Obesity is a condition when the energy intake exceeds energy expenditure to a point, which might leads to non-communicable diseases (NCD) such as coronary heart disease, diabetes mellitus, hypertension, atherosclerosis as well as some types of cancer (Chukwuonye et al., 2013). In layman terms, obesity occurs when “calories in” exceeds “calories out”. The Build & BP Study has shown that the adverse effect of overweight has the tendency of being delayed, sometimes for more than10 years or longer. Life insurance actuarial statistic and the epidemiological studies have also confirmed that increasing degrees of overweight & obesity are important predictors of decreased longevity (Kopelman, 2000). The incidence of NCD represents more than 75% of mortality in the world (Cdc.gov, 2015).
Obesity is a common public health problem affecting all population globally. There is good evidence indicating that even though obesity may started out as a lifestyle-driven problem, it can rapidly progress to disturbed energy balance regulation as a result of impaired hypothalamic signaling, which leads to a higher body weight set point. Thus, obesity may be considered a disease initiated by a complex interaction of generic and environment (Apovian C., 2016). There are approximately more than 1 billion of adults are found to have overweight issue and over 400 million of them are obese in 2011 by Finucane et al. (see Ghorbani et al., 2015). Medical statistic (Kopelman, 2000) gathered worldwide has found that obesity is the most significant contributor, replacing malnutrition and infectious disease, to ill health worldwide. The prevalence of obesity and overweight has increased to an alarming level in many parts of the world includes both developed and developing countries. USA has the highest proportion (global total of 13%) of overweight and obese people when its’ population only accounted 5% of the world’s population (Murray et al., 2015). Another significant finding from the WHO MONICA project is that prevalence of obesity among women was higher than men (WHO, 2000) especially age ranging from 25 to 44 years. This is the time when women tend to gain a lot of weights (Sidik et al., 2009). However the rising prevalence not only falls on single etiology. It can be due to significant changes in lifestyle including inadequate exercise, changes in dietary pattern, environmental changes or genetic factors. This is especially significant in married women after starting a family. Their focus will primarily be on their children thus losing attention on their own well being by maintaining a healthy regime such as doing enough exercise and eating healthy food. Take-away and junk food becomes the norm, as they are too exhausted to cook after caring for the baby/children. Apart from that most mothers will tend to eat any leftovers of the food cooked for the baby/children, which unknowingly increases their calories intake. Sticking to an exercise regime has become an almost an impossible task as they tend to feel too tired or exhausted after doing all the household chores. On the other hand, recent study indicates that due to the menopause transition and reproductive hormones changes, middle-age women have the tendency of weight gain and changes in body composition or fat distribution (Karvonen-Gutierrez and Kim, 2016).
Besides, Musaiger (2011) has concluded that non-working women are more likely to be obese and overweight compare to career women as the exposure of working women to the community at work may pay more attention to their appearance in particularly their weight due to peer pressure. Studies have also shown that men or woman who are in better physique tend to project a better image and confidence. On the contrary, previous studies have shown that people who’s having obesity problem were found to be less likely to take part in the labor force activity and are frequent absentees from work, reportedly having more limitations in performing their duties and are often the receivers of workers’ compensation and disability related income (Houston, Cai and Stevens, 2009).
Malaysia populations are at a high risk of having overweight and obesity problem. Based on the National Health and Morbidity Survey (2011), 33.3 percent and 27.2 percent of adult above 18 years were found to have overweight and obesity problem respectively, which is around 5.4 million and 4.4 million adult Malaysian. According to World Health Organization (WHO, 2015), underweight is body mass index (BMI) less than 18.5kg/m2, normal is BMI more than or equal to 18.5kg/m2 to 24.9kg/m2, overweight is when BMI more than or equal to 25.0kg/m2 and BMI more than or equal to 30.0kg/m2 is consider obese. Studies on normal healthy subjects showed that Malay and Chinese energy intake were significantly higher than Indian whereas in women, Malays has the higher energy intake than other ethnic groups (Ismail et al., 2002). This is because of their dietary pattern, Malays tend to consume more oily foods and high sugar drinks compare to other ethnic groups. Several studies show that there’s significant increase in protein and carbohydrate intake during the month of Ramadan that leads to remarkable weight gain (Suriani et al., 2015). This trend is indeed worrying and national health institution has repeatedly warned about the ever increasing overweight kids and adolescent and the age is getting younger. In accordance with WHO (2011), it’s predicted that in 2015 around 2.3 billion of people aged 15 years and above will have some kind of overweight problem and there will be around 700 million obese people globally (see Ghorbani et al., 2015). Studies have shown that overweight or obese kids will leads to persistent obesity in their adult life (Mamalakis et al., 2000). Despite then abundance of evidence on the benefits of maintaining a healthy weight and maintaining a physically active lifestyle, most people continue to consume larger portion sizes than what our body actually needs and leading a chronically passive lifestyle (Marks, 2004).
There are various ways and methods available to identify whether a person is overweight or obese. In the medical fraternity there are such methods as, but not limited to, bioelectrical impedance analysis, hydro densitometry, and skin fold thickness and waist circumference. Though these methods might have better accuracy for measuring the body fats but it’s quite costly to use at population level or at non-clinical environment. Yet some are difficult to measure accurately and constantly among large population (National Obesity Observatory, 2009). Therefore, these methods are usually not popular or widely use by the general population or health conscious individuals. Only when there are medical conditions or medical complications where a medical practitioner believes that it warrants a more detail investigation into his patient’s body fats, etc. Otherwise there is a more simple, cost effective, non-intrusive way to assess excess body fats (National Obesity Observatory, 2009). BMI or Body Mass Index is a calculation of a person’s body weights in kilograms divided by the square of their height in meters (BMI= body weight /height2). BMI was adopted as an indicator for overweight and obesity. However its’ accuracy is largely unknown (Romero-Corral et al., 2008). Even though BMI is used widely in research and clinical practice but there are lack of studies testing its diagnostic accuracy. Apart from that, no study is done for this in a large, multiethnic adult population representing men and women of different age group. Nevertheless under non-medical conditions and as a general guide in monitoring one’s own body weight, it is still one of the most popular methods in use.