Why women are most at risk in Africa's obesity crisis

Almost half of women in Africa will be obese or overweight by 2030, according to a new study, an "alarming rise" that has been "compared with the HIV epidemic", said The Guardian.

Unlike in most regions, where the obesity gender gap is "much smaller, or reversed", women in Africa are almost twice as likely to be overweight or obese as men. The latest data from the World Obesity Federation suggests that, similarly to HIV, stigma and lack of access to treatment have a "disproportionate impact on women". And that trend is "accelerating".

Why are women affected more than men?

Africa is grappling with rising obesity rates linked to the "proliferation of unhealthy diets" and increasingly sedentary lifestyles, said regional experts on The Conversation. This has a gendered element: women often stay at home caring for children and have "more sedentary lifestyles", while men "typically work outside the home". Women are also "stereotypically expected to gain weight after marriage as a symbol of their husbands' wealth and marital bliss".

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There are cultural factors at play too. In many African countries, it is "more culturally acceptable for women to have excess weight, and in some cases is desirable", Johanna Ralston, CEO of the World Obesity Federation, told The Guardian.

Urbanisation plays "a major role" in driving obesity across the continent, said Nomathemba Chandiwana, obesity specialist and chief scientific officer at the Desmond Tutu Health Foundation in South Africa. "Many African cities lack safe spaces for physical activity," she told the paper; "long working hours" and "safety concerns" make exercise that much harder for women.

Workers from rural areas taking low-paid city jobs "far from home" eat outside their homes "as much as the rich do", said The Economist. Many "flock to street stalls" that sell sweets and processed food. "Junk food is everywhere."

And while people in developed nations have long been assailed with anti-obesity campaigns, in much of Africa "few people are educated about the risks" of excess weight. Poor mothers "feed babies fizzy drinks and sugary juices alongside breast milk".

Drawing on the lessons of HIV

In Africa, obesity "feels like HIV but more compressed", said Chandiwana. "We've got a disease we don't quite understand, it's there, we're not doing much about it. The drugs are kind of there, but not available. Stigma is also an issue. So you can make a lot of parallels."

HIV treatments "add another layer" to the gender gap, she said. In countries with high HIV rates, such as South Africa, weight gain related to antiretroviral drugs is "becoming more noticeable" and "disproportionately affecting women".

But the parallels could also spark positive action. In South Africa, where more than half the adult population (and more than two-thirds of women) are overweight or obese, society is "drawing on the lessons from tackling the HIV epidemic" and "pulling together to address obesity", said the World Health Organization.

In the early 2000s, health advocates and doctors "famously fought the fight – and won – to reduce the stigma around HIV and Aids". This is "valuable experience for current efforts to reduce stigma around obesity", and facilitate access to health services and new medications.