• Overview
  • Obesity prevalence
  • Trends over time
  • Population breakdowns
  • Drivers
  • Comorbidities
  • Health systems
  • Actions
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Obesity prevalence

Adults, 2016

Survey type:Measured
Age:15+
Sample size:7767
Area covered:National
References:South Africa Demographic Health Survey
Notes:Demographic Health Survey data includes ever married women aged 15-49 years only and may include males aged 15-59. 3105 Men 4662 Women
Unless otherwise noted, overweight refers to a BMI between 25kg and 29.9kg/m², obesity refers to a BMI greater than 30kg/m².

Adults, 2012

Survey type:Measured
Age:15+
Sample size:7267
Area covered:National
References:NHANES South Africa http://www.hsrc.ac.za/en/research-outputs/view/6493
Unless otherwise noted, overweight refers to a BMI between 25kg and 29.9kg/m², obesity refers to a BMI greater than 30kg/m².

Adults, 2003

Survey type:Measured
Age:15+
Sample size:7756
Area covered:National
References:Department of Health, Medical Research Council, OrcMacro. 2007. South Africa Demographic and Health Survey 2003. Pretoria: Department of Health.
Unless otherwise noted, overweight refers to a BMI between 25kg and 29.9kg/m², obesity refers to a BMI greater than 30kg/m².

Adults, 1998

Survey type:Measured
Age:15+
Sample size:13585
References:Personal Communication from V Lambert. Anthropometric patterns in SA: Results from the National Demographic and Adult Health Survey, 1998
Unless otherwise noted, overweight refers to a BMI between 25kg and 29.9kg/m², obesity refers to a BMI greater than 30kg/m².

Children, 2012

Survey type:Measured
Age:2-14
Sample size:4278
Area covered:National
References:NHANES South Africa http://www.hsrc.ac.za/en/research-outputs/view/6493
Notes:IOTF Cut off. Reference: Cole TJ, Bellizzi MC, Flegal KM, Dietz WH. Establishing a standard definition for child overweight and obesity worldwide: International survey. BMJ. 2000 May 6;320(7244):1240-3
Cutoffs:IOTF

Children, 2001-2004

Survey type:Measured
Age:6-13
Sample size:10283
Area covered:National
References:Armstrong MEG, Lambert MI, Sharwood KA & Lambert EV. 2006. Obesity and overweight in South African primany school children - the Health of the Nation Study. South African Medical Journal, 96: 439 - 444.
Notes:IOTF Cut off. Reference: Cole TJ, Bellizzi MC, Flegal KM, Dietz WH. Establishing a standard definition for child overweight and obesity worldwide: International survey. BMJ. 2000 May 6;320(7244):1240-3.
Cutoffs:IOTF

Overweight/obesity by education

Men, 2016

Survey type:Measured
Age:15+
Sample size:3105 Men4662 Women
Area covered:National
References:South Africa Demographic Health Survey 2016
Notes:Demographic Health Survey data includes ever married women aged 15-49 years only and may include males aged 15-59.
Unless otherwise noted, overweight refers to a BMI between 25kg and 29.9kg/m², obesity refers to a BMI greater than 30kg/m².

Women, 2016

Survey type:Measured
Age:15+
Sample size:3105 Men4662 Women
Area covered:National
References:South Africa Demographic Health Survey 2016
Notes:Demographic Health Survey data includes ever married women aged 15-49 years only and may include males aged 15-59.
Unless otherwise noted, overweight refers to a BMI between 25kg and 29.9kg/m², obesity refers to a BMI greater than 30kg/m².

Men, 2003

Survey type:Self-reported
Age:15+
References:Department of Health, Medical Research Council, OrcMacro. 2007. South Africa Demographic and Health Survey 2003. Pretoria: Department of Health. (https://dhsprogram.com/pubs/pdf/FR206/FR206.pdf last accessed 08.07.20)
Unless otherwise noted, overweight refers to a BMI between 25kg and 29.9kg/m², obesity refers to a BMI greater than 30kg/m².

Women, 2003

Survey type:Self-reported
Age:15+
References:Department of Health, Medical Research Council, OrcMacro. 2007. South Africa Demographic and Health Survey 2003. Pretoria: Department of Health. (https://dhsprogram.com/pubs/pdf/FR206/FR206.pdf last accessed 08.07.20)
Unless otherwise noted, overweight refers to a BMI between 25kg and 29.9kg/m², obesity refers to a BMI greater than 30kg/m².

