Fat women in SA

Obesity weighing heavily on South Africa, says Discovery

Obesity in South Africa is rising faster than the global average – and with it, so are its the health and economic costs. With the release of its Vitality ObeCity Index 2017 yesterday, Discovery reported that overall impact of obesity in South Africa is some R701-billion each year.

The local prevalence of obesity in women has risen by a startling 14% between 1980 and 2015 to 45%, and by 2% for men, with 15% considered obese in 2015 (see graphic below).

Speaking at the release of the Vitality ObeCity Index 2017, Dr Craig Nossel, head of Vitality Wellness, said while communicable diseases historically played a very significant role in South Africa, the country was experiencing a shift.

Lifestyle diseases were increasingly having a more meaningful impact on South Africa’s healthcare system and the burden of disease.

Although the direct healthcare cost of obesity is often highlighted, there were also indirect costs to consider. The economic impact of obesity in South Africa was estimated to be roughly R700-billion per annum.

Approximately 30% of the global population – more than 2.1 billion people – are overweight or obese. If the growth rate continues at its current rate, almost half the world’s adult population will fall into this category by 2030. 

“I don’t think anyone will disagree that we really do have a big fat problem.” 

Obesity in SA graph

While obesity is a multi-faceted issue, one of the most important causes of the epidemic are changes in diets – including an increase in the consumption of sugar, salt, fat and processed foods.

According to the 2016 Global Burden of Disease Study, dietary risk factors and physical inactivity are associated with 11.7 million deaths globally.

“We are killing ourselves,” Nossel said.

The ObeCity Index is an effort to gain insight into the weight status and food purchasing behaviour of nearly half a million adult Vitality members living in Cape Town, Johannesburg, Pretoria, Durban, Bloemfontein and Port Elizabeth.

The index considered their weight status, ratio of healthy food purchased at Pick n Pay and Woolworths, average fruit and vegetable portions bought and average number of teaspoons of sugar and salt purchased.

While Cape Town had the best weight status score, with 53.5% of Capetonians having a normal weight status, it fared only marginally better than its counterparts, and significant strides still have to be made to reach a healthy weight status in the country’s major cities. Port Elizabeth came last – with 48.8% of people having a normal weight status.

Capetonians also had the highest average healthy purchasing score at 60.3%, followed by Bloemfontein (57.2%) and Port Elizabeth (57.2%).

The Mother City also came out tops with regard to its fruit and vegetable purchases, followed by Johannesburg and Bloemfontein.

With regard to sugar and salt, Durban purchased the least amount of salt and sugar, followed by Port Elizabeth and Pretoria.

Nossel said most people want to be healthy, but are presented with various challenges. One of these is low-cost convenience food that are often unhealthy and readily available. 

Unfortunately poor people fill their bellies with cheap food – and this often means salt-drenched starchy carbohydrates, highly processed sweetened products and the fattiest cuts of meat discarded by wealthier consumers. Street-food surveys found that chicken sold in townships is often little more than skin and other meat is just fatty offal, while foreign fast food is seen as sophisticated. Meanwhile mothers go without meals to ensure that their children eat, then gorge when they have money.

Guardian article, Obesity: Africa’s new crisis

He stressed that it is important to understand behavioural economics – how people make decisions – in order to shift behaviour in the right direction.

Incentives play a critical role in this regard. Its data showed that people were increasing their ratio of healthy food purchased by close to 10% where they received 25% of their money back for making healthier choices.

Nossel said going out for dinner used to be an indulgence, but today people could hardly drive 500 metres without a food outlet. A lot of research highlighted the health value of cooking at home. Home-cooked meals were often smaller in portion size, the type of food is healthier and people know what is going into the food.

In South Africa, sales of ready-made meals, snack bars and instant noodles increased by 40% between 2005 and 2010. Fast food consumption continues to grow, negatively impacting on body weight.

But tackling the challenges around obesity is not only one individual’s responsibility nor that of government, Helen Kean, senior economist at Econex said. All stakeholders have to play a role, including manufacturers, retailers, consumers, doctors and regulators.

Kean said this was not necessarily something that has to be addressed through hard structural changes and legislation, although it could help. Incentives and other approaches are having a positive impact and there is scope to work with interventions that are already effective.

“There is no one policy or programme or project that is going to tackle this. It really has to be a lot of separate but collaborative efforts.”….

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