Combating SA’s obesity epidemic will require more than a one-size-fits-all approach.
In the week of World Obesity Day, the Association for Dietetics in SA (Adsa) has warned that simplifying obesity to one cause could prevent effective treatment of the disease.
SA’s obesity levels are staggering – according to Stats SA’s latest figures an estimated 31% of men, 68% women and 13% children are classified as overweight or obese.
Adsa president Dr Christine Taljaard-Krugell believes obesity is a health condition 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.
“Obesity, a disease characterised by the interaction of genetic, behavioural, metabolic and environmental factors, embodies a complex matter requiring a comprehensive approach.
“A quick glance at the SA context highlights that combating obesity in SA will require more than a one-size-fits-all approach,” said Taljaard-Krugell.
She said 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 puts one at risk for a host of other medical conditions such as noncommunicable diseases, and it is too complex to solve with simple calorie restrictions plus exercise.
“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.”
She believes an evidence-based approach should be followed.
Obesity puts one at risk for a host of other medical conditions ... and is too complex to solve with simple calorie restrictions plus exercise.
— Dr Christine Taljaard-Krugell,
“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.”
“Obesity care cannot simply be about diet and exercise advice; it should include intensive nutritional therapy led by registered dietitians, physical activity programmes and pharmacotherapy, as well as psychological and even surgical interventions.”
The Heart and Stroke Foundation SA said the country was in the middle of an obesity epidemic and Covid-19 had “layered a crisis on a crisis”.
“Obesity is the main risk factor for comorbidities such as hypertension, diabetes mellitus, and CVD, and it has been widely acknowledged that these comorbidities are associated with a more severe course of the virus,” said Prof Pamela Naidoo, head of the foundation.
“However, some recent reports have also shown a strong association between obesity and the severity of Covid-19 infection despite the absence of other comorbidities.
“Furthermore, clinical evidence is linking obesity to worse outcomes in patients with Covid-19, where there is an increased risk for the development of severe pneumonia,” said Naidoo.
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