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BMC Public Health

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Open Access 01-12-2015 | Research article

Body image and weight control in South Africans 15 years or older: SANHANES-1

Authors: Zandile J. Mchiza, Whadi-ah Parker, Mokhantso Makoae, Ronel Sewpaul, Takura Kupamupindi, Demetre Labadarios

Published in: BMC Public Health | Issue 1/2015

Abstract

Background

South African studies have suggested that differences in obesity prevalence between groups may be partly related to differences in body image and body size dissatisfaction. However, there has never been a national study that measured body image and its relationship to weight control in the country. Hence, the main aim of the study was to examine body image in relation to body mass index and weight control in South Africa.

Methods

A cross-sectional survey and a secondary analyses of data were undertaken for 6 411 South Africans (15+ years) participating in the first South African National Health and Nutrition Examination Survey. Body image was investigated in relation to weight status and attempts to lose or gain weight. Data were analysed using STATA version 11.0. Descriptive statistics are presented as counts (numbers), percentages, means, standard error of means, and 95 % confidence intervals. Any differences in values were considered to be significantly different if the confidence intervals did not overlap.

Results

Overall, 84.5 % participants had a largely distorted body image and 45.3 % were highly dissatisfied about their body size. Overweight and obese participants under estimated their body size and desired to be thinner. On the other hand, normal- and under-weight participants over estimated their body size and desired to be fatter. Only 12.1 and 10.1 % of participants attempted to lose or gain weight, respectively, mainly by adjusting dietary intake and physical activity.

Discussion

Body mass index appears to influence body image and weight adjustment in South Africa.

Conclusions

South Africans at the extreme ends of the body mass index range have a largely distorted body image and are highly dissatisfied by it. This suggests a need for health education and beneficial weight control strategies to halt the obesity epidemic in the country.

ZAR: South African Rand - exchange rate: 1USD = ZAR 10.50 at the time of manuscript submission

Swinburn BA, Sacks G, Hall KD, McPherson K, Finegood DT, Moodie ML, et al. The global obesity pandemic: shaped by global drivers and local environments. Lancet. 2011;378:804–14. http://www.ncbi.nlm.nih.gov/pubmed/21872749.CrossRefPubMed

Stevens GA, Gitanjali M, Singh GM, Lu Y, et al. National, regional, and global trends in adult overweight and obesity prevalences. Popul Health Metrics. 2012;10:22. doi:10.1186/1478-7954-10-22.CrossRef

Yumuk V, Frühbeck G, Oppert JM, Woodward E, Toplak H. An EASO Position Statement on Multidisciplinary Obesity Management in Adults. Obes Facts. 2014;7:96–101 [http://easo.org/wp-content/uploads/2014/03/Multidisciplinary-Obesity-Management-in-Adults.pdf]CrossRefPubMed

Yako YY. Molecular investigation of genetic and environmental factors contributing to obesity in adolescent learners residing in the semi-urban/rural areas of the Western Cape Province, South Africa. PhD Dissertation. Chemical Pathology at Stellenbosch University, South Africa, 2012. [http://scholar.sun.ac.za/handle/10019.1/71644]

Griera JL, Manzanares JM, Barbany M, Contreras J, Amigó P, Salas-Salvadó J. Physical activity, energy balance and obesity. Public Health Nutr. 2007;10(10A):1194–9. http://www.ncbi.nlm.nih.gov/pubmed/17903330.

Steyn NP, Mchiza ZJ. Obesity and the nutrition transition in Sub-Saharan Africa. Ann NY Acad Sci. 2014;1311:88–101 [http://onlinelibrary.wiley.com/doi/10.1111/nyas.12433/pdf]CrossRefPubMed

Puoane T, Tsolekile L. Chapter 1: Challenges Faced by the Urban Black South Africans in the Prevention of Non-Communicable Diseases. Health and Nutritional Problems of Indigenous Populations [Ed, Kaushik Bose]. Tribes and Tribals. 2008;Special Volume(2):9–14 [http://repository.uwc.ac.za/xmlui/bitstream/handle/10566/242/PuoaneChallenges2008.pdf?sequence=3]

Puoane T, Steyn K, Bradshaw D, Laubscher R, Fourie J, Lambert V, et al. Obesity in South Africa: the South African demographic and health survey. Obes Res. 2002;10C:1038–48. http://www.ncbi.nlm.nih.gov/pubmed/12376585.CrossRef

Reddy SP, James S, Sewpaul R, Koopman F, Funani NI, Sifunda S, et al. Umthente Uhlaba Usamila – The South African Youth Risk Behaviour Survey 2008. Cape Town: South African Medical Research Council; 2010 [http://www.mrc.ac.za/healthpromotion/yrbs_2008_final_report.pdf]

10.

