The effects of culture and social norms on weight management in Malaysia: a qualitative study

Abstract

Malaysia is ethnically and culturally diverse, 60.5% of the population are overweight or obese (2011). Aims: Explore weight management (WM) experiences; perceived vs actual body mass index (BMI) using a visual scale and objective measures; and cultural influences on WM. Method: Purposefully sampling people engaged in WM, through Malaysia’s Ministry of Health by location, gender, profession and ethnicity. Semi-structured interviews designed to assess experiences of WM using behavioural theories were conducted (n=46). Data analysis followed principles of framework and thematic analysis. Findings: Participants on weight loss programs (WLP) or currently losing weight, or successfully maintaining WLP were realistic in BMI estimates. Success in WM was attributed to fear of returning to previous weight. Those not on WLP, failed to lose weight or maintain weight loss attributed failure to time and social factors. Both successful & unsuccessful WM weight managers perceived social and cultural norms as strong barriers to weight loss and believed monitoring by healthcare providers was strong motivation for success. Conclusion: WM requires active and continuous participation beyond healthcare monitoring and is heavily driven by cultural and social norms.