Updated 09 June 2014

Why South Africans are the fattest in Africa

DietDoc takes a look at why South Africans - especially women - are regarded as of the fattest in sub-Saharan Africa, and what we can do about it.

I think most people saw the rather startling photograph of an obese woman squeezed into a skimpy top that allowed fat bulges to balloon over the straining material, which was published in a number of newspapers at the end of May (see right).

Luckily it was a rear view and the feelings of the person who posed for this photo will hopefully have been spared. The accompanying headline was just as harrowing: “SA’s the fattest sub-Saharan African nation - study” (Malan, 2014).

Malan (2014) goes on to report that a study published in The Lancet, one of the leading UK medical journals, has found that we as a nation have the highest overweight and obesity rates in sub-Saharan Africa, which equates to 7 out of 10 women and 4 out of 10 men being overweight or obese.

Read: The report on obesity in South Africa

Endless bad press

It is sometimes downright disheartening to read anything that refers to South Africa’s expanding waistlines. In the present study, other countries in sub-Saharan Africa were found to have much lower rates of female obesity, for example: our neighbours Namibia, Lesotho and Zimbabwe have female overweight/obesity rates of 19,8%, 24,1% and 33,5%, respectively.

These are all less than half of the South African figure of 70% of women who are overweight, of which 40% are classified as obese.

The comparison is even less flattering if we compare our female population to the women of African countries such as Eritrea where only 4,7% of adult females are obese and Ethiopia where the percentage drops to 1,8%. Malan (2014) points out these figures are respectively 10 and 20 times less than in South Africa.

Endless theories

There are of course endless theories that have been propounded to try and explain these statistics, ranging from poor eating habits in a rapidly westernised and urbanised population (Stassen, 2014), to experiences of racism that may trigger overeating (Mapumulo, 2014).

One of these theories that seems to make sense to me, is the finding that as a nation, South Africans of all races do very little exercise.

We have taken to the comforts afforded by transport and modern gadgets with a vengeance and the finding that overweight or obese South Africans would rather use fad diets or swallow dodgy over-the-counter slimming pills that promise much and do little (like us?), than to do healthy exercise (Pillay, 2014), sounds like a logical reason for at least some of the weight gain in this country.

Read: Why are South Africans so fat?

I have proof of this tendency on the DietDoc Message Board every week when the majority of postings more often than not are all about fad diets and ‘lose 10 kg a week with Dr X’s magic injections’.

Pillay (2014) states that people in the UK have started to ditch their ‘fad diets, diet foods and drinks, diet pills and potions’ and are starting to use common-sense solutions such as eating smaller portions and doing more physical activity to lose weight.

A marketing survey conducted in 2013 found that sales of diet products had fallen in the period 2008 to 2013, which indicates that Britons are starting to be more sensible about weightloss.

Read: Why the world is getting fatter and fatter


There can be no doubt that we have a massive problem in South Africa when it comes to overweight and obesity and that this is going to have a dramatic knock-on effect on future epidemics of all the diseases of lifestyle such as diabetes, heart disease, certain types of cancer and metabolic syndrome which are associated with overweight (Stassen, 2014).

Read: 8 Scary facts about obesity

The most sensible thing we can possibly do to avert these looming health problems is to also ditch all the fads and quick fixes. We need to teach our population to reduce portion sizes, to moderately reduce their energy intake while still eating a balanced diet that includes all the food groups and to increase their activity levels by doing about of 30 minutes of walking or skipping or stair climbing or jogging every day.

 Test yourself: Are you obese or just a little overweight?

Making small changes like this may sound like a feeble solution, but over time, each little improvement in your eating habits and exercise output will translate into weightloss and that is what our population needs desperately.

So let’s tackle this seemingly insurmountable problem one step and one teaspoon and 50 kJ at a time.

DIETDOC© Text copyright: Dr I V van Heerden

References: (Malan M (2014). SA’s the fattest sub-Saharan African nation - study. Mail & Guardian; Mapumulo Z (2014). Racism linked to obesity -study. News24. Published on 20 April 2014: Pillay T (2014). Dieting ourselves fatter, we shun ‘exercise more, eat less’. Sunday Times, Published on 20 April 2014; Stassen W (2014). Bad eating habits behind growing rate of heart disease in SA. Pretoria News, Published on 7 April 2014)

Read more:

How dangerous is it to be overweight or obese?
The Kardashians and diet pill empires
How to sneak in a workout 

Image: Finnbar O'Reilly, Reuters

Dr Ingrid van Heerden is a registered dietician and holds a doctoral degree in Nutrition and Biochemistry. She believes that "we are what we eat" and offers free nutrition and weight loss advice via her DietDoc service on Read more of her articles.


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