Using Photovoice to Explore adults’ perceptions towards obesity and factors influencing food choice and physical activity in North Lebanon

Objective:
To explore adults’ perceptions towards obesity and factors influencing eating behaviour and physical activity in North Lebanon, using a variation of the Photovoice method.

Design:
This research is part of a broader qualitative study exploring factors influencing the rising levels of obesity and understanding the barriers and enablers for effective policy for obesity prevention using a socio-ecological model as a guiding framework. For this study, a variation of “Photovoice” was used to collect photographs to explore participants’ perspectives of obesity and its causes in Lebanon, using these photographs to generate discussion in one-to-one face-to-face interviews. Inductive and deductive thematic analyses were used to analyse the transcribed interviews.

Setting:
Tripoli, North Governorate, Lebanon.

Participants:
Twenty Lebanese adults aged 20-64 years were recruited.

Results:
The participants (n=20) generated 257 photographs representing various factors perceived to be associated with rising obesity in Lebanon: changes in the food and eating landscape, sedentary behaviours, food environments, eating out, and food marketing on social media platforms. Several themes specific to Lebanon were also identified, including the perceptions towards obesity, the central role of women in Lebanese food preparation and the family, and the sociocultural importance of food and social gatherings.

Conclusion:
This study highlights how influences across the five levels of the socio-ecological model shaped the participants’ food choices and physical activity levels. Collaborative initiatives and public policies are necessary to address the identified barriers and curb the increasing prevalence of obesity in Lebanon.