South Africa's Aids epidemic is driving a new health crisis in the country as women, fearful of appearing to be HIV positive, are becoming obese in record numbers.
Nearly one third of women in South Africa are now severely overweight, Tessa van der Merwe of the International Association for the Study of Obesity has revealed, as a combination of new fears and traditional, cultural factors encourage excessive weight gain.
"Regretfully, there is a perception that if a black woman is thin, she might have HIV/Aids," Ms Van der Merwe said.
The crisis in South Africa, where five million of its 45 million people are infected with HIV/Aids, will be high on the agenda as the world's largest gathering of Aids experts meets in Toronto this week.
It also has one of the world's highest rates of violent crime, which Ms Van der Merwe believes contributes to the weight problems, because it makes high-intensity, out-of-doors exercise difficult."There is the reality - it simply isn't safe to walk around," she said.
She also blamed the clinical obesity epidemic on the tribal belief that fatness was a sign of prosperity. She said there was a belief that if a woman was not rotund "her husband can't afford to feed her well". Added to these factors is the view in the South African black community that plump women are alluring.
The most famous symbol of this was the ample- figured Saartjie Baartman - known as Hottentot Venus - the woman from South Africa who was a circus attraction in Europe in the 19th century.
Her generous proportions were marvelled at and made her both a feminist icon and an example of stereotypical attitudes towards Africa.
"When being overweight is seen as a sign of health and wealth, it is extremely difficult to change this perception," Ms Van der Merwe said. "We should be convincing black women that weight loss has a markedly helpful effect on health."
Ms Van der Merwe, who is head of South Africa's first obesity clinic, addressed a major gastroenterology congress in South Africa last week, claiming the increasing level of obesity was causing health problems such as heart disease, hypertension and diabetes.
Ms Van der Merwe's research shows that there are weight problems across all race groups in South Africa, with half of women and one third of men overweight. Those levels are only 20 per cent lower than in the United States, seen by many as the world's fattest country.Reuse content