The World Health Organization estimates that 22 million children worldwide aged <5
years are overweight and highlights tackling childhood obesity as an urgent priority.
Childhood obesity is rising to epidemic proportions in the developing world, reflecting
changing physical activity levels and dietary intakes, adding a significant public health
burden to countries where undernutrition remains common. Interventions to prevent
childhood obesity have had disappointing results, because the science and aetiology of
obesity is poorly understood and prevention programmes have not targeted appropriate
behaviours nor adequately engaged communities being studied.
The origins of obesity appear simple – excess energy intake and/or low energy levels
expended on physical activity, leading to chronic energy imbalance. However, the
problem is more complex with underlying societal, behavioural and genetic causes of
energy imbalance remaining unclear. Obesity is driven by individual, household and
community factors: research to date has concentrated on individual factors with almost
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Findings from studies in developed countries are unlikely to be applicable to rural African
settings where there is an increasing transition from a state of undernutrition to that of
overnutrition. Few data exist on the prevalence of child and adolescent obesity from low
and middle income countries like South Africa. This thesis aimed to determine the
prevalence of overweight and obesity in children and adolescents (aged 7-15 years)
within this population and to identify possible risk factors.