With more than half of South Africans now overweight or obese, experts are calling for the 'gateway condition' to be treated as a medical problem and for urgent interventions to be put in place to address it, writes MedicalBrief.
Data from the WHO show that 70% of the Saudi Arabian population has the highest percentage of the world’s obese or overweight adults, followed by the USA (68%), New Zealand (66%), Australia (65%), UK (64%), Argentina (63%) and South Africa (54%).
The WHO estimates 39% of adults are overweight, and 13% are obese – 68% are women, 31% are men, and children make up a concerning 13% of this category, reports Health-e News.
Wits University clinical endocrinologist Dr Sundeep Ruder said the reason why more women are prone to being overweight or obese is not well researched, but could be explained through biological characteristics.
Women carry more fat for natural and hormonal health, and during certain periods – like pregnancy and menopause, there is always a change in weight as a part of the natural process. In an obesity environment, these processes are exemplified in women.
Ruder said hormonal changes can have a direct and indirect effect on a person’s weight. One of these ways is how the body responds to stress, “mental agitation due to unfulfilled or interrupted desires” – a condition that ends the body into a “fight or flight” mode.
“When this happens, hormones are being chronically released, being activated more through mental thoughts. Hormones that you need when you are stressed become overworked and activated because they are constantly used. When you stress, you self-soothe and this affects your eating behaviour.”
Another leading specialist endocrinologist has also warned that obesity is the “gateway” to more than 220 other health conditions and is not getting the medical attention it needs in South Africa, reports TimesLIVE.
Too many people “simply can’t lose weight despite all the hard work of exercising and changing diets” due to various underlying issues including genetics, environmental factors, psychological or neurological.
Dr Sindeep Bhana, from the Centre of Advanced Medicine and head of diabetes, endocrinology and metabolism at Chris Hani Baragwanath Hospital’s internal medicine department, said despite obesity being a public health crisis it was mostly regarded as a non-medical issue, even by doctors.
“It’s a huge problem and whether we admit it or not, it’s a medical problem because it leads to all other diseases. Obesity means more diabetes, more blood pressure, more cholesterol problems, more heart attacks, strokes and kidney failure. All of these conditions are costly to the patient, the patient's family, the society and, of course, to the government coffers as well.”
Bhana said not treating obesity as a “lifelong disease needing scientific insight and comprehensive lifelong healthcare treatment”, was not only problematic in South Africa as even in high-income countries, “only a very small percentage of people who have been recognised as being overweight and obese have been offered any form of treatment”.
“It’s a worldwide problem. Some countries are moving ahead, like Canada and the UK, where the management of this condition is better, but in South Africa being obese is blamed on patients, and the responsibility of losing weight is put squarely on their shoulders. No one says, when diet and exercise is failing, let’s consider pharmacotherapy … like we do with other chronic diseases such as diabetes and hypertension.”
The African Centre for Obesity Prevention (Action) estimates about 3.91m South African schoolchildren will be overweight or obese by 2025.
Paediatrician Dr Zakira Mukuddem-Sablay from the Red Cross Children’s Hospital in Cape Town said the medical fraternity should engage families about the rise in childhood obesity and address barriers to a healthy lifestyle. “Every effort should be made to correct misconceptions and to end stigmas within communities as another life-saving strategy to prevent and treat childhood obesity.”
Professor Shingai Mutambirwa, urology department head at the Sefako Makgatho Health Sciences University, said it’s “not too late to turn the tide on obesity”.
“The issue needs to be a discussion for everybody in the country, including medical practitioners, the government and patients, so that we all recognise obesity is a medical condition which needs to be addressed.”
Meanwile, the third “obecity”index has found that Cape Town’s residents again topped the charts for maintaining a healthy weight and being the healthiest food shoppers – Durban is the unhealthiest – while Johannesburg boasts the fittest population, doing the most exercise.
Based on the proportion of Discovery Vitality members who had a healthy weight, winner Cape Town was followed by Johannesburg, Durban, Pretoria, Bloemfontein and Gqeberha, reports BusinessLIVE.
Vitality also ranked the cities based on the contents of people’s shopping baskets at partner retailers Woolworths and Pick n Pay, and on how frequently they logged exercise on fitness trackers or at participating gyms and outdoor events such as Park Run.
The results of the analysis of 300 000 Vitality Health checks completed by members in the country’s six biggest cities were released last week as part of Discovery’s efforts to raise awareness of the health risks associated with being overweight or obese, the assessment being based on BMI and waist circumference.
Its 2017 index also put Cape Town on top and Gqeberha at the bottom.
“The obesity epidemic is a rising global challenge and we have one of the highest rates worldwide — more than half of all South African adults are overweight or obese,” said Vitality CEO Dinesh Govender said.
Discovery Health Medical Scheme (DHMS) said data shows obese members are more likely to have a chronic condition: 6.5 times more likely to have type 2 diabetes, 4.3 times more likely to have hypertension, and three times more likely to have heart disease.
Vitality wellness head Mosima Mabunda said the obesity epidemic was driven by biological and socioeconomic factors leading people to consume more calories than needed, with the proliferation of cheap, energy-dense food, oversized portions, displays of unhealthy food in shops and misleading food labelling as some of the ways consumers are increasing their unhealthy eating.
Challenges faced by Discovery members when trying to lose weight include lack of support (26%), lack of time to exercise or cook (23%), the cost of healthy food (17%), and lack of cooking skills of healthy food (6%).
Obecity index 2023
TimesLIVE article – Obesity is a disease and should be treated as such: doctors (Open access)
Health-e News article – ObeCity Index: Capetonians carry least weight (Open access)
See more from MedicalBrief archives:
SA cities rated on their healthy living profiles
Obese, overweight South Africans costing the country billions of rands
Sugar tax is not the only solution to SA’s obesity crisis