Men, 1998

Survey type:Self-reported
Age:15+
References:Demographic Health Survey 1998, Preliminary Report (https://www.samrc.ac.za/sites/default/files/files/2017-07-03/dhsfin1.pdf last accessed 08.07.20)
Unless otherwise noted, overweight refers to a BMI between 25kg and 29.9kg/m², obesity refers to a BMI greater than 30kg/m².

Women, 1998

Survey type:Self-reported
Age:15+
References:Demographic Health Survey 1998, Preliminary Report (https://www.samrc.ac.za/sites/default/files/files/2017-07-03/dhsfin1.pdf last accessed 08.07.20)
Unless otherwise noted, overweight refers to a BMI between 25kg and 29.9kg/m², obesity refers to a BMI greater than 30kg/m².

Overweight/obesity by age

Adults, 2016

Survey type:Measured
Sample size:3105 Men 4662 Women
Area covered:National
References:South Africa Demographic Health Survey 2016
Notes:Demographic Health Survey data includes ever married women aged 15-49 years only and may include males aged 15-59.
Unless otherwise noted, overweight refers to a BMI between 25kg and 29.9kg/m², obesity refers to a BMI greater than 30kg/m².

Adults, 2007-2010

Survey type:Measured
Sample size:3836
Area covered:National
References:Wu F, Guo Y, Chatterji S, et al. Common risk factors for chronic non-communicable diseases among older adults in China, Ghana, Mexico, India, Russia and South Africa: the study on global AGEing and adult health (SAGE) wave 1. BMC Public Health. 2015;15:88. doi:10.1186/s12889-015-1407-0.
Notes:Prevalence of obesity for adults aged 50+
Unless otherwise noted, overweight refers to a BMI between 25kg and 29.9kg/m², obesity refers to a BMI greater than 30kg/m².

Adults, 2003

Survey type:Self-reported
References:Department of Health, Medical Research Council, OrcMacro. 2007. South Africa Demographic and Health Survey 2003. Pretoria: Department of Health. (https://dhsprogram.com/pubs/pdf/FR206/FR206.pdf last accessed 08.07.20)
Unless otherwise noted, overweight refers to a BMI between 25kg and 29.9kg/m², obesity refers to a BMI greater than 30kg/m².

Adults, 1998

Survey type:Self-reported
References:Demographic Health Survey 1998, Preliminary Report (https://www.samrc.ac.za/sites/default/files/files/2017-07-03/dhsfin1.pdf last accessed 08.07.20)
Unless otherwise noted, overweight refers to a BMI between 25kg and 29.9kg/m², obesity refers to a BMI greater than 30kg/m².

Overweight/obesity by region

Men, 2016

Survey type:Measured
Age:15+
Sample size:3105 Men 4662 Women
Area covered:National
References:South Africa Demographic Health Survey 2016
Notes:Demographic Health Survey data includes ever married women aged 15-49 years only and may include males aged 15-59.
Unless otherwise noted, overweight refers to a BMI between 25kg and 29.9kg/m², obesity refers to a BMI greater than 30kg/m².

Women, 2016

Survey type:Measured
Age:15+
Sample size:3105 Men 4662 Women
Area covered:National
References:South Africa Demographic Health Survey 2016
Notes:Demographic Health Survey data includes ever married women aged 15-49 years only and may include males aged 15-59.
Unless otherwise noted, overweight refers to a BMI between 25kg and 29.9kg/m², obesity refers to a BMI greater than 30kg/m².

Adults, 2007-2010

Survey type:Measured
Age:50+
Sample size:3836
Area covered:National
References:Wu F, Guo Y, Chatterji S, et al. Common risk factors for chronic non-communicable diseases among older adults in China, Ghana, Mexico, India, Russia and South Africa: the study on global AGEing and adult health (SAGE) wave 1. BMC Public Health. 2015;15:88. doi:10.1186/s12889-015-1407-0.
Notes:Prevalence of obesity for adults aged 50+
Unless otherwise noted, overweight refers to a BMI between 25kg and 29.9kg/m², obesity refers to a BMI greater than 30kg/m².

Men, 2003

Survey type:Self-reported
Age:15+
References:Department of Health, Medical Research Council, OrcMacro. 2007. South Africa Demographic and Health Survey 2003. Pretoria: Department of Health. (https://dhsprogram.com/pubs/pdf/FR206/FR206.pdf last accessed 08.07.20)
Unless otherwise noted, overweight refers to a BMI between 25kg and 29.9kg/m², obesity refers to a BMI greater than 30kg/m².

