Prevalence of overweight and obesity among Kuwaiti adolescents and the perception of body weight by parents or friends

Objective Recently, the State of Kuwait has witnessed a steady rise in the prevalence of obesity among children and adolescents. The present study aims to provide an update on the rate of overweight or obesity among Kuwaiti adolescents and examines the associations between adolescents’ overweight/obesity levels and their perception of body weight as seen by parents or friends. Methods A cross-sectional study was conducted in Kuwaiti secondary schools and included adolescents between the ages of 15 and 18 years, using a multistage stratified random sampling method. Body weight and height were measured. A specifically designed self-report questionnaire was used to assess parents’ and friends’ perceptions of an adolescent’s body weight. Results A total of 706 adolescents were included the study. The prevalence of overweight or obesity among Kuwaiti adolescents reached nearly 50%, with males (54.3%) having a significantly higher overweight or obesity percentage than females (44.6%). No significant difference in the prevalence of obesity relative to age, from 15 to 18 years, was found. In addition, logistic regression analysis, adjusted for age and gender, revealed that adolescents perceived their parents (p = 0.011 and p < 0.001) or friends (p = 0.002 and p < 0.001) as more likely to classify their weight as overweight or obese, respectively. Conclusion Overweight or obesity levels appear to be high among Kuwaiti adolescents, and appears to have reached a plateau recently. Efforts to combat obesity and promote physical activity and healthy nutrition are needed. Future studies should seek to identify important moderators of parental and social underestimation/overestimation of children’s overweight or obesity.


Reviewers' Comments Authors' Reply
Reviewer #1: ABSTRACT -The values in this sentence "...perceived their parents (p < 0.001) or friends (p < 0.001) as more likely to classify their weight as overweight or obese" (lines 52-53) refer to the obese individuals, not the overweight people (parents: p = 0.011 and friends: p = 0.002).
We modified the sentence to be as follow: "… that adolescents perceived their parents (p = 0.011 and p < 0.001) or friends (p = 0.002 and p < 0.001) as more likely to classify their weight as overweight or obese, respectively.
MATERIALS AND METHODS -Describe in the manuscript when the data collection was performed.
The data collection was performed during the Fall of 2019.
-"Chi-square tests of independence was used to examine the relationships between overweight or obesity category and selected variables related to the influence of media on adolescents' decision to lose weight or their perception of body thinness" (lines 164-166). It is not clear the sentence above on the use of variables related to the influence of media on adolescents' decision to lose weight or their perception of body thinness, because the researchers didn't show the results/discussed about it.
The statement was modified to the following: Chi-square test of independence was used to examine the relationships of selected variables related to adolescents' perception of how parents' or friends' see their weight status relative to an adolescent's overweight or obesity versus nonoverweight/non-obesity status.
The results are shown in table 3.
Furthermore, in lines 157-158 it is described that "In the present study, we used the data from part three only, which was related to body weight perception by parents or friends" and it is the part two that is related to "influence of media on dieting to lose weight". Explain.
It is correct that the data were from part three. However, we slightly modified the sentences to read as follow: In the present study, we used the data from part three only, which was related to adolescent's body weight perception as seen by parents or friends.

RESULTS
-The 95% CI datum cited in the line 208 about overweight individuals is not compatible with the informed in the Table 5.
Thanks for the comments. We have corrected the wrong 95% CI datum shown in page 7, line 202. We corrected the sentence so to read as follow:

DISCUSSION
"… other studies published over the past 15 years [2][3][4]." -The researchers assessed the adolescents' perceptions of parents' and peers' opinions about their weight. I think it is valid to add other studies that have assessed the same (the adolescents' perceptions of how parents and peers assess their weight). And it would be interesting to describe the reason whereby you chose to collect this information from the adolescent, not by parents/peers.
Using PubMed and Google scholar search, we were unable to locate any study related to how parents (or friends) perceived adolescents' weight status as seen by the adolescents themselves. This is the major reason lead to the initiation of this study. It is also more important to assess the direct perception of the adolescents not the parents (or friend) about how they see other perception about their weight status.
We added a sentence in the strength of the present study indicating this aspect of the study.
Also, in the conclusion section the researchers mentioned of importance of parents' perception (and why not from friends?), lines 311-312.
Thanks. We added friends as well.