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BMC Public Health
Published in: BMC Public Health 1/2016

Open Access 01-12-2016 | Research article

Perceptions of body size, obesity threat and the willingness to lose weight among black South African adults: a qualitative study

Authors: Kufre Joseph Okop, Ferdinand C. Mukumbang, Thubelihle Mathole, Naomi Levitt, Thandi Puoane

Published in: BMC Public Health | Issue 1/2016

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Abstract

Background

The obesity epidemic is associated with rising rates of cardiovascular disease (CVD) among adults, particularly in countries undergoing rapid urbanisation and nutrition transition. This study explored the perceptions of body size, obesity risk awareness, and the willingness to lose weight among adults in a resource-limited urban community to inform appropriate community-based interventions for the prevention of obesity.

Method

This is a descriptive qualitative study. Semi-structured focus group discussions were conducted with purposively selected black men and women aged 35–70 years living in an urban South African township. Weight and height measurements were taken, and the participants were classified into optimal weight, overweight and obese groups based on their body mass index (Kg/m2). Participants were asked to discuss on perceived obesity threat and risk of cardiovascular disease. Information on body image perceptions and the willingness to lose excess body weight were also discussed. Discussions were conducted in the local language (isiXhosa), transcribed and translated into English. Data was analysed using the thematic analysis approach.

Results

Participants generally believed that obesity could lead to health conditions such as heart attack, stroke, diabetes, and hypertension. However, severity of obesity was perceived differently in the groups. Men in all groups and women in the obese and optimal weight groups perceived obesity to be a serious threat to their health, whereas the overweight women did not. Obese participants who had experienced chronic disease conditions indicated strong perceptions of risk of obesity and cardiovascular disease. Obese participants, particularly men, expressed willingness to lose weight, compared to the men and women who were overweight. The belief that overweight is ‘normal’ and not a disease, subjective norms, and inaccessibility to physical activity facilities, negatively influenced participants’ readiness to lose weight.

