High variation in overweight and obesity across sub-Saharan African countries by Subas Neupane, PhD, Post-doc researcher, UTA

A recently published article of the further analysis of Demographic and Health Survey (DHS) data collected in 32 sub-Saharan African countries among 250651 women (aged 15-49 years) shows a high variation in overweight and obesity among countries in sub-Saharan Africa. Body mass index (BMI) was calculated by dividing body weight by height squared to define overweight (25.0 – 29.9 kg/m2) and obesity (≥30.0 kg/m2). The pooled prevalence of overweight for the region was 15.9 % with the lowest in Madagascar 5.6% and the highest in Swaziland 27.7%.  Similarly, the prevalence of obesity was also lowest in Madagascar 1.1% and highest in Swaziland 23.0%. Twenty-seven of the studied countries had overweight prevalence higher than 10% and 7 countries had more than 10% prevalence of obesity.

Urban residents, women with high education and rich women as measured by wealth index quintile had higher odds of overweight and obesity in general. Authors argued that these findings put these countries at the risk of high burden of obesity related morbidity and mortality in the future. The authors also explained the rural-urban disparities in overweight obesity by the differences in lifestyle and dietary pattern between urban and rural dwellers in Africa. In rural areas, residents mainly eat fresh food from the farm, and mostly green and fresh fruits and vegetables are available from backyards. Therefore, the dietary pattern of rural folks although unintentional tends to be healthy compared to that of urban folks. Apart from diet, the lifestyle of urban residents is tilted towards westernization and the blind adoption of the so-called western lifestyle. There are growing numbers of western food outlet and urban residents perceive eating at such joints as a sign of affluence. Transnational fast-food companies in the region are aggressively exploiting this perception. The nature of occupation prevailing in rural and urban setting in Africa also contributes to the differences in obesity and overweight between the two settings. In most rural setting, the main form of occupation is still non-mechanized agriculture and physical activity based vocation such as fishing, small-scale mining and lumbering.

The authors concluded that owing to the well-known risk of overweight and obesity, the emerging epidemic in Africa needs to be addressed early enough to prevent its related morbidity and mortality. A number of interventions can be implemented. The fast growing cities should include in their development plans the creation of safe pedestrian walkways and bicycle lanes to enable pedestrians and cyclist feel safe.


Neupane S, KC P, Doku DT. Overweight and Obesity among Women: Analysis of Demographic and Health Survey Data from 32 sub-Saharan African Countries. BMC Public Health, 2016; 16:30. DOI: 10.1186/s12889-016-2698-5.

Link to full text: https://bmcpublichealth.biomedcentral.com/articles/10.1186/s12889-016-2698-5