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Background  Obesity is a global epidemic that affects 500 million people worldwide and is predicted to increase to one billion people by 2030. The prevalence of obesity is increasing across populations in South Africa. However, questions still remain surrounding the predisposing factors and obesity-related health problems especially in the rural areas. This study evaluated several lifestyle factors such as dietary habits, physical activity, smoking, alcohol intake, co-morbidities and their association with the prevalence of obesity and overweight in Nkonkobe Municipality of the Eastern Cape.    Methods  A cross-sectional, population-based survey was conducted among 118 residents in four rural/sub-urban townships of the study area. Measurements including weight, height, body mass index (BMI), physical activity and dietary habits were determined using a validated questionnaire.    Results  The overall prevalence of obesity and overweight was 38 and 19%, respectively. The highest prevalence of obesity (70%) was observed among those who do not undertake any physical activity. Close to half (48.48%) of the respondents who eat fast foods always were obese, and 30.30% were overweight; when combined, the prevalence for obesity is 78.78%. A negative association with obesity was observed among regular smokers (26.92%) and consumers of alcohol (4.00%). Arthritis, hypertension and tuberculosis were co-morbidities significantly ( P  < 0.05) associated with obesity in the study area.    Conclusions  The findings of this study reveal that lack of physical activity, overindulgence on fast and fried foods, low fruit and vegetable consumption as well as arthritis, hypertension and tuberculosis were significant risk factors of obesity in Nkonkobe Municipality.

Lifestyle factors and co-morbidities associated with obesity and overweight in Nkonkobe Municipality of the Eastern Cape, South Africa