Waistlines have ballooned as sedentary lifestyles, urbanisation and western diets have taken over East Africa

In early 2025, Said Shukuru, 31, was experiencing life-threatening health concerns. He weighed 150 kg (over 20 stone); his body mass index (BMI) was over 40 and he had a blood pressure of 190/100.

“It was very serious,” says Shukuru. In April last year, he underwent a successful mini gastric bypass operation at the Aga Khan Specialised Polyclinic in Masaki, Dar Es Salaam. His weight has since halved.

Shukuru’s case may be extreme, but his story serves as a warning. Overweight and obesity levels are increasing fast across East Africa, and particularly in Tanzania. Unless the government responds properly, the country faces a looming public health crisis.

Overweight and obesity in Tanzania have grown over the past 40 years because of economic development and liberalisation, urbanisation and increasingly sedentary lifestyles.…