Sex differences in obesity rates in poor countries: evidence from South Africa

Econ Hum Biol. 2009 Dec;7(3):271-82. doi: 10.1016/j.ehb.2009.07.002. Epub 2009 Jul 17.


Globally, men and women face markedly different risks of obesity. In all but of handful of (primarily Western European) countries, obesity is much more prevalent among women than men. We examine several potential explanations for this phenomenon. We analyze differences between men and women in reports and effects of potential underlying causes of obesity-childhood and adult poverty, depression, and attitudes about obesity. We evaluate the evidence for each explanation using data collected in an urban African township in the Cape Town metropolitan area. Three factors explain the greater obesity rates we find among women. Women who were nutritionally deprived as children are significantly more likely to be obese as adults, while men who were deprived as children face no greater risk. In addition, women of higher adult socioeconomic status are significantly more likely to be obese, which is not true for men. These two factors - childhood circumstances and adult SES - can fully explain the difference in obesity rates between men and women that we find in our sample. More speculatively, in South Africa, women's perceptions of an 'ideal' female body are larger than men's perceptions of the 'ideal' male body, and individuals with larger 'ideal' body images are significantly more likely to be obese.

Publication types

  • Research Support, N.I.H., Extramural

MeSH terms

  • Adult
  • Body Mass Index
  • Body Weights and Measures
  • Cross-Sectional Studies
  • Decision Making
  • Depression / complications
  • Developing Countries / statistics & numerical data*
  • Female
  • Health Status
  • Humans
  • Male
  • Obesity / complications
  • Obesity / epidemiology*
  • Sex Factors
  • Socioeconomic Factors
  • South Africa / epidemiology
  • Urban Population / statistics & numerical data