South Africa’s obesity crisis

Gary Feldman
4 March 2024
3 min read

South Africa is grappling with a significant obesity issue that extends beyond its impact on the healthcare system, costing billions of rands annually. This growing concern not only burdens the government's health expenditure, accounting for nearly 16%, but also poses challenges for employers dealing with decreased productivity and increased absenteeism. The repercussions are not confined to financial implications; it adversely affects the overall well-being and life expectancy of ordinary South Africans.

According to a study conducted by the University of the Witwatersrand's School of Public Health, obesity is responsible for an annual cost of R33 billion to the health system, contributing to early mortality and correlating with various comorbid conditions such as Type 2 diabetes, coronary heart disease, cancer, osteoarthritis, depression, and anxiety.

Maintaining a healthy weight extends beyond experiencing increased energy and fitting into smaller clothing sizes. It contributes to various aspects of quality of life, including:

  • Better sleep patterns
  • Reduced risk of developing type 2 diabetes
  • Reduced risk of developing heart disease
  • Reduced risk in developing certain cancers
  • Reduced risk of stroke
  • Reduced risk of liver related disease, including fatty liver and gallbladder disease
  • Better heart and circulatory system function
  • Better blood pressure regulation
  • An increase in energy and participation in daily activities
  • Fewer joint and muscle pain
  • Reduced back pain
  • Select healthier diet options focusing on fruits, vegetables, and lean proteins. Which are low-calorie foods but have higher amounts of nutrients, helping the body combat disease. Fibre contained in these high nutrient foods help aid gut function, and help you feel full for longer, preventing further weight gain.
  • Avoid processed foods, for example boxed and packaged snack foods, which are empty calories, and add up quickly, as you tend to eat a lot of these foods to feel full.
  • Reduce your sugar consumption, as it is key to keep your intake of added sugars low. Most often excess sugar consumption throughout the day is easily ignored or not noticed, as we add sugar to beverages including teas and coffees or reach for the sweet sugar drink during our lunch break, with a sugar snack for example a pie or biscuit.
  • Get moving, a key to maintaining a healthy body weight relies on moving the body, this can be as simple as walking before or after work, or during your lunch break, perhaps consider using the stairs. It’s good to keep in mind daily movement doesn’t need to be done all at once, as moderate activity is recommended. Don’t think you need to become an elite athlete overnight and complete strenuous workouts daily.

Body Mass Index (BMI) is the indicator of the amount of body fat in the body for most people. The BMI measure is used as a screening tool to identify a healthy weight, it is calculated as a numerical value of your weight in relation to your height. A BMI between 18.5 and 25kg/m2 indicates a normal weight. A BMI less than 18.5kg/m2 is underweight. A BMI between 25 kg/m2 and 29.9 kg/m2 is considered overweight. While a BMI over 30 kg/m2 is considered obese.

A BMI value is important as it indicates excess weight you are carrying around. Knowing how much extra you are carrying around is important, as excess weight increases the amount of work your heart is doing. Basically, your heart is working harder when you have more weight on your body. It also raises blood pressure and blood cholesterol, increasing triglyceride (bad) cholesterol levels while lowering HDL (good) cholesterol levels. This means that there is a risk that diabetes is more likely to develop, including heart disease and stroke. Lifestyle changes will reduce your risk of developing type 2 diabetes and improve your blood cholesterol.

A flaw of BMI measurement is that it does not consider differences in body composition, for example muscle mass, as is often the case with elite athletes. Resulting in a misclassification of individuals as obese or overweight, when in fact they are very healthy, being able to compete at professional levels in their sport.

Despite this limitation, BMI is an exceptionally useful tool to assess obesity, as it is often the initial first step in identifying individuals who are at risk of developing obesity-related health problems. It is also important to get professional and clinical advice, and judgement to assess your individual risk, to guide proper treatment decisions. Obesity is a complex condition that requires a holistic approach including lifestyle orientated changes to reduce the risks and, impact of obesity related health problems and burdens, not only on individuals, but also on South African society.

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