Introduction -
In a striking shift in global health trends, obesity among school-age children and adolescents (ages 5-19) has for the first time surpassed underweight; this overturns decades in which malnutrition was chiefly understood to mean a lack of food. According to a new UNICEF report titled Feeding Profit: How Food Environments are Failing Children, about 9.4% of children aged 5-19 are now obese, compared with 9.2% who are underweight.
This change has enormous implications: obesity is not just a matter of aesthetics, but a health risk with downstream consequences affecting metabolic disorders, cardiovascular disease, psychological health, and even national healthcare costs. In this article, we explore what led to this tipping point, where the crisis is worst, what risks are involved, and what solutions are being proposed or already implemented. We also look into subtle facets of this shift (the “double burden” of malnutrition, social determinants, food environments) and suggest what stakeholders can do.
Table of Contents
1. Background: Understanding Malnutrition, Underweight, Overweight, and Obesity
2. Key Findings from the UNICEF Report
3. Causes: What’s Driving the Surge in Childhood Obesity
4. Geographic Hotspots: Where the Problem is Most Acute
5. Health Risks & Long-Term Consequences
6. The Double Burden: When Underweight & Obesity Coexist
7. Role of Food Environments, Marketing & Ultra-Processed Foods
8. Social, Economic & Cultural Determinants
9. Policy Responses & Interventions
10. What Parents & Communities Can Do
11. Challenges & Barriers
12. Conclusion: A Call to Action
1. Background: Defining the Terms & Why It Matters
What is malnutrition?
Malnutrition refers broadly to imbalances in nutrient intake: this includes undernutrition (underweight, stunting, wasting), overnutrition (overweight and obesity), and also hidden hunger (micronutrient deficiencies).
• Underweight (thinness): when children are significantly lighter than standard for their age and height.
• Overweight & Obesity: when children exceed healthy weight thresholds for age, sex, and height; obesity being an extreme excess.
Why the distinction matters
Historically, public health efforts in many countries focussed on undernutrition. But as globalization, urbanization, dietary changes, and sedentary lifestyles increase, overnutrition is rapidly becoming a parallel, sometimes more pressing, concern. The shift where obesity overtakes underweight signals a need to reframe malnutrition strategies.
2. Key Findings from the UNICEF Report
Let’s summarize the major findings that underscore the significance of the new trend.
• Obesity among 5-19-year-olds has increased from ~ 3% in 2000 to ~ 9.4% in 2025. Meanwhile, underweight has dropped from about 13% to 9.2%.
• Globally, ~ 188 million children and adolescents aged 5-19 are now obese.
• The majority of this overweight burden (including obesity) is in low- and middle-income countries (LMICs). These countries now carry ~ 81% of the global overweight burden, up from ~ 66% in 2000.
• Underweight still remains significant, especially in certain regions, such as sub-Saharan Africa and South Asia, which are exceptions where underweight prevalence remains higher than obesity among children ages 5-19.
• Pacific Island nations (Niue, Cook Islands, Nauru, etc.) and some higher-income countries have alarmingly high obesity percentages—e.g. ~ 38% in some Pacific Islands.
3. Causes: What’s Driving the Surge in Childhood Obesity
Several interacting factors contribute to this rapid rise in obesity among children. Understanding them is essential to crafting effective responses.
Diet transitions & ultra-processed foods
• Shift from traditional diets (whole foods, fruits, vegetables, lean protein) to energy-dense ultra-processed foods (UPFs), high in sugar, salt, refined starches, unhealthy fats.
• Increased consumption of sugary drinks, fast foods, instant/packaged snacks marketed heavily to youth.
Sedentary lifestyles & decreased physical activity
• Urbanization leads to less active play, more screen time (TV, mobile phones, tablets, video games).
• Reduced physical activity in schools, limited safe outdoor spaces in many urban settings.
Socioeconomic changes
• As incomes rise, food access changes; more affordable processed foods but possibly less time/resources for home cooking.
• Globalization of food supply chains; cheaper imports of processed foods into LMICs.
Marketing, advertising & food environments
• Aggressive marketing of unhealthy foods to children: through TV, digital media, point of sale.
• Food deserts or food swamps: areas where unhealthy food options outnumber healthy ones.
• School canteen offerings, vending machines, snacks sold on or near school grounds.
Suboptimal policies & lack of regulation
• Weak or no restrictions on marketing unhealthy foods to minors.
• Insufficient food labeling, allowing misleading nutritional claims.
• Low taxation or regulation of sugar-sweetened beverages or junk food in many countries.
Other factors
• Genetic predisposition, though gene expression is influenced heavily by environment.
• Sleep deprivation, stress, mental health factors can increase risk of obesity.
• Prenatal and early childhood nutrition: maternal health, breastfeeding, micronutrient deficiencies can set the stage.
4. Geographic Hotspots: Where the Problem is Most Acute
The rise is global, but not uniform. Some regions are seeing more intense impacts.
Region / Country Obesity Prevalence (5-19 yrs) Key features or notes
Pacific Islands (Niue, Cook Islands, Nauru) ~ 33-38% obesity rates among 5-19 year olds in worst-affected islands. Rapid transition from traditional diets; isolated food supply; high importation of processed foods.
High-income countries (Chile ~27%, USA ~21%, UAE ~21%) Elevated obesity rates among youth. Urban lifestyle, high availability of fast food, cultural factors.
Low- & middle-income countries Carry ~ 81% of overweight/obesity burden; many now have obesity rates exceeding underweight among school age children. Face dual burdens: some children are undernourished, others overweight; food environment challenges.
Sub-Saharan Africa & South Asia Still more underweight than obese among 5-19 age group; however, obesity rising. Poverty, food insecurity, cultural dietary patterns keep underweight high, but obesity creeping in.
