Tackling the linked issues of obesity and diabetes requires changes in policy, economics and social attitudes. Photo: File
Obesity is a deeply entrenched public health problem. According to the Global Nutrition Report, an estimated 42.9% of adult women and 18.2% of adult men in South Africa are living with obesity. These worrying statistics are significantly higher than the regional averages in Southern Africa.
And the consequences are far-reaching: higher rates of heart disease, diabetes, strokes, certain cancers and mounting pressure on an already strained healthcare system. For millions of people, these are not abstract risks but everyday realities that influence how they live, work and plan for the future.
I know this intimately. I have experienced weight fluctuations over the years, often shaped by societal expectations. In my younger years, the motivation centred on appearance, achieving a smaller dress size, or fitting a certain image. With time, my priorities shifted towards maintaining health, mobility, mental clarity and quality of life. This is an experience many South Africans share, navigating environmental, cultural and economic pressures that make healthy living difficult.
Obesity arises from a complex mix of genetics, lifestyle, socio-economic conditions, stress, mental health and even the way our cities are designed. In urban areas, fast-food outlets are often easier to access and more affordable than fresh produce markets. In rural communities, limited infrastructure reduces opportunities for regular exercise. Coupled with the relentless marketing of ultra-processed, sugary products, these conditions create an environment where making healthy choices requires constant effort and vigilance.
Medical innovation is bringing new tools to this challenge. Wegovy (semaglutide 2.4 mg), now available in South Africa, offers a credible treatment option when used alongside balanced eating and regular physical activity. But studies show use of Wegovy carries a higher risk of side effects such as painful skin sensations and nausea. Clinical trials, such as the STEP studies, show average weight losses of between 14.9% and 17.4% over 68 weeks, with similarly positive results at 104 weeks, up to 15.2% sustained weight reduction and around one-third of participants losing 20% or more of their body weight
Data from the manufacturer further supports its effectiveness in long-term weight management.
Moreover, evidence from the Select study indicates that semaglutide can help maintain significant weight loss for as long as four years. This positions it as a valuable long-term option, when paired with lifestyle changes, and reinforces the importance of treating obesity as a chronic medical condition rather than a short-term issue.
Even so, no medical intervention can succeed in isolation. The environments where people live, work and learn must make healthy choices accessible and appealing.
Nutrition education in schools can equip children with knowledge that lasts a lifetime. Middle to upper-income communities benefit from safe parks, walking trails and fitness facilities that encourage daily activity. Access to affordable fresh produce, whether through supermarkets, street markets or community co-operatives, must be expanded.
Limiting the aggressive marketing of high-sugar, ultra-processed foods, especially to children, is another potential step, but this requires further governmental intervention.
Tackling the intertwined problems of obesity and diabetes requires more than isolated health campaigns. It demands a coordinated approach across policy, economics, social attitudes and cultural norms.
Government departments, medical insurers and employers all have roles in shifting outcomes. Subsidising access to proven treatments, funding awareness campaigns and embedding preventive health checks into workplace programmes can all make a measurable difference. South Africa’s sugar-sweetened beverage levy, which has already led to reduced consumption, shows how policy can influence behaviour. Similarly, workplace wellness initiatives that include health screenings, exercise challenges and nutrition workshops have demonstrated benefits for both staff well-being and organisational productivity.
As obesity-related conditions increase, healthcare costs climb and productivity drops. Low-income households often spend a disproportionate share of income on medical care, which can deepen cycles of poverty. Research from the South African Medical Research Council shows that non-communicable diseases, including those linked to obesity, are among the leading causes of premature death and lost economic potential. Public health investment is therefore not only a social imperative but also a strategy for economic resilience.
Another crucial aspect is dismantling the stigma that surrounds weight. When obesity is framed as a personal failing, people are less likely to seek support. Public health messages that focus on encouragement and practical steps can help create an atmosphere where individuals feel empowered to take action. Support groups, counselling services and inclusive fitness programmes all have a part to play in ensuring that those seeking better health do not face judgment or isolation.
Shifting cultural attitudes is equally important. A fixation on thinness often overshadows the broader goal of health. Conversations around body image, nutrition and exercise should centre on strength, vitality and well-being. Media outlets, community leaders and national campaigns can lead by sharing authentic stories of people making sustainable improvements in their health, regardless of size.
These issues are personal to me. My own journey with weight issues has strengthened my conviction that health equity is often neglected in South Africa. Reports from the National Institute for Communicable Diseases and the South African Medical Research Council highlight the extent to which obesity and diabetes, especially in low-income and marginalised communities, go under-recognised and under-treated. This reality drives my commitment to advocating for policy change that is both inclusive and evidence-based.
Health underpins almost every measure of national success. A healthier population supports stronger economic growth, greater social stability and improved quality of life for future generations. Failure to act will not only cost money, it will shorten lives and limit human potential. Making well-being a shared priority — in homes, workplaces and across public policy — is a practical choice with tangible benefits: longer lives lived well, stronger communities and a nation better equipped to meet the challenges of the future.
Katie Mohamed is the chief executive and founder of BrandFusion, W-Suite and ChangeHub. LinkedIn: Katie Mohamed, Instagram: katie_mohamed, Facebook: Katie Mohamed, X: @kayteebm