Perception of Obesity in Adults, | Samana Bakavoli K1602991

3. Results

3.1 Response rate

In total, 732 individuals were approached to complete the survey from which 246
people did not show any interest and 86 people were omitted due to not meeting the
criteria needed for participating which is being resident of the selected areas and over
the age of 18. Therefore, the response rate has been calculated as 54.6% (400/732).

3.2 Demographics
Table 3.1 shows the demographic information of all participants. The percentage of female
participants was 58% (n=232) which was slightly more compared to males at 42% (n=168).
Candidates age range varied between 18 and 84 and the mean and mode age were 37 and
18 respectively. As shown in table 3.1, there were a diverse ethnicity of population in
respondents. The top three ethnic groups were Asian (Indian, Pakistani, Bangladeshi,
Chinese) (33.8% (n=135)), White British (28.8% (n=115)) and Black African (10.5% (n=42)).
The responses about the level of education have confirmed that almost 9% of population has
classified themselves as having no education. The highest response for level of the education
was GCSE (22.5% (n=90)) and the second and third high levels were undergraduate degree
(19.8% (n=79)) and A-Levels/O-Levels/IB (19% (n=76)) respectively. Almost half (51.5%
(n=206)) of the population reported their income to be less than £20,000. Only 6.5% (n=26) of
respondents have an annual income of more than £40,000. Around 75% (n=300) of the
participants has reported to have at least one medical condition. The highest responses were
about high blood pressure (11% (n=44)), high cholesterol level (10% (n=40)), Joint pain (8.3%
(n=33)) and type 2 diabetes (6.3% (n=25)).
Demographic Factor Number of participants (%)
Gender
Male 168 (42)
Female 232 (58)

Ethnicity
White British 115 (28.8)
White and Black Caribbean 8 (2)
White and Black African 5 (1.3)
Other White Background 25 (6.3)
Other Mixed Background 5 (1.3)
Black African 42 (10.5)
Black Caribbean 7 (1.8)

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Other Black 4 (1)

Asian (Indian, Pakistani, Bangladeshi, 135 (33.8)
Chinese)
Other Asian Background 22 (5.5)
Other Ethnicity 25 (6.3)
Age
18-24 100 (25)
25-34 103 (25.8)
35-44 77 (19.3)
45-54 58 (14.5)
55-64 37 (9.3)
above 65 23 (5.8)
Mean Age 37 (9.3)
Mode Age 18 (4.5)
Median 34 (8.5)
Education
No Education 37 (9.3)
GCSE 90 (22.5)
A-Levels/O-Levels/IB 76 (19)
Foundation Degree 38 (9.5)
Undergraduate Degree 79 (19.8)
Postgraduate Degree 54 (13.5)
PhD 9 (2.3)
Other 17 (4.3)
Annual Income
Under £20,000 206 (51.5)
£20,000 - £29,999 112 (28)
£30,000 - £39,000 52 (13)
£40,000 - £49,000 12 (3)
£50,000 - £74,999 9 (2.3)
£75,000 and more 5 (1.3)

Medical Conditions
High Blood Pressure 44 (11)
High Cholesterol 40 (10)
Type 2 Diabetes 25 (6.3)

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Joint Pain 33 (8.3)

Heart Disease 17 (4.3)
Stroke 2 (0.5)
None 101 (25.3)
Other 38 (9.5)
Table 3.1: Demographical statistics of the participants.

Around 7% (n=28) of the participants are healthcare professionals as shown in figure 3.1.

Are you a healthcare professional?

7%

Yes
No

93%

Figure 3.1: Participant’s response whether they are healthcare professionals or no

3.3 Perception of obesity

Section 1 of the survey conducted was about the perception thus it investigated the people’s
understanding of weight and therefore obesity. Less than half, 42% (n=168) of the participants
claimed to be familiar with the term BMI. Females have shown more confidence in positively
answering this question (figure 3.2).

Are you familiar with the term BMI?

