Traditionally in African societies being overweight has been regarded as a sign of wealth and high social status. People have been encouraged to become obese from a young age either consciously or subconsciously. All of us have encountered obesity being encouraged by statements such as, “You are gaining weight, things must be going well for you.” or “You have lost weight, is everything ok?” Such subtle messages from early childhood has turned Africa into a continent that encourages obesity and it is not a coincidence that more and more people in Africa are becoming obese.
According to WHO, in 2008 35% of adults above the age of 20 were overweight, this figure has doubled since 1980.
Why the fuss?
Growing up I was made to believe that only rich people were afflicted by conditions such as diabetes, heart diseases and strokes. This was not entirely false at that time but the real reason why these diseases seemed to favor them had nothing to do with their wealth and everything to do with their lifestyles which made them overweight.
Being overweight is a major risk factor for the following
- Heart diseases and strokes (which were the leading cause of death in 2012)
- Muscle and joint problems ( for carrying the weight)
- Some cancers ( breast, ovarian, colon liver prostate etc)
These are called non communicable diseases as they are not spread from one person to another.
Definition of terms
It is often confusing with words such as obese, overweight, fat etc being used to know what they actually mean and how you can tell what your category is. The body mass index (BMI) is a simple calculation that you can use at home to monitor your own health. It is calculated by simply dividing your weight by the square of your height as below.
BMI = HEIGHT/(WEIGHT X WEIGHT)
This is how you would interpret the results
- BMI < 18.5 underweight
- BMI between 18.5 and 25 Normal weight
- BMI between 25 and 30 Overweight
- BMI > 30 Obesity
Why are we becoming obese?
Those in denial of the problem often blame genetics, they believe (or want to believe) that since they inherited their bodies from their parents they cannot do anything about it. However research has shown that the majority of people are obese because of lifestyle choices. Most of the food on the market today are sugary and fatty and designed to keep you coming back for more (addictive). What the manufacturer conveniently forgets to tell you is that their products are poisonous to your body.
Every night as I drive home from work I see parents and young children packed in fast food outlets feasting on fried chicken, fried chips and with large bottles of coke. They even give you extra salt to add. One look at these families will make you realize it is no longer the rich who are at greatest risk of obesity, it is the low and middle income families. The rich families are on the other side of town eating salads, prawns and fruits because somehow the healthy foods are the more expensive foods of the 21st century. It is not a surprise that the huge companies that make profit at the expense of our health such as Coca-Cola and KFC are making huge profits in poor countries, because we believe we are finally eating rich peoples food while those who are actually rich have realized the danger and moved on to healthier eating habits.
On the contrary, when I drive to work each morning in the rich neighborhood I see lots of people on their morning run or cycling. In the poor neighborhoods however this health consciousness is still lacking.
The growth of urbanization in developing countries has resulted in more people living sedentary lifestyles, spending most time on a couch in front of the tv or at work sitting on a desk. When I grew up in the village we used to wake up before sunrise to work in the fields, after that we would eat food that we grew ourselves, not refined, salty or greasy, then we would spend the day running after cattle and goats in the forest. Becoming obese under these conditions was taboo.
The modern child on a typical day wakes up to eat a bowl of cereal or tea and cake, they are then driven to school and dropped in the school yard (as opposed to walking 3km) where they will be picked up after school. After passing through a junk food restaurant they get home to spend the rest of the day on a PlayStation game. According to the WHO the number of obese children in Africa has doubled from 5.4 million in 1990 to 10.6 million in 2014.
What needs to be done?
According to a World Health Organization report of 2016, 70% of the deaths that occurred worldwide in 2016 were due to non communicable diseases and over 3 quarters occurred in low to medium income countries. Clearly it is becoming our problem and not “their” problem.
We have spent so much time and resources fighting the HIV epidemic (rightly so) but we have ignored a much more dangerous problem that needs urgent attention. South Africa has become the first African country to discuss the introduction of sugar tax which will see a 20% tax being imposed on sugary beverages. It would make sense that they would be the first to consider this since they have the highest obesity rates in Africa but the rest of Africa need to start thinking of their own solutions soon.
In my opinion solutions that target young children in schools would be more effective since lifestyles are developed during these early years. They should be taught healthy eating habits and the importance of exercise. It has been said that you can’t teach an old dog new tricks, but maybe you can make the old tricks more expensive like South Africa are planning to do.
The bottom line is each person’s health is their responsibility, while governments may put policies in place that protect us, ultimately it is up to us to change our lifestyles and promote our health
Drtendai is a Zimbabwean public health doctor. Twitter @conmut