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"Modifikasi perilaku gaya hidup telah menjadi langkah strategis dalam penatalaksanaan obesitas. Salah satu contohnya adalah pemberian insentif sebagai motivasi eksternal dalam bentuk kompetisi. Penelitian ini bertujuan untuk mengetahui pelaksanaan program kompetisi penurunan berat badan “Ideal Weight Challenge” di sebuah perusahaan tambang batu bara pada tahun 2020 serta faktor-faktor yang mempengaruhi. Desain penelitian ini menggunakan mixed-method dengan concurrent embedded model. Hasil pengukuran berat badan, lingkar pinggang dan indeks massa tubuh 127 peserta Ideal Weight Challenge dianalisis, kemudian dilakukan in depth interview terhadap 15 informan yang terkait dengan pelaksanaan Ideal Weight Challenge. Sebanyak 38 subjek penelitian (29.92%) mengalami penurunan berat badan lebih dari 5% dan sebanyak 80 subjek (70.87%) mengalami penurunan lingkar pinggang sebanyak lebih dari 3 cm. Terdapat penurunan bermakna antara hasil pengukuran bulan pertama dengan bulan ketiga, dan bulan pertama dengan bulan keenam pada variabel berat badan, lingkar pinggang dan indeks massa tubuh (P<0.001). Analisis kualitatif menemukan 3 domain yang mempengaruhi pelaksanaan kompetisi yaitu motivasi individu, dukungan grup dan dukungan perusahaan, dengan motivasi individu yang paling dominan dalam mempengaruhi hasil penurunan berat badan, lingkar pinggang, indeks massa tubuh dan kepesertaan dalam mengikuti program.

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Lifestyle behavior modification has become a strategic step in obesity management. One example is the provision of incentives as external motivation in the form of competitions. This study aims to determine the implementation of the "Ideal Weight Challenge" weight loss competition program in a coal mining company in 2020 and the factors that influence it. This research design uses mixed-method with concurrent embedded model. The results of measurements of weight, waist circumference and body mass index of 127 Ideal Weight Challenge participants were analyzed, then in-depth interviews were conducted with 15 informants related to the implementation of the Ideal Weight Challenge. A total of 38 research subjects (29.92%) experienced a weight loss of more than 5% and 80 subjects (70.87%) experienced a waist circumference reduction of more than 3 cm. There was a significant decrease between the measurement results of the first month and the third month, and the first month and the sixth month on the variables of body weight, waist circumference and body mass index (P<0.001). Qualitative analysis found 3 domains that influenced the implementation of the competition: individual motivation, group support and company support, with individual motivation being the most dominant in influencing the results of weight loss, waist circumference, body mass index and participation in the program."