200
165
Number of Participants

150
105
100
63 67
50

0
yes No

Male Female

Figure 3. 2: Number of male and female participants familiar with the term BMI

In this section, the height and weight of the participants were asked and according to this their
BMI was calculated and shown in figure 3. 3. By calculating each participants’ BMI, 33.5%

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(n=134) of respondents are overweight from which around 54% (72 out of 134) are female
and 46% (62 out of 134) are male. A total of 62 participants have been classified as obese by
their actual BMI calculation from which around 65% (40 out of 62) are female and 35% (22 out
of 62) are male.

PARTICIPANTS ACTUAL BODY WEIGHT CLASSIFICATION

Underweight
Obese 3%
15%

Normal
Weight
Overweight 48%
34%

Figure 3. 3: Participants actual body weight classification according to BMI.

Participants were then asked to describe their body weight classification by choosing from list
of words such as Underweight, Normal, Overweight and Obese. About a quarter, 25.7%
(n=103) of participants classified themselves to be overweight and only 2.8% (n=11) has
classified themselves as obese. This indicated that nearly 1 in 2 participants are either
overweight or obese compared to about 1 in 4 believing that. A total of around 69% (n=274)
of the participants have classified themselves as normal weight whereas by BMI calculation,
only around 48% (n=190) are categorized as normal weight.
Then the participants were asked to select their body image from figure 3.4. Only around 8%
(30 out of 400) chose the overweight image and around 6% (n=22) chose the obese image.

(60)
Figure 3.4: Image guide of Body Weight Classification in Female and Male

The perception of participants about their own body weight classification (verbally and visually)
and their actual body weight classification according to BMI was compared as shown in Figure
3.5.

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Actual BMI Vs Image Illustration and Word Perception

Verbal Perception % Visual Perception % Actual BMI %
Percentage of participants
100
80 68.5 69.5

60 47.5

40 33.5
25.75
17.5 15.25
20 7.5
3 3.25 2.75 5.5
0
Underweight Normal weight Overweight Obese

Figure 3.5: Participants’ verbal and visual perception of body weight classification and actual BMI comparison.

As shown in figure 3.6 the chosen image classification was further compared to their
calculated BMI from their given weight and height to see how closely they have visually
perceived their body weight. Only 8% (6 out of 72) of overweight females, have chosen their
body image correctly and 72% (52 out of 72) of the overweight female population have
classified themselves as normal. With regards to overweight males (n=62), 23% (14 out of 62)
correctly identified their body image and 55% (34 out of 62) classified themselves as normal.
More than half, 55% (22 out of 40) of obese females classified themselves as normal,
compared to 27% (6 out of 22) of obese males who have classified themselves as normal. By
comparing the data, there is very significant difference in participants’ perception of their body
weight and the reality. This suggests the underestimation of the public of their body weight.

Body Image Perception of actual Overweight or Obese participants

Underweight Normal Overweight Obese Number of Participants in corresponding category by BMI

80 72
62
Number of Participants

60
51

40
40 34

22 22
20 14 13
9 11 11
6 4 5 6 5
1 3 1
0
Overweight female by Overweight male by BMI Obese female by BMI Obese male by BMI
BMI

Figure 3.6: Participants response on choosing their own body classification and their actual weight comparison.

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The image in figure 3.4 without the labels were shown to participants and they were asked to
categorize the images by under-weight, normal, overweight, and obese. Less than half of the
population (47.5%, n= 190) were able to correctly label the image D for females as an
overweight which means more than half of the population are unable to classify a female
overweight picture, with 40% (n=159) classifying it as normal weight. The image of overweight
male was classified as normal by 79% (n=315) of the population and 17% (n=68) of the
population found the image to be underweight (figure 3.6).
The pictures corresponding to obese female were classified as overweight by 56% (n=224) or
even normal weight by 24.5% (n=98) of the participants. The female obese images were
classified correctly by only 19% (n=76) of the participants. When shown the image of obese
male, only 6.25 % (n=25) were able to correctly identify male obese images, with. 43.25%
(n=173) of the participants labelling this image as overweight and 50% (n=200) marking it as
normal (figure 3.6).