Women, 2003

Survey type:Self-reported
Age:15+
References:Department of Health, Medical Research Council, OrcMacro. 2007. South Africa Demographic and Health Survey 2003. Pretoria: Department of Health. (https://dhsprogram.com/pubs/pdf/FR206/FR206.pdf last accessed 08.07.20)
Unless otherwise noted, overweight refers to a BMI between 25kg and 29.9kg/m², obesity refers to a BMI greater than 30kg/m².

Men, 1998

Survey type:Self-reported
Age:15+
References:Demographic Health Survey 1998, Preliminary Report (https://www.samrc.ac.za/sites/default/files/files/2017-07-03/dhsfin1.pdf last accessed 08.07.20)
Unless otherwise noted, overweight refers to a BMI between 25kg and 29.9kg/m², obesity refers to a BMI greater than 30kg/m².

Women, 1998

Survey type:Self-reported
Age:15+
References:Demographic Health Survey 1998, Preliminary Report (https://www.samrc.ac.za/sites/default/files/files/2017-07-03/dhsfin1.pdf last accessed 08.07.20)
Unless otherwise noted, overweight refers to a BMI between 25kg and 29.9kg/m², obesity refers to a BMI greater than 30kg/m².

Overweight/obesity by socio-economic group

Men, 2016

Survey type:Measured
Age:15+
Sample size:7767
Area covered:National
References:South Africa Demographic Health Survey 2016
Notes:Demographic Health Survey data includes ever married women aged 15-49 years only and may include males aged 15-59.
Unless otherwise noted, overweight refers to a BMI between 25kg and 29.9kg/m², obesity refers to a BMI greater than 30kg/m².

Women, 2016

Survey type:Measured
Age:15+
Sample size:7767
Area covered:National
References:South Africa Demographic Health Survey 2016
Notes:Demographic Health Survey data includes ever married women aged 15-49 years only and may include males aged 15-59.
Unless otherwise noted, overweight refers to a BMI between 25kg and 29.9kg/m², obesity refers to a BMI greater than 30kg/m².

Adults, 2007-2010

Survey type:Measured
Age:50+
Sample size:3836
Area covered:National
References:Wu F, Guo Y, Chatterji S, et al. Common risk factors for chronic non-communicable diseases among older adults in China, Ghana, Mexico, India, Russia and South Africa: the study on global AGEing and adult health (SAGE) wave 1. BMC Public Health. 2015;15:88. doi:10.1186/s12889-015-1407-0.
Notes:Prevalence of obesity for adults aged 50+ by income level. Lowest (Quintile 1) is the quintile with the poorest households and Highest (Quintile 5) the quintile with the richest households.
Unless otherwise noted, overweight refers to a BMI between 25kg and 29.9kg/m², obesity refers to a BMI greater than 30kg/m².

Insufficient physical activity

Adults, 2016

References:Guthold R, Stevens GA, Riley LM, Bull FC. Worldwide trends in insufficient physical activity from 2001 to 2016: a pooled analysis of 358 population-based surveys with 1.9 million participants. Lancet 2018 http://dx.doi.org/10.1016/S2214-109X(18)30357-7

Men, 2016

References:Guthold R, Stevens GA, Riley LM, Bull FC. Worldwide trends in insufficient physical activity from 2001 to 2016: a pooled analysis of 358 population-based surveys with 1.9 million participants. Lancet 2018 http://dx.doi.org/10.1016/S2214-109X(18)30357-7

Women, 2016

References:Guthold R, Stevens GA, Riley LM, Bull FC. Worldwide trends in insufficient physical activity from 2001 to 2016: a pooled analysis of 358 population-based surveys with 1.9 million participants. Lancet 2018 http://dx.doi.org/10.1016/S2214-109X(18)30357-7

Estimated per-capita fruit intake

Adults, 2017

Survey type:Measured
Age:25+
References:Global Burden of Disease, the Institute for Health Metrics and Evaluation http://ghdx.healthdata.org/
Definitions:Estimated per-capita fruit intake (g/day)

Estimated per-capita processed meat intake

Adults, 2017

Survey type:Measured
Age:25+
References:Global Burden of Disease, the Institute for Health Metrics and Evaluation http://ghdx.healthdata.org/
Definitions:Estimated per-capita processed meat intake (g per day)

Estimated per-capita whole grains intake

Adults, 2017

Survey type:Measured
Age:25+
References:Global Burden of Disease, the Institute for Health Metrics and Evaluation http://ghdx.healthdata.org/
Definitions:Estimated per-capita whole grains intake (g/day)

