We would like to believe there may be small, simple solutions to big problems, but when is that actually true? The answer is probably, never. Intractable, extreme issues arise out of complexity, and nothing less than a host of multi-dimensional, cross-functional countermeasures issued at the right time and the right place can bring about sustainable transformation.
Obesity, a disease characterized by the interaction of genetic, behavioural, metabolic and environmental factors, embodies a complex matter requiring a comprehensive approach. A quick glance at the South African context (marked with more than 41% of women being obese) highlights that combatting obesity in South Africa will require more than a one size fits all approach.
This is why advising people who are obese to just consume fewer calories while burning more energy is not just doomed to fail but damaging to vulnerable people.
Obesity is a health condition beyond overweight that soars past trite platitudes. Research has shown that restricting calories while boosting exercise only makes a paltry 3 to 5% difference to sustainable weight loss and weight management. This is staggering, and it points out that the roots of obesity run deep – in the unseen details of our DNA; in the shadowy intricacies of our individual psychology, and day-to-day, in the banality of our homes, workplaces and communities where bias and shame are uncontested.
World Obesity Day, the 4th of March, is a time to acknowledge the global increase of obesity and its long-term impacts, while providing hope through awareness and education. Having a loved one on the brink, or all the way down the road, causes all involved parties to grapple with bona fide existential fear. Obesity puts one at risk for a host of other medical conditions such as non-communicable diseases, and it is too complex to solve with simple calorie restrictions plus exercise.
Dr Christine Taljaard-Krugell, President for ADSA (The Association for Dietetics in South Africa) says, “Simplifying obesity to one cause could prevent effective treatment. It ignores the various root causes such as biology, food, genetic risk, healthcare access, life events, marketing and sleep. Hence, when tackling obesity as a chronic disease, an evidence-based approach should be followed. Holistic patient care is critical. While cutting back on calories and increasing exercise is a relevant start and lays a foundation for healthy living at a healthy weight, it’s not the be all and end all when you’re aiming for sustainable change. This is a misconception that needs to shift.”
In recognition of World Obesity Day, the National Department of Health has stated that “it welcomes a broader view when it comes to dealing with obesity in South Africa, which is at an all-time high. Obesity is defined as a prevalent, chronic condition that impairs health, increases morbidity, and renders people prone to relapsing.”
Obesity care cannot simply be about diet and exercise advice; it should include intensive nutritional therapy led by registered dietitians, physical activity programmes, pharmacotherapy, as well as psychological, and even surgical interventions. For sustainability, the root drivers of obesity must be dealt with. These may be genetic and/or psychological drivers that will inevitably scupper calorie-restriction and exercise efforts if they persist as underlying causes.
People living with obesity also face bias and stigma that have major impacts on their life goals and aspirations, and therefore, their well-being. Here’s a way that we can all help counter the increasing obesity among SA adults and children: understand the complexity of the issue; don’t assume; don’t judge and don’t give off-the-cuff advice. Interrogate your own explicit and implicit biases. Promote and support holistic, professional patient care. There is a better way.
To find a registered dietitian in your area that can assist in the management of obesity, visit: http://www.adsa.org.za
The National Department of Health is inviting people to join the World Obesity Day webinar under the global theme “EveryBODY needs Everybody” on 4 March 2020 from 11am to 12pm. Click here to register for the webinar.
ADSA, the Association for Dietetics in South Africa, is one of the country’s professional organisations for registered dietitians. It is a registered non-profit organisation served by qualified volunteers. The Association represents and plays a vital role in developing the dietetic profession so as to contribute towards the goal of achieving optimal nutrition for all South Africans. Through its network of ten branches ADSA provides dietitians with the opportunity to meet and network with other professionals in their provinces. Through its comprehensive Continuing Professional Development (CPD) system, ADSA supports dietitians in meeting their mandatory on-going learning, which is essential to maintain their registration status with the Health Professions Council of South Africa (HPCSA). To find a registered dietitian in your area, visit: http://www.adsa.org.za
Such an indepth topic. Thanks for this information.
It’s not all about diet and exercise, it goes more deeper for someone suffering with this disease.
My weight borders obesity. This has been a big adjustment for me as my previous weight bordered on annorexia. I don’t have much of an appetite. Don’t need much food to get full either, but yet I simply can’t shake the fat. What I do know for sure though is that my family planning injection in isnprone to cause weight gain. It’s a terrible thing…stay on injection or get my dream body back?
Hi Avril, this is something I think a lot of are struggling with. I am overweight and because of some problems relating to my menstrual cycle I have had to go back on the pill which can add to weight gain, plus the medication that I am on for my bipolar disorder is adds to weight gain. I do think however that a lot can be done, at the moment I am on a health challenge with Helen Joubert, a health coach and nutritionist. I am learning so much and will share all of that with you soon!
This article is so so deep.many of suffer with weight issues.I used to fit into a size 30 and 32in my teens through my early twenties…Choosing incorrect birth control methods for my body set off a weightgaining trip that I could never really shake.Before my firstborn I was a 36,after having him(Via C-sections)After I went all the way to my highest ever at a 42.Im down to a 38 now but it’s a constant battle of the weight.