Obesity in African Children: Causes and Prevention

By Victory Onyenekwe. B.Sc. Ed (Physical and Health Education). Freelance Health Writer. Medically reviewed by: Michelle Buama Abebrese, MD.

December 2, 2025

An obese African boy seated in a fast food restaurant, with ultra-processed food on his table. AI generated image  from Gemini. Click on image to enlarge.

 

Highlights

• According to the World Health Organization, in 2019, Africa was home to over 24% of the world’s overweight children aged under 5 as childhood obesity and overweight remain a growing public health problem with rising trends.

• Statistics from the African Regional Overview of Food Security and Nutrition in 2022 indicate a high prevalence of childhood obesity in Northern and Southern Africa.

• The transition from African traditional meals to processed foods, along with sedentary lifestyles, socio-economic factors, cultural factors (such as media and beauty standards), parental lifestyles, etc., are all contributing factors to childhood obesity.

• Children living with obesity often struggle with health challenges such as cardiovascular diseases, sleep apnoea, type 2 diabetes, musculoskeletal problems, stigma, social withdrawal, depression and anxiety.

• Preventive measures such as cultivating healthy eating habits and lifestyles, promoting physical activity, implementing primary healthcare interventions and school health-based policies, strengthening regulatory food oversight and comprehensive public awareness can help control childhood obesity in African countries. 

 

Introduction 

Obesity is rapidly increasing as a public health concern in Africa, shifting from primarily an adult issue to one that now also impacts children. In 2019, Africa was home to 24% of the world’s overweight children aged under 5. A World Health Organization [WHO] analysis reported in 2022 predicted an increase in obesity by 2023 among adults from 13.6% to 31% and from 5% to 16.5% in children and adolescents. This means that nutrition problems in African children are gradually moving from under-nourishment to obesity.

In this article, you will learn about the causes of childhood obesity in African countries and how it can be prevented to promote healthy children.

 

What is Obesity?

Obesity is characterised by excessive deposits of fat in the body that can cause damage to the health of an individual. It can also be described as an above normal body weight for height. Obesity is commonly diagnosed in adolescents and adults by calculating the body mass index [BMI]. In children, it is diagnosed when weight-for-height rate is greater than 3 standard deviations above the WHO Child Growth Standards median. Recent studies have shown that measuring the waist circumference or waist-to-height ration are more accurate ways of diagnosing obesity in Africans (adults and children alike) who tend to accumulate body fat around the abdomen.

 

Global Trends versus the African Situation

In 2024, the World Health Organization [WHO] estimated that 35 million children under the age of 5 were overweight. Globally overweight/obesity prevalence rose by 47.1% in children over the last decades. 

The prevalence of obesity among children under 5 years of age in Africa was estimated at 4.9% in 2022, which is below the global estimate of 5.6%. However, there are variations in the prevalence of obesity across different parts of Africa.

Statistics reported in 2023 by the Africa Regional Overview of Food Security and Nutrition indicated a higher prevalence in Northern and Southern Africa [South Africa and Botswana had the highest prevalence]. Northern Africa takes the lead in comparison to other sub regions.

In the Sub-Eastern region of Africa, high prevalence of obesity was reported in Comoros 9%, Rwanda 7.76% and Mozambique 7.39%. The Western region of Africa was recorded to have already achieved the 2030 World Health Assembly target (i.e., reduction and maintenance of the prevalence of childhood overweight to below 5%) for obese children.  

General indications are that children living in urban settlements were more likely to be obese than those living in rural settlements. Many low- and middle-income countries within Africa face a double burden of obesity and undernutrition.

 

Understanding the Causes of Childhood Obesity in Africa 

Causes of obesity. AI generated. iImage credit Gemini. Click image to enlarge.

 

Childhood obesity can be caused by: [1, 2]

• Nutritional transition
• Sedentary lifestyle
• Socio-economic factors
• Cultural factors
• Genetics
• Parental and early life factors
• Medical conditions and medications
• Sleep. 

Nutritional Transition

There has recently been a shift from the consumption of traditional meals, rich in fibre and adequate nutrients, to overly ultra-processed foods [fast foods, sugary beverages, snacks]. These ultra-processed foods and quick-fix meals are readily available and aggressively marketed in urban settlements within Africa.

Sedentary Lifestyle

The World Health Organization recommends an average of 60 minutes of moderate-to-vigorous intensity physical activity for children aged 5- 17 years per day, across the week. Prolonged screen time, lying down or generally living an inactive life, contributes to obesity in African children.

