Factors Associated with Obesity among African Populations

In Africa, increasing economic development and decreasing seasonal food shortages, combined with decreasing manual labor, and increasing sedentary labor activities, now enable people to attain their desirable weight, defined culturally as plump or fat. Consequently, obesity and overweight have become commonplace among populations. While this surge in obesity and overweight and associated health problems is recognized, lack of data precludes a good understanding of obesity related factors and its associated complications among specific groups and populations. This article addresses some of the factors associated with overweight and obesity among African populations.

The prevalence of obesity is a worldwide public health concern. Contrary to conventional wisdom, the epidemic is present in developed industrialized countries and in developing countries. It is estimated that over 115 million people suffer from obesity related health conditions in the developing nations [1]. Since 1980, the prevalence of obesity has doubled in more than 70 countries and has continuously increased in most other countries [2]. In 2017-2018, the age-adjusted prevalence of obesity in adults was 42.4%, and there were no significant differences between men and women among all adults or by age group. The ageadjusted prevalence of severe obesity in adults was 9.2% and was higher in women than in men. Among adults, the prevalence of both obesity and severe obesity was highest in non- Hispanic black adults compared with other race and Hispanic-origin groups [3]. Traditional African culture considers being overweight as socially desirable perhaps reflecting historical trends of hunger and starvation in agricultural society. In an environment where food is scarce, being overweight implies a higher social status and ability to afford food. With economic development, and consistent with the nutritional transition [4], decreasing incidents of seasonal food shortages then enables people to now attain their desirable weight, defined culturally as plump or fat [5].

Overweight and obesity result from an energy imbalance-consuming more calories than are equivalently expended in physical activity. Across Africa, two reasons for this are decreased physical activity and increased food supply resulting from changes in socioeconomic status and overall improvements in level of economic development (Popkin 1999) [4]. Compounding the problem, the pervading social desirability for overweight has created disproportionally high rates of overweight and obesity particularly among women of high socioeconomic status. Physical inactivity and sedentary lifestyle are independent risk factors for the occurrence of obesity leading to cardiovascular complications [6]. Physical inactivity leads to the accumulation of visceral fat and consequently the activation of a network of inflammatory pathways that promote the development of some pathological disorders, among which are insulin resistance and atherosclerosis, and thereby resulting in the development of a cluster of diseases defined as the ‘disease of physical inactivity’, which include metabolic syndrome [6].

In West Africa, social desirability for overweight women contributes to the well-documented direct relationship between obesity and socio-economic status [7]. Indeed, across Africa, some ethnic groups historically preferred overweight women and embraced cultural practices that encouraged female obesity (as in the pre-marital “fattening rooms” of Nigeria). Thus, the recent increase in overweight and obesity in West Africa may not be a consequence of changes in the environment alone but rather the result of society-wide intentional weight gain enabled by the increased availability of food concurrent with decreased need for physical exertion [8]. Indeed, sociocultural, institutional, and peerrelated factors are powerful forces shaping body size preferences, food choices and participation in physical activity [5].

Latest WHO reports show that overweight and obesity are becoming the leading causes of death worldwide [9]. Overweight and obesity are associated with elevated mortality from all causes in both men and women, and the risk of death rises with increasing weight. Overweight and obesity require increased attention and a multidisciplinary approach to health to prevent morbidity in among populations. The need therefore arises for regular screening as well as awareness creation of the public on overweight and obesity and its related complications.

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