Beliefs and attitudes to obesity, its risk factors and consequences in a Xhosa community : a qualitative study
Thesis (MMed)--Stellenbosch University, 2012.
Background: The issue of obesity is an important one because in some communities obesity is perceived in many ways such that it is not recognised as a problem as typified by the black community of Khayelitsha with high levels of obesity and associated diseases but low levels of concern and recognition of the problem. This study aimed to explore this by trying to understand how people think and feel about their obesity in a peri-urban Xhosa community, with a view to improving interventions that will reduce the burden of disease related to overweight and obesity as well as with prevention programmes targeted at obesity as a risk factor. Methods: A qualitative study was carried out using recorded interviews of 8 purposively selected subjects who are long term Xhosa-speaking residents, 18 years and older, with BMI more than 30 and no Diabetes, Hypertension or Osteoarthritis at Nolungile CHC, Khayelitsha, a peri-urban black community in Cape Town, South Africa. Results: Interviewed subjects identified various dietary factors for their obesity. These include overeating widely available fatty diets from street vendors, with a perception that cheap food is fatty food. They also attributed their obesity to other factors like poverty and clearly expressed that it is expensive to eat healthily. Other reasons given are a sedentary habit, fear of embarrassment, safety issues and a poor support system regarding exercise. Respondents also differ in their behaviours towards their obesity but generally accept their obesity. Furthermore, they experienced various effects of their obesity. Other than being viewed as affluent and in good health by the community, respondents are aware of effects like compromised daily activities, associated chronic illnesses, dressing difficulties, aging and other negative effects. Conclusions: A few concepts, in agreement with previous linked studies were identified in relation to the Burden of disease, diet, exercise, socio-economic and perception issues. However, the effects of environmental influence on perceptions and behaviour regarding exercise and diet were found. This seemed to indicate an evolving culture in transition. Based on these understandings, health intervention should be directed at addressing such local beliefs and behaviour at the community level, with a need for control of environmental factors. Further studies regarding weight loss was suggested.