Cardiovascular Journal of Africa: Vol 28 No 5 (September/October 2017)

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CARDIOVASCULAR JOURNAL OF AFRICA • Volume 28, No 5, September/October 2017 AFRICA 329
As indicated in the literature on West Africa, 10 problems
of excess weight affect the urban environment more than the
rural environment, therefore showing just how environmentally
dependent the nutritional transition is in Senegal. In Dakar, the
modern lifestyle36 is combined with a decrease in physical activity
and a higher calorie content diet. In Tessekere, where there is no
running water or electricity, a pastoral lifestyle still protects the
population from the obesity epidemic, particularly by obliging
people to travel long distances daily to feed and water their herds.
However, our results show that such differences between the
urban and rural environment may not last, as overweight and
obesity rates among women born after the great drought of
1973–1974, hitande bonde [the worst year in Pulaar], are now
approaching those of their urban counterparts. The gradual
closing of the gap between urban and rural populations is also
borne out by results concerning the ideal body size. In the rural
environment, the ideal body type for both men and women is in the
overweight category, whereas it is in the normal range in Dakar.
The social value placed on the overweight body undeniably acts
as a factor in the development of excess weight in rural areas.16
At the same time, it is important to note the considerable
tolerance that both rural and urban Senegalese show toward
overweight. At a BMI of 27.5 kg/m², less than 40% of the men
in Dakar and Tessekere saw themselves as too fat, compared to
50% of urban women and 30% of rural women. By comparison,
in France, for the same BMI, 60% of the men and 85% of
women saw themselves as too fat.29 Therefore, not only are
body weight norms higher in Senegal than in France, but they
are also less strict, which can only foster development of the
obesity epidemic.16 A tightening of these body weight norms
is conceivable in the years to come, both pro-actively, through
public health messages issued by the Senegalese government, and
also through globalisation and the media, which convey beauty
standards that emphasise a slimmer body, particularly in the
urban environment.37,38
Our investigation has several limitations. First, the study
design was cross-sectional, which does not allow us to explore
causation. To overcome this limitation, it would be necessary
to conduct a longitudinal study in Dakar in the future. Second,
due to insufficient numbers of older adults in the study, we
were unable to survey the evolution of body weight after 50
years of age, which should be analysed in the future, given the
significant rise in weight-related problems with age, and the
aging population on the continent.39
Conclusion
This study shows that the prevalence of obesity is bound to rise
quickly among Senegalese women living in a rural environment,
partly due to high body weight norms and a large tolerance
towards overweight and obesity. To combat problems of obesity
in Senegal at present, public health messages should be geared
towards the population category most at risk, in other words
mature women living in urban areas. However, to limit the scope
of the epidemic over the entire country, health centres, which are
the only local health structures in rural areas, must begin to raise
awareness of the problems that arise with excess body weight.
The authors received funding for this research from the National Center for
Scientific Research, France (PEPS ‘Ecological Health’).
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