Obesity has been defined as the presence of excess body weight in an individual (Brannon & Feist, 2006). In terms of the biomedical view on obesity, obesity is measured in terms of Body Mass Index (BMI). The BMI has been found to be useful in identifying excess body weight as it tracks the percentage of body fat and gives a an estimate of the health risk as a result of any excess weight (Morris, 2011). BMI values > 30kg/ m? are considered or recognised as obesity (Morris, 2011).
Obesity is characterised by alterations in metabolic functions that result from an increase in total body fat mass as well as the accumulation of visceral adipose tissue (van der Merwe & Pepper, 2006). The metabolic alterations are strongly associated with the development of comorbid diseases such as type 2 diabetes, hypertension and cardiovascular disease (van der Merwe & Pepper, 2006). Obesity has been associated with certain forms of chronic diseases namely sleep apnoea, heart disease, hypertension, diabetes (type 2) (Du Toit & Van der Walt, 2009). These are the most common diseases associated with obesity.
In terms of the South African context, impacting contributing factors for obesity include low exercise levels, consuming unhealthy fatty foods and high dietary energy (van der Merwe & Pepper, 2006). These risk factors are relevant mainly to people who live in urban areas, however, these are by no means the only factors that impact on obesity levels. Low weight at birth has been linked to obesity (van der Merwe & Pepper, 2006). In South Africa there is a view that malnourished children and therefore stunted, are more prone to gain a lot of weight when fed empty alories (Du Toit & Van der Walt, 2009). Therefore this contributes to alarming obesity rates in South Africa. This is a predominant case in South Africa due to high rates of poverty, unemployment and low socioeconomic status (Du Toit & Van der Walt, 2009). Coupled with this predisposition, unhealthy (junk) food is made cheaper and thus more readily available to the masses for consumption. It is estimated that 19% of children are stunted from malnutrition due to many people living below the breadline (Du Toit & Van der Walt, 2009).
Obesity is also connected with genetics and has been found to be inheritable (Brannon & Feist, 2006; van der Merwe & Pepper, 2006). As far as psychosocial views are concerned, different ethnic groups in South Africa have been shown to perceive obesity differently. In a study conducted by Morris (2011), few African women subjects (16%) viewed themselves as obese yet the BMI results indicated that 59% actually were overweight and obese. In the same study, 54% of white women perceived themselves to be overweight yet 49% of the sample was actually overweight.
South African men and women have inaccurate perceptions of their body weight (van der Merwe & Pepper, 2006). 9. 7% of men and 22. 1% of women perceive themselves as overweight, while 29. 2% of men and 56. 6% of women actually are overweight. Only 16% of black South African women perceived themselves as overweight compared to 31% of Indian women, and 54% of white women (van der Merwe & Pepper, 2006). It would appear from the outset that there is disparity about obesity amongst white and African people.
In terms of racial groups in South Africa, of women, black women showed the highest rates of obesity and for men white men showed higher rates of obesity (van der Merwe & Pepper, 2006). A misperception of ‘healthy or benign obesity’ exists amongst the black ethnic African racial group in South Africa (van der Merwe & Pepper, 2006). Obesity is assumed to not have any consequence on health yet results show that of black patients in clinics with type 2 diabetes, obesity is prevalent in 35-47% of women and 15. 5% in men.
Although heart disease is seen as an uncommon disorder for black people, results or statistics show that more black people die of heart disease than do whites (van der Merwe & Pepper, 2006). Obesity is considered to be a doubtful atherogenic factor within the black ethnic group. The high prevalence rate of obesity in Black women is perpetuated by many misperceptions about obesity as a health risk. The notion that increased body mass or weight is seen as a token of wealth, wellbeing, happiness and an indication that their husband is able to care for his wife and family (van der Merwe & Pepper, 2006).
Overweight children are also seen as a positive state of health and sustenance (Du Toit & Van der Walt, 2009). Obesity has also been found to be prevalent amongst HIV patients from Soweto as obesity helps to lower the risk of contraction tuberculosis (Du Toit & Van der Walt, 2009). Obesity has been recognised as a chronic disease by the World Health Organisation thus it needs to be treated (van der Merwe & Pepper, 2006). In terms of culture, obesity is highly prevalent and ‘normalised’ in the black ethnic group most notably to black women (van der Merwe & Pepper, 2006).
As the black ethnic group represent a major set of the South African population, the myth of a healthy obesity and the biomedical facts need to be relayed to them in order to prevent obesity levels and the various other diseased that are associated with the obesity (diabetes and heart disease). The media has been cited as the main source for nutritional information to Black South African women, health professionals need to act and use the media as a tool to reach out to counter misperceptions and to provide accurate health information about obesity (van der Merwe & Pepper, 2006).
In conclusion, it can be seen that obesity is a health issue in South Africa. The prevalence rate can be reduced provided culturally accepted false perceptions of obesity and nutrition are changed based on reporting and spreading of accurate biomedical information to the many people that deem obesity as either healthy or without any adverse health consequences.
Brannon, L. & Feist, J. (2006) An Introduction to Behaviour and Health.
Cengage Learning. Du Toit, D. D. , & Van der Walt, J. L. (2009).
Childhood overweight and obesity patterns in South Africa: a review: health. African Journal For Physical, Health Education, Recreation And Dance, 15(1), 15-31. Morris, A. G. (2011).
Fatter and fatter: South Africa's rise in body mass index. South African Journal Of Science, 107(3/4), 12. van der Merwe, M. , & Pepper, M. (2006). Obesity in South Africa. Obesity Reviews, 7(4), 315-322. [pic]