Obesity is one of the biggest health challenges facing the world today, affecting around 800 million people, with millions more at risk. The prevalence of obesity has tripled over the past four decades, imposing an enormous burden on people’s health as well as the healthcare system.
According to a World Health Organization (WHO) report, more than a quarter of South Africans live with obesity, making the country among the top 20% of the most obese nations in the world!
Studies by the SA Medical Research Council indicate that nearly half of all South Africans are overweight. Even more shocking, is the fact that 22% of children between 1 and 9 are overweight or obese. The pandemic, lockdown and increased sedentary lifestyle has made the situation worse
Dr Morgan Mkhatshwa,Head of Operations at Bonitas Medical Fund says, for overweight or obese people it’s not just an issue of vanity or fitting into a pair of jeans. ‘Risks associated with obesity include: Significantly contributing to the development of cardiovascular disease, type 2 diabetes, hypertension (high blood pressure), cancer (particularly colon, prostate and breast), sleep apnoea, degenerative joint disease, digestive tract diseases (gallstones), mental health and dermatological disorders.
What determines if you are obese or not?
Your Body Mass Indicator (BMI) calculator checks if you’re at a healthy weight. Here’s how to calculate yours:
- Divide your weight in kilograms (kg) by your height in metres (m²)
If your BMI is over 25 you are considered overweight, at 30+ you’re classified as obese.
There are detractors of BMI on its own
The BMI screening may not be the best option for bulky, body-builder or stocky men for example. This is because it does not distinguish between lean muscle mass and body fat. Best practice is to measure body fat percentage along with the BMI calculation. This provides a better indication of one’s body composition.
‘Obesity is a chronic and progressive disease,’ says Dr Mkhatshwa,‘Urbanisation and the lifestyle associated with it, is one of the main contributing factors.’
There are two reasons for this:
- Lack of exercise: Cities are often over-populated, there are too few public spaces for physical activity and many residents use transport to commute
- Poor nutrition. Changes in diet include more processed and refined food, an increase in high-fat and high-sugar diets, less fruit and vegetables, less complex carbohydrates and fibre
Although obesity is often associated with poor lifestyle choices, lack of motivation or unhealthy habits – it isn’t always the case. In America, where 40% of adults are obese, obesity has been recognised as a disease by the American Medical Association for nearly a decade. Despite this, they are still seeing most treatment approaches for obesity focus solely on behavioural therapy. The stigma and assumptions like this continue to create barriers that have limited better obesity care.
The origin of obesity is complex and poorly understood, but includes nutritional, physiological,
psychological and genetic factors.
- Environmental factors such as a sedentary lifestyle and excess calorie consumption can cause obesity
- Genetic studies with adopted children have demonstrated that they have similar BMIs to their biologic parents but not their adoptive parents. Twin studies also demonstrate a genetic influence on BMI
- Secondary causes of obesity can result from medications (eg. antipsychotics, steroids and anti-viral drugs) and endocrine disorders like Cushing’s syndrome and hypothyroidism
According to the International Journal of Obesity, adults with obesity (BMI ≥ 30) incur 42% higher medical costs per capita and are nearly two times more likely to die before age 70 than adults with a healthy weight. They also say that health care providers play a vital role in the prevention, treatment and control of obesity. They recommend that multicomponent behavioural interventions, pharmacotherapy and bariatric (stomach shrinking) surgery are all effective strategies that support clinically significant weight loss. Obesity as with other co-morbidities, was also a poor prognostic factor for Covid-19 hospitalisations
The general consensus regarding self-monitoring though is through:
- Calorie restriction: Reducing your intake by 500-1000 kcal per day will reduce total body weight by an average of 8% over a year
- Exercise: 30 minutes a day will yield health benefits, but 60 – 80 minutes will assist in weight loss and additional benefits
- Behaviour modification: Goal setting, self-monitoring and modification of one’s environment to enhance behaviours that will support weight management
‘The reality’, says Dr Mkhatshwa, ‘is that obesity and concomitant lifestyle diseases have become a pandemic in South Africa. Diabetes 2 is amongst these and has significant health implications. Managing this disease is imperative. We offer a diabetes management programme to help people understand this long-term condition and empower them to make the right decisions to stay healthy. This includes access to specialised diabetes doctors, dieticians, podiatrists and diabetic educators to effectively manage of diabetes. However, if you are not on a medical aid, there are several diabetic support groups.’
‘Everybody needs to act’. It’s time to increase awareness of the root causes of obesity and encourage advocacy for change.
Administered by Medscheme Holdings (Pty) Ltd, Bonitas aims to make quality
healthcare accessible to all South Africans and offers a wide range of plans that are simple to understand and easy to use. The Fund has the largest GP
network in South Africa, a Specialist Network and a host of supplementary
benefits paid from risk and carefully crafted managed care programmes to
cover chronic conditions, cancer, diabetes and HIV/AIDS. This allows members to derive real value for money and stretch their benefits as far as possible
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Thank you for this informative article!