"Latar belakang. Obesitas merupakan masalah kesehatan masyarakat dunia dengan prevalensi yang semakin meningkat. Obesitas meningkatan risiko sindrom metabolik dan penyakit kardiovaskular, yang diyakini akibat inflamasi dan stres oksidatif. Penurunan berat badan (BB) dengan cara diet dan olahraga merupakan strategi dasar dalam manajemen obesitas. Penyandang obesitas seringkali mengalami peningkatan dan penurunan BB yang dikenal sebagai weight cycling (WC). Penelitian menunjukkan risiko sindrom metabolik dan penyakit kardiovaskular meningkat pada WC dibandingkan dengan penyandang obesitas pemula [first encounter obesity (FEO)]. Penelitian ini bertujuan untuk menilai pengaruh program penurunan BB terhadap komposisi tubuh, petanda sindrom metabolik, petanda inflamasi dan stres oksidatif pada penyandang obesitas WC dibandingkan dengan FEO.Metode. Penelitian ini merupakan uji klinis terbuka selama delapan minggu yang dilakukan di Balai Kota DKI Jakarta. Subyek penelitian diambil secara konsekutif dan diklasifikasikan menjadi kelompok WC dan FEO. Kedua kelompok diberikan program penurunan BB yang terdiri dari pengurangan asupan energi sebesar 1000 kkal/hari dan olah raga intensitas ringan - sedang tiga kali seminggu selama 45 menit. Pengukuran antropometri dan komposisi tubuh (BB, indeks massa tubuh/IMT, massa lemak/ML, massa bebas lemak/MBL, massa otot/MO, rating lemak viseral, intracellular water /ICW yang merupakan indikator anabolisme protein ), petanda sindrom metabolik (kadar trigliserida/TG dan LP), petanda inflamasi (high sensitivity C-reactive protein/hs-CRP, interleukin/IL-6), dan stres oksidatif (F2-isoprostan) dilakukan pada awal penelitian, minggu ke-4 dan pada akhir penelitian (minggu ke-8).Hasil. Dari total 73 subyek (34 subyek kelompok WC dan 39 subyek kelompok FEO) didapatkan karakteristik yang setara dalam hal usia, riwayat obesitas pada keluarga, asupan makanan, proporsi komposisi makronutrien, dan aktivitas fisik, namun tidak terdapat kesetaraan dalam hal distribusi subyek laki-laki dan perempuan, riwayat lamanya obes. Kelompok WC memiliki ML yang lebih tinggi , MBL, MO dan ICW yang lebih rendah, serta petanda inflamasi yang lebih buruk dibanding kelompok FEO, sebaliknya kelompok FEO memiliki kadar TG, F2-isoprostan lebih tinggi daripada WC. Setelah intervensi diet dan olah raga selama 8 minggu, penurunan BB, IMT, ML, MBL, MO, rating lemak viseral dan kadar ICW pada kelompok WC cenderung lebih rendah daripada kelompok FEO (p >0,05). Penurunan LP pada kelompok WC cenderung lebih rendah daripada kelompok FEO (p = 0,23). Kadar TG pada kelompok WC meningkat, sedangkan pada kelompok FEO terjadi penurunan kadar TG, namun perbedaannya tidak bermakna (p = 0,055). Penurunan kadar hs-CRP dan IL-6 pada kelompok WC cenderung lebih besar daripada FEO (p >0,05). Penurunan kadar F2-isoprostan lebih tinggi pada kelompok FEO daripada kelompok WC (p = 0,017).Kesimpulan: Penyandang obesitas WC memiliki ML yang lebih tinggi dari FEO, disamping itu memiliki anabolisme protein yang lebih rendah, oleh karena itu program diet dan olahraga pada WC harus mempertimbangkan modalitas yang mampu meningkatkan anabolisme protein.Penyandang WC memiliki petanda inflamasi yang lebih buruk dibanding FEO, sedangkan setelah menjalani program diet dan olahraga selama 8 minggu pada penelitian ini tidak didapatkan perbedaan perubahan BB, komposisi tubuh, petanda sindrom metabolik, dan petanda inflamasi, kecuali perubahan petanda stres oksidatif yang lebih baik pada penyandang FEO.

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Background. The worldwide prevalance obesity is increasing rapidly and has become serious health burden globally. Obesity increases risks of metabolic syndrome and cardiovascular diseases which may partly caused by inflammation and oxidative stress. Effective weight loss programs include diet and exercise,and these interventions are considered as first line strategy of obesity management. Obese individuals often experience repeated cycles of weight loss followed by weight regain, which is recognized as weight cycling (WC). Several studies demonstrated that weight cycler has higher risk of metabolic syndrome and cardiovascular diseases than individuals with first encounter obesity (FEO). This study aimed to assess the effect of weight loss programs using diet and exercise on body composition, selected markers of metabolic syndrome, inflammation, and oxidative stress in obese subjects with WC and FEO.

Methods.This study was an 8-week open clinical trial held at Balai Kota DKI Jakarta. Subjects were recruited consecutively and classified into WC and FEO groups. All subjects were assigned to receive weight loss programs with the following goals: 1,000 Kcal reduction of total energy intake/day and 45-minute mild-to-moderate intensity exercise, three times a week. Antropometric and body composition (body weight/BW, body mass index/BMI, fat mass, fat free mass, muscle mass, visceral fat rating, intracellular water/ICW as indicator of protein anabolism), markers of metabolic syndrome (triglyceride/TG levels and waist circumference), inflammation (high sensitivity C-reactive protein/hs-CRP, interleukin/IL-6), and oxidative stress(F2-isoprostane)were measured at baseline, week 4, and the end of study (week 8).

