(This article was first published in the New Vision on September 14, 2022)
By Agnes Kyotalengerire
Ten-year-old Mary Alinda (not real name) used to look forward to school. But she has now lost interest in her studies after being bullied over the size of her body.
Alinda, a Primary Four pupil at a high-end school in Kampala, says her peers and teachers make derogatory comments about the size of her body, which makes her uncomfortable.
“I hate school because pupils and teachers insult me. They are not nice to me and I hate myself,” she told her mother recently.
Although Alinda does not know her body mass index (BMI), which is one’s weight in kilogrammes divided by the square of one’s height in metres, her mother is worried that her daughter could be obese.
Research published in the Journal of Nutrition and Food Sciences in 2018 indicates that 32.3% of Ugandan children in school were obese, while 21.7% were overweight. This means three out of 10 children were obese, while two out of the 10 were overweight.
The study, titled, The underestimated problem of obesity among children in Sub-Saharan Africa: A case of Uganda and South Africa, reveals that childhood obesity stands at 16.6% among learners in private schools and 11.5% in public schools.
The survey, which was led by Edison Arwanire, a senior paediatrician consultant at Mulago Hospital, blames the high prevalence of obesity and overweight on, among others, low physical activity, sedentary lifestyles and diets.
The World Health Organisation defines obesity and overweight as abnormal fat accumulation, but what makes the two different is the amount of weight in relation to height.
Alinda, who might be part of the childhood obesity crisis in Uganda, says she has grown shy and prefers to be alone at school rather than with children who bully her.
However, apart from exposing her to non-communicable diseases, can Alinda’s growing body size impact her academic performance?
Academic Performance
A 2015 study published in the Indian Journal of Family Medicine and Primary Care says childhood obesity is associated with poor academic performance and poor quality of life for a child.
This condition, the study further shows, can greatly impact a child’s physical health, self-esteem, social and emotional wellbeing with implications on their academic performance.
“These negative social problems contribute to low self-esteem, low self-confidence and a negative body image among children and can also affect their academic performance,” the study shows.
This, according to the survey, arises from the fact that overweight and obese children are not only bullied, but also face stereotypes and discrimination at school.
They are also excluded from activities that require them to move as fast as their peers, yet they are slower and tend to struggle with shortness the breath, it adds.
Yet another study published in the World Journal of Nutrition and Health in 2016 reveals that physical activity and the number of hours of sleep improve a child’s quality of life and academic performance.
However, the lack of these among some children due to excessive weight and non-communicable diseases greatly undermines their academic success, the study explains.
As a result, the researchers found that obese and overweight children were more likely to report having problems at school than their normal weight peers.
Additionally, they are also more likely to miss school more frequently compared to their normal weight peers partly due to health conditions brought about by their excessive weight, which affects their academic performance.
Mariam Nyendwoha, a psychologist in Kampala, agrees with the findings.
She says the ability of obese children to learn and maintain high self-esteem is not only undermined by bullying, but also the feeling that they are different from their normal weight peers. This, she adds, affects their learning and academic performance.
Diets
Several studies show that obesity is caused by both genetic and lifestyle factors, which means excessive weight is heritable, but can also be caused by lifestyle factors, such as lack of physical exercises and the kind of foods consumed.
However, Richard Baguma, the chair of the Civil Society Alliance for Nutrition Uganda, partly attributes obesity and overweight among children to the carbohydrate-rich foods served by schools.
Safina Musene, the commissioner for medical training at the education ministry, says fast foods and drinks which have sugar could also be responsible. These are mostly packed by parents for their children.
“The children are eating more than their bodies require yet they sit throughout the day with minimal physical exercise, resulting in weight gain,” she adds.
“This can have an effect on their wellbeing and academic performance,”
According to the guidelines on school feeding and nutrition, learners should be served a variety of foods, including vegetables.
Lillian Namukose, a principal nutritionist at the health ministry, says schools should make every effort to ensure that children’s meals consist of diverse foods so that learners can stay healthy and their academic dreams are not affected.
While parents should limit the amount of processed foods and drinks that their children take to fight lifestyle-related obesity, Namukose says schools also need to serve nutritious and non-processed foods and also educate the children about the benefits of healthy diets.
Meanwhile, Namukose suggests that Alinda needs to see a health professional to find out if her weight is healthy.
She says the school should also protect Alinda from any form of harassment as this could get in the way of her learning and affect her academic growth.
Physical Exercises
Dr John Omagino, the executive director of the Uganda Heart Institute, recommends daily physical exercises for learners to control weight and reduce the risk of developing health complications.
The commissioner physical education and sports, Duncan Mugumya, says physical exercises, coupled with healthy diets, could help parents control lifestyle-related obesity.
Mugumya adds that the new curriculum for lower secondary school, which has made physical education compulsory, will address part of the problem.
“The curriculum requires that classes end early so that all children can do physical activity, which is good for cognitive development,” he says.
“Proper cognitive development has an effect on academic performance,” Mugumya adds.
Jessica Namiro, the headteacher of Namuwaya Education Centre in Bweyogerere, a city suburb, underscores the need to educate parents on the benefits of healthy diets and physical exercises, as well as their effects on the child’s academic performance.
“We can fight obesity if parents stop giving their children junk food,” she says.
Godfrey Ocen, a parent, urged his fellow parents to encourage children to eat fresh foods and juices and discourage them from watching television for long as sitting for extended periods contributes to fat build-up in the body.
Fagil Mandy, an educationist, says schools should facilitate learners to undertake physical exercises as this does not only keep the children from gaining excessive weight, but will also reinvigorate their minds, which will allow learners to perform well in various aspects, including academics.
Mandy encourages schools without playgrounds to use public play spaces in their neighbourhoods. The US Center for Disease Control and Prevention recommends 6o minutes of physical activity for children and adolescents daily.
Big Problem
Uganda is not the only country in East Africa struggling with obesity among school children.
A 2013 study published in the Journal of Scientific Research put the percentage number of Kenyan overweight at 18.1% and 9.3% in private and public primary schools, respectively.
Led by Florence Kyallo, a researcher in the department of human nutrition sciences at Jomo Kenyatta University of agriculture and technology, the study also found that 10.9% and 2.2% of Kenyan children in private and public schools respectively were obese.
In Tanzania, a 2021 study led by Mary Mosha, a researcher in community health at Kilimanjaro Christian Medical University College in Tanzania, shows that 9% and 6% of the Tanzanian primary school children were overweight and obese respectively.
The studies show that there were more overweight and obese children in urban schools than rural ones.
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