Mental health - depression disorders

Adults, 2015

References:Prevalence data from Global Burden of Disease study 2015 (http://ghdx.healthdata.org) published in: Depression and Other Common Mental Disorders: Global Health Estimates. Geneva:World Health Organization; 2017. Licence: CC BY-NC-SA 3.0 IGO.
Definitions:% of population with depression disorders

Mental health - anxiety disorders

Adults, 2015

References:Prevalence data from Global Burden of Disease study 2015 (http://ghdx.healthdata.org) published in: Depression and Other Common Mental Disorders: Global Health Estimates. Geneva:World Health Organization; 2017. Licence: CC BY-NC-SA 3.0 IGO.
Definitions:% of population with anxiety disorders

Oesophageal cancer

Men, 2018

Age:20+
References:Global Cancer Observatory, Cancer incidence rates http://gco.iarc.fr/ (last accessed 30th June 2020)
Definitions:Estimated age-standardized incidence rates (World) in 2018, oesophagus, adults ages 20+. ASR (World) per 100,000

Women, 2018

Age:20+
References:Global Cancer Observatory, Cancer incidence rates http://gco.iarc.fr/ (last accessed 30th June 2020)
Definitions:Estimated age-standardized incidence rates (World) in 2018, oesophagus, adults ages 20+. ASR (World) per 100,000

Breast cancer

Women, 2018

Age:20+
References:Global Cancer Observatory, Cancer incidence rates http://gco.iarc.fr/ (last accessed 30th June 2020)
Definitions:Estimated age-standardized incidence rates (World) in 2018, breast, females, ages 20+. ASR (World) per 100,000

Colorectal cancer

Men, 2018

Age:20+
References:Global Cancer Observatory, Cancer incidence rates http://gco.iarc.fr/ (last accessed 30th June 2020)
Definitions:Estimated age-standardized incidence rates (World) in 2018, colorectum, adults, ages 20+. ASR (World) per 100,000

Women, 2018

Age:20+
References:Global Cancer Observatory, Cancer incidence rates http://gco.iarc.fr/ (last accessed 30th June 2020)
Definitions:Estimated age-standardized incidence rates (World) in 2018, colorectum, adults, ages 20+. ASR (World) per 100,000

Pancreatic cancer

Men, 2018

Age:20+
References:Global Cancer Observatory, Cancer incidence rates http://gco.iarc.fr/ (last accessed 30th June 2020)
Definitions:Estimated age-standardized incidence rates (World) in 2018, pancreas, adults, ages 20+. ASR (World) per 100,000

Women, 2018

Age:20+
References:Global Cancer Observatory, Cancer incidence rates http://gco.iarc.fr/ (last accessed 30th June 2020)
Definitions:Estimated age-standardized incidence rates (World) in 2018, pancreas, adults, ages 20+. ASR (World) per 100,000

Gallbladder cancer

Men, 2018

Age:20+
References:Global Cancer Observatory, Cancer incidence rates http://gco.iarc.fr/ (last accessed 30th June 2020)
Definitions:Estimated age-standardized incidence rates (World) in 2018, gallbladder, adults, ages 20+. ASR (World) per 100,000

Women, 2018

Age:20+
References:Global Cancer Observatory, Cancer incidence rates http://gco.iarc.fr/ (last accessed 30th June 2020)
Definitions:Estimated age-standardized incidence rates (World) in 2018, gallbladder, adults, ages 20+. ASR (World) per 100,000

Kidney cancer

Men, 2018

Age:20+
References:Global Cancer Observatory, Cancer incidence rates http://gco.iarc.fr/ (last accessed 30th June 2020)
Definitions:Estimated age-standardized incidence rates (World) in 2018, kidney, adults, ages 20+. ASR (World) per 100,000

Women, 2018

Age:20+
References:Global Cancer Observatory, Cancer incidence rates http://gco.iarc.fr/ (last accessed 30th June 2020)
Definitions:Estimated age-standardized incidence rates (World) in 2018, kidney, adults, ages 20+. ASR (World) per 100,000

Cancer of the uterus

Women, 2018

Age:20+
References:Global Cancer Observatory, Cancer incidence rates http://gco.iarc.fr/ (last accessed 30th June 2020)
Definitions:Estimated age-standardized incidence rates (World) in 2018, cervix uteri, females, ages 20+. ASR (World) per 100,000

Raised blood pressure

Adults, 2015

References:Global Health Observatory data repository, World Health Organisation, http://apps.who.int/gho/data/node.main.A875?lang=en
Definitions:Age Standardised estimated % Raised blood pressure 2015 (SBP>=140 OR DBP>=90).

