Indepth – Obesity: A Black woman’s fatal reality

A BLACK WOMAN’S FATAL REALITY

Multiple researches show that we top the list as the FATTEST group in South Africa. We PROBE how this came to be and WAYS TO CURB the excess weight.

Despite an emerging enthusiasm for fitness and eating well among black women – what with #BodyGoals and #SummerBodyLoading peppered all over social media – the reality is we remain the fattest race and sex in the country. In 2013, the SA Institute of Race Relations (SAIRR) found that almost a third of black South African women are obese. In the article Where does the black population of South Africa stand

on the nutrition transition?, research shows that as a race, particularly urban blacks, fat intakes have increased from 16.4% to 26.2%. “We define obesity as the abnormal or excessive accumulation of fat in the human body that holds health risks such as cardiovascular diseases, high blood pressure and diabetes,” Professor Hans de Ridder told Health24. Furthermore, up to 70% of women are classified as overweight or obese, according to the Heart and Stroke Foundation of South Africa.

It doesn’t end there. According to a Health Department study, fat intake among Africans has jumped almost 65% since 1940. As a result, obesity-related diseases like hypertension and diabetes are on the rise. More South African adults die from obesity than from poverty.

To probe this matter, the University of the Western Cape conducted a study called Perceptions of Body Size, Obesity Threat and The Willingness to Lose Weight

among Black South African Adults. It found that middle-aged black women are a potential major stumbling block in the country’s battle against obesity. It revealed that unlike their normal-weight counterparts, the women – participants from Langa township in Cape Town aged between 35 to 70 – were not only content with their weight, but many wanted to pack on more kilograms. They also admitted to over-eating fatty and sugary foods, and even said they’d only consider eating healthier if their current habits made them chronically ill.

FOOD ADDICTION

What these women may have ignored is the silent epidemic of food addiction they’re unknowingly part of. Popular American health expert Dr Oz says that similarly to drugs and alcohol, food can also become addictive. Psychologists network group Psychologists, Anywhere,

Anytime, says food addiction is “characterised by compulsive eating and an obsession with weight and body

“While opinions on thinness and overweight differed, the common view was that thin was bad, while overweight was socially desirable.”

image. Persons with a food addiction display an obsession with and craving for food and eating; a preoccupation with finding sources of food associated with pleasure and comfort; a compulsive cycle of eating and a lack of an ability to stop abusing food.”

The site also lists the three common types of food addictions: Binge Eating Disorder or Compulsive Overeating, which is when a person “engages in frequent episodes of uncontrolled eating during which they may feel frenzied or out of control. They’ll eat much more quickly than is normal, and continue to do so even past the point of being uncomfortably full.” Binge eaters have no control of their eating and have many failed attempts to lose the excess fat by going on futile diets. When unattended, this type of food addiction can lead to high cholesterol, diabetes, hypertension and clinical depression. It’s long term effects include kidney disease, arthritis and stroke.

TRUE LOVE attended a local Overeaters Anonymous (OA) group meeting in Norwood, Joburg. “OA is a worldwide nonprofit organisation that has been in existence for 37 years. It’s based on the same principles as Alcoholics Anonymous,” says the group leader who wants to remain anonymous. The organisation is a fellowship of individuals who share their experiences and hope to recoverfrom compulsive overeating. In the meeting, women (and two men) varying in ages, size and race talk about their personal journeys of food addiction, which can range from anorexia to bulimia. They meet four times a week. The general consensus is that they joined OA after many years of struggling with food addiction and failed suicide attempts.

“I got to the point where food controlled me so much that whenever someone even said the silliest thing I didn’t like, I needed to eat something to feel better. It became too much, I’d binge until it hurt. I couldn’t handle the control food had over me,” one member says. She adds: “OA has helped me find happiness and emotional balance. I have since lost 57kg.” Dr Oz says while everyone may overeat from time to time, food addiction is when food cravings turn into an obsession. Signs to look out for include:

“Hiding food in the car, home or office; basically, when food becomes a secret, there’s shame associated, which is the cornerstone of addiction.

“Also, you think about food more than one hour a day. Addicts use food as a diversion. They turn to eating instead of dealing with their emotions in a healthy way. Another sign is going straight to food arguing with a spouse or a friend. Again, in this situation, food becomes a drug used to become numb to painful emotions. You experience withdrawal symptoms when you’re not eating,” he says.

