INTRODUCTION
The obesity rate has increased by 3% every year, and now one in three or four adults is obese. The obese population has increased, and in a 1998 survey, the prevalence of obesity with a body mass index (BMI) of 25 kg/m2 or more was reported to be 15.7%. Obesity is defined as a state in which excessive fat is accumulated in the body, and it causes chronic diseases such as hypertension, arteriosclerosis, diabetes, and cancer. In addition to diseases caused by obesity, the general public’s negative perception of obesity causes many social and psychological difficulties for obese people, and this prejudice has a greater impact on women. Therefore, many women are deeply interested in obesity prevention and treatment, and some obese women try to solve their obesity with extreme methods such as anorexia nervosa or hyperphagia. However, it is true that these methods are accompanied by physical side effects such as the yo-yo effect or disease occurrence.
By lowering the concentration of leptin, an appetite-stimulating hormone produced from the ob gene of fat storage, or by lowering leptin resistance, body weight can be reduced by regulating food intake and energy expenditure (Schwartz and Seeley, 1997). These include circulating signals, the pancreatic hormone insulin (encoded by the ob gene, which is secreted by fat cells), and brain peptides such as neuropeptide Y, which are released from nerve terminals in the hypothalamus and mediate adaptive changes in energy balance by inducing changes in feeding behavior and energy expenditure (Schwartz and Seeley, 1997).
Weight loss through dietary control is achieved by a significant decrease in blood leptin levels, which can be related to a decrease in body fat (Considine et al., 1996). In other words, when body fat in obese individuals is reduced through dietary control, the secretion of leptin produced in fat cells decreases, which suppresses neuropeptide Y in the hypothalamus and reduces appetite. This change in energy balance due to long-term weight loss also has a significant impact on carbohydrate and blood lipid metabolism (Lamarche et al., 1992). Even at biological extremes of body fat, circulating leptin concentrations are closely related to fat content. Furthermore, in trained individuals with low leptin concentrations, acute exhaustive exercise does not have an immediate effect on circulating leptin concentrations (Hickey et al., 1996).
Diets that are high in carbohydrate and low or moderate in fat tend to be low in energy, and energy intake was lowest among vegetarians (Kennedy et al., 2001). Weight loss through diet includes very low-calorie diets, which are very low-calorie diets that consume fewer calories than the amount required for basal metabolism, usually 200–800 kcal/day, so they are difficult to eat as a regular meal, and many people use products manufactured by health food companies. However, very low-calorie diets are recommended only for those who have failed to eat regularly or are severely obese. In particular, they are prohibited for use by infants, children, pregnant women, lactating women, the elderly, and patients with diseases other than diabetes.
This study aimed to investigate the relationship between weight control experience, obesity and body shape awareness, experience of recent popular diet methods, interest in dieting, degree of body shape distortion, implementation of popular diet methods, and satisfaction with them in some female college students.
MATERIALS AND METHODS
Research subjects
This study surveyed 1,563 students from a university in Seongnam from April to September 2024. The results of the survey of 1,486 students were analyzed after excluding those with insufficient or missing responses. This study was approved by Eulji University (approval number, 2024-2-35).
Questionnaire composition
It consisted of questions about the degree of experience with popular diet methods, the relationship between subjective judgment and objective evaluation of body shape, the relationship between the degree of obesity and the degree of satisfaction with the effects of diet methods tried, and the relationship between distortions in body shape perception and the degree of satisfaction with the effects of diet methods tried.
Obesity of the research subjects
Obesity was classified as underweight when the BMI was 18.5 kg/m2 or less, normal when 18.5–23 kg/m2, overweight when 23–25 kg/m2, and obese when 25 kg/m2 or more, and used as an objective indicator. Body shape perception was divided into very thin, thin, average, fat, and very fat, and used as a subjective judgment of obesity.