Conclusion

Low perception of threat of obesity to health particularly among overweight women in this community indicates a considerable challenge to obesity control. Community health education and promotion programmes that increase awareness about the risk associated with overweight, and improve the motivation for physical activity and maintenance of optimal body weight are needed.
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Literature
1.
2.
Joubert J, Norman R, Bradshaw D, Goedecke JH, Steyn NP, Puoane T. Estimating the burden of disease attributable to excess body weight in South Africa in 2000. South African Med J. 2007;97(8):683–90.
3.
Bradshaw D, Norman R, Pieterse D, Levitt NS. Estimating the burden of disease attributable to diabetes in South Africa in 2000. South African Med J. 2007;97:700–6.
4.
Bourne LT, Lambert EV, Steyn K. Where does the black population of South Africa stand on the nutrition transition? Public Health Nutr. 2002;5(1a):157–62. Cambridge Univ Press.CrossRefPubMed
5.
Steyn K, Sliwa K, Hawken S, Commerford P, Onen C, Damascene A, et al. Risk factors associated with myocardial infarction in Africa: The INTERHEART Africa Study. Circulation. 2005;112:3554–61.CrossRefPubMed
6.
Yusuf S, Rangarajan S, Teo K, Islam S, Li W, Liu L, et al. Cardiovascular Risk and Events in 17 Low-, Middle-, and High-Income Countries. N Engl J Med. 2014;371(9):818–27.CrossRefPubMed
7.
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;10:1038–48.CrossRefPubMed
8.
Shisana O, Labadarios D, Rehle T, Simbayi L, Zuma K et al. South African National Health and Nutrition Examination Survey (SANHANES-1). Cape Town: HSRC press, 2014.
9.
Steyn NP, Mchiza ZJ. Obesity and the nutrition transition in Sub-Saharan Africa. Ann N Y Acad Sci. 2014;1311:88–101.CrossRefPubMed
10.
Scott A, Ejikeme CS, Clottey EN, Thomas JG. Obesity in sub-Saharan Africa: Development of an ecological theoretical framework. Health Promot Int. 2013;28:4–16.CrossRefPubMed
11.
Flynn KJ, Fitzgibbon M. Body images and obesity risk among black females: a review of the literature. Ann Behav Med. 1998;20(1):13–24.CrossRefPubMed
12.
Goedecke Julia, Jennings Courtney LE. Obesity in South Africa: Chronic disease of lifestyle in South Africa (1990–2005). Medical Research Council Technical Report. Tygerberg, W Cape: MRC, 2006;33–47.
13.
Sonneville KR, Calzo JP, Horton NJ, Haines J, Austin SB, Field AE. Body satisfaction, weight gain and binge eating among overweight adolescent girls. International Journal of Obesity. 2012;36(7):944–9.
14.
Draper CE, Davidowitz KJ, Goedecke JH. Perceptions relating to body size, weight loss and weight-loss interventions in black South African women: a qualitative study. Public Health Nutr. 2015;13:1–9.
15.
Faber M, Kruger HS. Dietary intake, perceptions regarding body weight, and attitudes toward weight control of normal weight, overweight, and obese black females in a rural village in South Africa. Ethn Dis. 2005;15:238–45.PubMed
16.
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;8:509–19.CrossRefPubMed
17.
Micklesfield LK, Lambert EV, Hume DJ, Chantler S, Pienaar PR, Dickie K, et al. Socio-cultural, environmental and behavioural determinants of obesity in black South African women. Cardiovasc J Afr. 2013;24:369–75.CrossRefPubMedPubMedCentral
18.
Puoane T, Tsolekile L, Steyn N. Perceptions about body image and sizes among black African girls living in Cape Town. Ethn Dis. 2010;20:29–34.PubMed
19.
Case A, Menendez A. Sex Differences in Obesity Rates in Poor Countries: Evidence from South Africa. Econ Hum Biol. 2010;7:271–82.CrossRef
20.
Alwan H, Viswanathan B, Paccaud F, Bovet P. Is accurate perception of body image associated with appropriate weight-control behavior among adolescents of the seychelles. J Obes. 2011;1–8.
21.
22.
Obesity and overweight in South Africa: Trends, causes and required interventions. Obesity Reviews. 2010;1(1):11–25.
23.
Rito AI, Carvalho MA, Ramos C, Breda J. Program Obesity Zero (POZ)--a community-based intervention to address overweight primary-school children from five Portuguese municipalities. Public Health Nutr. 2013;16(6):1043–51.CrossRefPubMed
24.
Millar L, Kremer P, de Silva-Sanigorski A, McCabe MP, Mavoa H, Moodie M, et al. Reduction in overweight and obesity from a 3-year community-based intervention in Australia: The “It”s Your Move!’ project. Obes Rev. 2011;12 Suppl 2:20–8.CrossRefPubMed
25.
Puoane TR, Tsolekile L, Igumbor EU, Fourie JM. Experiences in developing and implementing health clubs to reduce hypertension risk among adults in a south african population in transition. International Journal of Hypertension. 2012;1–6. doi:10.​1155/​2012/​913960