Results. A total of 73 subjects consisting of 34 subjects with WC (WC group) and 39 subjects with FEO (FEO group). Both groups had similar characteristics in age, family history of obesity, dietary intakes, macronutrient composition, and physical activities; meanwhile, gender and duration of obesity were significantly different between groups. WC group had more body fat, less fat free mass, muscle mass and ICW, higher markers of inflammation than FEO group. On the other hand, TG and F2-isoprostane levels in FEO group were higher than WC group. Following 8-week intervention with diet and exercise, the reduction in BW, BMI, fat free mass, muscle mass, visceral fat rating, and ICW in WC group was comparable with FEO group (p>0.05). The reduction of waist circumference in WC group tended to be lower than FEO group (p = 0.23). Triglyceride levels in WC group increased, but it declined in FEO group. However, these differences were not statistically significant(p= 0.055). The decline in hs-CRP and IL-6 levels in WC group tended to be higher than FEO group (p>0.05). Meanwhile, the decrease in F2-isoprostane levels in FEO group was significantly higher than WC group (p=0.017).

Conclusion.Obese subjects with WC had more body fat but lower protein anabolic capacity than those with FEO. These results suggest that diet and exercise program for weight cycler should consider effective ways to enhance protein anabolism.In addition, obese subjects with WC had higher inflammatory process than those with FEO.Using the current model of 8-week intervention with diet and exercise, this study was not able to demonstrate differences between WC and FEO groupsin the magnitude of changes in body composition and inflammation indicators, except oxidative stress indicator."

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Berat badan berlebih merupakan salah satu permasalahan kesehatan yang sering terjadi pada anak-anak dan remaja di seluruh dunia, baik negara maju maupun negara berkembang. Hal ini didukung oleh data hasil prevalensi terhadap kasus overweightpada anak usia 2–19 tahun di Amerika Serikat yang terus menunjukkan peningkatan dari tahun ke tahun. Berdasarkan hasil penelitian National Health and Nutrition Examination Surveytahun 2009–2010 di Amerika, didapatkan persentase overweightdan obesitas berdasarkan kelompok umur dengan jumlah prevalensi tertinggi terjadi pada remaja berusia 12–19 tahun (33,6%). Data Riskesdas tahun 2013 menunjukkan bahwa prevalensi gizi berlebih secara nasional pada remaja berusia 16–18 tahun di Indonesia mencapai angka tertinggi yaitu 11,5%. 

Pada penelitian ini, peneliti berusaha mencari tahu lebih lanjut mengenai fenomena terdapatnya keterkaitan antara seorang individu khususnya remaja di Indonesia yang memiliki berat badan berlebih dengan citra tubuh (body image)yang dimilikinya, apakah berdampak positif atau negatif. Sejumlah 350 remaja dengan rentang usia 16–18 tahun dari kedua SMA di Jakarta Selatan, tepatnya SMA Negeri 109 dan SMA Negeri 28, dipilih untuk menjadi subjek penelitian dan setelahnya diteliti dengan desain studi potong lintang (cross-sectional) dan metode observasional analitik.  Proses pengambilan data untuk penelitian yang dilakukan pada bulan Desember 2017 di SMA Negeri 109 dan bulan Januari 2018 diawali dengan pengukuran antropometri, selanjutnya responden berkewajiban untuk mengisi instrumen penelitian berupa kuesioner tipe King College London Body Image Questionnaire’s. Melalui hasil skoring total seluruh komponen pertanyaan serta hasil analisis dengan uji hipotesis chi-squaredidapatkan bahwa nilai p menunjukkan angka 1,000 yang berarti p tidak bermakna (uji hipotesis 0 diterima), sehingga hubungan antara berat badan berlebih terhadap body image tidak dapat ditentukan dan cenderung tidak signifikan. 

Kata kunci        : 

Berat Badan berlebih, Body Image, Jakarta Selatan, Remaja 16-18 Tahun.

