Nutrition transitions, obesity and T2DM in the Middle East and North Africa

Obesity and type 2 diabetes mellitus (T2DM) are global epidemics, but their burden is particularly pronounced in the Middle East and North Africa (MENA) region. This Review provides a comprehensive overview of their epidemiological landscape among adults in the MENA region, encompassing disease burden, temporal trends, intersecting risk factors and key gaps in research, policy and practice, while highlighting regional heterogeneity. Despite worsening trends, the broader landscape, including disease burden and its drivers, remains insufficiently addressed. Contributing risk factors include poor diet quality, physical inactivity, genetic predisposition, obesogenic food environments and socioeconomic and cultural influences. While high-income places in the Gulf region have undergone earlier and more advanced nutrition transitions, with some of the highest prevalences of obesity and T2DM globally, places in North Africa are experiencing rapid shifts, with some of the steepest increases in high BMI and elevated fasting plasma levels of glucose. Although places share common drivers such as urbanization and sedentary lifestyles, the magnitude and distribution of risk vary widely owing to differences in economic development, healthcare infrastructure, cultural norms and public health nutrition policies. These epidemics impose a substantial and under-recognized economic burden. Prevention and management efforts remain fragmented, highlighting the need for stronger regional collaboration, improved evidence generation and culturally tailored interventions.