How sugar addiction is driving South Africa's obesity crisis

South Africa is currently grappling with a concerning obesity crisis that is escalating at a rate faster than many Western nations, with sugar addiction emerging as a principal culprit.

The 2025 World Obesity Atlas suggests that excessive sugar consumption is intricately linked to rising obesity rates and myriad non-communicable diseases, including diabetes and heart disease, which collectively account for approximately 63% of deaths in South Africans under 70.

Dr Tommie Smook, a medical practitioner, highlights that sugar's impact extends far beyond physical appearance, significantly elevating the risk of serious health issues such as high blood pressure, heart disease, type 2 diabetes, and depression.

“This is no longer just about weight - it’s about survival and quality of life,” he said.

Research highlights a staggering increase in sugar intake, with South Africans consuming almost three times more than they did five decades ago.

The rise is predominantly attributed to the growing prevalence of ultra-processed foods, which Dr Smook points out notably contain hidden sugars in cereals, sauces, and “natural” fruit juices.

“We’re in a war with sugar, and sugar is winning. It hijacks the brain’s reward system, creating cravings and withdrawal symptoms. A soda contains about seven teaspoons of sugar - enough to keep the cycle going,” said Smook.

Smook further explained that over time, excess sugar raises blood pressure, inflames blood vessels, and builds up visceral fat around organs.

“This creates the perfect storm for heart attacks and strokes, which is already placing immense strain on South Africa’s health system,” he warned

Smook said GLP-1 therapies, originally for diabetes, are now a global breakthrough for sugar addiction and weight loss.

These treatments mimic natural hormones, reducing cravings, slowing digestion, and promoting fullness for safe, steady weight loss.

Beyond weight, he said GLP-1s stabilise blood sugar and insulin, lower blood pressure, reduce inflammation, and improve heart health by enhancing blood vessel health, cholesterol levels, and cardiovascular function.

“Within weeks, patients notice fewer cravings, improved appetite control, and steady weight loss. Combined with lifestyle changes, this represents the future of preventative health, protecting South Africans’ hearts while helping them feel good in their own skin again,” stated Smook.

In response to this urgent health crisis, Pharma Dynamics and the Heart Stroke Foundation SA (HSFSA) have launched the Low Sugar booklet, the eighth edition of its award-winning Cooking from the Heart series.

This guide aims to aid the public in recognising hidden sugars and making healthier food choices.

Pharma Dynamics spokesperson Nicole Jennings said sugar is a silent contributor to a national health crisis, largely unknown to most South Africans, with the daily sugar intake significantly surpassing safe limits.

The booklet emphasises the serious health issues associated with consuming too much sugar, such as obesity, type 2 diabetes, high blood pressure, cardiovascular disease, and tooth decay.

Jennings said the prevalence of these lifestyle diseases is rising at a worrying rate in the country.

“Much of this can be traced back to unhealthy eating patterns, sedentary lifestyles, and a lack of awareness about what’s really in the food and drinks we consume daily,” she said.

One of the major challenges the booklet addresses is the high quantity of hidden sugars in processed and packaged foods, from breakfast cereals and flavoured yoghurts to sauces, energy drinks, and so-called “health” snacks.

Jennings said many of these products contain sugar under unfamiliar names, making it harder for consumers to identify and limit their intake.

Prof Pamela Naidoo, CEO of the HSFSA, said in many cases, people think they’re making healthier choices, not realising just how much added sugar they’re ingesting.

“The booklet includes comprehensive sugar charts, clearly showing the sugar content of commonly consumed foods and drinks in South Africa. It empowers people to make better decisions for their health,” she said.

Naidoo warned that if a food item tastes very sweet, then the chances are there are unacceptably high levels of sugar in that item.

According to the World Health Organization (WHO), adults should consume no more than six teaspoons or 30 grams of sugar per day.

However, Jennings said the average South African consumes between 12 and 24 teaspoons of sugar daily, with up to eight teaspoons coming from sugar-sweetened beverages alone.

“These drinks deliver sugar in liquid form, which is absorbed rapidly and causes blood sugar spikes… They also provide no nutritional value or satiety, making them a dangerous source of empty calories,” she said.

The booklet offers practical guidance for reducing sugar intake through 11 simple, sustainable strategies.

These include gradually cutting back on sugar added to tea, coffee, cereal, and porridge, and replacing sugar-laden beverages with healthier options like water, herbal tea, or unsweetened drinks.

Smook also advises caution with “low-fat” products due to their high sugar content, suggesting a focus on whole foods and natural sweeteners like cinnamon, citrus zest, or vanilla.

The booklet encourages the public to become more label-savvy by learning how to spot hidden sugars under various names and paying close attention to portion sizes and serving information.

Other tips include avoiding sugar-heavy breakfast options like sweetened cereals and muffins, and instead choosing protein- and fibre-rich foods, such as oats with fruit or eggs and vegetables.

The booklet also highlights the sugar content hidden in sauces and condiments, suggesting flavourful alternatives like herbs, spices, lemon juice, and vinegar.

It encourages people to shift towards whole foods, such as vegetables, legumes, whole grains, and unprocessed proteins, and to steer clear of highly processed items like sugary snacks, cereals, and fast food.

In addition, the booklet promotes the inclusion of healthy fats like avocados, nuts, and seeds to curb sugar cravings, while cautioning against misleading “health” snacks that may contain as much sugar as sweets.

“The guide also explains the link between sleep deprivation and sugar cravings, urging readers to prioritise adequate rest, and reinforces the value of mindful eating as a powerful tool for making more intentional, health-focused choices,” Jennings said.

She stated that medicine alone is not enough; the focus is on holistic wellness supporting healthier lifestyles that reduce the risk of disease before it starts.

Jennings added that the Cooking from the Heart series demonstrates that eating for your heart does not have to be bland or restrictive. “You can eat well, with joy and flavour, while still looking after your health.”

Professor Naidoo stressed the importance of early intervention.

“We’re seeing a rise in lifestyle diseases, even among children. Educating the public about nutrition and giving them the tools to make healthier choices is critical. This booklet is a valuable step toward a healthier nation,” she said.

Naidoo said being overweight and obese is now being considered a medical condition.

“If you have been diagnosed with the condition of obesity, mindful consumption of food low in sugar, together with mindful eating of a balanced diet, will go a long way towards overall health,” she said.

The Low Sugar booklet is freely available online at www.mydynamics.co.za, including the full collection of Cooking from the Heart resources, while Hearty can be accessed via www.heartyfood.co.za

Have thoughts on this topic or other subjects you’d like us to explore? Want to share your experiences? Reach out to me at karen.singh@inl.co.za – I’d love to hear from you!