Vartanian LR. Self-Discrepancy Theory and Body Image. Encyclopedia of BIand Human Appearance. 2012;2:711–7.CrossRef

11.

Brown TA, Cash TF, Mikulka PJ. Attitudinal body-image assessment: factor analysis of the Body-Self Relations Questionnaire. J Pers Assess. 1990;55(1-2):135–44.CrossRefPubMed

12.

Gardner RM. Methodological issues in assessment of the perceptual component of body image disturbance. Br J Psychol. 1996;87(2):327–37.CrossRefPubMed

13.

Rakhkovskaya LM, Warren CS. Ethnic identity, thin-ideal internalization, and eating pathology in ethnically diverse college women. Body Image. 2014;11:438–45.CrossRefPubMed

14.

Puoane T, Fourie JM, Shapiro M, Rosling L, Tshaka NC, Oelofse A. ’Big is beautiful’ – an exploration of urban black women in a South African township. S Afr J Clin Nutr. 2005;18(1):6–15.CrossRef

15.

Mciza Z, Goedecke JH, Steyn NP, Charlton K, Puoane T, Meltzer S, et al. Development and validation of instruments measuring body image and body weight dissatisfaction in South African mothers and their daughters. Public Health Nutr. 2005;8(5):509–19.CrossRefPubMed

16.

Mchiza ZJ, Goedecke JH, Lambert EV. Intra-familial and ethnic effects on attitudinal and perceptual body image: a cohort of South African mother-daughter dyads. BMC Public Health. 2011;11:433 [http://www.biomedcentral.com/content/pdf/1471-2458-11-433.pdf]CrossRefPubMedPubMedCentral

17.

Caradas AA, Lambert EV, Charlton KE. An ethnic comparison of eating attitudes and associated body image concerns in adolescent South African schoolgirls. J Hum Nutr Diet. 2001;14(2):111–20. http://www.ncbi.nlm.nih.gov/pubmed/11330260.CrossRefPubMed

18.

Morris PF, Szabo CP. Meanings of thinness and dysfunctional eating in black South African females: a qualitative study. Afr J Psychiatry. 2013;16(5):338–42. http://www.ncbi.nlm.nih.gov/pubmed/24051666.

19.

Kakeshita IS, Almeida SS. Relationship between body mass index and self-perception among university students. Rev Saude Publica. 2006;40(3):1–7 [http://www.scielo.br/scielo.php?pid=S0034-89102006000300019&script=sci_arttext&tlng=pt]CrossRef

20.

Truby H, Paxton SJ. Development of the Children’s BI Scale. Br J Clin Psychol. 2002;41(2):185–203. http://www.ncbi.nlm.nih.gov/pubmed/12034005.CrossRefPubMed

21.

Stunkard A, Sorensen T, Schulsinger F. Use of the Danish Adoption Register for the study of obesity and thinness. In: Key S, Roland I, Sigman R, Matthysse S, editors. The genetics of neurological and psychiatric disorders. New York: Raven; 1983.

22.

Williamson DA, Davis CJ, Bennett M, Goreczny AJ, Gleaves DH. Development of a simple procedure for assessing Body image disturbances. Behav Assess. 1989;11(4):433–46.

23.

Bulik CM, Wade TD, Heath AC, Martin NG, Stunkard AJ, Eaves LJ. Relating body mass index to figural stimuli: population-based normative data for Caucasians. Int J Obes Relat Metab Disord. 2001;25(10):1517–24. http://www.ncbi.nlm.nih.gov/pubmed/11673775.CrossRefPubMed

24.

Shisana O, Labadarios D, Rehle T, the SANHANES-1 Team, the SANHANES-1 Team (2014), the SANHANES-1 Team, et al. South African national health and nutrition examination survey (SANHANES-1): 2014 Edition. Cape Town: South Africa. HSRC Press; 2014.

25.

Census 2011: Statistical release-P0301.4/ Statistics South Africa. Pretoria. 2012 Available from [http://www.statssa.gov.za/publications/P03014/P030142011.pdf]

26.

Lee RD, Nieman DC. Biochemical assessment of nutritional status. Lee RD, Nieman DC, eds. Nutritional Assessment: 6^th ed. Ney York. McGraw-Hill. Appalachian State University 2013. ISBN: 0078021332

27.