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Overweight is one of the health problems that often occur in children and adolescents throughout the world, both in developed and developing countries. This is supported by the results in USA that there is an increase of overweight prevalence at children aged 2–19 years from year to year. In addition, based on the results of the National Health and Nutrition Examination Survey 2009–2010 in United States, the percentage of overweight and obesity by age group with the highest prevalence was found at the age of 12–19 years with a score of 33,6%.According to the data obtained by Riskesdas in 2013, it shows that the prevalence of adolescents aged 16–18 years in Indonesia reached the highest value of 11,5%.

In this study, researcher trying to find out more about a phenomenon if there is relationship between teenagers in Indonesia who have excess body weight with body image, whether the positive or negative impact. Three hundred and fifty adolescents ranging in age at 16–18 years old from two senior high school in South Jakarta, which is 109 senior high school and 28 senior high school were chosen to be the participants, with cross sectional study and analytic observational method. Data collection process started from December 2017 until January 2018 performing antropometric measurements, and participants had to complete the King College London Body Image Questionnaire's. The result from hypothesis testing with chi-square shows that p score is 1,000, which means p score is meaningless and also prove that there is no significant relationship between excessive body weight and body image.

Keywords:

Body Image, Overweight and Obesity, Teenagers Aged 16-18 Years Old, South Jakarta.

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"Ibadah haji adalah ibadah fisik, sehingga jemaah haji dituntut mampu secara fisik dan rohani agar dapat melaksanakan rangkaian ibadah haji dengan baik dan lancar. Di Indonesia hipertensi dengan komplikasi 5,3 merupakan penyebab kematian nomor 5 lima pada semua umur, prevalensi hipertensi pada jemaah haji risti di Kabupaten Cirebon Pada tahun 2016 sebesar 31,6 . Berdasarkan data Riskesdas 2013 prevalensi obesitas sentral di Kabupaten Cirebon sebesar 15,2 . Dalam penelitian ini menggunakan Standar hipertensi menurut AHA/ACC tahun 2017, sedangkan obesitas sentral menggunakan ukuran lingkar pinggang menurut WHO tahun 2006. Obesitas sentral sangat berhubungan dengan resistensi insulin, intoleransi glukosa, hipertensi, dan dislipidemia. Penelitian ini bertujuan mengetahui hubungan obesitas sentral dengan kejadian hipertensi pada jemaah haji Kabupaten Cirebon tahun 2017. Desain penelitian menggunakan crossectional dengan menggunakan data Siskohatkes Kabupaten Cirebon tahun 2017, analisis multivariat dengan menggunakan cox regression. Hasil penelitian menunjukkan bahwa proporsi hipertensi pada jemaah haji Kabupaten Cirebon tahun 2017 sebesar 68,64 , sedangkan proporsi obesitas sentral sebesar 57,50. Hasil analisis multivariat menunjukkan bahwa jemaah haji Kabupaten Cirebon tahun 2017 yang mengalami obesitas sentral berisiko 1,736 kali PR:1,736;95 CI:1,560 ndash; 1,932 untuk terjadi hipertensi bila dibandingkan dengan jemaah haji tanpa obesitas sentral setelah dikontrol oleh variabel umur. Rekomendasi untuk jemaah haji agar dapat berolahraga secara teratur untuk menjaga lingkar pinggang tetap normal, mengatur asupan gizi yang seimbang, berperilaku hidup bersih dan sehat.

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Hajj is a physical worship, so that pilgrims of hajj are required able to physically and spiritually in order to perform the series of hajj that is good. In Indonesia, hypertension with complication 5.3 is the cause of death number 5 five at all ages, prevalence of hypertension in prospective high risk pilgrims in Cirebon district In 2016 that is 31.6 . Based on data The basic health research in 2013, prevalence of central obesity in Cirebon district amounted to 15.2 . In this study using the standard hypertension from AHA ACC in 2017, while abdominal obesity using standard waist circumference measurement from WHO in 2006. Abdominal obesity is strongly associated with insulin resistance, glucose intolerance, hypertension, and dyslipidemia.

This study aims to determine the relationship of abdominal obesity with the incidence of hypertension in pilgrims of hajj in Cirebon District 2017. The research design is cross sectional using Siskohatkes data of Cirebon district in 2017, multivariate analysis using cox regression.

