Abstract
Obesity is a major public health problem in Libya and increases the risk of non-communicable diseases. However, there is a shortfall in studies regarding this problem, and little has been done to explore the meaning behind people’s health and eating behaviours. Aim: To explore the knowledge, beliefs and attitudes of community members, health care professionals and health policy makers regarding obesity in Libya. Methods: A case study was adopted, using multiple methods for data collection including semi-structured interviews with 9 health care professionals and 6 health policy makers, and 6 focus groups conducted with 48 community members from different socio-economic classes and education levels. The Findings: Drawing on the socio-ecological Model (McLeroy et al., 1988) the study findings suggest that the rise of obesity in Libya is associated with multiple factors that occurred at five levels. 1) At the intrapersonal level, poor knowledge regarding obesity and fatalistic attitudes were identified amongst community members. Perceptions of obesity as a medical problem was recognised across health care professionals and there was a lack of confidence in obesity assessment among nurses. 2) At the interpersonal level, obesity was largely correlated with the influence of culture related views and traditions. 3) Social gatherings, poor urban planning, lack of green spaces and affordable sports centres were reported as barriers at the community level. 4) Factors at the institutional level involved a lack of basic facilities for obesity management in public hospitals, and insufficient training programmes in weight management and opportunities for healthier choices at university. 5) Numerous challenges in the management and governance of the healthcare service were suggested to impede effective obesity management at the policy level. The impact of the food subsidy programme on dietary intake was also reported. Implications: A whole system approach and interventions at multiple levels are needed to tackle the complexity of obesity from the individual level to the policy level. A person-centred approach and effective health policies and promotion programmes that meet individual, social and cultural needs are recommended. The study findings contribute towards providing a comprehensive picture of obesity in Libya to inform future public health and promotion programmes.