OBESITY AND LACK OF PHYSICAL FITNESS AMONG SOUTH AFRICANS

Obesity is characterized by an excessive accumulation of body fat.  If a person weights 20% more than is given in the standard height/weight tables, one is considered to be obese.  Except for heavily muscled persons, this is presumed to be correct.

Obesity is caused by consuming too much food and not consuming the energy that we obtain from the food we eat.  If the body does not utilise all the energy it is stored as body fat.

Obesity is not only an adult disease but it appears as in one in four children who weight more than they should.  This may lead to type 2 Diabetes and their lives might be cut short or affected by blindness, kidney failure or heart disease.

Energy intake and energy expenditure need to be in balance to maintain a healthy weight.

Reasons for behaviour that contribute to a lifestyle disease:

Social factors

Obesity is six times more prevalent among lower class women than upper-class women.  The social class into which a person is born is a powerful determinant of obesity.  Obesity is more prevalent among lower class children than upper class children. Sweet and starchy food is often cheaper.

Social factors such as religion and ethnicity are also linked to obesity.  Indigenous people or those of Asian heritage are at greater risk of lifestyle diseases even if they are only slightly overweight.

Psychological factors

Many obese persons report that they tend to overeat when emotionally upset.  Diseases closely linked to emotional eating are Bulimia (a sudden ingestion of large amounts of food followed by vomiting or the taking of laxatives) and Night-eating syndrome (morning anorexia, evening over eating and insomnia). As stress and anxiety are some of the reasons why people tend to overeat, hypnotherapy and psychotherapy can make a major contribution to weight loss and weight control by assisting with a total lifestyle change.  

Genetic Factors

Children acquire their genes from their parents which also has an influence on their children’s behaviour such as eating habits.

Obesity runs in families.  80% of the children of two obese parents are obese, 40% of one obese parent is obese and 10% of the offspring of 2 non-obese parents are obese.

Endocrine Factors

A number of metabolic abnormalities may contribute to obesity.

Developmental factors

When a person becomes overweight the fat tissue as well as the size of the cells increase.  During weight loss the size of the cells will decrease but not the amount of cells.

Physical Activity

Decreased physical activity is cited as a major factor in the cause of obesity.

Page 18 of Soul Buddyz (SABC Education) states the following reasons:

• Food high in fat and sugar
• Children are not very active
• Children prefer to watch TV and play computer games
• Children that live in areas where there is a lot of crime and violence are not allowed to play outside
• Food prepared for family meals may be high in fat and sugar

Signs and symptoms of Obesity

• A body mass index (BMI) of above 25.  A BMI of 30 is considered obese.  This applies to adults.  Weight and height tables are available for children. If a person weights 20% more than is given in the standard height/weight tables, one is considered to be obese.
• If one suffers from diseases related to obesity such as Type 2 Diabetes, High Cholesterol and Heart Disease.
• Trouble in keeping up with friends and family during physical activities as a result of obesity.
• Tires easily during normal daily activities such as walking and climbing stairs.

Recommendations to address the problem:

• Rule out possibilities of metabolic diseases by having a thorough medical investigation.
• If child is an emotional eater, address types of problem with individual and family psychotherapy.
• Parents should not focus on the problem of obesity but rather attempt at helping the teenager become a positive confident human being with a healthy self-image.
• Do not put the overweight child on a strict diet.
• Provide meals for the family that are low in fat and sugar.
• Eat family meals together which encourages healthy eating habits by the parents setting an example.
• Serve smaller portions if in the past big portions were served.
• Limit snacks to fruit, popcorn, yoghurt or other healthy alternatives.
• Family activities should focus on fun physical activities for example cycling and walking.
• Encourage children to participate in school sport
• Spend 30 minutes every day walking or doing other light exercises.
• Parents should never pacify or reward children with sweets. Use unconditional positivity and small surprises to encourage children.
• Make children aware of the health risks of obesity.
• Remind children that it took a long time to put on weight and it is a slow process to loose weight but worth it in the long run.
• Parents should lead by example.

Institutions that may offer assistance:

• Private organisations such as Weigh Less, Weight Watchers and Sure Slim
• Diet clinics at Academic Hospitals
• Psychological Services at Academic Hospitals
• Dieticians in Private Practice
• Psychologists in Private Practise

Written by Dr R van der Walt, registered psychologist and hypnotherapist: 081 5475 272 for discussions.