South Africa has the highest overweight and obesity rate in sub-Saharan Africa, with up to 70% of women and a third of men being classified as overweight or obese. A staggering 40% of women in our country are obese, which means they have a body mass index greater than 30 kg/m2. However, this is no longer just an adult problem, 1 in 4 girls and 1 in 5 boys between the ages of 2 – 14 years are overweight or obese. Obesity is associated with a number of diseases including type 2 diabetes, heart disease, stroke, hypertension (high blood pressure), joint pain and certain cancers. This National Obesity Week, 15 -19 October, the Heart and Stroke Foundation SA (HSF) is highlighting the seriousness of obesity and urging South Africans to shed the kilograms by adopting a healthier lifestyle.
“There are many reasons as to why we are facing this obesity epidemic,” says Dr Vash Mungal-Singh, CEO of the Heart and Stroke Foundation SA. “It is difficult to pinpoint one culprit but people need to understand that our lifestyles are largely to blame. South Africans eat too much, drink too much alcohol, and don’t move enough,” she adds.
Additionally, perceptions of weight and weight loss complicate the issue further in our country. In the South African context weight loss is often associated with negative connotations such as HIV/AIDS; therefore even if someone is overweight they fear that if they lose weight it could be interpreted that they are HIV positive. It is also a cultural belief amongst many South Africans that being overweight is a sign of affluence and wealth. In the SA National Health and Nutrition Survey, most South Africans surveyed acknowledged when they were overweight, but the majority were happy with their ‘fat’ body image.
“South Africa is a country that’s been going through a nutrition transition. The bulk of our population used to be physically active and ate a diet high in fibre and indigenous vegetables, low in animal protein and refined carbs. However, due to increased urbanisation, people are adopting a more westernised diet, high in unhealthy fats, sugar and salt. Greater disposable income and a faster paced lifestyle have resulted in people consuming more fast foods and convenience foods. This is partly why there has been an increase in overweight and obesity over the last 15 years,” says Dr Mungal-Singh.
The inactivity of South African’s is another major contributor to the obesity epidemic. The problem starts in childhood and continues into adulthood, with less than two-thirds of children participating in weekly physical activity. In adults half of males and almost two thirds of females are physically inactive.
“We need to educate the South African public about the risks of an unhealthy lifestyle and being overweight. If the public does not believe that they need to eat healthier and exercise more, any strategies that address these issues will be unsuccessful,” says Gabriel Eksteen, Registered Dietitian at the HSF.
The Department of Health realises the significance of the obesity crisis, and has included this in the national non-communicable diseases strategic goals to assist with the obesity problem in South Africa:
1. Increase physical activity by 10% by 2020
2. Reduce the consumption of alcohol by 20% by 2020
3. Reduce the percentage of people who are obese and/or overweight by 10% by 2020.
“It’s encouraging that targets have been set by government to reduce obesity in South Africa, however clear strategies to achieve these goals are still lacking,” says Dr Mungal-Singh. “To combat obesity we need a multipronged approach that includes cooperation from food manufacturers and catering establishments, appropriate legislation, strategies to make physical activity more accessible for everyone and education and awareness regarding obesity,” she adds.
“Ultimately the onus is on the individual to lose weight. Once an individual decides to lose weight, they need to develop a strategy to reach their goal. There is no one-size-fits-all approach to losing weight effectively, but sustainable weight loss involves making changes to your diet and your physical activity that you can sustain long-term,” concludes Eksteen.