The truth about Type 2 diabetes and obesity

World Obesity Day on the 4th March has a compelling theme: Changing systems, healthier lives. “Let’s put a spotlight on the systems — not people — that need to change” is their rallying cry. But how does this relate to diabetes? Let’s unpack the truth about Type 2 diabetes and obesity.

Weight stigma

To begin with, let’s talk about stigma. Weight stigma – related to having obesity – and the stigma of Type 2 diabetes are both pervasive. The combination of these two can be a heavy burden to carry. “Living with diabetes is most definitely harder to function with being obese, as there’s so much stigma,” explains Sweet Life community member Rochelle Levitt. “Oh, she’s fat, she’s diabetic!” It sometimes makes me want to crawl up under the covers and not leave the house…”

This speaks directly to the World Obesity Day 2025 theme: it’s time to stop expecting individuals to deal with obesity on their own. “In many countries, people living with obesity are regularly blamed for their disease. Weight stigma reinforces assumptions that obesity is merely a person’s individual responsibility,” explains the World Obesity Federation fact sheet.

How Type 2 diabetes and obesity are connected

But why is there such a strong correlation between Type 2 diabetes and obesity? Simply put, having obesity makes you more likely to develop diabetes, because carrying excess weight can cause insulin resistance. Insulin resistance is when your body does not use the insulin in your body as well as it should. This leads to high blood sugar which, over time, can lead to Type 2 diabetes. NIH explains it succinctly, “Experts believe obesity, especially too much fat in the abdomen and around the organs, called visceral fat, is a main cause of insulin resistance.”

The South African response to obesity and Type 2 diabetes

Unsurprisingly, we have a robust strategic document in South Africa for obesity prevention and management. The Strategy for the Prevention and Management of Obesity in South Africa 2023-2028 states that, “The highest rates of increase in obesity have been recorded in middle-income countries, including South Africa. In South Africa, obesity has emerged as an urgent public health crisis.”

It goes on to confirm that obesity is a significant risk factor for Type 2 diabetes. A reported 87% of Type 2 Diabetes is related to elevated BMI. But where are the actions related to this two-year-old strategy?

“Obesity and Type 2 diabetes are both widespread in South Africa, and women are the most affected,” explains Nomathemba Chandiwana, Chief Scientific Officer at the Desmond Tutu Health Foundation. “But too often, the conversation focuses on personal responsibility instead of the bigger picture — how our food systems, healthcare access, and everyday environments shape health outcomes. Tackling obesity means addressing these systemic barriers, not blaming individuals. We need real, sustainable solutions that support people in leading healthier lives.” 

No quick fix

The World Obesity Federation fact sheet highlights that there is no quick fix for obesity. “‘Eating less, moving more’ implies that weight loss is just about diet and exercise, ignoring other drivers of obesity. Exercise alone is not an effective obesity treatment.” Rochelle Levitt confirms this, saying, “One of my biggest wishes is that others would know that we don’t need to be told we’re fat, ugly, not appropriate. If it was so simple to lose weight and maintain it, everyone would be walking around with a body like Gigi Hadid!”

There is an opportunity, here, for conversation that drives change. Let’s all start speaking up about obesity – as it relates to diabetes, and other conditions. We can challenge the action (or lack thereof) that is being taken on the ‘urgent public health crisis’ as defined by the South African National Health Strategy. Let’s refuse to add to the stigma that makes life with obesity so much more difficult.

Healthier lives await for all of us when we do.