Abstract
ABSTRACT Background Levels of obesity are rising in South Africa, notably among adolescent females. Excessive energy-dense diets and physical inactivity are among the factors contributing to this increase. Given that these factors are largely behavioural, understanding young people’s views of obesity can contribute to more targeted behavioural interventions. Yet little is known of how rural South African adolescents view obesity. Objectives The aim of this study was to explore rural South African adolescents’ views of obesity, including their understanding of its causes, consequences, and solutions. Methods This qualitative study took place within the MRC/Wits Rural Public Health and Health Transitions Research Unit (Agincourt) study area, in rural northeast South Africa. Three focus group discussions were held with male (n = 16) and female adolescents (n = 15), aged 14–19 years in 2018. Data were analysed using thematic analysis and the Social Cognitive Theory used to frame the findings. Results Participants presented conflicting views of obesity, with both positive and negative opinions expressed. Causes of obesity were seen to be multifactorial, including genetics, diet, lack of physical activity, and HIV treatment. Adolescents proposed medication and hospitalisation as ways to address obesity. When discussing interventions to address obesity, adolescents expressed the need for more information, suggesting that providing information to both themselves and their family members as part of interventions would be important. Conclusions Rural South African adolescents have a complex perspective of obesity, likely driven in part by the current nutrition transition underway and do not inherently see individual behaviour as a driver or mitigator of obesity. Complex interventions including the involvement of other household members are needed to change adolescents’ views on the role of the individual, and ultimately, change both individual and household behaviour to prevent obesity.
Highlights
Levels of obesity are rising in South Africa, notably among adolescent females
Defined as a body-mass index (BMI) >30, the pre valence of obesity continues to rise globally, a trend reflected in sub-Saharan Africa (SSA) [11], where levels of obesity differ significantly between males and females, with South African females seeing a rapid rise during adoles cence [8,9]
All participants resided in the same village, and the average BMI for the focus group discussions (FGDs) participants was 20.8 for males and 22.5 for females
Summary
Excessive energy-dense diets and physical inactivity are among the factors contributing to this increase Given that these factors are largely behavioural, understanding young people’s views of obesity can contribute to more targeted behavioural interventions. Objectives: The aim of this study was to explore rural South African adolescents’ views of obesity, including their understanding of its causes, consequences, and solutions. Complex interventions including the involvement of other household members are needed to change adolescents’ views on the role of the individual, and change both individual and household behaviour to prevent obesity. In studies from rural South Africa (SA) and other parts of sub-Saharan Africa (SSA) [7,8,9], the double burden of malnutrition, stunting, in the early years of life, coupled with increasing over weight and obesity in adolescent girls and young women, is evident [9]. As part of the reducing childhood obesity mandate, understanding obesity from the
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