The results showed that the proportion of hypertension in pilgrims of hajj in Cirebon District in 2017 amounted to 68.64 , the proportion of abdominal obesity amounted to 57.50. The results of multivariate analysis showed that Hajj pilgrims in 2017 with abdominal obesity at risk 1,736 PR 1,736 95 CI 1,560 1,932 for hypertension when compared with pilgrims without abdominal obesity after controlled by age variables. The Recommendation for pilgrims of hajj in order to exercise regularly to maintain waist circumference, regulate balanced nutrition, live clean and healthy. "

"ABSTRAK Latar Belakang Penelitian dilakukan untuk mengetahui hubungan antara kesertaan latihan fisik usia dan jabatan dengan pengendalian berat badan karyawan perusahaan T yaitu perusahaan minyak dan gas di Kalimantan Timur Metode Penelitian dilakukan dengan metode potong lintang kepada karyawan perusahaan T yang konsisten mengikuti Medical Check Up MCU dari tahun 2009 ndash 2011 Data sekunder didapatkan dari hasil MCU tahun 2009 ndash 2011 dan daftar hadir latihan fisik di tempat kerja tahun 2009 ndash 2011 Hasil Penelitian Jumlah karyawan yang konsisten mengikuti MCU adalah 110 orang merupakan jumlah sampel yang diteliti Proporsi karyawan dengan berat badan terkendali lebih banyak yang tidak latihan fisik usia 21 ndash 35 tahun dan teknisi Secara statistik menunjukkan proporsi karyawan dengan berat badan terkendali pada kelompok mengikuti latihan fisik tidak berbeda bermakna dengan yang tidak mengikuti latihan fisik OR 0 64 90 CI 0 28 ndash 1 41 proporsi karyawan dengan berat badan terkendali pada kelompok usia 21 ndash 35 tahun tidak berbeda bermakna dengan 35 tahun OR 1 63 90 CI 0 85 ndash 3 40 akan tetapi tingkat pengendalian berat badan karyawan teknisi berbeda bermakna dengan superintendent dan supervisor OR 5 61 90 CI 2 75 ndash 16 46 Analisis multivariat menunjukkan jabatan memiliki hubungan signifikan dengan pengendalian berat badan OR 5 41 90 CI 2 26 ndash 12 92 Dari 29 karyawan yang mengikuti latihan fisik proporsi karyawan dengan berat badan terkendali lebih banyak pada usia 21 ndash 35 tahun dan teknisi Secara statistik menunjukkan bahwa proporsi karyawan dengan berat badan terkendali pada kelompok usia 21 ndash 35 tahun tidak berbeda bermakna dengan 35 tahun OR 3 75 90 CI 1 01 ndash 13 80 akan tetapi tingkat pengendalian berat badan karyawan teknisi berbeda bermakna dengan superintendent dan supervisor OR 7 333 90 CI 1 80 ndash 29 73 Analisis multivariat menunjukkan jabatan memiliki hubungan signifikan dengan pengendalian berat badan OR 5 63 90 CI 1 26 ndash 25 07 Kesimpulan Karyawan teknisi perusahaan T mempunyai peluang memiliki berat badan terkendali 5 415 kali dibanding jabatan lain setelah dikontrol variabel kesertaan latihan fisik dan usia Kata Kunci aktivitas fisik berat badan lebih latihan fisik pengendalian berat badan program pengendalian di tempat kerja.ABSTRACT Background This study was conducted to determine the association between participation in physical exercise age and position with employees body weight control company T which is an oil and gas company in East Kalimantan Method The study was conducted by cross sectional method to employees who consistently perform Medical Check Up MCU in 2009 ndash 2011 Secondary data used were MCU result and attendance list participating in physical exercise in 2009 ndash 2011 at the company T Result The number of employees who consistently perform MCU in 2009 2011 was 110 who became the sample of this study The proportion of employees with controlled body weight was higher among employees who do not participate in physical exercise were at the age 21 ndash 35 years and were technicians There were no significant association between participation in physical exercise and age with controlled body weight but a very significant difference in controlled body weight was found between technicians and superintendent supervisor OR 5 61 90 CI 2 75 to 16 46 Multivariate analysis showed that job position has a very significant association with body weight control ORadj 5 41 90 CI 2 27 to 12 93 Among 29 people who attend physical exercise the proportion of employees with controlled body weight were higher in employees aged 21 ndash 35 years and technicians There were no significant associations between age with controlled body weight but a significant difference in controlled body weight was found between technicians and superintendent supervisor OR 7 33 90 CI 1 81 to 29 73 Multivariate analysis showed that job position has a significant association with body weight control ORadj 5 63 90 CI 1 27 to 25 1 Conclusion Technicians in company T have opportunity to have controlled body weight 5 41 times compared to other positions after controlled by participation rate in physical exercise and age variable Key words body weight control control programs in the work place obesity overweight physical activity physical exercise."