5. Health Risks & Long-Term Consequences
Being obese in childhood does not just pose short-term problems; it implicates a lifetime of health, social, and economic challenges.
• Metabolic disorders: obesity increases risk of type 2 diabetes, insulin resistance, dyslipidemia.
• Cardiovascular disease: elevated blood pressure, early onset coronary issues.
• Musculoskeletal issues: excess weight strains the joints; posture, bone development issues.
• Psychological and mental health: stigma, low self-esteem, depression, anxiety.
• Risk of obesity persisting into adulthood, increasing mortality risk, lowering life expectancy.
• Economic burden: increased healthcare costs (chronic disease treatment), reduced productivity, disability.
6. The Double Burden: When Underweight & Obesity Coexist
An important nuance: many countries are now facing double burden of malnutrition, where undernutrition (stunting, wasting, underweight) coexists with overnutrition (overweight, obesity). This can happen:
• Within the same country
• Even within same communities
• Sometimes even within same households
This complexity requires policies that are nuanced: it's not simply “increase calories” vs “reduce calories,” but “balanced, nutrient-rich, appropriate calories” vs “excessive, processed, nutrient-poor calories.”
7. Role of Food Environments, Marketing & Ultra-Processed Foods
The UNICEF report underscores how external factors (food environments) often drive obesity more than individual choice.
• Ultra-processed and fast foods: cheap, convenient, heavily marketed.
• Advertising & digital media: children see ads for sugary drinks, snacks; marketing targeted to youth via social media, influencer marketing.
• School food environment: what’s sold in canteens, vending machines; what is allowed in and around schools.
• Food labeling, packaging: misleading health claims; weak regulation.
• Accessibility & affordability of healthy foods: fruits/vegetables often cost more, less convenient, subject to spoilage.
8. Social, Economic & Cultural Determinants
Beyond diet and marketing, several larger forces affect obesity risk:
• Income level: Middle-income families often shift diets first, adopting high processed food consumption. But obesity is also increasingly seen among lower income groups as the cheap processed foods become more pervasive.
• Urban vs rural: Urbanization tends to increase access to processed foods and sedentary lifestyle; rural areas may lag but are catching up.
• Education & awareness: Knowledge about nutrition, reading labels, understanding calories is uneven.
• Cultural norms: Perceptions about body size, “plumpness” as desirable in some cultures; social eating; celebrations etc.
• Infrastructure: Safe play areas, walkability, sports facilities; availability of public transport vs reliance on motor vehicles.
• Food policies & subsidies: Subsidies for unhealthy staples vs lack of support for fresh produce.
9. Policy Responses & Interventions
To reverse or slow this trend, public policy and community action are essential. Some measures being proposed or already in use:
Regulatory & Fiscal Measures
• Taxes on sugar-sweetened beverages (SSBs), junk food.
• Subsidies or price support for fruits, vegetables, healthy foods.
• Restrictions on marketing of ultra-processed foods to children (TV, online, packaging).
School & Institutional Interventions
• Nutritional standards for school lunches / canteen food.
• Banning or limiting unhealthy snack / drink sales in and around schools.
• Incorporating nutrition education into curriculum.
Labeling & Transparency
• Clear front-of-package labeling (traffic light systems, warnings).
• Disclosure of sugar, salt, fat content.
Community & Grassroots Approaches
• Promoting physical activity: safe playgrounds, sports programs, walking/cycling infrastructure.
• Local initiatives: community gardens, healthy cooking workshops.
• Engaging parents & caregivers in behavior change.
Public Health Campaigns & Awareness
• Mass media campaigns about healthy eating, risks of obesity.
• Informing about balanced diets, portion sizes.
10. What Parents & Communities Can Do
While policy is crucial, the responsibility doesn't lie solely with governments. Parents, schools, neighborhoods, and individuals can take action now.
• Offer wholesome meals: lots of fruits, vegetables, legumes; whole grains.
• Limit sugary snacks and drinks. Make water or healthy beverages the default.
• Encourage physical activity: limit screen time; promote outdoors, sports, active play.
• Educate kids about nutrition, reading food labels, making healthy choices.
• Model behavior: parents as role-models in diet, activity.
• Foster safe environments: community parks, playgrounds, supportive neighborhood.
11. Challenges & Barriers
There are many obstacles to reversing this trend; understanding them helps in designing realistic interventions.
• Cost and affordability: Healthy foods often cost more; poor households may prioritise quantity over quality.
• Infrastructure limitations: Lack of safe outdoor spaces, sports facilities in many neighborhoods.
• Cultural preferences & habit: Foods with high sugar/salt are tasty; processed food convenience is strong.
• Industry resistance: Food industry lobbying, marketing budgets, resistance to regulation or reform.
• Weak enforcement: Even where policies exist, enforcement is spotty.
• Information gaps: Poor nutritional literacy; lack of consistent data monitoring in some countries.
12. Conclusion: A Call to Action
The fact that childhood obesity now exceeds underweight globally isn't just a statistic—it’s a turning point. It indicates that malnutrition is evolving; health systems, policy makers, parents and society need to evolve with it.
This transformation calls for:
• Holistic nutrition policies balancing both undernutrition and overnutrition.
• Stronger regulation of food environments.
• Investment in healthy food accessibility.
• Community engagement, awareness raising.
• Monitoring & research: better data, tracking trends, evaluating interventions.
We are at a moment where course correction is possible. Without immediate, coordinated, multi-level action, the upcoming generation could face heightened burdens of chronic disease, reduced quality of life, and strained health systems. With urgency and collaboration, though, we can turn the tide.