Objectives: The objectives of the study were to determine the level of practice of a healthy lifestyle, to assess the health education provided to patients with diabetes and to determine the prevalence of obesity among Basotho patients with diabetes.

Design: A cross-sectional study enrolled 192 patients between November 2004 and July 2005. Descriptive statistics on demographic, socio-economic and lifestyle data were computed. Weight, waist circumference and hip circumference measurements were taken to compute body mass index (BMI), waist-to-hip ratio (WHpR) and waist-to-height ratio (WHtR).

Setting and subjects: Patients with diabetes attending three hospitals in Lesotho were recruited in the study.

Outcome measures: These included obesity indices, the quality and quantity of physical exercises, the quality and quantity of provided health education and the frequency with which the subjects sought medical help.

Results: The participants' mean age was 54.73 years. The prevalence of smoking (14.6%) was higher than that of drinking (9.4%). Only 20.8% of the participants participated in recommended physical exercise. Most participants (95%) consulted their physicians on a regular basis. The Health Education Quantity Index was very low: 49.9%. The prevalence of obesity measured by BMI, WHpR and WHtR was 67.7%, 69.8% and 95.3% respectively.

Conclusion: The practice of a healthy lifestyle was suboptimal, but help-seeking behaviour was satisfactory among participants. It is recommended that health education and the promotion of a healthy lifestyle are encouraged, that diabetes education is rendered by accredited educators or healthcare providers trained in communicating health messages, and that the fight against obesity is made a priority.