"Remaja dengan kelebihan berat badan harus diintervensi agar tidak menjadi orang dewasa dengan obesitas. Berkembangnya patient-centered care sebagai upaya pemberdayaan diri dapat menjadi pendekatan terpilih. Dibutuhkan motivasi besar dalam menjalani proses perubahan perilaku. Coaching dilakukan untuk mendampingi klien (coachee) agar mampu mengoptimalkan potensi sehingga memiliki sikap positif, mental yang kuat, dan gaya hidup yang lebih baik. Belum ada penelitian yang mengidentifikasi keberhasilan patient-centered care berbasis pemberdayaan diri dengan metode coaching pada mahasiswa obesitas.Penelitian dilakukan dengan mixed method dalam tiga tahap. Tahap 1 merupakan studi potong lintang untuk mengidentifikasi persepsi mahasiswa terhadap dampak obesitas bagi kesehatan. Kuesioner daring terdiri dari identitas, data antropometri, S-Weight, dan P-Weight. Tahap 2 dilakukan pengembangan model pelayanan dengan cara melaksanakan focus group discussion. Peserta diskusi adalah pakar di tingkat mikro, meso dan makro sistem layanan kesehatan. Tahap 3 menilai kemamputerapan dan efektivitas model layanan yang dikembangkan. Studi dilakukan pada dua kelompok mahasiswa obesitas (usia 18-24 tahun) yang dibagi dalam kelompok intervensi dan kontrol. Pada kedua kelompok diberlakukan model layanan yang sama yaitu pengukuran status antropometrik dan komposisi tubuh, pengisian kuesioner pada awal program, edukasi, dan kembali dilakukan pengukuran status antropometrik dan komposisi tubuh serta pengisian kuesioner pada akhir program. Pada kelompok intervensi ditambahkan uji coba coaching sebanyak 6 sesi setiap dua minggu. Pengukuran awal dan akhir berjarak 3 bulan.Tahap 1 diperoleh 134 mahasiswa obesitas (respons rate 14.1%). Teridentifikasi responden berada pada tahap kontemplasi (35,8%) dan aksi (35,1%) terhadap perubahan perilaku dalam proses menurunkan berat badan. Kesiapan responden bersifat positif (76,9%) pada emosi, dan bersifat negatif pada konsekuensi, dukungan, dan aksi dalam menurunkan berat badan.Tahap 2 dilaksanakan dua tahap FGD terhadap 2 kelompok @ 10 orang. Teridentifikasi bahwa program penurunan berat badan harus diinisiasi dengan membangkitkan rasa kebutuhan untuk lebih sehat dengan berat badan yang ideal. Program harus bersifat personal. Diperlukan dukungan lingkungan seperti ketersediaan makanan sehat dan sarana untuk beraktivitas. Program harus merupakan program yang menimbulkan dukungan terhadap peserta, profesional, dan tersedia di layanan kesehatan. Berdasarkan hal tersebut disusun metode coaching yang sesuai dengan patient-centered care berbasis pemberdayaan diri bagi mahasiswa obesitas dalam program penurunan berat badan. Program terdiri dari 6 sesi coaching. Setiap tema dalam sesi coaching menggunakan langkah SMART dan diberi nama “From Fat to Fit with SMART Program”. Program dilaksanakan dalam waktu 3 bulan. Tema berturut-turut adalah healthy behavior habit, vision strategy, body self-image, timeline perspective/ state line exercise, happiness model, dan healthy behavior habit/ vision board. Kedua kelompok mendapatkan edukasi mengenai dampak obesitas bagi kesehatan, prinsip gizi seimbang, aktivitas fisik dan hidrasi yang sesuai bagi remaja dari para ahli yang terdiri dari spesialis penyakit dalam, spesialis gizi klinik, dan spesialis kedokteran olahraga yang dilakukan secara daring. Pengukuran antropometri, komposisi tubuh (menggunakan Bioelectric Impedance Analysis), pemantauan asupan makanan (menggunakan formulir food record), pemantauan aktivitas fisik (menggunakan bouchard activity record), pemberdayaan diri (menggunakan kuesioner subjective wellbeing dan skala kepuasan healthy behavior habit), dibandingkan antara dua kelompok menggunakan uji T berpasangan (jika distribusi data normal) dan uji Mann-Whitney (jika distribusi data tidak normal).Tahap 3 diawali dengan penerapan program terhadap dua kelompok @ 30 mahasiswa obesitas. Peserta dibagi menjadi kelompok intervensi dan kelompok kontrol. Kelompok intervensi mendapatkan coaching dari health coach yang telah mendapatkan pelatihan sebelumnya dari coach bersertifikat Internasional. Seorang health coach mendampingi 4 mahasiswa obesitas. Health coach berjumlah 8 orang yang terdiri dari dokter spesialis kedokteran keluarga layanan primer, dokter spesialis penyakit dalam, dokter spesialis kedokteran olahraga, dokter pengelola program studi fakultas, dan coach yang berpengalaman dengan pendekatan coaching di tempat kerjanya. Sesi coaching dibagi menjadi enam pertemuan setiap dua minggu secara daring melalui media zoom meeting dengan bantuan host dari tim peneliti. Namun, meningkatnya kondisi PPKM (pemberlakuan pembatasan kegiatan masyarakat) pada tahap ini, mahasiswa yang berhasil menyelesaikan program adalah 23 mahasiswa kelompok intervensi dan 18 mahasiswa kelompok kontrol.Nilai perubahan pada kelompok intervensi secara signifikan lebih besar dibandingkan kelompok kontrol pada komponen total lemak tubuh [-0.9 (-12,9, 0,70) vs 0,0 (-6,9, 3,50), p=0,02) dan healthy behavior habit [13.5 ± 11,85 vs 7,5 ± 8,08, p=0,04]. Nilai perubahan skala kepuasan healthy behavior habit secara signifikan lebih besar dibandingkan kelompok kontrol pada aspek hobby/passion [2(-4,6) vs 1(-2,2), p=0,02], movement exercise [2,3 ± 2,11 vs 1,2 ±1,93, p=0,03], sleep rest [2(-6,5) vs 1(-3,2), p=0,01], dan spiritual [1(0,6) vs 0( -1,3), p=0,00].

