits and other lifestyle-related risk factors are mainly implicated for this increasing burden, and research related to these risk factors is essential, considering their role as future physicians and role models in public health intervention programs.

Questions related to obese respondents are depicted in [Table 3]. It is observed that 64.28% students accept that they are responsible to their obesity by their eating habits. Approximately 78.58% participants feel shame or uncomfortable in society due to obesity. Approximately 82.14% participants feel uncomfortable while working out in gym. In total, 64.28% responded that their physical health has been negatively impacted by overweight. Approximately 89.28% feels that they can lose pounds by exercises.
Table 3: Questions related to overweight, pre-obese, and obese respondents

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Questions related to underweight respondents are depicted in [Table 4]. It is observed that 68.42% participants are too much diet conscious and about maintaining lean and thin body. Approximately 68.42% students have been told about their underweight by the physician. Approximately 60.53% students do not feel any shame or discomfort about their underweight, and 18.42% students who are categorized in underweight consider themselves as they are depressed and underweight is responsible to their depression.
Table 4: Questions related to underweight respondents

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[Tables 3] and [4] show that approximately 66% students are not conscious about their BMI and approximately 75.75% students believe that supportive counselling can assist in sustaining their underweight/obesity healing regimen. Most of the female respondents are not willing to participate as they do not want to share their weight. Improving Ayurveda medical student’s awareness about BMI and counselling them to take balanced nutrition; to eat breakfast and meals regularly; to avoid frequent snacks and fatty food consumption; to stop eating before fullness; to avoid smoking, soft drinks, and alcohol consumption; to control stress; and to do regular physical exercise may promote healthy body weight management among students and thus reduce the prevalence of underweight (Karshya) and obesity (Sthoulya) among future medical professionals.

In this study, underweight was an issue among student population. Moreover, it is common among women compared to men. This is similar to most of the studies,[14] where women found to be more underweight than men. The lower rate of obesity among female students is expected as women are more cautious about their weight status to maintain their thin and lean body than men, due to society perceptions that encourage women to be slender. This assumption was supported by the fact that only 21.05% of men were underweight and 78.95% of women were underweight in this studied sample.

In this study, all the participants were belonging to only one medical college of Maharashtra. Hence, the results of the study cannot be generalized to all the medical students throughout the country. A multicentric study involving many medical colleges with large number of participants can be undertaken in future to understand the relationship between BMI and health awareness. Moreover, in this study other detailed factors can also be included such as dietary habits, family history, and medical conditions. An additional limitation of the BMI is that it does not capture body fat location information.

Interventions should be designed and implemented for primordial prevention of underweight in college. There is both a need and an opportunity to address the issue of underweight/overweight among Ayurveda medical students. The college administration can include topics of healthy lifestyle as a part of the induction program. Facilities for healthy diet and exercise should be made available in the college premises. Moreover, there is also need of future experimental (clinical) research to evaluate the impact of such intervention programs.


  Conclusion Top


The study reveals that underweight were prevalent among students, more than one third, that is, 38% participants were in the category of underweight (BMI < 18.5). By using Asia-Pacific BMI classifications, it is estimated that underweight rate in female students is higher than that of male students and the overweight and obesity rate in male students are higher than those of female students, which is quite alarming among medical students considering their role as future physicians. Hence, the study reinforces the need to aware about maintaining healthy lifestyle, healthy balanced diet, and a physically active daily routine targeting the students at the beginning of their college career to prevent the risks of developing chronic degenerative diseases.

Acknowledgement

The authors gratefully acknowledge the study participants for their cooperation during the study. Special thanks to my teachers who guided me during this entire work.

Financial Support and Sponsorship

Datta Meghe Institute of Medical Sciences (DU).

Conflicts of Interest

There are no conflicts of interest.



 
  References Top

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Murthy S. Madhav Nidan. Chapter no. 34/1–8. Varanasi, India: Chaukambha Orientalia;2007. p. 121.  Back to cited text no. 3
    
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Mathew KG, Aggarwal P. Medicine. 4th ed., Chapter no. 11.New Delhi, India: Elsevier;2012. p.663.  Back to cited text no. 7
    
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Doley P, Gandhi AP, Balasubramania T, Pardeshi G. Changes in body mass index (BMI) during first year among undergraduate students of a medical college in New Delhi. Natl J Community Med 2019;10:145-8.  Back to cited text no. 9
    
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Amruth M, Kumar A. A cross-sectional study on BMI and eating habits among students in a medical college in Kerala. Int J Community Med Public Health 2019;6:1285-94.  Back to cited text no. 10
    
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Pan WH, Yeh WT. How to define obesity? Evidence-based multiple action points for public awareness, screening, and treatment: An extension of Asian-Pacific recommendations. Asia Pac J Clin Nutr 2008;17:370-4.  Back to cited text no. 11
    
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Expert Panel on the Identification, Evaluation, and Treatment of Overweight and Obesity in Adults. Executive summary of the clinical guidelines on the identification, evaluation, and treatment of overweight and obesity in adults. Arch Intern Med 1998;158:1855-67.  Back to cited text no. 12
    
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Yahia N, Achkar A, Abdallah A, Rizk S. Eating habits and obesity among Lebanese University students. Nutr J 2008;7:32.  Back to cited text no. 13
    
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Rada C. Body mass index and eating habits in young adults from Romania. Int J Med Res Health Sci 2016;5:42-50.  Back to cited text no. 14
    
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  [Table 1], [Table 2], [Table 3], [Table 4]



 

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