Obesity and excess weight gain, traditionally perceived as health issues predominantly affecting high-income countries, are now increasingly prevalent in low and middle-income regions.
Sub-Saharan Africa, in particular, is no longer a continent just grappling with hunger and starvation — it is now also dealing with citizens who are obese and overweight. This primarily due to the proliferation of unhealthy diets and lifestyles.
The increasing prevalence of obesity can be attributed to rising incomes, increasingly sedentary lifestyles, the adoption of western cultures and the consumption of processed foods high in fat, sugar and salt.
The health risks associated with weight gain are severe, with more people dying from weight and obesity-related diseases than from undernutrition. In Africa, the mortality rate from weight-related non-communicable diseases such as cardiovascular disease, diabetes, strokes and certain cancers is also rising rapidly.
The increasing prevalence of over-nutrition, when nutrient intake exceeds one’s physical activity level and metabolism, is creating a double malnutrition burden as Africa continues to grapple with under-nutrition.
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African women and obesity
In Africa, women are more likely to be overweight and obese than men. In the sub-Saharan African region, for example, women are up to 10 times more likely to be obese than men.
Read more:
Obesity is on the rise among South African women — a risk to maternal and child health
In many African countries, economic development is more likely to lead to weight gain in women than in men. This is because women often assume the role of stay-at-home mothers due to childcare and unpaid domestic responsibilities, while men typically work outside the home.
Stay-at-home mothers tend to have more sedentary lifestyles, which increases the risk of weight gain.
African women are stereotypically expected to gain weight after marriage as a symbol of their husbands’ wealth and marital bliss. This panders to the prevailing notion that the wealth of an individual in an African society is reflected in her body weight.
Our recent study in the journal Review of Development Economics specifically examined how local economic development specifically impacts weight gain among African women.
Measuring local economic development
Economic development is a primary factor contributing to rising obesity rates in developing countries. It has become the norm to measure economic development at the national level as a driver of weight gain.
However, this approach has limitations because obesity is measured at the individual level, while economic development is assessed at the state or country level.
Measuring economic development at the national level doesn’t account for uneven distributions of economic activities and income inequality, which can lead to an uneven spatial distribution of obesity. Without accurate local data, proper identification becomes difficult.
Because local economic statistics are often unreliable, researchers commonly use night light intensity as a proxy for economic activity at the local level.
This data is gathered from the Visible Infrared Imaging Radiometer Suite, which records daily light data at a fine level of detail. Our research used night light intensity data as a measurement of local economic development in sub-Saharan Africa.
Local economic development and weight gain
Our research argues that an increase in local economic development causes an increase in body mass index and a greater prevalence of obesity or overweight.
Economic development is often accompanied by technological change that reduces labour-intensive or agricultural-focused types of work and replaces them with less active and service-oriented types of work.
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Additionally, economic development introduces technologies that promote sedentary leisure pursuits, such as TV viewing, browsing the internet or using social media. These changes encourage inactive and unhealthy lifestyles and reduce the need for physical activity. Increased use of cars as a mode of transportation also reduces the need for physical exertion.
However, higher levels of economic development can also contribute to reduced weight gain in different ways:
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Education: Higher levels of education are associated with greater development. Educated people often have increased access to the internet and social media platforms can make obesity-reducing knowledge and ideas more accessible.
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Health innovation: Advances in health innovation accompanies higher development because health technologies, such as in-home blood pressure monitoring equipment, become more affordable and accessible.
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Income: Higher incomes enable people to access technologies, gyms, and healthier food that help in weight reduction.
What can be done?
The increasing rate of obesity in sub-Saharan Africa has led to the proposal or implementation of a sugar tax in countries like South Africa and Ghana. Other countries, such as Kenya, Tanzania, Rwanda, Namibia, Botswana and Zambia, are considering it as well.
But this is not enough on its own — especially if the revenue accruing from these sugar taxes isn’t invested in the health care and physical infrastructure needed to promote active lifestyles.
Read more:
South Africa needs more than a sugar tax to get to the bottom of obesity
Increased economic activity can negatively impact public health, making it essential for African governments to allocate a significant portion of economic gains from development towards building health infrastructure, such as hospitals and clinics.
When constructing physical infrastructure, the emphasis should also be on creating recreational centres, bicycle lanes and sidewalks to discourage sedentary lifestyles. Revenue should be specifically earmarked for health infrastructure, not just to boost domestic revenue.
Wealth creation should not be seen as detrimental solely because it may lead to higher rates of weight gain or obesity. Instead, the focus should be on educating and raising awareness among the population about the health risks associated with weight gain. Health campaigns must be intensified to effectively reach a large portion of the population, particularly women in developing countries, where obesity prevalence is higher.
Sylvanus Kwaku Afesorgbor receives funding from the African Economic Research Consortium (AERC), the United States Department of Agriculture (USDA), and the Ontario Ministry of Agriculture and Rural Affairs (OMAFRA). He is the Executive Founder of the Centre for Trade Analysis and Development (CeTAD Africa) based in Ghana.
Edward Martey receives funding from the Consortium of International Agricultural Research Centers (CGIAR), the Bill and Melinda Gates Foundation (BMGF), the United States Department of Agriculture (USDA), and the International Fund for Agricultural Development (IFAD).
Justice Moses K. Aheto receives funding from the World Health Organization, Bill and Melinda Gates Foundation, National Institute of Health, Japan International Cooperation Agency, and European Union. He is affiliated to the London School of Hygiene and Tropical Medicine – UK, WorldPop at the University of Southampton – UK, College of Public Health at the University of South Florida – USA, and the University of the Gambia – Gambia.