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Adolescents with excess weight should be intervened so as not to become adults with obesity. The development of patient-centred services as an effort to empower oneself could be the approach of choice. It takes great motivation in undergoing the process of behaviour change. Coaching is carried out to assist the client (coachee) to optimize their potential so that they had a positive attitude, strong mentality, and a healthier lifestyle. There has been no research that has identified the success of patient-centred care based on self-empowerment with coaching methods for obese students.

Mixed method research were in three stages. Phase 1 was a cross-sectional study to identify students' perceptions of the impact of obesity on health. The online questionnaire consisted of identity, anthropometric data, S-Weight, and P-Weight. Phase 2 was developing a service model by conducting focus group discussions. Discussion participants were experts at the micro, meso, and macro levels of the health care system. Phase 3 assessed the applicability and effectiveness of the developed service model. The study was conducted on two groups of obese college students (aged 18-24 years) in the intervention group and the control group. Both groups were subjected to the same service model, namely an initial physical examination, a questionnaire at the beginning of the service, and education about how to lose weight. A final physical examination and questionnaire were carried out at the end of the program. However, the intervention group was given a coaching method. Initial and final examinations were 3 months apart.

Phase 1 obtained 134 obese students (response rate of 14.1%). Respondents identified as being in the contemplation stage (35.8%) and action (35.1%) on behaviour change in the process of losing weight. Respondents' readiness was positive (76.9%) on emotions about losing weight and was negative in terms of consequences, support, and action in losing weight.

