Abstract
Childhood overweight and obesity are pressing and escalating public health challenges in South Africa. Low-income communities face the greatest burden due to compounding social, economic, and environmental constraints. Schools are widely recognised as critical sites for prevention. However, the perspectives of teachers, who are directly engaged with learners, are rarely included in research or policy discussions. This study explored how teachers in low-income public primary schools in the Ugu District, KwaZulu-Natal, perceive and respond to childhood overweight and obesity. A qualitative, exploratory, and descriptive design was employed. Thirteen teachers with at least three years of experience participated in semi-structured interviews, and the data were analysed thematically using Braun and Clarke’s six-step framework. Data saturation was reached by the ninth interview, with four additional interviews confirming consistency. Ethical approval was obtained from the University of Johannesburg and the KwaZulu-Natal Department of Basic Education (DBE), and all participants provided written informed consent prior to participation. Teachers recognised childhood overweight and obesity as growing health concerns among learners but reported varying levels of awareness regarding its causes, health implications, and appropriate responses within the school environment. They identified poor diet, limited physical activity, and persistent poverty as key drivers, while also highlighting the obesogenic influence of tuck shops and informal food vendors within the school environments. Teachers described limited confidence in addressing this issue, citing inadequate training, competing curriculum demands, and insufficient institutional support. Learners were perceived to experience social and emotional consequences, including stigma, low self-esteem, and exclusion. Despite these challenges, teachers expressed willingness to support interventions if they received appropriate training and resources, and emphasised the importance of collaboration with parents and communities. They also raised concerns about the contradiction between health messaging and the realities of school environments. The need for improved teacher training in nutrition awareness, early identification of overweight and obesity, and referral procedures within school health systems, together with stronger institutional support, was strongly emphasised. Although teachers acknowledged the seriousness of childhood obesity, they face barriers at multiple levels that limit their ability to identify, address, or refer affected learners within existing school health structures. Achieving meaningful improvements in learner nutrition and physical activity requires collaboration between the education sector, health services, and community stakeholders. Empowering teachers with the knowledge, training, and institutional...