26.
Rivis A, Sheeran P, Armitage CJ. Augmenting the theory of planned behaviour with the prototype/willingness model: predictive validity of actor versus abstainer prototypes for adolescents’ health-protective and health-risk intentions. Br J Health Psychol. 2006;11(Pt 3):483–500.CrossRefPubMed
27.
Champion VL, Skinner CS. The Health Belief Model. In: Health Behavior and Health Education: Theory, Research and Practice. 2008;45–65.
28.
Hukkelberg SS, Dykstra JL. Using the Prototype/Willingness model to predict smoking behaviour among Norwegian adolescents. Addict Behav. 2009;34(3):270–6.CrossRefPubMed
29.
Shahnazi H, Saryazdi H, Sharifirad G, Hasanzadeh A, Charkazi A, Moodi M. The survey of nurse’s knowledge and attitude toward cancer pain management: Application of Health Belief Model. J Educ Health Promot. 2012;1:15.CrossRefPubMedPubMedCentral
30.
Africa, Statistics South 2011. No Title. Pretoria: Census 2011; 2011.
31.
Okop KJ, Levitt N, Puoane T. Factors Associated with Excessive Body Fat in Men and Women: Cross-Sectional Data from Black South Africans Living in a Rural Community and an Urban Township. PLoS One. 2015;10(10):e0140153.CrossRefPubMedPubMedCentral
32.
Teo K, Chow CK, Vaz M, Rangarajan S, Yusuf S. The Prospective Urban Rural Epidemiology (PURE) study: Examining the impact of societal influences on chronic noncommunicable diseases in low-, middle-, and high-income countries. Am Heart J. 2009;158:1–7.e1.
33.
World Health Organization. Obesity: Preventing and managing the global epidemic. Report of a WHO consultation. WHO Technical Report Series 894. World Health Organization Technical Report Series; 2000:161–276.
34.
Puoane T, Fourie J, Shapiro M. ‘Big is beautiful’-an exploration with urban black community health workers in a South African township. South African J Clin Nutr. 2005;1:6–15.
35.
Ettarh R, Van de Vijver S, Oti S, Kyobutungi C. Overweight, obesity, and perception of body image among slum residents in Nairobi, Kenya, 2008–2009. Prev Chronic Dis. 2013;10:E212.CrossRefPubMedPubMedCentral
36.
Braun V, Clarke V. Thematic analysis. In: APA handbook of research methods in psychology, vol. 2. Washington: Research designs: Quantitative, qualitative, neuropsychological, and biological; 2012. p. 663–80.
37.
Burnard P, Gill P, Stewart K, Treasure E, Chadwick B. Analysing and presenting qualitative data. Br Dent J. 2008;204(8):429–32.CrossRefPubMed
38.
Long T, Johnson M. Rigour, reliability and validity in qualitative research. Clin Eff Nurs. 2000;4:30–7.CrossRef
39.
Mayosi BM, Flisher AJ, Lalloo UG, Sitas F, Tollman SM, Bradshaw D. The burden of non-communicable diseases in South Africa. The Lancet. 2009; 934–47
40.
Kumanyika S, Wilson JF, Guilford-Davenport M. Weight-related attitudes and behaviors of black women. J Am Diet Assoc. 1993;93(4):416–22.CrossRefPubMed
41.
42.
Surka S, Edirippulige S, Steyn K, Gaziano T, Puoane T, Levitt N. Evaluating the Use of Mobile Phone Technology to Enhance Cardiovascular Disease Screening by Community Health Workers. Int J Med Inform. 2014;83(9):6–12. Elsevier Ireland Ltd.CrossRef
43.
Levitt NS, Puoane T, Denman CA, Abrahams-gessel S, Surka S, Mendoza C, et al. Referral outcomes of individuals identified at high risk of cardiovascular disease by community health workers in Bangladesh, Guatemala, Mexico, and South Africa. Glob Health Action. 2015;1:1–7.
44.
Mayosi BM, Lawn JE, van Niekerk A, Bradshaw D, Abdool Karim SS, Coovadia HM. Health in South Africa: Changes and challenges since 2009. Lancet. 2012;380:2029–43.CrossRefPubMed
45.
Morón C. Food-based nutrition interventions at community level. Br J Nutr. 2006;96 Suppl 1:S20–2.CrossRefPubMed
46.
Loopstra R, Tarasuk V. Perspectives on community gardens, community kitchens and the good food box program in a community-based sample of low-income families. Can J Public Heal. 2013;104(1):55–9.
47.
Santos I, Mata J, Silva MN, Sardinha LB, Teixeira PJ. Predicting long-term weight loss maintenance in previously overweight women: A signal detection approach. Obesity. 2015;23(5):957–64.CrossRefPubMed
Metadata
Title
Perceptions of body size, obesity threat and the willingness to lose weight among black South African adults: a qualitative study
Authors
Kufre Joseph Okop
Ferdinand C. Mukumbang
Thubelihle Mathole
Naomi Levitt
Thandi Puoane
Publication date
01-12-2016
Publisher
BioMed Central
Published in
BMC Public Health / Issue 1/2016
Electronic ISSN: 1471-2458
DOI
https://doi.org/10.1186/s12889-016-3028-7

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