The WHO issued its first-ever guidelines on the integrated management of obesity in children on 7 October. Childhood obesity is rising worldwide and in India, where it now adds to the problem of undernutrition.

• Obesogenic environment: It is an environment that promotes weight gain and is not conducive to weight loss, within the home or school.
• Double burden: Low- and middle-income countries such as India face the unfinished agenda of undernutrition and communicable diseases and, at the same time, rising obesity and overweight at younger ages.
• South Asia trend: In 2000, South Asia had the lowest prevalence of overweight children and adolescents, but by 2022 it had risen nearly fivefold across all three age bands (5–9, 10–14 and 15–19).
• Early diseases: Type 2 diabetes, cardiovascular diseases and metabolic dysfunction-associated steatotic liver disease (MASLD), once seen as adult diseases, are now being diagnosed in children.

• WHO guidelines (2026): The first guidance on managing obesity in children aged 29 days to 10 years.
• Eat Right India: FSSAI’s campaign for safe and healthy food, which also covers school children.
• Fit India Movement: A national campaign to promote physical activity.
• POSHAN Abhiyaan: India’s nutrition mission, which targets undernutrition in children.
• National Programme for Prevention and Control of Non-Communicable Diseases (NP-NCD): It supports screening and care for diseases such as diabetes and heart disease.

The causes lie in nutrition in early life, diet and the food environment.

• Early nutrition: Inadequate prenatal, infant and child nutrition sets the stage for later problems.
• Food choices: Growing children are exposed to high-fat, energy-dense and micronutrient-poor foods.
• Low activity: Recreation and transport now need less energy, and children are less physically active.
• Food environment: Weak action against marketing on TV and other media and the lack of front-of-package labelling make it the toughest challenge.

• Younger patients: Screening for non-communicable diseases (NCDs) must now start at younger ages.
• Complications in productive years: Chronic kidney disease, chronic liver disease and certain obesity-driven cancers will appear at younger, productive ages.
• Stress on two fronts: Health systems must deal with undernutrition and obesity together.
• Takeaway: Childhood obesity today means a larger NCD burden among working-age adults tomorrow.

• Double burden: The system must tackle undernutrition and obesity at the same time, with limited resources.
• Food environment: Marketing of unhealthy food and the absence of front-of-package labels are hard to regulate.
• Early detection: Screening for NCDs at young ages requires new capacity.
• Regional variation: Food habits, ethnicity and culture differ across regions, so one approach will not work everywhere.
• Cost: Interventions need higher capital investment.