What is overweight and obesity?
A crude way to measure obesity is with the body mass index (BMI): a person’s weight (in kilograms) divided by the square of his or her height (in meters). A person with a BMI of 30 or more is generally considered obese. A person with a BMI equal of 25 or more is considered overweight.
Overweight and obesity are major risk factors for a number of chronic diseases, including diabetes, cardiovascular diseases and cancer. Once considered a problem only in high income countries, overweight and obesity are now dramatically on the rise in low- and middle-income countries, particularly in urban settings.
source: World Health Organisation (WHO)
Although large parts of Africa are plagued with malnutrition, the continent must now also deal with another problem: obesity. With transition and lifestyle changes, the number of overweight Africans is growing rapidly – and opening up a whole new set of problems.
Obesity is a widespread problem. The Red Cross speaks of an “obesity epidemic” and according to the World Health Organization (WHO), 65 percent of the world's population lives in a country where being overweight kills more than being underweight. The growth of overweight people continues, also in Africa.
“In Sub-Saharan Africa, twenty-three percent of adult men and thirty percent of adult women are overweight or obese,” says Dr Timothy Armstrong from WHO’s Department of Chronic Diseases and Health Promotion. “The expectations are that in the next twenty years, these numbers will double.”
The problem also grows among children, notes Dr Mary Limbe, paediatrician at the Aga Khan University Hospital in Nairobi, Kenya. She told Radio Netherlands Worldwide last year she has been seeing more and more obese children. “The lifestyle of children has changed in a lot of ways. In the past, children would walk to go to school and play a lot in the school compound, but now they are picked up and dropped off.”
But this doesn’t mean that people are getting fatter in the whole continent, nuances Dr Jaap Seidell, professor of Nutrition and Health at the VU University Amsterdam in the Netherlands. “Roughly speaking, obesity issues lie mainly in the north and south of Africa. In the middle part, other health problems like famine and infectious diseases still prevail.”
Deep-fried street food
Africa faces a double burden. On the one hand there is malnutrition and famine, caused by economic and political factors, on the other there is a growing number of overweight and obese people (see sidebar), influenced by social factors.
“The problem is mainly on the increase in rural areas,” says Armstrong. “It’s closely related to urbanisation and industrialisation. In the cities, there is an increasing lack of activity and cheap foods are more accessible and affordable.”
Seidell agrees. “A popular trend in Africa is street food: deep-fried snacks and soda drinks. You find stands now on every street corner.”
Big is beautiful
The African Population and Health Research Center reports that in certain sections of African populations, obesity is regarded positively – as a symbol of high social status. “In Africa there are more overweight women than men,” explains Seidell. “Traditionally, larger women are appreciated for ensuring offspring. In some cultures young women are overfed to become suitable wives for their future husbands. In other regions, women don’t want to lose weight because people will think they are sick. In South African townships, half of the women are overweight and the other half are HIV infected. To avoid being associated with HIV, overweight women would never consider a diet.”
Poor people’s problem
Obesity can result in cardiovascular diseases, diabetes and certain forms of cancer. But according to Armstrong, the health systems in Africa are not strong enough to carry that weight.
“Governments don’t consider this a big problem,” adds Seidell. “It’s very important they take structural measures, regarding public health. We now see that poor people cannot get insulin for treating diabetes, but rich people can. Thereby this becomes a problem of poor people. I think this is forgotten too often by aid organisations. Help systems for chronic illness and infectious diseases are not working together as much as they should.”
However, according the Armstrong, the first steps lie with governments to create awareness and prevent policies. “In the western world there are national guidelines for food producers, and this should also be done in Africa. Less salt, sugar and fat in products can bring big changes.”