Statement from the Physicians Association for Nutrition South Africa on the new Clinical Practice Guideline for the Management of Obesity in Adults in South Africa.
The Physicians Association for Nutrition (PAN) South Africa welcomes and supports the release of the first national clinical practice guideline for the management of obesity in adults in South Africa, published in the South African Medical Journal of Science during October 2025. Given the high obesity burden in South Africa, this landmark document is a necessary and timely advancement in healthcare, establishing obesity as a complex chronic disease that requires a multifaceted approach.
As an organisation committed to advancing nutrition in healthcare, we commend the guideline’s strong emphasis on plant-dominant nutrition outlined in the ‘Medical Nutrition Therapy in Obesity Management’ section. We particularly support the following:
Endorsement of plant-dominant nutrition in obesity management: We strongly support the inclusion of vegetarian and predominantly plant-based diets as one of the approaches in medical nutrition therapy for obesity management, recognising their benefits in supporting weight management, improving glycaemic control, and promoting overall metabolic health. The guideline further emphasises the benefit of moderate intake of dairy and limited consumption of meat, consistent with the Mediterranean dietary pattern, which closely aligns with the EAT-Lancet’s newly updated Planetary Health Diet. Importantly, it also recognises the need to screen for and appropriately manage potential micronutrient deficiencies associated with following a predominantly plant-based diet.
The importance of food-based dietary guidelines in nutrition interventions: We strongly support the use of food-based dietary guidelines (FBDGs) as a foundational tool of nutrition education and interventions. However, it is essential that these guidelines reflect the broad spectrum of plant-based dietary patterns, providing clear, evidence-based guidance on what constitutes a plant-based diet and how to ensure that it’s nutritionally adequate. While our recent analysis on dietary guidelines in Africa indicates that South Africa’s FBDGs are advanced in having a position on plant-based diets, there is a need to revise them to incorporate emerging evidence and to better support medical nutrition therapy for noncommunicable diseases using plant-based approaches.
Individualised, non-restrictive approaches: We agree that there is no one-size fits all eating pattern for people living with obesity. Nutrition interventions must be patient-focused, flexible, and culturally sensitive, considering individual preferences, health status and socio-economic context.
Focus on long-term health outcomes: We agree that the primary goal of obesity management should be to improve health outcomes, including reduced chronic disease risk, lower mortality, and improved quality of life. Therefore, health professionals should be willing to adopt evidence-based practices that support these outcomes.
Overall, this guideline marks a significant step forward for the comprehensive management of obesity in South Africa.
