Prevalence and predictors of overweight and obesity among young adults in Lephalale between 2021 and 2023, Limpopo province, South Africa

Background: Overweight and obesity are rising health concerns in South Africa, increasingly affecting young adults in rural communities, and are influenced by distinct demographic, socio-economic and behavioural factors. Aim: This study aimed to determine the prevalence of body mass index (BMI)-defined overweight and obesity among young adults aged 18–29 years. Setting: The study was conducted in Lephalale, a predominantly rural-industrial area located within the Waterberg District Municipality of Limpopo province, South Africa. Methods: A community-based cross-sectional survey of 1063 adults aged 18–29 years from 42 rural settlements collected data on socio-demographic characteristics, employment, income, government grant receipt, physical activity (International Physical Activity Questionnaire – IPAQ), dietary practices (processed and fast food intake, fruit and vegetable consumption), smoking and alcohol use. BMI was calculated as weight divided by height squared (kg/m2) and classified using WHO criteria. Univariate and multivariable logistic regression analyses identified the predictors of combined overweight and obesity compared with normal or underweight participants. Results: The combined prevalence of overweight and obesity was 35%. Significant independent predictors included age 25–29 years (adjusted odds ratio [AOR]: 2.05; 95% confidence interval [CI]: 1.40–3.00), government grant receipt (AOR: 1.55; 95% CI: 1.05–2.28), daily processed food intake (AOR: 1.85; 95% CI: 1.25–2.73), weekly fast food intake (AOR: 1.70; 95% CI: 1.18–2.45), smoking (AOR: 1.25; 95% CI: 1.00–1.72) and daily alcohol use (AOR: 2.10; 95% CI: 1.35–3.15). Overweight and obesity were prevalent among rural young adults and were associated with socio-economic vulnerability and modifiable lifestyle behaviours. Conclusion: Overweight and obesity were highly prevalent among young adults living in a rural-industrial setting in Limpopo province. Contribution: The findings highlight priority behavioural and social determinants that can inform targeted public health interventions and obesity-prevention policies in transitioning rural communities.