Social valorisation of stoutness as a determinant of obesity in the context of nutritional transition in Cameroon: The Bamileke case
ABSTRACT Body size perceptions were assessed among members of the Bamiléké, an ethnic group in an urban setting in Cameroon with high rates of obesity, but also a positive perception of stoutness in its social representations. We first implemented a qualitative study (April 2007) to identify local representations of body weight among Bamiléké using semi-structured interviews. We then quantitatively assessed body size perceptions among a representative sample of Bamiléké (May to June 2007), employing a body image assessment scale and a questionnaire that included declarative body weight self-satisfaction, health status, and attempts to reduce weight. Results indicate Desired Body Size (DBS) for women, and particularly for men, was situated in the overweight category. Qualitative analyses show that overweight is considered as a normal and healthy body size in the Bamiléké. On the other hand, the quantitative study reveals that high rates of obesity, especially in women (40.8% obese), are associated with high blood pressure. Moreover, subjects who had a negative perception of their health status wanted to lose weight (p < 0.01). Unlike males, females have a DBS lower than their Current Body Size (p < 0.001). In addition, subjects (particularly males) who felt they were too lean, were older than those who felt too fat. We therefore conclude that the social valorisation of stoutness exposes Bamiléké, particularly males, to obesity. Although the women stated a desire to lose weight and present aesthetic criteria more oriented towards slimness, the attitude of the Bamiléké remained oriented toward stoutness appreciation. This preference can help protect against body image disturbances identified in Western societies, but may also increase of the incidence of obesity and its associated pathologies in this part of the world.
- SourceAvailable from: Fiona M Vanobberghen[Show abstract] [Hide abstract]
ABSTRACT: The burden of non-communicable diseases (NCDs) is increasing in sub-Saharan Africa, but data available for intervention planning are inadequate. We determined the prevalence of selected NCDs and HIV infection, and NCD risk factors in northwestern Tanzania and southern Uganda. A population-based cross-sectional survey was conducted, enrolling households using multistage sampling with five strata per country (one municipality, two towns, two rural areas). Consenting adults (≥18 years) were interviewed using the WHO STEPS survey instrument, examined, and tested for HIV and diabetes mellitus (DM). Adjusting for survey design, we estimated population prevalences of hypertension, DM, obstructive pulmonary disease, cardiac failure, epilepsy and HIV, and investigated factors associated with hypertension using logistic regression. Across strata, hypertension prevalence ranged from 16 % (95 % confidence interval (CI): 12 % to 22 %) to 17 % (CI: 14 % to 22 %) in Tanzania, and from 19 % (CI: 14 % to 26 %) to 26 % (CI: 23 % to 30 %) in Uganda. It was high in both urban and rural areas, affecting many young participants. The prevalence of DM (1 % to 4 %) and other NCDs was generally low. HIV prevalence ranged from 6 % to 10 % in Tanzania, and 6 % to 12 % in Uganda. Current smoking was reported by 12 % to 23 % of men in different strata, and 1 % to 3 % of women. Problem drinking (defined by Alcohol Use Disorder Identification Test criteria) affected 6 % to 15 % men and 1 % to 6 % women. Up to 46 % of participants were overweight, affecting women more than men and urban more than rural areas. Most patients with hypertension and other NCDs were unaware of their condition, and hypertension in treated patients was mostly uncontrolled. Hypertension was associated with older age, male sex, being divorced/widowed, lower education, higher BMI and, inversely, with smoking. The high prevalence of NCD risk factors and unrecognized and untreated hypertension represent major problems. The low prevalence of DM and other preventable NCDs provides an opportunity for prevention. HIV prevalence was in line with national data. In Tanzania, Uganda and probably elsewhere in Africa, major efforts are needed to strengthen health services for the early detection and treatment of chronic diseases.BMC Medicine 05/2015; 13(1):126. DOI:10.1186/s12916-015-0357-9 · 7.28 Impact Factor