Centers for Disease Control and Prevention: CDC 24/7: Saving Lives, Protecting People^TM. Division of Nutrition, Physical Activity, and Obesity. [http://www.cdc.gov/healthyweight/assessing/bmi/childrens_bmi/about_childrens_bmi.html]

28.

29.

Puoane T, Tsolekile L, Steyn N. Perceptions about body image and sizes among Black African girls living in Cape Town. Ethn Dis. 2010;20(1):29–34.PubMed

30.

Szabo CP, Allwood CW. Body figure preference in South African adolescent females: a cross cultural study. Afr Health Sci. 2006;6(4):201–6 [http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1832064/pdf/AFHS0604-0201.pdf]PubMedPubMedCentral

31.

Matoti-Mvalo T. An exploration of perception about thin HIV/Aids and BIin black South African women. University of the Western Cape, School of Public Health, 2006, MPh thesis. [http://etd.uwc.ac.za/xmlui/bitstream/handle/11394/2066/Matoti-Mvalo_MPH_2006.pdf?sequence=1]

32.

Puoane T, Hughes GD. Impact of the HIV/AIDS pandemic on non-communicable disease prevention. SAMJ. 2005;95(4):1–2. http://www.ncbi.nlm.nih.gov/pubmed/15889843.

33.

Puoane T, Bradley H, Hughes GD. Human obesity: a major health burden. Human Ecology Special Issue. 2005;13:91–5.

34.

Brink PJ. “Stigma and obesity”. Clin Nurs Res. 1994;3(4):291–3 [http://cnr.sagepub.com/content/3/4/291.extract]CrossRefPubMed

35.

Kwan S, Trautner MN. Beauty Work: individual and institutional rewards, the reproduction of gender, and question of agency. Sociology Compass. 2009;3(1):49–71 [http://www.acsu.buffalo.edu/~trautner/Kwan_Trautner_Soc_Compass.pdf].CrossRef

36.

Lemon SC, Rosal MC, Zapka J, Borg A, Anderson V. Contributions of weight perceptions to weight loss attempts: Diferences by body mass index and gender. Body Image. 2009;6(2):90–6 [http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2692706/pdf/nihms105891.pdf]CrossRefPubMedPubMedCentral

37.

Mchiza ZJ, Goedecke JH, Lambert EV. Accuracy of reporting food energy intake: Influence of ethnicity and body weight status in South African Women. S Afr J Clin Nutr. 2010;23(2):84–9 [http://www.ajol.info/index.php/sajcn/article/viewFile/56382/44817]CrossRef

38.

Visser J, Notelovitz T, Szabo CP, Fredericks N. Abnormal eating attitudes and weight loss behaviours of girls attending a “traditional” Jewish high school in Johannesburg, South Africa: prevalence of teachers’ awareness. S Afr J Clin Nutr. 2014;27(4):208–16 [http://www.sajcn.co.za/index.php/SAJCN/article/viewFile/891/1221]CrossRef

39.

Le Grange D, Louw J, Russell B, Nel T, Silkstone C. Eating attitudes and behaviours in South African adolescents and young adults. Transcult Psychiatry. 2006;43:401–17. http://www.ncbi.nlm.nih.gov/pubmed/17090625.CrossRefPubMed

40.

Lemacks J, Wells BA, Ilich JZ, Ralston PA. Interventions for improving nutrition and physical activity in adult African American populations: a systematic review. January 2000 through December 2011. Centre for Diseases Control and Prevention. Preventing chronic diseases. Public Health Res Pract Policy. 2013;10:1–6 [http://www.cdc.gov/pcd/issues/2013/pdf/12_0256.pdf]

Title: Body image and weight control in South Africans 15 years or older: SANHANES-1
Authors: Zandile J. Mchiza
Whadi-ah Parker
Mokhantso Makoae
Ronel Sewpaul
Takura Kupamupindi
Demetre Labadarios
Publication date: 01-12-2015
Publisher: BioMed Central
Published in: BMC Public Health / Issue 1/2015
Electronic ISSN: 1471-2458
DOI: https://doi.org/10.1186/s12889-015-2324-y

At a glance: The STEP trials

Springer Medicine

Body image and weight control in South Africans 15 years or older: SANHANES-1

Abstract

Background

Methods

Results

Discussion

Conclusions

At a glance: The STEP trials

Springer Medicine

Abstract

Background

Methods

Results

Discussion

Conclusions

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