Research procedures and statistical processing methods
The purpose of weight control, selection of weight control methods, frequency of diet methods, etc. were investigated and analyzed. The correlation between subjective judgment and objective evaluation of one’s body shape, and the degree of satisfaction with the effectiveness of the diet method tried were tested for statistical significance using the Mantel-Haenzel chi-square test. The difference in the degree of distortion in body shape perception and the degree of satisfaction with the effectiveness of the diet method tried were tested for statistical significance using the Kruskal–Wallis test. The statistical significance level was set at 0.05, and the SAS ver. 8.1 (SAS Institute Inc.) was used.
RESULTS
General characteristics of the study subjects
The average age of the subjects was 22.35 years, the average height was 161.4 cm, the average weight was 51.76 kg, and the average BMI was 19.59 kg/m2.
Types and methods of diet
In the answers that allowed duplication, the experience rate of popular diet methods was tea diet (28.60%), raw food diet (22.00%), various fruit diet (20.26%), vinegar diet (10.43%), laxative (9.29%), Danish diet (7.60%), and herbal medicine (6.86%). A significant number of female college students also used laxatives or diuretics (3.63%), which are known to have serious side effects.
Evaluation of body shape
In response to the question “What is your body shape?,” 54.44% responded “average,” 27.46% “obese,” 11.91% “skinny,” 3.50% “very skinny,” and 2.69% “very obese.” However, when calculating the degree of obesity based on BMI based on weight and height, 1.14% were “obese,” 4.17% were “overweight,” 66.76% were “normal,” and 27.93% were “underweight,” showing a large difference between subjective opinion and subjective judgment (Table 1). In terms of distortion of body shape perception, 34.37% of the normal group responded “obese,” while 55.90% of the underweight group thought they were “obese” or “normal.”
Satisfaction with diet methods
The average number of popular diet methods tried was 1.67 in the entire target group, 1.28 in the underweight group, 1.66 in the normal group, 3.66 in the overweight group, and 4.05 in the obese group, indicating that these diet methods were tried more frequently depending on the degree of obesity.
Satisfaction with the above diet methods was 9.58% in the underweight group for “it was very effective after trying,” 28.38% for “it was slightly effective after trying,” 34.97% for “it was effective only during the trial period,” and 27.07% for “it was not effective.” In the normal group, the values were 2.60%, 20.40%, 41.61%, and 35.39%, respectively; in the overweight group, the values were 2.20%, 14.98%, 29.52%, and 53.30%; and in the obese group, the values were 4.35%, 7.25%, 24.64%, and 63.76%, indicating that the level of satisfaction with diet methods was lower in obese individuals.
Relationship with diet satisfaction
The number of experiences of popular diet methods according to body type awareness was 3.62 on average for those who responded that they were “very obese,” 2.16 on average for those who responded that they were “obese,” 1.59 on average for those who responded that they were “average,” 0.79 on average for those who responded that they were “slim,” and 0.53 on average for those who responded that they were “very thin.” The rate of experience of implementing diet methods was higher when the body type awareness was perceived as being obese. In addition, the satisfaction level was lower when the body type awareness was perceived as being obese.
Effect on the level of interest in dieting
The number of experiences according to the level of interest in dieting was 3.24 on average in the group that responded that they were “very interested,” 2.34 on average in the group that responded that they were “highly interested,” 1.25 on average in the group that responded that they were “average,” and 0.73 on average in the group that responded that they were “not interested.” The higher the interest, the higher the rate of experience. However, there was no significant correlation between the level of interest and the level of satisfaction.
Correlation with the degree of satisfaction with body shape perception
The group that responded that their body shape was normal or obese in the underweight group and the group that responded that they were obese in the normal weight group were defined as the body shape distortion group, and the other respondents were divided into the nondistorted group. The number of diet experiences between the distorted group and the nondistorted group was 1.95 on average in the distorted group and 1.49 on average in the nondistorted group, showing a higher rate of experience in the distorted group. The degree of satisfaction was also 4.53% for “It was very effective after the implementation,” 16.87% for “It was slightly effective after the implementation,” 28.77% for “It was effective only during the implementation period,” and 49.83% for “It was not effective.” In the nondistorted group, the degrees of satisfaction were 3.76%, 24.89%, 46.76%, and 24.59%, respectively, showing that the degree of satisfaction in the distorted group was significantly lower than in the nondistorted group.
