Wellness for Greatness - Obesity in Kenya

Obesity is the new silent killer, a disease that can decrease the life expectancy of the child. Obesity is a condition that occurs when a person has excess weight or body fat that might affect their health. A doctor will usually suggest that a person has obesity if they have a high body mass index (BMI).

The roots of obesity are complex and include:

• Genetics
• Sedentary lifestyles
• Physical inactivity
• Maternal weight and health during pregnancy
• Excess consumption of unhealthy and especially ultra-processed foods
• Stress
• Limited availability of healthy options in many places.

The fundamental cause of obesity and overweight is an energy imbalance between calories consumed and calories expended. This is what brings out the difference between Overweight and Obesity. To determine this you use BMI (Body Mass Index).

BMI is the tool that is used to assess whether or not a person has an appropriate weight for their age, sex, and height. It combines a person’s weight in kilograms divided by the square of their height in meters.

Having a BMI between 25 and 29.9 indicates that a person is carrying excess weight - overweight.

A person is classified to be Obese if their BMI is 30 or over.

• If your BMI is less than 18.5, it falls within the underweight range.
• If your BMI is 18.5 to <25, it falls within the healthy weight range.

Certain other factors — such as a person’s waist-to-hip ratio, waist-to-height ratio, and amount and distribution of fat — also play a role in determining how healthy their weight is.

There is a strong genetic component to obesity, including the weight of the mother before and during pregnancy. A person’s genetic makeup may make him or her susceptible to obesity, but other factors as mentioned above are required to complete the picture. It’s however very possible to keep Obesity at bay by practicing healthy lifestyles.

Obesity is a disease in its own right, and therefore harmful to your health and a major risk factor for most NCDs which continue to overwhelm the already stretched health services.

The immediate and long-term effects of overweight and Obesity are:

• high blood pressure and high cholesterol (cardiovascular disease);
• breathing problems such as asthma;
• type 2 diabetes, impaired glucose tolerance, insulin resistance;
• psychological problems such as anxiety and depression;
• joint and musculoskeletal disorders;
• poor self-esteem and quality of life;
• social problems such as bullying; and
• some cancers.

Obesity It also makes COVID outcomes much worse. The World Health Organization has highlighted non-communicable diseases (NCDs) as a risk factor for becoming seriously ill with COVID-19. Today, emerging data suggests that obesity is a key risk factor for COVID-19 complications.

It’s both, Obesity is a physical disease but mental health plays a role in obesity as well. Children with obesity have lower life satisfaction, and are more prone to being bullied by schoolmates, and can lead to lower class participation and reduced educational performance.

In many countries, people with obesity are mistakenly seen as being to blame for what is actually a disease and a response to a food environment with few healthy options. We can correct this by starting to ensure that healthcare professionals and the Kenyan population understand obesity as a disease rather than a sign of personal weakness. Then people with obesity can get help – medical and nutritional – before they get very sick.

Therefore it’s important to know that overweight and obesity are sensitive issues for children and families and must be addressed with compassion, understanding, and caring, in using People First Language. In schools, children may also be equipped with personal skills that enable them to make healthy decisions, and to deal with stressful situations such as Obesity related stigma, and discrimination.

Doctors and researchers have called for better nutrition at home and at school, and more physical exercise to prevent a generation from becoming adults at greater risk of diabetes, heart disease and cancers due to excessive weight. It’s important to start with children and to ensure they have access to healthy diets, safe places for physical activity, education and skills in preparing healthy foods. While parents and caregivers are largely responsible for laying the foundations of lifelong good health in their children, schools also have a unique opportunity to tackle obesity in childhood. Schools can instill lifelong concepts in all children, and can help learners understand the benefits of healthy living. School provides an ideal setting for promoting Obesity education, they remain an important setting, offering an efficient and effective way to reach many children and, through them, families and community members.

The school years cover a period that runs from childhood to adolescence, these are influential stages in people’s lives when lifelong sustainable health related behaviors, as well as beliefs and attitudes, are being developed. Children are particularly receptive during this period and the earlier the habits are established, the longer lasting the impact. Finally it’s also critical for adults, to recognize if a person has a family history of obesity they are at risk, so that they can be prescribed healthy options as well as medication if needed.

Yes, it increases the likelihood of premature death due to COVID, diabetes, cancer, and many other diseases.

Obesity among children has increased tenfold since the 1970s. To demonstrate this, a research done in Kenya, South Africa and Nigeria:

KENYA - Boys Living with Obesity: 1975 – 0.3% and 2016 – 6.5%

KENYA - Girls Living with Obesity: 1975 – 1.5% and 2016 – 16.2%

The rise in the burden of obesity can be associated with demographic and social changes such as globalization, urbanization, adoption of unhealthy lifestyles including unhealthy diets and physical inactivity. Childhood Obesity is an urgent global public health concern, with implications both for the physical and emotional wellbeing of children, as well as risks for health later in life.

Many parts of Africa are witnessing skyrocketing child obesity rates, one contributing factor is the African culture where obesity is perceived as sign of power which makes obesity seem harmless. Many factors have contributed to the current situation and they include; sedentary lifestyles, technology, space invasion by real estate developers taking away kids play areas. Childhood Obesity rates will continue to rise if nothing is done to tackle these obesogenic factors.

Yes, fast foods can be associated with unhealthy food choices, excess calories from fast-food meals can cause weight gain. This may lead to overweight and obesity.

Let me bring this to perspective:

NCDs have existed among African communities from time immemorial. These diseases were controlled and effects minimized, largely because of peoples’ lifestyle and adoption of healthy and nutritious foods, there was abundant knowledge of herbs used to mitigate such diseases. With the advent of contemporary medicine and lifestyles, traditional foods have been pushed to the periphery leading to an upsurge of lifestyle diseases. There is therefore need to document African knowledge on how NCDs were controlled and treated; as well as collect and conserve the traditional foods and medicinal plants.

In Kenya there are several organizations working to help people with obesity,

• Wellness for Greatness Kenya
• NCD Alliance
• The heart and diabetes groups also work in this area.  
• The World Obesity Federation

You can also find a lot of resources online and your doctor should also be able to help.

Other Obesity and Overweight prevention and Management School Based strategies:

• Assessing learners for possible risk factors associated with overweight and obesity (hypertension, risk for type 2 diabetes, and family history) (NASN,2013);
• making necessary referrals to healthcare providers for further assessment and treatment;
• developing Individualized Healthcare Plans that address elevated BMIs and recommendations for lifestyle modifications;
• providing individual counseling and motivational interviewing to support weight-related behavior change;
• promoting individual nutrition and physical activity assessments to help children and adolescents identify healthy behaviors and set healthy goals;
• encouraging follow up for counseling and ongoing psychological support for learners;
• promoting healthy messages that encourage the consumption of healthy foods and daily physical activity;
• school leadership serving as role models and encouraging of healthy lifestyle choices by parents and teachers; and
• educating learners, parents, and the school community about evidence-based overweight and obesity prevention strategies, healthy lifestyle behaviors, daily physical activity requirements, and preventable health risks associated with overweight and obesity.