A new cross-sectional descriptive study published in the journal PLOS One on December 22, 2025, has revealed significant obesity variation in Africa.
South Africa had the highest prevalence at 30.8 per cent, followed by Eswatini (30.1 per cent) and the Seychelles (29.4 per cent), while Ethiopia (2.8 per cent), Madagascar (4.3 per cent), and Eritrea (4.8 per cent) reported the lowest rates.
The top 10 countries by prevalence were South Africa, Eswatini, the Seychelles, Algeria, Mauritania, Lesotho, Gabon, Botswana, Mauritius, and Namibia. The bottom 10 countries included Ethiopia, Madagascar, Eritrea, Rwanda, Burundi, Niger, Central African Republic, Malawi, Democratic Republic of Congo, and Sierra Leone.
The study also reveals that across nearly all countries, women exhibited considerably higher obesity prevalence than men.
In South Africa, female obesity prevalence was 45.8 per cent, compared to 13.9 per cent in men a difference of 31.8 percentage points. Large sex disparities were also observed in Eswatini (difference: 28.8), Mauritania (26.1), Lesotho (24.2), Equatorial Guinea (21.8), and Seychelles (19.4).
In contrast, only a few countries, such as Burundi, Chad, and Madagascar, showed negligible or slightly higher obesity prevalence among men.
Adult obesity is increasing in many African countries, often alongside persistent undernutrition. This coexistence creates a growing double burden of malnutrition with serious health, social, and economic consequences.
Despite growing attention to obesity in Africa, comparable, up-to-date, sex-disaggregated estimates remain limited. Existing studies often focused on individual countries or subregions, relied on heterogeneous methods, or draw on data collected at different times, making cross-country comparisons difficult. These limitations have obscured a clear understanding of the scale and distribution of sex disparities in obesity and constrained efforts to design context-appropriate interventions.
To address these gaps, the current study provided comparable, sex-disaggregated estimates of adult obesity prevalence (body mass index (BMI) of 30 or higher) across 47 African countries.
The data were primarily from 2022 and obtained from the World Health Organization Health Equity Assessment Toolkit (HEAT), covering adults aged 18 years and older.
These disparities reflect the sociocultural, economic, and biological factors influencing obesity risk, including urbanisation, dietary transitions, and gender norms.
The pronounced sex disparity points to the need for context-specific, sex-sensitive interventions and policies to effectively address obesity and its health consequences.
Policymakers and health practitioners should prioritise multi-sectoral strategies that promote healthy diets and physical activity and address the unique barriers faced by women, the authors noted.
Strengthened surveillance and further research are also essential to better understand the determinants of obesity and to monitor progress toward reducing health inequities across Africa, including through fiscal, regulatory, and community-based actions tailored to women’s needs, they added.