CHAPTER ONE INTRODUCTION
Childhood obesity has increased considerably over the past decades and currently noted as one of the World's major public health concerns. Worldwide, obesity has risen from 4.2% in 1990 to 6.7% in 2010 (Muhihi et al., 2013). Initially believed to be a condition associated with Western countries, childhood obesity is now increasing in developing parts of the World. Obesity can be defined as a serious degree of overweight caused by excessive storage of fat and usually measured using the Body Mass Index. The World Health Organization defines it as “abnormal or excessive fat accumulation that presents a risk to health” (WHO, 2012). In a report by the International Obesity Task Force (IOTF) to the World Health Organization in the year 2000, it was documented that 155 million school-aged children can be classified as overweight or obese (Ahmad et al., 2010) and that more than one in every four children in the world is overweight or obese ( Karnik and Kanekar, 2012; McAllister, 2009).
Genetic and environmental factors have been identified as potential causes of obesity. Obesity develops when food consumption outweighs the physiological need of the body. In today's world where leisure time activities for children are becoming more sedentary coupled with the growing westernization evidenced in the increased preference for energy-dense western diets and fast foods, a gloomy picture is painted for Ghana's public health in combating childhood obesity (Ben-Sefer et al., 2009).The prevalence of childhood obesity has increased steadily in developed countries. The number of overweight children has more than doubled, with most of the increases recorded in the last decade.
Nationally representative surveys carried out in developing countries have also shown a high prevalence of overweight in Primary School pupils. Mexico, India, Argentina and Brazil reported prevalence rates greater than 15% between 2008 and 2011 (Gupta et al., 2012). The estimated prevalence in Africa as at 2010 was pegged at 8.5%. This is expected to increase to as high as 12.7% by 2020 (Onis et al., 2010) .
In Ghana, Abachinga (2001) recorded 19.3% prevalence in his study of school aged children in Legon and Achimota, suburbs of Accra. Watara et al. (2008) reported obesity prevalence of 4% among adolescents of the University of Ghana Staff Village School and University of Ghana basic Schools. Mogre et al. (2013), in a study of school aged children in the Northern region of Ghana also recorded a combined prevalence of 8.5% for overweight and obesity. However, a study conducted in basic schools in Accra by Mohammed and Vuvor (2012) found a higher prevalence of obesity among children at the University of Ghana Primary School which was 10.9 % . In that same study, a combined prevalence of overweight and obesity was 26.7%. These findings confirm the existence of obesity in Ghanaian school children and thus the need for intervention by stakeholders.
Obesity is of significant importance, especially to developing countries such as Ghana, because of its association with morbidities such as diabetes, hypertension, hyperlipidemia, renal, liver diseases and certain cancers and the stress on public budget to meet the treatment cost of such diseases (Gupta et al., 2012). To stress the serious dimension the subject of obesity has taken, the American Medical Association has officially classified obesity as a disease. This is in a quest to get doctors, insurance companies and other stakeholders to place more emphasis on the condition to minimize its deleterious effects
(Wabitsch et al., 2014). The high rise in the average BMI's identified in WHO Global Burden of Diseases Study emphasizes the challenge diet-induced chronic diseases pose if preventive and treatment mechanisms are not put in place (Branca et al., 2007).
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