Abstract
Overweight and obesity are a growing public health challenge among women of reproductive age. While cultural norms suggest preference for an overweight body image, limited evidence exists regarding women's beliefs and experiences of overweight in Ghana. The current study explored beliefs, perceptions, experiences, and practices concerning overweight among women living in suburban Accra, Ghana. Four focus group discussions, and 10 in-depth interviews (IDI) were implemented among 42 adult women (>18 years) seeking preventive child health services in Dome, Accra. All the women in the IDI were overweight. In addition to notes, interviews and discussions were audio-recorded and transcribed for systematic content and narrative analysis. Overweight was considered undesirable by most women. Overweight individuals were often stigmatized using uncomplimentary names, such as cargo, obolo, and so on. However, some weight gain was admired and expected by women and their family and friends. Weight gain that was considered beautiful was believed to "evolve naturally." Weight gain that is either medically induced perceived as excessive was not viewed positively. Weight gain by women was perceived as a sign of financial prosperity and good care by a spouse. Overweight was perceived to be linked with heredity, childbirth, gluttony, and contraception. Adverse experiences of overweight included poor self-image, declining social lifestyle, increased disease risk, and feeling tired always. Strategies that had been used in order to lose weight included skipping meals, avoiding carbohydrate-based foods, and drinking herbal teas. There is admiration for some weight gain among women but when it is excessive, overweight is stigmatized. Misperceptions regarding partner expectations, determinants of overweight, and weight reduction strategies require effective behavior change interventions in Ghana.
Highlights
An adult is considered overweight if his or her body mass index (BMI) exceeds 25 kg/m2
Overweight is recognized as a threat to quality of life, some amount of body weight is admired and socially expected among some Ghanaian women as we have demonstrated in the Ga East district
In addition to interventions that address dietary energy intake, health education messages that help women to manage their perceptions of weight gain and that of their spouses will be an important aspect of a public health strategy to address overweight in Ghana and other similar settings
Summary
An adult is considered overweight if his or her body mass index (BMI) exceeds 25 kg/m2. Overweight has become a major public health challenge. An estimated 35% of adults 20 years and above were overweight at the end of 2008 [1]. It is estimated that more than half a billion adults are obese, that is, having a BMI in excess of 30 kg/m2. There is evidence which further suggests that overweight is increasing at a faster pace in developing countries [2, 3]. The evolution of overweight and obesity often shows a pattern where women initially have higher rates than men [1]
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