Social valorisation of stoutness as a determinant of obesity in the context of nutritional transition in Cameroon: the Bamiléké case.

Body size perceptions were assessed among members of the Bamiléké, an ethnic group in an urban setting in Cameroon with high rates of obesity, but also a positive perception of stoutness in its social representations. We first implemented a qualitative study (April 2007) to identify local representations of body weight among Bamiléké using semi-structured interviews. We then quantitatively assessed body size perceptions among a representative sample of Bamiléké (May to June 2007), employing a body image assessment scale and a questionnaire that included declarative body weight self-satisfaction, health status, and attempts to reduce weight. Results indicate Desired Body Size (DBS) for women, and particularly for men, was situated in the overweight category. Qualitative analyses show that overweight is considered as a normal and healthy body size in the Bamiléké. On the other hand, the quantitative study reveals that high rates of obesity, especially in women (40.8% obese), are associated with high blood pressure. Moreover, subjects who had a negative perception of their health status wanted to lose weight (p < 0.01). Unlike males, females have a DBS lower than their Current Body Size (p < 0.001). In addition, subjects (particularly males) who felt they were too lean, were older than those who felt too fat. We therefore conclude that the social valorisation of stoutness exposes Bamiléké, particularly males, to obesity. Although the women stated a desire to lose weight and present aesthetic criteria more oriented towards slimness, the attitude of the Bamiléké remained oriented toward stoutness appreciation. This preference can help protect against body image disturbances identified in Western societies, but may also increase of the incidence of obesity and its associated pathologies in this part of the world.