Dr Oz suggests having a tough talk with yourself before reaching for food. “When you’re struggling, think of the reason behind it. Food will not take those feelings away. Find a positive way to deal with your emotions and break the association.” He adds: “Journaling helps you understand the association between emotion and food. Write down what you’re eating and how you’re feeling. Over time, you’ll see patterns emerge. A food log will also tell you not only what you ate and when you ate it, but how you were feeling when you ate it. This will help you identify the triggers for making bad food choices and allow you to break those patterns.”

THIN LINE BETWEEN THICK AND FAT

In a controversial article titled Black Women are Proud Fatties; Proud Fatties are Black Women in The New York Times, writer Alice Randall suggested that black women are fat because they want to. She also added that they want to be fat because being bigger is a bonus for the men in our lives, who love curvy figures. Was she on to something?

Celebrities like Blac Chyna and Amber Rose are celebrated for their curvy figures. The term ‘thick’ is thrown around when describing them; it refers to when a woman has big boobs, a small waist, big behind and thick thighs. Even Beyoncé coined the word ‘bootylicious’ saying, “I wrote that [song] because, at the time, I’d gained weight and the pressure that people put you under, the pressure to be thin, is unbelievable.”

Instagram is now filled with pages that flaunt women with curvy assets. So does that mean as black women we embrace being thick or bootylicious? Founder of Team Hlasela – a popular healthy living Instagram page – Zintle Ntshikila says she doesn’t endorse being ‘thick’ because it encourages stereotypes. “I used to justify my weight as I was growing up, but my strong will power helped me to snap out of it and face the truth that there’s no such thing as thick or big boned.”

In the Perceptions of Body Size, Obesity Threat and The Willingness to Lose Weight among Black South African

Adults investigation, it’s suggested that women of all sizes believed their culture, or genetics, determined their size. “We have big bones. Being overweight is something we inherited,” the women said. “According to our values and culture, it’s important for a woman to have a large body. It makes you to be respected.” The authors of the study found that while opinions on thinness and overweight differed, the common view was that thin was bad, while overweight was ‘socially desirable’. If you were thin, you were viewed as unhealthy, and associated with people living with HIV/ Aids or tuberculosis or battling cancer. Similarly, Shane Norris, a researcher at Wits University in the African Centre

on Obesity Prevention, told the Saturday

Independent that, “traditionally, bigger was seen as better,” which shifted with an assimilation of the Western ideals of thinness. He also pointed out that the idea of thinness took on a negative spin because society associated it with being HIV positive.

If that’s the case, why do we applaud success weight loss stories of singers Jennifer Hudson and Judith Sephuma, Basetsana Khumalo, Idols SA judge, Unathi Msengana, Tumi Morake and the likes? Is it merely a small group of black women that actually want to be healthy? What about the likes of Boity Thulo, Team Hlasela and others who lead healthier lives? More importantly what about thriving businesses like Weighless? There’s a thriving health movement currently occurring in South Africa where the likes of Sibahle Mpisane, have gained popularity and have over 400 000 followers on her social media pages. What about this group of women that endorses healthy physiques?

WORRYING CONTRIBUTORS

A more scary phenomenon is the group of people who call themselves, feeders. Found in a thriving online group called Feabie.com with more than 100 000 members, they describe themselves as, “a dating site for feeders, feedees, fat admirers and big, handsome men and women. We’re a quirky bunch of men and women who love words like curvy, thick, plump, bellied, chubby, fat, obese, super-size and so much more!” The group is actually proud of promoting overeating.

On the other hand, another contributer to obesity is inactivity. Chairman of the South African Society for the Study of Obesity, Professor Tessa van der Merwe, says obesity among black women has been under-diagnosed for years on end, and the dire consequences went unrecognised. Every day, 60 South Africans are affected by strokes and heart attacks. The World Health Organisation predicts that in the next 20 years, obesity-driven diabetes across sub-Saharan Africa will double.

