The life styles causing overweight or obesity: Based on 5 years of experience in two centers in Sulaimani Governorate, Kurdistan Region/Iraq

Background: One of the top worldwide health problems is overweight and obesity, Body weight gain over a number of years could be achieved through cumulative positive energy balances, which may be the result of habitual behaviors adopted through personal choice. Despite the increased in physical activity, the percentage of people who are overweight has increased, after decades-old efforts and awareness on the issue to nudge consumers towards healthier lifestyles through dietary guidelines, dietrelated diseases are still on the rise. Is there potential variables need to be evaluated for any relation with gaining weight and obesity in the patient's life styles? Objectives: Exploration of the possible factors in the life style of overweight and obese patients, resulting in weight gain. Patients and Methods: A prospective randomized study including 440 overweight or obese patients from a total of 689 patients, who consulted for advice, diet and or drugs and various bariatric operations. Thiswas conducted in the period of 5 years from January 2, 2012 to October 1, 2017. For the information collection, each patient was interviewed face-to-face, by three Surgical Board Trainees were interviewing patients face-to-face to fill an originally-designed questionnaire in English translated to the Kurdish language. The questionnaire was composed of demographic data, medical data, biological data, and potential factors of their overweight or obesity. A comparison was made between these patients in the conception of case matching to 446 patients who were of normal body weight, and a normal BMI. Results: Most of the patients (females; n = 200, 86.95% and males; n = 167, 79.52%) in group A, while (females; n = 14, 5.90% and males; n = 21, 10.05%) were drinking water within 30 min after every meals, meanwhile (females; n = 202, 85.23%, and males; n = 173, 82.77%) from group B patients were drinking water 60 min after every meals. Nearly half of the patients have a Television intheir kitchen/dining room(n = 239/440, 54.39%), however only (51.59%), (13.90%) of the patients from group A, and B respectively were watching TV while eating, A great number of the patients (Group A: n = 358, 81.36%) were operating their computers while eating, versus minority (n = 53,11.88%), inGroup B, andmajority of the patients in groupAwere using theirsmart phones or making phone calls while eating (n = 390/440, 88.63%) versus small number (n = 49/460,10.65%) in group B. Conclusion: Excessive habitual usage of a cell phone, early drinking (within 30 min) of water or other liquids after meals may be the potential factors in the initiation of becoming overweight and obese. University students living in the areas where entertainments are not affordable for all, the only remaining entertainment is using cellphones for social media and communication may be more vulnerable to gain weight, overweight and obesity. (C) 2018 The Authors. Published by Elsevier Ltd on behalf of Surgical Associates Ltd.