Body image classification

Underweight Normal Overweight Obese
Number of Participants

350 315
300
250 224
190 200
200 159 173
150 98
100 68 68 76
45
50 6 7 25
2 2
0
Image Overweight Image Overweight male Image Obese female Image Obese male
Female

Figure 3.6: Body weight classification of visual illustrations of overweight and obese, male and female images.

As illustrated in Figure 3.7, most of non-obese participants are happy with their weight.
Whereas as the BMI increases the number of unhappy participants also increases. Overall,
female shown more dissatisfaction of their weight than male as 60% (24 out of 40) of the
obese female are unhappy about their weight which is 46% (10 out of 22) in obese male.

Are you happy with your weight?

happy neutral unhappy
76
80 66
Number of Participants

60
38
40 32 32
25 24
19
20 9 9 8 11 13 11 7 10
5 5
0
None-obese Female None-obese Male Overweight Female Overweight Male Obese Female Obese Male

Figure 3.7: Participants’ feelings with their weight.

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Annual income and body weight:

As shown in figure 3.8, around 52% (n=205) of the participants are earning less than £20,000
per year. The second top answer in regards to annual income is earning between £20,000
and £30,000 by 28% (n=112) of the participants which indicates that majority of the
participants are earning less than £30,000 per annum. The Percentage of Overweight and
Obesity is slightly decreasing as the annual income is increasing.

Annual Income and Weight category

25
Underweight
20 Normal weight
Percentage of participants (%)

15 Overweight

Obese
10

0
Under £20,000 £20K - £29,999 £30K - £39,999 £40K - £49,999 £50K - £74,999 £75K and more
Annual income (£)

Figure 3.8: Annual income and weight category of Participants

Education:
Almost 10% (n=37) of the population have reported to have no education and more than
40% (n=166) have reported their highest education level is A-Levels or below. Overall, only
33% (n=133) of the population are holding university degrees.

Highest Education Level

Other
PhD
Postgraduate Degree
Undergraduate Degree
Foundation Degree
A-Levels
GCSE
No Education

0.0 5.0 10.0 15.0 20.0 25.0

Percentage of participants (%)

Figure 3.9: Education level of the participants

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3.4 Diet and Knowledge

One section of the survey investigated the lifestyle of the participants to find possible
correlation with their weight. Figure 3.8 shows the NHS recommendation for a balanced meal.

Figure 3.8: The Eatwell Guidance by NHS (60)

The participants were asked about the percentage of each food group in their main meal. Less
than half of the population were aware of the NHS daily fruit and vegetable recommendation
and 11% (n=42) clearly said they do not know where 33% (n=129) of the population gave
answers below the recommendation.
The average proportion of each food group in their main meal is shown in Figure 3.9 below.

9%
6% 20% Fruits and vegtables
Carbohydrates
Dairy

26% Protein
oil and spreads
30%
fats in food and junk
9%

Figure 3.9: The average percentage of each food group in participant’s main meal.

As shown in table 3.2 almost 87% (n=346) of the participants did not meet the NHS
recommendation (60) of 40% fruits and vegetables in main meal from which 50% (173 out of
346) are either overweight or obese. More than quarter (33% (n=131)) of the participants eat
more carbohydrates than the NHS recommendation of 38%, from which around half of them
are either overweight or obese. More than three quarter of the participants responded correctly
to the vegetable percentages under the NHS recommendation value of 40%. Nearly 72%
(n=285) of the population overestimated the recommended fat intake.

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Met recommendation Did not meet the recommendation

Fruit and vegetables 54 (13%) 346 (87%)
Carbohydrates 269 (67%) 131 (33%)
Protein 310 (77%) 90 (23%)
Fats 113 (28%) 287 (72%)
Diary 189 (47%) 211 (53%)
Table 3.2: Participants comparison if they met the NHS Eatwell guidance

Participants were asked on how many days a week they eat breakfast, 51% (n=204) of the
participants missed at least one breakfast per week. When asked what their breakfast mostly
consist of, eggs, bread and cereal are the highest frequency breakfast options.
NHS recommends to have 5 portions of fruit a day, (61) around 79% (n=317) of the sample
population does not meet this recommendation as shown in Figure 3.10 below. From this 50%
(152 out of 317) are either overweight or obese.