DISCUSSION
In the United States, over 600 different food diets and drinks have been tried for short-term weight loss, and most of the diets are harmful to health regardless of their popularity. Among the diets mentioned in this study, the Emperor diet and Danish egg diet, which are low-carbohydrate, high-protein, and high-fat diets, can increase the risk of dizziness, orthostatic hypotension, fatigue, bad breath, and coronary artery disease due to electrolyte and water loss.
In particular, a study by Reddy et al. (2002) found that the Emperor diet (meat) increased uric acid and urinary stone formation, bone loss, and disrupted blood calcium balance.
In this study, the weight control experience rate was 84.1% of all subjects. This high rate is due to the increased interest in and experience with weight control. The degree of distortion in body shape recognition was also shown to be 34.37% in the normal group and 55.90% in the underweight group, showing distorted awareness of body shape. The main ways to obtain information about diet were friends or people around them, TV or broadcast media, the Internet, newspapers or monthly magazines, diet-related books, and hospitals. As computers and the Internet became more widespread, information acquisition through these methods increased, and the number of cases through TV or broadcast media was also higher than in previous studies.
The exercise that is mainly performed for weight control is walking, working out, running, aerobics, jumping rope, etc., and they prefer exercises that are not intense and can be done alone. There were significantly many responses that the reason for weight control was for beauty, and it is thought that people who are actually obese or thought to be obese try many types of diet methods and are relatively dissatisfied with the results. It is judged that education on effective and desirable weight control methods is necessary in the future.
Leptin weight was found to have a positive relationship with body fat percentage and success, and after adjusting for fat mass and lean mass, leptin weight was reduced in the subjects. The lower fat oxidation and lower plasma leptin concentrations observed in individuals after obesity may partly explain their tendency to relapse (Filozof et al., 2000).
Regardless of age, being younger and more physically active has been shown to lower the risk of chronic diseases such as cardiovascular disease, type 2 diabetes, and obesity. (Woolf et al., 2008). Central leptin hypersensitivity occurs early in the weight gain process induced by a high-saturated fat diet, while central leptin insensitivity occurs as obesity progresses (Fam et al., 2007). The discovery of leptin and the evidence that leptin replacement therapy reverses the obesity syndrome in ob/ob mice have had a profound impact on our understanding of metabolism and nutritional homeostasis, and it is clear that much challenging work is needed in the future (Flier, 1997).
BMI was significantly lower in both men and women on the high-carbohydrate diet and highest in the low-carbohydrate diet group (Kennedy et al., 2001). A 6-week low-carbohydrate, high-protein diet can significantly increase the acid load on the kidneys, increasing the risk of stone formation, decreasing estimated calcium balance, and increasing the risk of bone loss (Reddy et al., 2002). The relationship between net acid excretion and urinary urea and potassium/urea is similar in calcium stone formers with and without idiopathic hypercalciuria, but patients with idiopathic hypercalciuria have increased urinary calcium excretion rates at all levels of net acid excretion (Lemann, 1999). The association between dietary acid load and total lean mass (%) was different by gender, with a negative effect on total lean mass only in older women. Therefore, an alkaline diet may be helpful in maintaining total lean mass in older women, especially those with low protein intake (Faure et al., 2017). In conclusion, prescribing a nutritionally sound diet and making lifestyle changes can lead to long-term weight control (Fitzwater et al., 1991).
This study investigated the relationship between female college students’ weight control experience, degree of obesity and body type awareness, and the degree of diet method implementation and satisfaction with it in relation to weight control and popular diet methods, and the following conclusions were reached. 34.37% of the normal weight group and 55.90% of the underweight group showed distorted body type awareness. The exercises mainly performed for weight control were walking, working out, running, aerobics, and rope jumping, and they preferred non-strenuous exercises that could be performed alone. The rate of experience with diet methods was found to be higher in those who were actually obese or thought they were obese.
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