Phase 2 was carried out in 2 stages of FGD with 2 groups of 10 people. It was identified that a weight loss program should be initiated by generating a sense of the need to be healthier with ideal body weight. Programs should be personal. Environmental support was needed such as the availability of healthy food and facilities for activities. The intervention program should be a program that creates support for participants, professional, and available in health services. Based on this, a coaching method was developed following patient-centred care based on self-empowerment for students with obesity in weight loss programs. The program consisted of 6 coaching sessions. Each session used SMART steps. Each coaching session was themed sequentially and was named “From Fat to Fit with SMART Program”. The program was implemented within 3 months. The successive themes of the coaching session were healthy behaviour habits, vision strategy, body self-image, timeline perspective/ state line exercise, happiness model, and healthy behaviour habit/ vision board. Both groups received online education about obesity, balanced diet, physical activity and hydration from experts consisting of internal medicine specialists, clinical nutrition specialists, and sports medicine specialists. Anthropometric measurements, body composition (using Bioelectric Impedance Analysis), monitoring food intake (using a food record form), monitoring physical activity (using a bouchard activity record), self-empowerment (using a subjective wellbeing questionnaire and healthy behaviour habits satisfaction scale) were compared between the two groups using paired T-test (if the data distribution was normal) and the Mann-Whitney test (if the data distribution was not normal).

Phase 3 began with the application of the program to two groups of 30 obese students. Participants were divided into an intervention group and a control group. The intervention group received coaching from a health coach who had received previous training from an internationally certified coach. A health coach accompanied 4 obese students. There were 8 health coaches consisting of family medicine and primary care specialists, internal medicine specialists, sports medicine specialists, faculty study program manager doctors, and coaches who were experienced with coaching approach in the workplace. The coaching session was divided into six meetings every two weeks online via a zoom meeting with the help of a host from the research team. However, the increasing conditions of pandemic restrictions on community activities at this stage, students who completed the program were 23 students in the intervention group and 18 students in the control group. The value of change in the intervention group was significantly greater than the control group in the component of total body fat [-0.9 (-12.9, 0.70) vs 0.0 (-6.9, 3.50), p=0.02 ) and healthy behaviour habit [13.5 ± 11.85 vs. 7.5 ± 8.08, p=0.04].

The value of the change in the healthy behaviour habit satisfaction scale was significantly greater than the control group in the hobby/passion aspect [2(-4.6) vs 1(-2.2), p=0.02], move exercise [2,3 ± 2.11 vs 1.2 ±1.93, p=0.03], sleep rest [2(-6.5) vs 1(-3.2), p=0.01], and spiritual [1( 0.6) vs 0( -1.3), p=0.00]. This method has been proven to be able to be applied and is effective in reducing total body fat and significantly increasing healthy behaviour habits. This coaching method, which is following self-empowerment-based patient-centred care, has been proven to be able to be applied in the university's primary health services. However, support is needed from supportive university policies so that students participating in the program could follow it completely until all the expected output indicators are achieved properly"

"Gaya hidup masyarakat perkotaan yang difasilitasi dengan ketersediaan dari kemudahan terhadap layanan transportasi berkontribusi pada kurangnya aktivitas bergerak diperkuat dengan kemudahan akses untuk mengkonsumsi makanan tidak sehat berperan sebagai faktor risiko terjadinya obesitas. Intervensi pengaturan pola makan menggunakan piring model T dan aktivitas fisik mempengaruhi pengetahuan dan berhasil menurunkan berat badan sebanyak 2 kilo gram. Diharapkan klien mampu mempertahankan pola makan sehat dengan aktivitas fisik yang teratur untuk mengoptimalkan penurunan berat badan menuju berat badan ideal.

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Combination of Diet Arrangement and Monitoring of Physical Activities as Obesity Management of Adult Family in Depok. The lifestyle of urban communities facilitated by the availability of facilities for transportation services contributes to the lack of moving activities reinforced by easy access to consuming unhealthy foods as a risk factor for obesity. Dieting intervention using plate model T and physical activity affected knowledge and succeeded in losing weight as much as 2 kilograms. It is expected that the client is able to maintain a healthy diet with regular physical activity to optimize weight loss towards the ideal body weight.

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