100
No. of paricipants

80
60
40
20
0
0 1 2 3 4 5 6 more
than 6
Daily fruit portions

Figure 3.10: Participants daily fruit consumption compared to NHS daily fruit recommendation.

Around 30% (n=117) of the participants have reported to have at least one takeaway per week
and around 50% (n=198) have reported two or more takeaways per week. From the people
having takeaways weekly (n=315) around 33% (n=103 out of 315) are overweight and a further
16% (n=49 out of 315) are obese. In terms of snacking, almost 90% (n=353) of the population
have at least one snack per day. The results suggest that 4 out of 5 of the participants have
crisps, chocolate, and biscuit as the first choice of snack. Also 16% (n=64) of the respondents
have at least one soft drink per day and 10% (n=40) have more than two soft drinks daily.

Exercise vs Knowledge:
The NHS recommendation on physical activity is 150 minutes of moderate intensity exercise
(48)
or 75 minutes of vigorous exercise per week. When participants were questioned on the

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NHS weekly exercise recommendation, less than 5% (n=19) responded correctly and around
60% (n=234) clearly said they don’t know the recommended exercise time When the
participants were asked about the time they spend doing moderate exercise per week, 73%
(n=293) of the total population did not meet the NHS weekly exercise recommendation (figure
3.11). From the population who did not meet the NHS exercise recommendation around 34%
(n=98 out of 293) are overweight and a further 16% (n=46 out of 293) are obese.

80 72 72
Number of participants

70 57
60 47 46
50 37 34 35
40
30
20
10
0
0 less than 30 60 90 120 150 180+
30
Weekly Moderate Exercice achieved

Figure 3.11: The weekly moderate exercise carried out by participants compared to NHS recommendation shown
in green color.

The participants were then asked about the type of physical activity they carryout. The most
common answer was walking and then going to the gym.

Alcohol vs Knowledge:
(61)
NHS advice on safe maximum units of alcohol to be no more than 14 units weekly to
minimize the possible harms. When the participants were asked about the safe maximum
level, only 8% (n=30) knew the correct answer and 67% (n=262) said they do not know where
4% (n=16) overestimated the maximum units. Respondents were asked if they are drinking
alcohol and 50% (n=200) have answered yes to this question from which 46% (n=92 out of
200) are either overweight or obese. From the population who are drinking alcohol around
15% are drinking the maximum safe units of alcohol or above.

Nutritional behavior vs Knowledge:

Around half of the population found taste to be their priority when buying food when 24%
(n=96) confirmed health and nutrition is their least priority. 1 out of 10 of the population said
they are not checking nutritional labels when shopping food. 1 out of 4 of the population are
checking calories and sugar contents on the labels.

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The participants were then asked about the eat well guide plate to investigate whether they
are aware of each food group percentage in the main meal. Only 9% (n=34) of the participants
knew about the recommended carbohydrates and protein and vegetables percentage in the
main meal. Guideline Daily Amounts (GDA) label on front packaging of food products provides
the nutritional information in the food. The participants knowledge on components of the
nutritional information on GDA was tested in one of the questions. Around 36% (n=141) of the
population were able to answer correctly, 25% (n=103) of the participants indicated they did
not know the correct option and the rest answered incorrectly. The participants were also
shown three different nutritional labels as shown in Table 3.3 to rank as healthiest and least
healthy. Only 35% of the population correctly identified the healthiest option which is C.

A) B) C)
Table 3.3: The GDA labels shown to the participants

Subsequently, the participants were shown the traffic light nutritional labels as shown in table
3.4 to rank from least to most healthy. Around 71% (n=290) of the population correctly selected
option A as healthiest and option B as least healthy which is correct.