Socio-economic Factor

The impact of socio-economic status on obesity affects both high- and low-income families. Children living in neighbourhoods with low-income status have less access to recreational centres, which results in a sedentary lifestyle. The urbanization and westernisation of parts of Africa, give children born in high-income homes access to fast foods that are energy-dense.  

Cultural factors

There are a lot of cultural factors that may lead to obesity. Some of these factors include:

• Beauty Standards: Plumpness or a larger body size is considered as a sign of healthy and wealthy living in some cultural context. 

• Parental Eating Habits: Parents act as the role models and food environment gatekeepers for young children. By controlling the availability of food and modelling preferences [healthy or unhealthy], they directly pass on dietary habits. Furthermore, common parental feeding practices such as using food as a reward, or pressuring children “to clean their plate” can impair a child’s ability to self-regulate food intake significantly contributing to the risk of obesity.

• Urbanization and Education Pressure: The spread of urbanization raises safety concerns that cause parents to restrict outdoor play. This restriction combined with the persistent cultural emphasis on academic excellence at the expense of physical activities directly promotes sedentary lifestyles in children.

• Accessibility to Fast Food Outlets: The close proximity of fast food outlets to schools, makes them a convenient and routine gathering place for students after school, leading to frequent consumption of high energy-dense snacks and meals.

• Media: Aggressive marketing of unhealthy foods and drinks, creates more demands for these products.

Genetics

Genes play a crucial role in the ability of children to gain excessive weight. Some children inherit traits that make it easier for them to gain weight. Parental obesity is also a strong risk factor for excess weight in children.

Predisposing genes for obesity can interact with environmental factors and be amplified or reduced accordingly.

Parents and Early Life Factors

The parental environment during the preconception period can influence the emergence of excess weight in childhood. Specifically maternal obesity is associated with a greater risk of obesity in an offspring, but paternal influence is also significant; the father’s obesity status prior to conception is also a risk factor for obesity in childhood. Other preconception environmental risk factors for obesity in an offspring include: smoking, maternal stress, exposure to air pollutants and assisted reproduction. [1] 

Excessive maternal weight gain during pregnancy increases the risk of babies who are born large-for-gestational age, and these infants are at greater risk of obesity in later life. Maternal illnesses such as gestational diabetes can lead to the overnutrition of the foetus primarily as a result of maternal hyperglycemia during pregnancy. [1] Other factors include exposure to endocrine disruptors which can cause epigenetic changes that influence obesity risk.

A short duration of exclusive breastfeeding and the premature introduction of solid foods - especially sweetened beverages, processed food and snacks are risk factors for obesity.

Medical conditions and Medications

Although uncommon in children, certain diseases such as hypothyroidism, growth hormone deficiency and Cushing’s syndrome can be contributing factors to the onset of obesity. So can some medications prescribed in specific condition that act through stimulating appetite, interfering with glucose metabolism (breakdown) and storage, water retention and decreased energy use. 

Sleep 

Inadequate quantity and quality of sleep increases the chances of obesity. Short sleep duration is associated with changes in the hormonal metabolism that regulates appetite. 

 

What are the Consequences of Childhood Obesity?

Image illustration of the consequences of obesity. Image credit Gemini

 

The consequences of childhood obesity are far-reaching, fundamentally affecting a child’s physical health, mental state and social integration. Let’s examine these diverse consequences.

Health Consequences

Childhood obesity significantly increases the risk of non-communicable diseases (NDC) such as:

• Cardiovascular diseases e.g. abnormal cholesterol levels, heart failure.
• Hypertension [high blood pressure]
• Sleep apnoea 
• Type 2 diabetes
• Musculoskeletal problems: impaired balance, increased joint pain and reduced muscle strength at the lower limbs.
• Insulin resistance
• Asthma 

These diseases often continue into adulthood, reducing quality of life and creating long-term risk for chronic diseases.

Social Consequences

Children living with obesity often face significant stigma. This frequently manifests as bullying and constant ridicule within their school, home, and community. Furthermore, they are often excluded from physical activities, because they are perceived as being slower or less capable than their classmates. Over time this emotional toll can interfere with learning, ultimately contributing to poor academic performance and self-imposed social withdrawal.

