Johannesburg - Just walking out of her front door is a daunting experience for Ofentse Matlala. The stares and whispers she endures in public over her weight are a nightmare.
The 30-year-old from Northriding in Johannesburg has been battling obesity for the last five years. However it wasn’t an overindulgence in food that caused Matlala’s weight to spiral out of control, but rather an underlying medical condition.
“I took prescription medication, and over time I couldn’t reverse the effects. I was initially treated for swollen and damaged optic nerves when I was a student, which was discovered to have been due to high pressure in the brain and I was treated with steroids. This is what started the weight gain.”
Even though her obesity is a result of an underlying medical condition, she says it doesn’t change people’s perception of her.
“One of the biggest challenges aside from the low energy levels and inflexibility I have, is the societal judgments. When kids are small and a bit chubby they are praised and loved for being cute, but when you are an adult battling with obesity you are judged for being irresponsible like you have no self-control. It’s shocking.”
But what makes it even harder to live with her condition was having very little medical support.
“The world is not designed for obese people. We can’t do things as a family because we always have to scope out environments to see whether it is suitable for me.
“The world is designed for convenience which makes it difficult to stick to a healthy diet and consistent exercising. I have learnt over the years that diet and exercise alone are not the answer. I believe obese people need medical support similar to other diseases. I have been blessed that I do not have diabetes, cholesterol or high blood pressure but these high-risk factors and others are a constant worry.”
Matlala is just one of hundreds of thousands of South Africans who battle the disease. In South Africa it is estimated that 68% of women and 31% of men are either overweight or obese and 13% of children under the age of 5 are overweight, which is double the global average of 6.1%.
This weekend SA will host the International Obesity Summit in Sandton to create awareness about the chronic disease and its associated threats.
Among the attendees is head of obesity research at global healthcare company Novo Nordisk, Dr Mads Tang-Christensen. The well-known Copenhagen-based researcher believes that the world is in the midst of an obesity pandemic.
“Currently we have 650 million people living with obesity and it is estimated that this number will grow to close to one billion by 2030,” says Tang-Christensen.
“We do not fully understand why the rate of people with obesity is growing so fast, but we know about at least two factors - genetic make-up and the environment.”
“During most of human existence, there has been a natural selection favouring people who are able to conserve and use as little energy as possible. During the past 30 to 40 years, and often energy-dense food has become available, and combined with a more sedentary lifestyle, this has become a ‘toxic cocktail’.”
As next Friday marks World Obesity Day, Tang-Christensen says it is important to raise awareness on the chronic disease.
Obesity is linked to a number of life-threatening illnesses including Type 2 diabetes, cardiovascular disease, non-alcoholic steatohepatitis, and is also strongly correlated with cancer.
“It is a chronic disease and once you get it, it is almost impossible to escape it. While we all live in the same ‘obesogenic environment’, we do not all get obesity and genetics play a major part.”
One of the biggest problems that obesity patients face according to Tang-Christensen, is that it is rarely acknowledged, diagnosed and treated as a serious chronic condition.
“It is probably the first thing that we need to change not only in South Africa but throughout the world.”
“If people are only told to go home and ‘eat less and move more’, things will not change. Obesity is a disease where stigma and bias is very prominent among the general public, healthcare professionals and even patients themselves.”
Tang-Christensen said one way of eradicating obesity is preventing children from becoming overweight in the first place.
“If you have obesity as a child there is higher likelihood of you being obese as an adult. We also need to have treatment alternatives for patients who already have developed obesity because for them, prevention is too late.”
“But first and foremost we need to get obesity recognised as a serious, chronic disease,” Tang-Christensen said.
Dr Grant Fourie, a GP in functional and metabolic medicine based in Cape Town, says obesity seems to be more prevalent in lower socio-economic groups in South Africa.
“This does indicate that poor quality nutrition also plays a role in obesity and not only, as people suppose, excess calories or in-fact under-activity,” says Fourie.
“We still too easily blame poor lifestyle and over-eating as the problem. This is only a part of the problem.”
Fourie agrees with Tang-Christensen about preventing children from becoming obese. “Children respond to simple changes like reducing sugar, refined carbs and increasing activity. I like to suggest focusing on increasing fruit consumption rather than vegetables. Of course, as many vegetables should be introduced as possible but fighting with children over correct eating really doesn’t help.”
“Dessert should never be offered as a reward for eating a plate of food and children should be encouraged to stop eating when they have eaten enough.”