In Kenya, and across Africa, an unexpected epidemic: Obesity


Valentine Akinyi talks with her son, Driffal, 11, outside their Nairobi home in the Kibera section of the city. PHOTO/Andrew Renneisen/The New York Times

As she walks through the alleyways of her poor neighborhood, to a job washing other people’s clothes, Valentine Akinyi weathers the jeers yelled at her: “Elephant, elephant, elephant.”

She has gotten used to the insults, she said, but still, it hurts.

“Who’s going to want to marry me?” she asked.

It used to be difficult in Kenya to find many people built like Ms. Akinyi, who, at 5 feet 9 inches tall and 285 pounds, is obese.

In Africa, the world’s poorest continent, malnutrition is stubbornly widespread and millions of people are desperately hungry, with famine conditions looming in some war-torn countries.

But in many places, growing economies have led to growing waistlines. Obesity rates in sub-Saharan Africa are shooting up faster than in just about anywhere else in the world, causing a public health crisis that is catching Africa, and the world, by surprise.

In Burkina Faso, the prevalence of adult obesity in the past 36 years has jumped nearly 1,400 percent. In Ghana, Togo, Ethiopia and Benin, it has increased by more than 500 percent. Eight of the 20 nations in the world with the fastest-rising rates of adult obesity are in Africa, according to a recent study by the Institute for Health Metrics and Evaluation at the University of Washington.

It is part of a seismic shift in Africa as rapid economic growth transforms every aspect of life, including the very shape of its people.

Many Africans are eating more junk food, much of it imported. They are also getting much less exercise, as millions of people abandon a more active farming life to crowd into cities, where they tend to be more sedentary. More affordable cars and a wave of motorbike imports also mean that fewer Africans walk to work.

Obesity may be an especially tough battle in Africa for other reasons. For one, people who did not get enough nutrients when they were young (which is still a problem in Africa) are more prone to putting on weight when lots of food is available. And second, African health systems are heavily geared toward combating other diseases.

African doctors say their public health systems have been so focused on AIDS, malaria, tuberculosis and tropical fevers — historically, Africa’s big killers — that few resources are left for what are called noncommunicable diseases, like diabetes and heart ailments.

“What we are seeing is likely the worst epidemic the country will ever see, probably in the long run worse than the H.I.V. epidemic of the ’90s,” said Anders Barasa, a cardiologist in Kenya, referring to obesity and its related diseases. “But changing the health care system to cater for obesity related diseases is like turning a supertanker.”

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