Childhood obesity: Why this silent epidemic needs urgent attention

According per World Health Organization (WHO), childhood obesity is defined as excess body weight that affects the health of the individual. WHOuses BMI-for-age percentiles: children above the 95th percentile is considered to be obese, and those children in-between 85th–95th percentile are overweight.Childhood obesity has doubled in the past two decades.In 2025, WHO estimates, one in ten children or 188 million children globally are living with obesity. The Prevalence in India has increased significantly as per data from National Family Health Survey (NFHS) which is a follow, under5yrs overweight/obesity increased from 1.5% in 2005–06 to 3.4% in 2019–21, and 125% increase in overweight/obesity among girls and a 288% increase among boys over the same period.Calorie intake > calorie burnt→Leading to excess energy stored as fat.→ Enlargement and new fat cell formation.Enlarged fat cells release leptin enzyme, insulin, ghrelin, cortisol→ Leptin resistance is developed→ increases appetite.→ Insulin resistance increased → increases more fat storage.→ Ghrelin misbehaves → causes persistent hunger.→ Cortisol levels increase → causes central fat accumulation.Alters gut bacteria: the gut starts getting more energy from food and less protection against inflammation, because there is → Reduced good fatty acid (SCFA)production, which helps in reducing inflammation. → This increases gut permeability → allowing bacterial toxins to enter blood streamEnlarged fat cells, along with gut toxins trigger immune responseIt attracts these immune cells into the fat tissue, these immune cells release chemicals that leading to insulin resistance and promotes more fat storage and precipitates inflammation in the individual.Chronic inflammation along with insulin resistance and gut dysbiosis→ Increases hunger, supports fat accumulation.→ Worsens Obesity leading → Higher risk of diabetes, Liver diseases similar to the changes found in alcoholics and heart disease.1. Excessive consumption of processed food and calorie dense foods. 2. Physical inactivity, extensive screen time.3. Urbanization and lack of play areas.4. Hereditary predisposition.5. Distorted Digital media influence and social pressure.6. Reduced physical education and sports events in schools. • Onset of type 2 diabetes at a young age.• Increased risk of Hypertension and cardiovascular risks• Affects bone health at a young age•Affects the self-esteem, causes depression, bullying and body shaming.• Increases the risk of chronic diseases, if obesity persists from childhood to adulthood. • Stop sugary drinks and replace them with plenty of fluids, such as water or buttermilk and soups.•Portion control and regular meal timings.• Outdoor activity for at least 30 minutes on a daily basis.• Limiting screen time to less than 2 hours/day.• Including all the food groups in the right proportion- fruits, vegetables, whole grains, lean proteins.• Encourage daily physical activity routine of 45–60 minutes, activities such as playing outdoor games or cycling.• Maintaining consistency in sleep timing.•Reduced intake of packaged and processed foods.• Introducing mindful eating and hunger recognition in early childhood.•Regular monitoring of weight and growth in schools.1. Accessibility of the type of food:Then: Home-cooked, traditional diets; junk food was occasional and less accessible.Now:Over indulgency into sugary drinks, and fast food.2. Perspective of opting food:Then: Limited advertising of junk foods; and less child-targeted marketing on television and print media.Now:Influence to unhealthy foods and promotions in the digital media and its accessibility.3. Games and other outdoor activities:Then: Children played outdoors games more, went to schoolboy walking or cycling, and had active lifestyle.Now:Sedentary lifestyles, increased screen time, pressure of academic achievements, and no outdoor activities.4. Joy of cooking and time allocation to cooking:Then:Dependent on home cooked meals; eating out was very less.Now: Urban lifestyle, both parents earning, hasled to more dependency on restaurant food due to lack of time for cooking and also the improved financial status.5. Nutrition Awareness &its Transition:Then: Focus was on undernutrition; rather than childhood obesity.Now: Obesity is indicated as a rising risk. Moreover, having knowledge of healthy lifestyle isn’t enough, because daily habits and surroundings push children towards obesity unintentionally.6. Socioeconomic Status:Then:Under developed rural lifestyle was very common, that contributed to traditional diets and increased outdoor activities.Now:Rapid Transition in lifestyle, has contributed to increased unhealthy eating and lack of activity, even in developing areas. According to the WHO, Childhood obesity is a little more than extra weight, it’s a real a health concern that can affect a child’s health, with long term implications in future too. Although, with the increasing numbers of childhood obesity around the world, in low- and middle-income countries, it’s becoming an issue that cannot be ignored. The good thing aboutchildhood obesity is, it can be prevented, by helping children choose nutritious foods, by following active lifestyle, by spending less time in front of the screen. This calls for creating asupportive environment for children at home, in schools, and in the communities, which can make a real difference. These small and consistent changes around them can help children adapt healthy eating habits and active lifestyle with long lasting and significant changes in terms of normal growth and maintaining good healthy now and in future. Dr. Sandhya Singh S PhD., HOD & Chief Clinical Dietitian, Department of Nutrition & Dietetics, Apollo Hospitals, Bangalore