For the Sake of Our Children!

 

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If you are a parent and reading this, then it is just as much your responsibility to protect your children. However, I think this is a problem that we all must get behind. What does the latest data reveal about childhood obesity? Childhood obesity has solidified its status as a global public health emergency, with its rapid escalation across the globe like wildfire, out of control, demanding immediate action. In 2024, an estimated 35 million children under five years were overweight. Among children and adolescents aged 5–19, over 390 million were overweight in 2022, including 160 million living with obesity, reflecting a dramatic rise from 8% in 1990 to 20% in 2022 (WHO, 2025). Projections are even more alarming, with the World Obesity Atlas 2024 forecasting that 88% of children with overweight and obesity will live in LMICs by 2035, and childhood obesity rates could reach 30% globally by 2030, with boys at 34.2% and girls at 27.4% (World Obesity Federation 2024; Sun et al., 2023). In the United States, the CDC (2022) reports that approximately 19.7% of children aged 2–19 are obese, with higher prevalence among Hispanic (26.2%) and non-Hispanic Black (24.8%) populations, underscoring the link between race, poverty, and dietary risk environments. The prevalence of obesity in early childhood is particularly troubling, as it predicts continued health challenges into adulthood, including cardiovascular disease, Type 2 diabetes, and reduced life expectancy.

Fast-food companies have long invested in marketing strategies that target impressionable young people. Research indicates that children exposed to food advertisements, particularly those embedded in the media, are more likely to develop a preference for high-fat, high-sugar, and ultra-processed, nutrient-poor foods. These strategies often utilize psychological cues, such as toys, branding, and celebrity endorsements, to foster brand loyalty in children at an early age. Many of these advertisements are disproportionately aired during children’s programming and thereby effectively weaponize and exploit children for profit. Children do not make dietary decisions in a vacuum. The structural conditions of their communities shape their food choices. Neighborhoods saturated with fast food chains and lacking supermarkets or fresh produce outlets, commonly called “food swamps” or “food deserts,” impose barriers to healthy eating. Studies indicate that proximity to fast food restaurants correlates positively with childhood obesity, particularly when these establishments are located near schools. As such, any meaningful intervention must include urban planning and policy reform that addresses these environmental determinants.

Obesity in children is not just a clinical issue but a justice issue. Low-income families often experience limited access to affordable, nutritious food, safe recreational spaces, and healthcare services. In these contexts, fast food offers a perceived solution to caloric needs at a low monetary cost, yet this “cheap” food carries long-term physiological and economic burdens. For example, increased healthcare costs due to obesity-related complications amount to approximately $14 billion annually in the United States for children alone. Addressing this requires a shift in policy from individual blame to systemic accountability. The surge in childhood obesity in LMICs is propelled by a confluence of environmental, socio-economic, behavioral, and biological factors that have reshaped children’s lives into an obesogenic landscape. Central to this is the nutrition transition, fueled by globalization and rapid economic growth. As low- and middle-income country (LMIC) markets open, foods high in sugar, unhealthy fats, and ultra-processed nutrition-deficient foods have become ubiquitous, often cheaper and more accessible than nutrient-rich alternatives, such as fruits and vegetables.

Urbanization, linked to rising gross national income, has further entrenched these dietary shifts, with countries such as India and China experiencing a rapid shift toward Western-style diets characterized by a greater consumption of processed foods (Popkin, 2024). This transition is particularly acute in regions undergoing economic development, where 79% of adults with obesity-related high body mass index (BMI) reside, contributing to 78% of global obesity-related deaths in LMICs (World Obesity Federation 2024). Physical inactivity compounds this dietary shift, driven by technological advancements and urban design deficits. Children in low- and middle-income countries (LMICs) are increasingly drawn to sedentary activities, such as watching television, using smartphones, and playing video games, rather than engaging in physical play. In India, children watching over 90 minutes of television daily are significantly more likely to be overweight, a trend exacerbated by the lack of safe recreational spaces, such as parks or cycling paths, in many urban and rural settings. Socioeconomic position (SEP) adds complexity, presenting a stark contrast to that of high-income countries. In LMICs, higher SEP is often associated with increased obesity risk, as affluent children in countries like India lead sedentary lives enriched with technology and rely on motorized transport, with private school cafeterias serving unhealthy fare. Conversely, lower SEP children, while more physically active, face undernutrition due to limited access to nutritious foods, perpetuating the dual burden of malnutrition.

