PREVALENCE, PERCEPTION AND SOCIODEMOGRAPHIC DETERMINANTS OF OVERWEIGHT AND OBESITY AMONG GHANAIAN WOMEN

ABSTRACT

Introduction: Understanding the determinants and perceptions of overweight (OV) and obesity (OB) using both quantitative and qualitative approaches is important due to their association with other chronic diseases. Objective: To identify the sociodemographic determinants of OV and OB and explore the perceptions of Ghanaian women about OV and OB. Methods: Data on sociodemographic characteristics and anthropometry (weight, height, percent body fat) were collected on 799 biological mothers of school children (9-15 y) in Accra and Kumasi, Ghana. Determinants of OV and OB were identified in a multinomial logistic regression using SPSS version 16.0. Mothers‟ views on OV and OB were explored in a focus group discussion (FGD) with 29 mothers using 5 thematic areas: knowledge; levels of concern about the issue; views on responsibility; possible consequences; ideas on prevention of OV/OB. FGDs were audio-recorded and transcribed. Analysis was done by noting the patterns in the comments and responses in the transcripts using Microsoft Word and Excel. Results: Mothers in Accra had higher education (p= 0.014), were less likely to have their own houses (p< 0.0001), earned less income (p< 0.0001), have fewer children (p= 0.005) and more likely to be heads of their households (p= 0.043) than those in Kumasi. The overall prevalence of OB was 42.7% and OV, 35.0%. After adjusting for several sociodemographic variables in the regression, traders were more likely to be OV compared to mothers who were not employed (OR= 2.36; 95% CI =1.07-5.21). Women in the highest income category were more likely to be OB compared those in the lowest wealth category (OR= 5.36; 95% CI= 1.20-23.86). Mothers with 3 children were more  likely to be OB than mothers with one child (OR= 2.71; 95% CI= 1.06-6.92). From the FGDs, the mothers defined OV/OB as deviations from „normal‟/„average‟ weight; ideal weight in relation to height and age; undesirable body proportions. OV/OB mothers were more likely to perceive factors that they have no control over such as genetics as the most important cause. There was a general preference for being just overweight to being morbidly obese (BMO) because BMO gives the impression of impaired metabolism, bad eating habits, inactivity and physical problems. The mothers believed that economic development, sedentary behaviour, changing dietary patterns and apathy are mainly responsible for the upsurge of OV/OB in Ghana. OV/OB mothers were more concerned about the psychosocial and socio-cultural consequences (i.e. depression, weight stigmatization) of OV/OB apart from clinical and economic problems. Mothers agreed that OV/OB is a problem in Ghana and that both conditions are controllable. Education or awareness and a general change of mindset about preferring a larger body size emerged as the most important preventive measure. Conclusions: OV and OB were prevalent among Ghanaian women. The women interviewed had adequate knowledge about OV and OB. They perceived OV and OB, especially OB as problematic conditions that mainly require changes in lifestyles and environment. The country should take advantage of this knowledge and mount a serious educational campaign about the need for adopting healthy lifestyles, improving eating habits and increasing physical activities. Mass education should make people aware about the health risks associated with OV and OB.