Men, 2015

References:Global Health Observatory data repository, World Health Organisation, http://apps.who.int/gho/data/node.main.A875?lang=en
Definitions:Age Standardised estimated % Raised blood pressure 2015 (SBP>=140 OR DBP>=90).

Women, 2015

References:Global Health Observatory data repository, World Health Organisation, http://apps.who.int/gho/data/node.main.A875?lang=en
Definitions:Age Standardised estimated % Raised blood pressure 2015 (SBP>=140 OR DBP>=90).

Raised cholesterol

Adults, 2008

References:Global Health Observatory data repository, World Health Organisation, http://apps.who.int/gho/data/node.main.A885
Definitions:% Raised total cholesterol (>= 5.0 mmol/L) (age-standardized estimate).

Men, 2008

References:Global Health Observatory data repository, World Health Organisation, http://apps.who.int/gho/data/node.main.A885
Definitions:% Raised total cholesterol (>= 5.0 mmol/L) (age-standardized estimate).

Women, 2008

References:Global Health Observatory data repository, World Health Organisation, http://apps.who.int/gho/data/node.main.A885
Definitions:% Raised total cholesterol (>= 5.0 mmol/L) (age-standardized estimate).

Raised fasting blood glucose

Men, 2014

References:Global Health Observatory data repository, World Health Organisation, http://apps.who.int/gho/data/node.main.A869?lang=en
Definitions:Age Standardised % raised fasting blood glucose (>= 7.0 mmol/L or on medication).

Women, 2014

References:Global Health Observatory data repository, World Health Organisation, http://apps.who.int/gho/data/node.main.A869?lang=en
Definitions:Age Standardised % raised fasting blood glucose (>= 7.0 mmol/L or on medication).

Diabetes prevalence

Adults, 2017

References:Reproduced with kind permission of IDF, International Diabetes Federation. IDF Diabetes Atlas, 8th edition. Brussels, Belgium: International Diabetes Federation, 2017. http://www.diabetesatlas.org
Definitions:Diabetes age-adjusted comparative prevalence (%).

Health systems

Economic classification: Upper Middle Income

Health systems summary

South Africa has co-existing public and private health care systems that results in unequal and unequitable healthcare access among its population. The public system - provided for by the government - is made up of public clinics and hospitals accessible to all. Most services are free at point of service within the public system, including primary healthcare services. The public system, however, is chronically underfunded and understaffed. The private system, on the other hand, delivers high quality care but is financially out of reach for majority of the population who do not have health insurance. The private system has a disproportionate amount of funding and healthcare professionals considering it only covers only 16% of the population.

South Africa is currently discussing the implementation of a National Health Insurance scheme that will reduce inequities in healthcare access between different socioeconomic groups.

Indicators

Where is the country’s government in the journey towards defining ‘Obesity as a disease’?No
Where is the country’s healthcare provider in the journey towards defining ‘Obesity as a disease’?Some progress
In practice, how is obesity treatment largely funded?Out of pocket
Is there specialist training available dedicated to the training of health professionals to prevent, diagnose, treat and manage obesity?Partial
Have any taxes or subsidies been put in place to protect/assist/inform the population around obesity?Yes
Are there adequate numbers of trained health professionals in specialties relevant to obesity in urban areas?Partial
Are there adequate numbers of trained health professionals in specialties relevant to obesity in rural areas?No
Are there any obesity-specific recommendations or guidelines published for adults?Yes
Are there any obesity-specific recommendations or guidelines published for children?No

Perceived barriers to treatment

  • Lack of political will, interest and action
  • Economic crisis
  • Fragmented or failing health system
  • Lack of training for healthcare professionals

Summary of stakeholder feedback

The stakeholder reported although there is awareness of the extent of the obesity challenge in South Africa, there is a lack of political will to address it systematically.

The public health system - that covers the bulk of the population - is considered to be poor in terms of obesity prevention and treatment. There is a lack of healthcare professionals to treat obesity in both urban and rural areas, but widespread staff shortages throughout the health system mean that increasing the number of specialist obesity professionals is not a priority.

Compared to the public system, provision in the private sector is advanced. Private insurers appear to cover some treatments and the insurer Discovery Health was noted to have particularly good coverage. However, as such a small percentage of the population have private insurance coverage, it appears that obesity treatment is generally paid for out of pocket.

Based on interviews/survey returns from 1 stakeholder

Last updated: June 2020

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