The health hazards that come with obesity include an increased risk of inflammation that leads to heart disease, diabetes, and certain cancers. Joint problems, pregnancy risks, high blood pressure and depression are also cited as the side effects of obesity. The extreme obesity cases lead to organ failure and amputations Despite these alarming facts, statistics show that the majority of black women in South Africa are fat and very few are doing something about it. Physical trainer Rick Horsman blames this on lack of physical activity. With a rise in urbanisation, lifestyles have become progressively more inactive. Furthermore, an increase in disposable income means access to junk food and sugary drinks, which are marketed as modern and desirable. A more western diet is also being adopted which includes large quantities of unhealthy fats in fried foods, high sugar and salt. CEO of the Heart and Stroke Foundation SA Dr Vash Mungal-Singh echoes this. “South Africa is a country that’s been going through a nutrition transition. The bulk of our population used to be physically active and ate a diet high in fibre and indigenous vegetables, low in animal protein and refined carbs. However, due to increased urbanisation, people are adopting a more westernised diet, high in unhealthy fats, sugar and salt. A greater disposable income and a faster-paced lifestyle has resulted in people eating more fast foods. “This is partly why there has been an increase in overweight and obesity over the last 15 years,” says Dr Mungal-Singh.

In a 2014 report, WHO found that South African women topped the list

WHO predicts that in the next 20 years, obesity-driven diabetes across sub-Saharan Africa will double.

of heavy-drinkers in Africa citing that 41.2% of us were binge drinkers. “Alcohol affects the body’s detoxification systems and will affect metabolism. Calories consumed from large amount of alcoholic drinks will affect weight gain,” says Smith. Jantjies explains: “A heavy drinker can consume an extra 1 000 to 3 000 calories per day on top of their normal diet. That, coupled with a lack of exercise and a bad mix of nutrients, can lead to obesity.”

As South Africans, our stress levels are peaking. According to studies done by University of KwaZulu-Natal researcher Lourens Schlebusch, an estimated 7 582 South Africans take their own lives every year. Dieticians warn that there are a few ways stress can contribute to weight gain. When feeling stressed, people tend to eat or drink. Stress eating is a type of emotional eating, which contributes to excess calories and, when done often enough, leads to weight gain. In addition, the type of food people crave when stressed is generally high in fat or sugar. Stress also causes the body to produce cortisol, which is a stress hormone that promotes body fat, especially around the stomach. Lastly, when someone’s stressed, they sleep less. Insufficient sleep causes the hunger hormone ghrelin to rise, making one to feel hungry even when they don’t need to eat.

GOVERNMENT’S EFFORTS

The Department of Health’s director of chronic diseases Dr Elamin Mohamed says the social and cultural aspects of obesity can’t be ignored. Government is on board too. In his budget speech, Finance Minister Pravin Gordhan confirmed a sugar tax, which will commence from 1 April 2017. This will include an “introduction of a tax on sugarsweetened beverages” such as carbonated soft drinks, fruit juices, sports drinks, energy drinks and vitamin waters, sweetened ice tea, lemonade, cordials and squashes. These will exclude juices that say 100% fruit juice.

The proposal is that these drinks be taxed at a rate of 2,29 cents per gram of sugar. This translates to drinks with large amounts of added sugar being taxed more. A 330ml can of Fanta Grape contains nearly 10.5 teaspoons of sugar and will be taxed an additional R1. A can of Coca-Cola (with more than eight teaspoons of sugar) will cost R0,80 more. Sugar, of course, once taken in large amounts can lead to diseases like diabetes, stroke and obesity. Research by the University of Witwatersrand found that a suggested 20% tax on sugar could possibly reduce obesity in 220 000 adults. Countries where this law is in effect include France, Mexico and several states in America. However, the resistance against the policy is that its establishment will lead to job losses.

Dr Mohamed said that the new dietary guidelines were just one aspect of a fullblown, multi-sectoral obesity prevention and management strategy being developed to help curb obesity. The new guidelines contain simple health messages that are food-based and not nutrient-based (protein, carbohydrate and so on), as in the past. While the government and health sector are doing all they can to contain this frightening health trend that’s claiming many lives of black women, Jantjies has these parting words: “We need to educate the South African public about the risks of an unhealthy lifestyle and being overweight. If the public does not believe that they need to eat healthier and exercise more, any strategies that address these issues will be unsuccessful.”