As Rwanda continues to battle well-known public health issues such as stunting, a new concern is quietly gaining ground in urban areas—childhood obesity. While this growing health risk is not yet widespread, it is beginning to emerge as a problem, particularly in Kigali and other cities.
Experts warn that without immediate intervention, childhood obesity could escalate into a national public health crisis.
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According to the Rwanda Demographic and Health Survey (DHS) 2020, the nutritional status of Rwandan children under five years old shows mixed results; 33% of children aged 6 to 59 months are stunted (short for their age), 1% are wasted (thin for their height), 8% are underweight (thin for their age), and 6% are classified as overweight (heavy for their height).
September marks National Childhood Obesity Month, a crucial time to raise awareness about the increasing threat of childhood obesity. Nutrition experts stress the dangers, preventive measures, early signs to watch for, and the root causes of obesity.
Private Kamanzi, Chairman of the Rwanda Nutritionists Society (RNS), pointed out a concerning pattern, a steady rise in childhood obesity in cities like Kigali.
He noted that while national statistics on childhood obesity remain limited, some evidence suggests the problem is growing, driven largely by lifestyle changes in urban settings.
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"This trend, if not addressed, could become a major public health issue in the coming years,” Kamanzi warned.
Causes
He said that the rise in obesity is primarily due to sedentary lifestyles and poor dietary habits, noting that urban children often spend most of their time indoors, engaging in little to no physical activity, while being heavily exposed to high-calorie, high-fat foods.
He added that children in urban areas often lack space to be physically active as they live in confined homes without large play areas, which limits their ability to run around and engage in games that promote fitness.
Kamanzi explained that some children spend increasing amounts of time glued to television screens, smartphones, and other digital devices, reducing their opportunities for outdoor play and exercise.
He added that poor dietary choices are fueling the rise in childhood obesity as children, especially those in cities are frequently exposed to high-calorie, high-fat foods such as sugary beverages, snacks, and processed items like margarine and mayonnaise.
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"As families’ purchasing power increases in urban areas, they have greater access to these unhealthy foods, which are often mistakenly seen as a sign of improved family status”, he stressed.
Simon-Pierre Niyonsenga, the Director of the Diabetes and Other Metabolic Diseases Programmes at Rwanda Biomedical Centre (RBC), stressed that multiple factors contribute to childhood obesity and the potential complications it brings. Just like Kamanzi, Niyonsenga pointed out that childhood obesity is driven by a combination of factors, with unhealthy dietary habits and physical inactivity being the primary causes.
Consequences, solutions
Niyonsenga added that socio-economic conditions may affect food choices and, in some cases, stress or emotional trauma can lead to overeating as a coping mechanism, and psychological factors may also play a role.
The consequences of childhood obesity are far-reaching, affecting both the physical and mental health of children. Niyonsenga warned that obese children are at a higher risk of developing heart diseases, respiratory problems like sleep apnea and asthma, and joint and musculoskeletal disorders as excess weight strains developing bones and joints.
"Psychosocial problems such as low self-esteem, depression, bullying, and social isolation can also have long-term impacts on their mental health. Additionally, obesity can lead to non-alcoholic fatty liver disease, where fat builds up in the liver, causing inflammation and potential scarring,” he stated.
Kamanzi pointed out that parents are not fully aware of the effects of obesity on children’s health since many think it’s a symbol of good health when their children appear overweight, a critical gap in public awareness.
Limit screen time
He stressed that obesity in children can lead to severe long-term complications, including heart disease, type 2 diabetes, and respiratory issues.
He urged parents to ensure that children consume balanced meals with a healthy mix of proteins, carbohydrates, fruits, and vegetables, rather than relying on processed and sugary foods.
Additionally, Kamanzi calls upon parents and guardians to especially "limit screen time” and provide opportunities for their children to engage in physical activities, whether through play, sports, or simple family activities like walking.
Niyonsenga added that dietary changes and increased physical activity are the first lines of defense in treating childhood obesity, calling upon parents and caregivers to help their children adopt healthier eating habits and become more physically active.
For children dealing with emotional issues that contribute to overeating, he noted, psychological support is essential, and addressing the mental health aspect of obesity can prevent further complications.
Niyonsenga said: "In rare and extreme cases where lifestyle changes and medical interventions are ineffective, bariatric surgery may be considered a treatment option for severely obese children.
"However, it is very uncommon in children and only used when all other measures have failed. Bariatric surgery is done to help you lose extra weight and reduce your risk of possibly life-threatening weight-related health problems.”
Diagnosing childhood obesity is not straightforward, Kamanzi said.
For children under five, the traditional Body Mass Index (BMI) measurement used for adults and older children is not typically applied. Instead, Rwanda uses a different standard, the Z-score, which measures the deviation from the norm for a child’s age and height.