The landscape of childhood diet is being rewritten dramatically. Over the decades, the largest problem for low- and middle-income nations was undernutrition—children being wasted, stunted, and underweight. Today, however, we are witnessing a change that is reflective both of progress and new problems: obesity among children has now become more prevalent than underweight on a global front.
UNICEF’s recent report indicates that over 188 million children aged 5-19 years now have obesity, noting an alarming epidemic sweeping over regions previously haunted by hunger. This paradox of malnutrition—of having undernutrition alongside obesity—is a product of rapid urbanization, changing diets, and increasingly sedentary lifestyles.
Dr. Rahul Verma, Director of Pediatrics, Neonatology & General Paediatrics, Sir HN Reliance Foundation Hospital, Mumbai
Children’s are consuming more ultra-processed food containing a lot of sugar, fat, and salt while simultaneously engaging in fewer physical activities due to screen time, limited safe spaces to play, and shifting family lifestyles. The outcome is a generation at risk: child obesity is not just a short-term problem; it significantly increases the risk of adult-onset diabetes, high blood pressure, and heart disease, adding to already strained health systems. What is most concerning about this trend is that parents are largely unaware of the silent threat. In resource-poor settings, being ‘chubby’ still also continues to be seen as a mark of health and good fortune, overlying the severe long-term health consequences.
Addressing this crisis will necessitate an approach multi-pronged—stricter nutrition policies that control toxic food marketing, making healthier school meals, developing environments fostering physical activity, and educating parents about the value of balanced nutrition. We should understand that the battle against malnourishment is no longer about hunger reduction, but about averting obesity as well. Both sides of the malnutrition spectrum pose danger to children’s health, and both require concerted and immediate world action.
Dr . Vimal Pahuja, MD, Associate Director, Internal Medicine & Metabolic Physician, Diabetes & Weight Management Clinic, Dr. LH Hiranandani Hospital, Powai
For generations, child malnutrition equated to hunger, stunting, and underweight status. However, the world picture has dramatically altered. According to the latest UNICEF figures, for the first time in history, there are more obese children than underweight children. Currently, almost 391 million children and adolescents between 5 and 19 years of age are overweight or obese, while 349 million are underweight. In 2000, it was just the opposite: 362 million children were underweight but only 155 million were overweight.
This transformation is most apparent in low- and middle-income countries, which today represent four out of every five overweight children globally. Underweight has long been the norm in South Asia—but childhood obesity is now increasing at alarming rates. In India, countrywide surveys indicate that obesity among children aged 5–19 has increased more than twice during the past twenty years, rising from about 2–3% in 2000 to over 7–8% currently. Urban regions have higher rates and, at close to one in every 10 school-aged children being overweight or obese.
In my practice, this paradox is enacted every day. One family might present with concern over a child’s ongoing low weight, and another with concern over accelerated weight gain. The denominator is a diet of packaged snacks and sweetened beverages, combined with extended periods of screen time, minimal outdoor play, and pressure to perform academically that cuts back on physical activity.
The health effects are grim. Overweight kids are twice as likely to develop type 2 diabetes, hypertension, and cardiovascular disease in childhood as their healthy counterparts. Unlike the “baby fat” of yesteryear that could be anticipated to fade away as a child grew older, childhood obesity nowadays frequently follows adult life, advancing long-term risks of metabolic disease and early death.
The fresh new face of malnutrition requires immediate attention. All policies need to fortify school nutrition, curb the marketing of junk food, and give parents better, more affordable choices. Malnutrition is no longer a matter of deficiency—it is also a matter of the over-consumption of the wrong foods.
