Health workers in Orange Farm, south of Johannesburg, say poor diets, little exercise and unsafe play spaces are putting adolescents at risk in a country already burdened by high obesity rates.
Community health worker Mapule Mbhele from Barney Molokoane Clinic in Orange Farm says unhealthy eating habits often start early.
According to Mbhele, many children are eating sweets, snacks, sugary drinks and other processed food from a young age.
This is the reality for 16-year-old *Precious Myeni, who says unhealthy eating has become routine.
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Precious, who lives with her mother and two siblings, says she has been gaining weight since she was about 10 years old. Today she weighs 95kg.
"I enjoy snacks, chips, sugary drinks and kota," she says. "At school I eat from the feeding scheme, but I also buy snacks and juice. At home, we eat basic food like fat cakes, bunny chow and porridge. We deep-fry meat and do not really control portion sizes."
To make matters worse, says Mbhele, fruit, vegetables and regular physical activity are often missing from their daily lives.
Princess says she does not participate in sports or regular exercise.
"I spend my time watching television and being on social media while lying in bed," she says. "At school I am mostly sitting. I walk to school - that is the only activity I do."
Life-terms effects
Speaking to Health-e News at a World Obesity Month roundtable in Sandton this week, specialist physician and endocrinologist Dr Reyna Daya said childhood obesity can have long-term health consequences that start earlier and last longer.
"If someone is obese as a child, they are more likely to continue being obese as an adult," she says. "That means they may develop conditions like diabetes and high blood pressure much earlier, in their 20s or 30s, instead of later in life."
Daya says this can affect a person's health, ability to work and support their families.
"We're seeing obesity starting younger now - in teenagers, adolescents and sometimes even in children under the age of 10," she says.
Delayed interventions
Mbhele says clinic staff and community health workers regularly do health talks, outreach work and door-to-door visits to encourage healthier lifestyles. She says despite these efforts, more children and adolescents are struggling with overweight and obesity.
"Parents often want to correct eating habits of children when the child's life is in danger or they are already sick," she says. "In our marginalised communities like Orange Farm, child obesity is often embraced and associated with being healthy."
Precious' mother, *Boitumelo Myeni, says she wants to support her daughter to become healthier.
"Precious cannot walk for a long time, we hardly go out, she wants to be seated or lying down," she says.
"I will be accompanying her to the clinic just to check if there are any health risks and how she can lose weight correctly without endangering herself."
Boitumelo says families eat what is easiest to find and prepare.
Access and affordability
Registered dietitian and nutritionist Azi Booi says obesity in low-income communities is not just about personal choice.
"The main drivers are definitely access and affordability," she says. "You might find that one grant is supposed to feed the whole family, so people go for foods that make you feel full quickly, but that can lack nourishment, fibre, protein and variety."
Booi says school and community food environments also shape what children eat.
"Tuck shops and spaza shops often promote convenient foods, sugary drinks and snacks. They feel more affordable, and children enjoy them, so they become part of daily life," she says.
Booi says families and clinics should focus on encouraging healthier habits without shaming children.
"Trying to encourage more variety and helping children enjoy what healthy eating looks like is important," she says. "Sugary drinks should become less of a part of the daily diet and more occasional. The more children are exposed to healthier foods and lifestyle changes, the better."
Nutrient-poor, ultra-processed "poverty foods"
The Just Transition in the Food System group, a coalition of food justice and health advocates, says affordability remains critical. In a recent submission to the SA Human Rights Commission's food systems inquiry, the group says many poor households rely on cheap, highly processed 'poverty foods'. The network of organisations says that high food prices are driving South Africa's growing obesity crisis.
A 2025 South African Journal of Clinical Nutrition study, led by Wits-affiliated researchers, found that overweight and obesity are especially common among adolescent girls in urban areas. The findings suggest that the problem is not limited to one community.
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The study highlights a wider 'triple burden of malnutrition' - underweight, micronutrient deficiencies and obesity exist side-by-side.
The daily reality
*Lebogang Seema, 15, says she likes her body but struggles with confidence.
"I am body-shamed and mistaken for being old," she says. "I started gaining weight when I was about 13 years old."
Today Lebogang weighs 80kg and says she is often tired and spends a lot of time sleeping or eating. She says there are few safe places for children in her area to play or take part in sport.
"At home we eat basic food like fatcakes, bread, porridge, sodas and chips, which are my favourites," she says.
Her mother, *Sarah Seema who is 40 years old, says she worries her daughter may face the same health problems she now lives with.
"I started like her, but today I can barely walk for 10 minutes," she says. "We need to start eating correctly. It's hard, but we can try." - Health-e News
*Not their real names
*Additional reporting by Adel van Niekerk and Ina Skosana