C)
A) B)
Table 3.4: The nutritional traffic light labels shown to the participants

3.5 Knowledge of obesity causes and consequences

One section of the survey was investigating the knowledge of the population on obesity
causes, consequences, and healthy lifestyle. Figure 3.12 is demonstrating the knowledge of
the population on causes of obesity. Between 82-90% (n=348 to 357)of the population found
binge-eating, inactivity, excessive calorie intake from fats and sugar to be the main underlying
causes of obesity. Around 65% (n=258) of the respondents were aware that excess alcohol
intake can lead to obesity and 24% (n=93) did not know this when 11% (n=49) were thinking
this is completely wrong. Although 42% (n=167) of the population know that the annual income
can affect the weight status of the public, still 26% (n=107) of the people do not know this and
a further 32% (n=126) think annual income has no effect on obesity rates. Although more than
half of the population agreed to the statement that genetic can cause obesity, still 25% (n=102)

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 Perception of Obesity in Adults, | Samana Bakavoli K1602991

of the total population were not aware of this and around 12% (n=46) disagreed with the
statement. Around 34% (n=135) of the participants did not know that stopping smoking can
lead to weight gain and obesity where 25% (n=96) disagree this statement.

Knowledge on obesity causes

High Alcohol…
Stress and low mood
Low household income
Agree
Diabetes
Genetics Neither
Excess calories
Disagree
Less exercise
Binge-eating
Stop Smoking

0 50 100 150 200 250 300 350 400

Number of participants

Figure 3.12: Knowledge of the participants on causes of obesity

Figure 3.13 is showing the knowledge of the participants on consequences of obesity. Only
40% (n=161) of the population knew that obesity causes cancer. Around 38% (n=149) of the
population did not know this and a further 23% (n=90) did not agree to this statement. The
majority, 86% (n=344) of the respondents were aware that excess body weight can affect the
heart function and cause heart diseases but still 10% (n=40) did not know this and around 4%
(n=16) thought heart disease may not be related to weight. Less than half of the respondents
agreed that obesity is a factor for infertility and 35% (n=139) did not have enough knowledge
on this, whereas 17% (n=66) disagreed with this statement. Nearly three quarter of the
population knew there is a link between obesity and hypertension and high blood cholesterol
and around 10% (n=40) were unaware of this whereas 4% (n=10) did not agreed to the
statement. A small percentage (14%) of the population did not know diabetes can be a
consequence of obesity and a further 9% (n=29) disagreed with this statement.

Knowledge on obesity consequences

Stroke
Infertility
Diabetes Agree
Depression Neither
Cancer
Disagree
Joint Problems
High Cholesterol
Heart Disease
Hypertension
0 50 100 150 200 250 300 350 400
Number of participants

Figure 3.13 Knowledge of the participants on consequences of obesity

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3.6 Advice and Awareness

The sample population were asked if they have heard about health campaigns that encourage
healthy lifestyle. Nearly 24% (n=97) of the population were aware of health campaigns and
Change For Life was the most common specific answer. TV was the top communication route
that raised awareness of health campaigns. Only 0.75% (3 out of 400) of participants heard
about the health campaigns from pharmacy. In addition, only 13% (n=51) of the participants
knew about weight management services available in their local pharmacies as shown in
Figure 3.14 below.

Are you aware of weight management services in your local pharmacy?

13% Yes

No

87%

Figure 3.14: Participants’ awareness of weight management services in their local pharmacies.

The population were then asked about the advice they may give to their families and friends
which helps them lose weight and their most common answers are shown in Figure 3.15
below. The top answer was increasing physical activity by 67% of the participants. Stress and
time to exercise were the top two barriers for losing weight and getting healthier. Visiting GP,
reducing calorie and alcohol intake as well as increasing fruit and vegetables were the second
top advice by around 40% of the population. 34% (n=136) of the respondents advised to visit
local pharmacy can help to lose weight. A few, 16% (n=62) will give advice on reducing fat
intake and only 5% (n=18) on reducing sugar intake.
Number of participants

300
250
200
150
100
50
0
Exercise Visit GP Visit a Reduce Reduce Reduce fat Reduce increase
more pharmacy daily calorie alcohol intake sugar fruit and
intake intake intake vegetables

Participants advices

Figure 3.15: Participants advice to friends and family for losing weight.

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