Aggressive marketing by fast-food chains and food brands further entrenches unhealthy eating habits. These companies target children with promotions, such as combo meals and media campaigns, significantly influencing their food preferences. A study conducted across six low- and middle-income countries (LMICs) found that media exposure and brand recognition influenced children’s dietary choices, mirroring tactics employed in wealthier nations (Borzekowski & Pires, 2018). While genetic predispositions and hormonal disorders, such as hypothyroidism, contribute to obesity in some cases, their impact is typically amplified by these pervasive environmental pressures. The spatial-temporal trend of childhood obesity, migrating from Western countries to Asia and Africa alongside economic development, underscores the global nature of this challenge (Sun et al., 2023).

The health consequences of childhood obesity are both immediate and far-reaching, casting a long shadow over individual lives and public health systems. In the short term, obese children face a constellation of health issues, including high blood pressure, dyslipidemia, cardiac abnormalities, hyperinsulinemia, and insulin resistance, which signal early risks of cardiovascular disease and type II diabetes. These physical ailments often intertwine with mental health challenges, such as depression and eroding quality of life. Long-term childhood obesity is a robust predictor of adult obesity, ushering in chronic conditions like hypertension, cardiovascular diseases, diabetes, and certain cancers. The Global Burden of Disease Study 2021 reveals that obesity accounts for 80% of disability-adjusted life years (DALYs) in low- and middle-income countries (LMICs), compared to 20% in high-income countries, thereby amplifying the burden on resource-constrained health systems (World Obesity Federation, 2024). Economically, the costs are staggering, with overweight and obesity causing an estimated $2 trillion in global productivity losses annually, hitting LMICs hardest where health infrastructure is ill-equipped to manage non-communicable diseases (NCDs).

Reversing this epidemic requires a comprehensive, evidence-based approach tailored to low- and middle-income countries (LMICs) contexts. Healthy public policy is paramount, with fiscal measures proving effective. For example, education guidelines, updated in 2024, reinforce bans on bad fats, high-sugar, ultra-processed foods in schools. Regulatory efforts must also curb the marketing of unhealthy foods to children and mandate clear nutritional labeling to empower informed choices. Creating supportive environments involves dismantling obesogenic settings by improving access to healthy foods and physical activity spaces. Community action has yielded promising results, which engaged teachers, doctors, and parents to reduce children’s waistlines and boost physical activity. Health systems must prioritize early detection and management, including screening for maternal diabetes during pregnancy, and addressing cultural dietary misconceptions, as emphasized in the World Health Organization’s (WHO) 2024 guidelines (WHO, 2024).

The Framework for Nutrition targets undernutrition and obesity, aiming to reduce the prevalence of overweight individuals to below 3% by 2030 (World Bank, 2021). Lessons from high-income countries, like Canada’s APPLE Schools and France’s EPODE initiative, reinforce the value of school-based, multi-stakeholder efforts. Challenges persist, particularly in LMICs. Resource constraints limit training, with health systems often prioritizing undernutrition and infectious diseases over obesity. Data gaps hinder surveillance, with inconsistent BMI definitions and limited environmental metrics impeding progress (World Health Organization, 2024). The forecasted spike in obesity prevalence by 2030 underscores the urgency of action (The Lancet 2025). Solutions include dedicated funding from taxes on unhealthy products. These standardized national surveillance systems incorporate waist circumference measurements and expanded research into prevention strategies, such as SSB taxation and anti-obesity medications (AOMs). While AOMs promise to reduce cardiometabolic risks, their accessibility in LMICs remains limited, necessitating the implementation of public health measures to complement their use (World Economic Forum, 2025).

Childhood obesity has become a global problem, as urbanization, sedentary lifestyles, socio-economic disparities, and aggressive marketing pose a dire threat to health and economic stability. With 88% of overweight children projected to reside in LMICs by 2035, the epidemic demands urgent, multi-faceted action. Robust policies, supportive environments, community-driven efforts, education, and strengthened health systems, informed by recent data and global frameworks, offer a path forward. By adapting successful models and addressing systemic challenges, LMICs can halt this crisis, ensuring healthier futures for their children.

References

Borzekowski, D. L. G., and P. Pires. 2018. A Six-Country Study of Young Children’s Media Exposure. Journal of Children and Media 12(2): 143–58.

Popkin, B. M. (2024). Nutritional Patterns and Transitions. The Lancet.

Sun, M., et al. 2023. Spatial–Temporal Trends in Global Childhood Overweight and Obesity from 1975 to 2030. Globalization and Health.

The Lancet. 2025. Global, Regional, and National Prevalence of Child and Adolescent Overweight and Obesity, 1990–2021.

World Economic Forum. 2025. Are Lower- and Middle-Income Countries Ready for the Roll-Out of Anti-Obesity Medications?

World Obesity Federation. (2024). World Obesity Atlas 2024.

World Health Organization. (2025). Obesity and Overweight Factsheet.