(P24-003-24) Perceptions of Body Size, Obesity Threat and Willingness to Lose Weight Among Adults With Type 2 Diabetes in Cotonou, Benin: A Qualitative Study

Objectives: Despite the well-established negative effects of obesity on type 2 diabetes (T2D) outcomes, there is a lack of studies examining awareness of this association among T2D patients in Africa. To fill this gap, this research investigates the perceptions of body size, awareness of obesity-related health risks, and willingness to lose weight among T2D patients in Cotonou, Benin.

Methods: This qualitative study involved four group discussions with 42 purposefully selected T2D patients aged 35-65. The participants' weight and height measurements were taken to calculate their body mass index (BMI), which was used to classify them as normal weight, overweight, or obese. Blood sugar levels were measured using Hemoglobin A1c. Participants were asked to discuss topics related to obesity threats, diabetes risk, body image perceptions, and willingness to lose weight. The discussions were conducted in French, transcribed, and translated into English. The data was analyzed thematically and interpreted using the Prototype Willingness Model (PWM).

Results: Participants generally acknowledged that obesity could lead to serious health issues such as heart attacks, strokes, and hypertension, but fewer mentioned diabetes. In addition, obese patients were more aware of obesity-related health risks than overweight and normal-weight patients due to their personal experiences and family observations. While some participants were willing to lose weight, factors such as perceiving overweight as less threatening to health, societal preferences for overweight individuals (especially women), and limited access to physical activity facilities and counseling adversely affected participants' readiness to pursue weight loss.

Conclusions: The low perception of obesity as a threat to health among T2D patients, and perception of a fuller body as culturally more desirable, especially among females, pose a considerable challenge to diabetes control. Our findings highlight the need to promote community health initiatives that raise awareness about the risks of overweight and encourage physical activity while maintaining a healthy body mass index.

Funding Sources: This work was supported by the National Institutes of Health Fogarty International Center (Award number K01TW012422).