Perceptions and experiences of women in Benoni regarding weight loss strategies

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Cox, Johannita
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University of the Free State
Obesity is a worldwide disease reaching epidemic proportions and is characterised by abnormal or extreme fat accumulation, affecting all socio-economic groups in both advanced and developing countries irrespective of sex, culture, or age. More women compared to men are overweight in South Africa. With the high percentage of overweight and obesity in South Africa and given the social pressures on women in the media and among their peers to be thin (particularly in certain demographic areas), it might be expected that women would seek help from available weight-loss diets, programmes, strategies, and applications. In response, the weight-loss market has exploded. To date, very little is known regarding South African women’s opinions of and involvement with weight loss programmes and diets. Hence, a cross-sectional survey was conducted to evaluate: The perceptions and experiences of women 18 years and older on weight-loss strategies and how they were perceived by women residing in Benoni, a city close to Johannesburg, South Africa. An electronic self-reported survey, created with Evasys Software®, was shared via the local community newspaper and online social media platforms. Descriptive statistics were calculated, and associations were investigated by crosstabulation and using chi-square, Fisher's exact, and Wilcoxon rank tests as applicable. For the purpose of this study, programmes and different diets known to South African women were categorised and incorporated into the following seven categories: (i) commercial weight-loss diet plans; (ii) commercial weight-loss aids; (iii) commercial coaching methods; (iv) self-imposed dietary restrictions and adapted eating patterns; (v) diets prescribed by a health professional; (vi) diets prescribed by non-health professionals, and (vii) other, including mobile weight loss apps. A total of 272 participants completed the survey. Almost half of the participants fell in the age group between 40 to 60 years (48.2%), 71.7% held a tertiary qualification, 50.3% earned between R19 601.00-R38 200.00 per month, 75.8% were married or in a permanent relationship, and 88.2% were White. Most participants (71.7%) did not smoke, but smokers reported smoking and eating less when stressed. Most participants (76.9%) were overweight or obese, with low activity levels (52.6%), drank less than eight glasses of water per day (86.9%), and rated their health as good (71.2%). Participants reported having followed up to 10 diets in the last three years. A total of 619 diets, strategies, or applications were used across the different categories. The main motivation for following one of these was reported as weight loss. Across the different categories, self-imposed dietary restrictions/adapted eating patterns were used by the highest percentage (54.0%) of participants. Participants provided the following information for each reported strategy that they had followed: the reason(s) for discontinuing the diet plan, whether it was easy or hard to follow, and why it was too difficult, as well as challenges, level of frustration and hunger experienced while using the strategy. Among all the strategies followed, the highest percentage for objective obtained was reported for intermittent fasting. The highest percentage for no challenges experienced was reported for using a mobile weight-loss application, and the highest percentage of no frustration or hunger experienced, while using a strategy for an approach prescribed by a personal trainer. Only 31 out of the 619 strategies followed (chosen by 11.4% of participants) were prescribed by a healthcare professional, with half of these prescribed by dietitians. Dietitians need to position themselves as the preferred choice when spending money on weight loss. Future research needs to focus on exploring the reasons for the poor uptake of weight loss strategies by health professionals and dietitians compared to the other strategies. The insights provided by the current study regarding the weight loss strategies South African women choose and their experiences with these strategies may assist dietitians and other healthcare professionals to design and choose approaches that may lead to improved adherence to following a diet and long-term weight loss.
Dissertation (M.Sc. (Nutrition and Dietetics))--University of the Free State, 2021, Overweight and obesity, Risk factors, Weight loss strategies, Perceptions, Experiences, Socio-demographic factors, Lifestyle factors, Fad diets, Psychological effects