Perceptions about body image and sizes among Black African girls living in Cape Town.

OBJECTIVE To assess beliefs about body size (fatness and thinness) and body image in Black girls aged 10-18 years living in Cape Town. DESIGN Exploratory using qualitative methods. SETTING Cape Town, South Africa. METHOD Participants were Black African girls (n=240), aged 10-18 years, who attended 5 primary and 6 high schools in Black townships in Cape Town. The schools and the girls were randomly selected. This paper presents qualitative data from 6 focus groups among 60 girls regarding their beliefs about thinness and fatness, and the advantages and disadvantages of being overweight or thin. RESULTS Beliefs regarding body image indicate that two thirds of the girls perceived fatness as a sign of happiness and wealth. Socially, fatness was accepted but one third of the girls had contradictory views about its advantages. Among obese girls who believed that being obese was preferable, the dominant reasons were that being fat allowed one to engage in sport activities that need strength and also makes one look respectable. On the other hand fatness was viewed as associated with diseases such as diabetes and hypertension and with increased difficulty in finding appropriate clothing sizes. Three quarters of the girls associated thinness with ill health particularly HIV and AIDS and tuberculosis. An advantage of thinness was being less prone to develop chronic non-communicable diseases. CONCLUSION The study shows that opinions and beliefs about body image start in adolescence. It is therefore important to consider these perceptions when designing interventions for preventing obesity and other chronic non-communicable diseases during early childhood.