Psychological Consequences

The medical and social effects of obesity place a significant toll on the mental well-being of children living with the condition. The most notable psychological consequences include: 

• Low self esteem 
• Negative body image
• Eating disorders
• Depression 
• Anxiety
• Self-isolation/ Social withdrawal 

 

How can Childhood Obesity be prevented?

To effectively prevent and reduce the incidence of overweight/obesity among children in Africa, the following key measures can be taken: [2]

• School Health-Based Policies:
  • Implementation of school health programs and policies that prioritise the nutritional well-being of African children. This can be achieved by:

• Mandating schools to serve healthy and nutritious meals or snacks that meet dietary guidelines and nutritional needs of school children.

• Actively educating parents on the importance of preparing and sending their children to school with healthy, balanced homemade meals instead of nutrient-poor foods.

• Limiting the sales of junk food within and around the school environment.

• Strengthen Regulatory Food Oversight: Regulatory bodies overseeing food consumption within African countries should ensure that all food items – whether domestically or imported adhere to health standards and cater to the nutritional needs of African children.

• Developing Physical Education in Schools: The following actions can be taken to encourage physical activity participation in African schools: 

• Enhance physical education programs and dedicate class time to foster active and mandatory physical activity participation. 

• Provide standard, well-maintained sports and games equipment and facilities to create variety and effectively promote physical fitness. 

• Create a supportive school environment that encourages healthy habits and actively supports all children, including those who are reluctant to participate in games and sports.

• Promote Physical Activity: Create opportunities for children to engage in outdoor play and physical activities through fun, energy-expending games and sports. Concurrently, parents must enforce clear limits on screen time and other sedentary behaviours. 

• Comprehensive Public Awareness: Develop and execute public awareness campaigns and support initiatives to significantly improve parental and community knowledge regarding the risks, prevention and management of obesity.

• Primary Healthcare Interventions:
  • Primary healthcare centres should play a critical, multi-faceted role in preventing obesity: 

• Healthcare providers must actively educate parents on the consequences of obesity in children. It is also crucial to discredit the harmful notion that excess weight is a sign of healthy growth and development.

• Carry out targeted enlightenment programs in communities, promoting and supporting exclusive breastfeeding for the first six months of a child’s life. 

• Offer in-depth nutritional counselling for pregnant and nursing mothers. This education should also extend to fathers, addressing how traits associated with excess weight can be passed on epigenetically to the foetus. 
   

• Cultivate Healthy Eating Habits and Lifestyles:
  • Families should be educated on the importance of a healthy diet that emphasises grains, fruits and vegetables. They can also take an active role by:
  • Modelling healthy eating behaviours that children can mimic

• Encouraging the transition back to healthy traditional African meals in place of over-processed alternatives.

• Practicing appropriate portion control and establishing consistent meal times. 

• Data and Monitoring Systems:
  • Create and maintain reliable data collection systems to monitor overweight/obesity trends within Africa. Systematically tracking and evaluating the effectiveness of all implemented intervention methods.

 

Conclusion

Childhood obesity in Africa should not be misinterpreted in cultural sense as a sign of wealth, healthy growth or a beauty standard. Rather it must be considered as a serious health condition that poses significant long-term health risks to a child’s well-being.

To successfully address this challenge, a unified approach is required. Parents, schools, policy makers, healthcare providers and others must work together productively to ensure that the nutritional needs of the African child for healthy growth are fully met. 

The government has a key responsibility to monitor and control food production within African countries, making certain that health guidelines are duly followed. Furthermore, childhood obesity trends within Africa should be regularly monitored and implementation of preventive methods effectively enforced.

 

References:

1. Nogueira-de-Almeida CA, Weffort VRS, Ued FDV, Ferraz IS, Contini AA, Martinez EZ, Ciampo LAD. What causes obesity in children and adolescents? Jornal de pediatria. 2024;100 Suppl. 1: S48 -S56. Available from here.

2. Klingberg S, Draper CE, Micklesfield LK, Benjamin-Neelon SE, van Sluijs EMF. Childhood Obesity Prevention in Africa: A Systematic Review of Intervention Effectiveness and Implementation. International Journal of Environmental Research and Public Health. 2019; 16(7):1212. doi: 10.3390/ijerph16071212. Available from here.

 

Related:

Fighting the Growing Obesity Epidemic in South Africa 

Estimating Chronic Health Risks in Africans: Is Waist Circumference Better than BMI?

What BMI Tells You about Your Health Status as an African

 

 

Published: December 2, 2025

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