title: Interest in healthy living outweighs presumed cultural norms for obesity for Ghanaian women.
abstract: BACKGROUND
  Cultural norms indicate that obesity reflects increased wealth and prosperity. Yet obesity is linked to serious medical illnesses. The purpose of this study was to determine if Ghanaian women would change their body image if it meant a healthier life.
  
  
  METHODS
  A questionnaire was administered to 305 Ghanaian women waiting for clinic appointments at Korle Bu Teaching Hospital, Accra Ghana. This survey included questions on current health, selection of figural stimuli, decision making on health and social determinants and 5 questions on self-perception of health from SF-36. Anthropometric measures were taken and body mass index calculated. Women were also provided with health related information at the conclusion of the interview.
  
  
  RESULTS
  The majority of all women surveyed would reduce their current body image if it meant that they would have an overall healthier life and reduce the risks of obesity-linked illnesses and complications. Currently obese women were significantly more likely than non-obese women to reduce their body image to reduce the risk of hypertension (OR 2.03 [1.64 - 2.51],<0.001); cardiovascular accident (OR 1.96 [1.61 - 2.38],<0.001); diabetes (OR 2.00 [1.63 - 2.44],<0.001); myocardial infarction (OR 2.27 [1.80 - 2.86],<0.001); if requested by a spouse(OR 2.64 [1.98 - 3.52],<0.001); and to improve overall health (OR 1.95 [1.60 - 2.37], <0.001). There was no association with current body image and responses to SF-36. The decision to select a new body image was not influenced by education, income, marital status or parity. Age 50 years old and less was significantly associated with the body image size reduction to reduce the risk of hypertension, diabetes, and a cardiovascular accident.
  
  
  CONCLUSIONS
  The Ghanaian women interviewed in this study are interested in living a healthy life and are willing to reduce their body size to reduce the risk of obesity-linked illnesses. The target group for any interventional studies and measures to reduce obesity appears to be women age 50 and younger.
authors.affiliation: Department of Surgery, Beth Israel Deaconess Medical Center, RW871, 330 Brookline Ave, Boston, MA 02215, USA. rduda@caregroup.harard.edu
authors.forename: Rosemary B
authors.initials: RB
authors.lastname: Duda
authors.forename: Naana Afua
authors.initials: NA
authors.lastname: Jumah
authors.forename: Allan G
authors.initials: AG
authors.lastname: Hill
authors.forename: Joseph
authors.initials: J
authors.lastname: Seffah
authors.forename: Richard
authors.initials: R
authors.lastname: Biritwum
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000886:Anthropometry; D001294:Attitude to Health / Q000208:ethnology*; D001828:Body Image; D003657:Decision Making; D005260:Female; D005869:Ghana; D015438:Health Behavior / Q000208:ethnology*; D006784:Hospitals, Teaching; D006801:Humans; D008875:Middle Aged; D009765:Obesity / Q000150:complications / Q000208:ethnology* / Q000517:prevention & control; D012649:Self Concept; D012925:Social Conformity; D011795:Surveys and Questionnaires; D016387:Women's Health / Q000208:ethnology*