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LAST year, Bataung Matsau lost nearly 28kg. The Pimville, Soweto, resident began running, cycling and following a healthy diet and went from 96,4kg down to 68,8kg.
But instead of congratulating him, his neighbours were wary.
Matsau said some people would ask, “are you okay”, and others would ask his friends, “is Matsau alright”?
They were assuming that his dramatic weight loss had come about as a result of HIV.
Matsau has learned to ignore the stigma, but it seems others would rather risk their long-term health than face similar rumours.
“People are afraid to lose weight because they may end up being labelled Aids sufferers. Yet it seems acceptable to suffer from hypertension,” Matsau said. “They don’t realise that with high blood pressure, you may not wake up the next day.”
In addition to hypertension, being overweight contributes to chronic illnesses such as cardiovascular disease (heart attack), strokes, cancer and type-2 diabetes. Yet according to a 2010 study commissioned by GlaxoSmithKline, 78 percent of obese and 52 percent of morbidly obese South Africans consider themselves “healthy”. And with most SA adults being declared too heavy – 61 percent are overweight or obese – this attitude becomes even more alarming.
SA’s obesity rates are rapidly gaining on industrialised superpowers such as the US and the UK. Obesity is no longer a rich man’s problem. While it was once considered a luxury to spend money on overeating, it is now considered a luxury to spend money – and time – on losing weight. Fat wallets help make skinny people.
“I used to think: people with money, they can worry about weight loss. In the township, why would I want to get skinny? People will think I’m poor,” Matsau said. “Being poor is already a forced diet. And if you exercise, you’re wasting all of that energy. We need to harness it.”
Socio-economic barriers to weight loss are pervasive. Gym memberships are too expensive and inconvenient for many. Doctor’s visits can also incur costs, so unhealthy people may avoid check-ups altogether.
Beryl Chaka, a diabetic, was prescribed a healthy diet by her doctors. She does not follow it because the recommended foods are too expensive, she said.
When magwinyas (fatcakes) sell for only a rand at every corner, it is no surprise that nutritious foods don’t provide enough bang for the buck.
Cheap and ubiquitous fast food is a classic side-effect of rapid urbanisation, a result of SA’s transition to democracy. This phenomenon has been dubbed the “nutrition transition” by public health experts. Many countries in political transition have moved from hunger straight to obesity, with significant overlaps – obese people are often simultaneously malnourished because of poor diets full of empty calories.
A 2008 study revealed that 84 percent of elderly women in Sharpeville were obese despite being chronically food insecure, according to an African Food Security Urban Network report.
As more people move into urban areas and make more money, they opt for convenience over nutrition.
“Parents don’t cook for kids. They give them money to buy food,” said cobbler Jimmy Nyambi.
Nyambi’s children dislike the cabbage and spinach he boils for dinner. “Generally, people don’t like to eat healthy food. Junk food seems to be tastier,” Matsau said. “This morning at 7am, I saw a guy going to buy a kota.”
Kotas (a quarter-loaf of white bread filled with processed food like chips, cheese and polony) can be purchased for as little as R8. Fast food chains such as KFC and Chicken Licken are also growing in popularity, and the “brand names” attract diners.
To top it off, urbanisation diminishes physical activity.
“People take a taxi (from Pimville) to Maponya Mall,” Nyambi said. “You can walk to Maponya.”
Junk food is becoming more prevalent, and, in turn, healthy options are being pushed out.
“On every corner, you’ll find a kota. But for nutritious food, you have to walk far. There are no fruit shops around,” Matsau said.
Matsau believes he lives in a food desert: an area where fresh produce is scarce, with grocery stores being few and far between.
To get to the closest grocery store, he cannot walk, he must take a taxi.
“You end up spending more on transport than on food,” said community activist Sam Ndlovu.
Matsau explained: “There are people who sell fruits on the corner, but they’re perishable. So you won’t find anyone selling the whole range (of produce).”
Ndlovu believes the community needs to take this problem into its own hands.
“We as Africans are afraid of going back to our roots. When we buy spinach, we add fat and a lot of salt,” Ndlovu said.
Ndlovu wants to take an unused patch of land in Pimville Zone 4 and turn it into a community garden, allowing citizens to grow their own fresh vegetables. He has been in discussions with authorities.
However, there are many obstacles to face before his vision of this oasis becomes a reality.
“If you start a garden here, it’s not properly fenced. You do the labour but other people will take the food,” Matsau said.
For now, promoting education is Ndlovu’s top priority.
“I think most people are afraid of going to check-ups. They think they are going to get negative results,” Ndlovu said.
“Even educating one small community can make a difference to the country as a whole,” said Matsau.
“There are other people who will have high blood pressure or diabetes whether they exercise or not. It’s genetic.
“But queues of unhealthy young (overweight) people are clogging up the health system.”