One in three South Africans now obese: Urgent action needed to combat rising sugar addiction

In a stark revelation from the latest World Obesity Atlas 2025, it has been reported that one in three South Africans is now classified as obese, a concerning trend that sets the nation on a course towards a public health crisis.

With alarming predictions that half of all women may fall into the obese category within just five years, experts are calling for immediate and decisive action to address this escalating issue, with sugar addiction at the forefront of the battle.

Dr Tommie Smook, of Dr Smook & Partners and co-owner of practice manager RXME, notes that obesity is no longer merely a question of aesthetics, but a matter of survival. "With a Body Mass Index (BMI) of 25 marking the threshold for being overweight, and a BMI of 30 indicating obesity, the implications of excess weight penetrate deep into societal health," he warns.

"During September, recognised as Heart Awareness Month, it's crucial to highlight the wide-ranging impacts of sugar consumption that extend far beyond the waistline."

According to Dr Smook, high sugar intake significantly increases the risk of developing serious health conditions such as hypertension, heart disease, type 2 diabetes, and even depression. Currently, approximately 63% of South Africans under the age of 70 succumb to non-communicable diseases, with excess weight prominently featured as a critical risk factor.

Sugar’s grip on the body

Sugar lurks in many everyday products, from cereals to sauces, and even in fruit juices that proudly claim to be "100% natural". Over the past 50 years, research indicates that South Africans are consuming nearly three times more sugar than before, primarily driven by a surge in ultra-processed foods.

According to Dr Smook, "We’re in a war with sugar, and sugar is winning," as it activates the brain's reward system, leading to insatiable cravings and withdrawal symptoms. For example, just one soda contains approximately seven teaspoons of sugar - an insidious cycle that perpetuates unhealthy eating habits."

The repercussions of excessive sugar intake are dire. Dr Smook elaborates, "Over time, this excess raises blood pressure, inflames blood vessels, and leads to a build-up of visceral fat around organs, creating a perfect storm for heart attacks and strokes." Given the immense pressure on South Africa’s already struggling healthcare system, the time to act is now.

Breaking the cycle

Dr Smook advocates for practical, manageable changes to one's diet rather than an all-or-nothing approach to sugar consumption. He suggests several small yet impactful alterations:

Rethink sauces: A spoonful of chutney can contain more sugar than a biscuit; consider using spice rubs or lemon juice as alternatives.

Skip flavoured drinks: Infuse sparkling water with slices of fruit to replace sugary juices or sodas.

Check your cereal: Many mueslis touted as 'healthy’ are laden with sugar; opt for oats complemented with nuts and fresh fruit.

Beware of “low fat”: Often, these products compensate for flavour with loads of sugar - rather focus on whole, unprocessed foods.

Sweeten naturally: Swap sugar in your coffee or baking with cinnamon, citrus zest, or vanilla essence.

Dr Smook emphasises that "these substitutes can retrain your taste buds over time, making sugary foods less appealing as you progress."

The role of medical support

Many individuals find sugar’s alluring grip challenging to overcome alone, which is where GLP-1 therapies come into play. Originally intended for diabetes management, these medications represent a breakthrough in addressing obesity by mimicking the body's natural hormones that control appetite and blood sugar levels. By reducing cravings, slowing digestion, and promoting a fuller sensation after meals, GLP-1 treatments aid in safe, steady weight loss, said Dr Smook.

“As patients begin to notice fewer cravings, improved appetite control, and consistent weight management within weeks, we see the dawn of a new paradigm in preventative healthcare,” says Dr Smook. “It’s about protecting South Africans’ hearts while helping them regain confidence in their wellbeing.”