International Journal of Clinical Science and Medical Research

Background: Diet, physical activity, sleep patterns, bowel habits, and consumption of sugary drinks are some of the lifestyle factors that contribute to obesity, a growing global health concern. Fast food consumption and sedentary lifestyles have led to an increase in obesity rates in Iraq. A special environment for evaluating lifestyle modifications and their effect on the severity of obesity is provided by the Al-Arbaeen pilgrimage. 

The study's objective is: to determine the predictors of severe obesity and evaluate the relationship between lifestyle factors and obesity classes among Al-Arbaeen participants. 

Method: During the Al-Arbaeen period, a cross-sectional study was carried out. A structured questionnaire was used to gather information on sociodemographics, dietary habits, physical activity levels, sleep duration, bowel habits, and soft drink consumption. Waist circumference and body mass index (BMI) were examples of anthropometric measurements. Class I, Class II, and Class III obesity were distinguished. Descriptive comparisons and multivariate regression were used in the statistical analysis to find important predictors of the severity of obesity. 

Findings: Class Obesity was the most prevalent. Fast food, soft drinks, inactivity, poor sleep, sedentary work, and delayed bowel habits were all associated with higher obesity classes. As the degree of obesity increased, so did the waist circumference. A poor diet, inactivity, and gender were important predictors. Conclusion: Among Al-Arbaeen participants, lifestyle choices significantly influence the degree of obesity. To lower the risk of obesity and improve overall metabolic health, the findings highlight the necessity of focused health interventions that improve sleep patterns, increase physical activity, improve diet quality, and reduce consumption of sugary drinks.

