Unexpected stumbling block in tackling obesity-related health threats
The question of whether South Africa’s envisaged sugar tax will positively address increasing obesity levels was thrown into sharp focus by research which revealed an unexpected stumbling block – a large number of South Africans seem quite happy to be overweight.
The research, published last year in the UK-based peer-reviewed journal BMC Public Health, was the work of a University of the Western Cape-Chronic Disease Initiative for Africa (CDIA) research team. Based at the University of Cape Town, the CDIA is a network of multidisciplinary researchers from the Universities of the Western Cape, Cape Town, Stellenbosch and Harvard, the South African Medical Research Council and the local and national Departments of Health. The research is the latest in a series of studies by the researchers highlighting challenges to tackling obesity-related health threats.
The researchers were Dr Kufre Okop, a UWC School of Public Health PhD graduate who is now a postdoctoral research fellow at UCT, UWC doctoral fellow Ferdinand Mukumbang, UWC senior researcher Dr Thubelihle Mathole, CDIA Director and head of diabetic medicine and endocrinology at UCT, Professor Naomi Levitt, and UWC School of Public Health Emeritus Professor Thandi Puoane.
They found that overweight, middle-aged black women, unlike their normal weight and obese counterparts in the study, had no issues with their weight.
Not only were they content, but many indicated they wanted to pack on even more kilogrammes.
The women were among nearly 80 men and women from Langa, aged 35 to 70, involved in the study, titled Perceptions of body size, obesity threat and the willingness to lose weight among black South African adults.
Although the overweight women had a Body Mass Index (BMI) of 25 to 29.9kg/m², as opposed to the 18 to 24.9kg/m² of the normal weight participants, and cited overeating and fatty and sugary foods as causes of weight gain, they were adamant that being overweight equaled happiness.
Only those who had struggled previously with a chronic disease wanted to lose weight.
These attitudes are particularly concerning given that a study published in the BioMed Central journal last year reported the prevalence of overweight and obese South Africans at 85 percent, up from 65 percent four years previously. A 2000 study blamed excess body weight (BMI over 25) for 87 percent of Type 2 diabetes, 38 percent of heart disease and 45 percent of strokes.
More concerning news from the UWC-CDIA study was that women of all sizes believe their culture or their genetics determined their size. “We have big bones…Overweight is something we inherited,” one said. Another added: “According to our values and culture, it is important for a woman to have a large body. It makes you to be respected (sic).”
The authors found that while opinions on thinness and overweight differed, the common opinion was that this was bad, while overweight was “socially desirable”.
If a woman was thin, she was viewed as unhealthy and associated with people living with HIV/Aids, tuberculosis or cancer. She was also considered likely to have mental health issues such as depression.
One of the women in the overweight category went so far as to say that if her child lost weight, she’d be concerned.
There were indications, however, that younger women (aged 36 to 40) thought differently, and this could indicate a shift in perceptions in the longer term.
Women in this age group, in both the overweight and obese categories, challenged the persistent cultural tolerance of large body size, the authors reported.
One participant, who said she believed things were changing, pointed out that women ate because of men’s view that overweight women were “desirable”.
Not only did the women in the overweight category fail to see themselves as being at risk of obesity, they also appeared oblivious to the associated health risks.
The authors said the fact that three-quarters of the study participants were unemployed and of low socioeconomic status and education levels could slant their views. However, they remained concerned, arguing that appropriate strategies to boost awareness of the risks associated with obesity were critical.