Obesity, lifestyle, arbaeen piligrims, Karbala

1. Abe, M. et al. (2021) “Comparison of body mass index and waist circumference in the prediction of diabetes: a retrospective longitudinal study,” Diabetes Therapy, 12(10), pp. 2663–2676.
2. Akhlaghi, M. and Kohanmoo, A. (2023) “Sleep deprivation in development of obesity, effects on appetite regulation, energy metabolism, and dietary choices,” Nutrition Research Reviews, pp. 1–21.
3. Aldubikhi, A. (2023) “Obesity management in the Saudi population,” Saudi Medical Journal, 44(8), p. 725.
4. Alsulami, S. et al. (2023) “Obesity prevalence, physical activity, and dietary practices among adults in Saudi Arabia,” Frontiers in Public Health, 11, p. 1124051.
5. Bhattarai, P., Vaidya, A. and Tylleskär, T. (2025) “Overweight, obesity and physical inactivity among women of reproductive age in Eastern Nepal: a cross-sectional community-based study,” PLOS Global Public Health, 5(3), p. e0004360.
6. Cooper, A.J. et al. (2021) “Sex/gender differences in obesity prevalence, comorbidities, and treatment,” Current obesity reports, 10(4), pp. 458–466.
7. Czernichow, S. et al. (2021) “Costs of the COVID‐19 pandemic associated with obesity in Europe: A health‐care cost model,” Clinical Obesity, 11(2), p. e12442.
8. Elias, C. et al. (2025) “Prevalence of overweight/obesity and its association with fast food consumption among adolescents in Southern Ethiopia, 2022: a community-based cross-sectional study,” Frontiers in Nutrition, 11, p. 1475116.
9. Franzago, M. et al. (2022) “The epigenetic aging, obesity, and lifestyle,” Frontiers in Cell and Developmental Biology, 10, p. 985274.
10. Ghosh, S. et al. (2023) “Sedentary lifestyle with increased risk of obesity in urban adult academic professionals: an epidemiological study in West Bengal, India,” Scientific reports, 13(1), p. 4895.
11. Gresser, D. et al. (2025) “The Impact of Sleep Deprivation on Hunger-Related Hormones: A Meta-Analysis and Systematic Review,” Obesities, 5(2), p. 48.
12. Hulsegge, G. et al. (2021) “The mediating role of lifestyle in the relationship between shift work, obesity and diabetes,” International Archives of Occupational and Environmental Health, 94(6), pp. 1287–1295.
13. Jeong, S.-M. et al. (2024) “2023 obesity fact sheet: prevalence of obesity and abdominal obesity in adults, adolescents, and children in Korea from 2012 to 2021,” Journal of Obesity & Metabolic Syndrome, 33(1), p. 27.
14. Koceva, A. et al. (2024) “Sex-and gender-related differences in obesity: from pathophysiological mechanisms to clinical implications,” International Journal of Molecular Sciences, 25(13), p. 7342.
15. Kohanmoo, A. et al. (2024) “Short sleep duration is associated with higher risk of central obesity in adults: A systematic review and meta‐analysis of prospective cohort studies,” Obesity Science & Practice, 10(3), p. e772.
16. Li, M., Zhu, P. and Wang, S. (2022) “Risk for cardiovascular death associated with waist circumference and diabetes: a 9-year prospective study in the Wan Shou Lu cohort,” Frontiers in Cardiovascular Medicine, 9, p. 856517.
17. Li, Z. et al. (2025) “Differential impact of general and abdominal obesity on the labor–bone health association: a cross-sectional study in rural China,” BMC Public Health [Preprint].
18. Lopez-Barreiro, J. et al. (2024) “Artificial intelligence-powered recommender systems for promoting healthy habits and active aging: A systematic review,” Applied Sciences, 14(22), p. 10220.
19. Mahmoud, A.M. (2022) “An overview of epigenetics in obesity: the role of lifestyle and therapeutic interventions,” International journal of molecular sciences, 23(3), p. 1341.
20. Nam, G.E. et al. (2021) “Obesity fact sheet in Korea, 2020: prevalence of obesity by obesity class from 2009 to 2018,” Journal of obesity & metabolic syndrome, 30(2), p. 141.
21. Nestle, M. and Jacobson, M.F. (2000) “Halting the obesity epidemic: a public health policy approach,” Public health reports, 115(1), p. 12.
22. Nevill, A.M., Duncan, M.J. and Myers, T. (2022) “BMI is dead; long live waist-circumference indices: But which index should we choose to predict cardio-metabolic risk?,” Nutrition, Metabolism and Cardiovascular Diseases, 32(7), pp. 1642–1650.
23. Nguyen, M. et al. (2023) “Sugar-sweetened beverage consumption and weight gain in children and adults: a systematic review and meta-analysis of prospective cohort studies and randomized controlled trials,” The American Journal of Clinical Nutrition, 117(1), pp. 160–174.
24. Pan, Q. et al. (2025) “A study of trends in body morphology, overweight, and obesity in Chinese adults aged 40–59 years,” BMC Public Health, 25(1), p. 833.
25. Pardak, P., Filip, R. and Woliński, J. (2022) “The impact of sleep-disordered breathing on ghrelin, obestatin, and leptin profiles in patients with obesity or overweight,” Journal of Clinical Medicine, 11(7), p. 2032.
26. Rafique, N. (2023) “Short sleep duration is a novel independent risk factor for overweight and obesity,” Saudi Medical Journal, 44(11), p. 1160.
27. Rassy, N. et al. (2023) “Association of healthy lifestyle factors and obesity-related diseases in adults in the UK,” JAMA network open, 6(5), pp. e2314741–e2314741.
28. Santos, L.P. et al. (2022) “Sugar sweetened beverages intake and risk of obesity and cardiometabolic diseases in longitudinal studies: a systematic review and meta-analysis with 1.5 million individuals,” Clinical nutrition ESPEN, 51, pp. 128–142.
29. Silveira, E.A. et al. (2021) “Prevalence of constipation in adults with obesity class II and III and associated factors,” BMC gastroenterology, 21(1), p. 217.
30. Silveira, E.A. et al. (2022) “Sedentary behavior, physical inactivity, abdominal obesity and obesity in adults and older adults: A systematic review and meta-analysis,” Clinical nutrition ESPEN, 50, pp. 63–73.
31. Stamatakis, E., Hirani, V. and Rennie, K. (2008) “Moderate-to-vigorous physical activity and sedentary behaviours in relation to body mass index-defined and waist circumference-defined obesity,” British Journal of Nutrition, 101(5), pp. 765–773.
32. Steenackers, N. et al. (2021) “Effect of obesity on gastrointestinal transit, pressure and pH using a wireless motility capsule,” European Journal of Pharmaceutics and Biopharmaceutics, 167, pp. 1–8.
33. Taha, S. et al. (2025) “The consumption of fast food and obesity associated with hypertension among restaurant workers in Jordan,” Clinical Nutrition Open Science, 60, pp. 141–154.
34. Wahabi, H. et al. (2023) “The impact of age, gender, temporality, and geographical region on the prevalence of obesity and overweight in Saudi Arabia: scope of evidence,” in Healthcare. MDPI, p. 1143.
35. Wang, K. et al. (2023) “The effect of breakfast on childhood obesity: A systematic review and meta-analysis,” Frontiers in nutrition, 10, p. 1222536.
36. Wicherski, J., Schlesinger, S. and Fischer, F. (2021) “Association between breakfast skipping and body weight—A systematic review and meta-analysis of observational longitudinal studies,” Nutrients, 13(1), p. 272.
37. Wilson, J.E. et al. (2022) “Associations between childhood to adulthood socio-economic mobility and adult diet quality,” British Journal of Nutrition, 128(1), pp. 103–113.
38. Yang, B. et al. (2025) “Association of Skipping Breakfast with Metabolic Syndrome and Its Components: A Systematic Review and Meta-Analysis of Observational Studies,” Nutrients, 17(19), p. 3155.
39. Yuan, F. et al. (2021) “Association of physical activity and sitting time with overweight/obesity in Chinese occupational populations,” Obesity Facts, 14(1), pp. 141–147.
40. Zaninotto, P., Head, J. and Steptoe, A. (2020) “Behavioural risk factors and healthy life expectancy: evidence from two longitudinal studies of ageing in England and the US,” Scientific Reports, 10(1), p. 6955.