Childhood obesity is rising globally. It can have lifelong implications

Most people now live in countries where being overweight or obese is a bigger problem than being underweight. More than one billion people worldwide are estimated to be living with obesity – and 159 million of them are children or adolescents.

The growth in childhood obesity rates is concerning. Back in 1975, fewer than 1 in every 100 children was obese – now the rate is almost 10 per 100 young people, according to figures from the World Obesity Federation. And when you look at the combined prevalence of both obesity and being overweight among children and adolescents, a fifth are affected, compared to just 4% in 1975.

Unhealthy weight in childhood is linked to multiple adverse physical and mental health outcomes, and is likely to have lifelong implications. And unless action is taken, it is likely that obesity and being overweight will become increasingly common. As such, it is recognized as one of the most important public health problems we currently face.

The prevalence of obesity has grown significantly in the past 50 years.Image: World Obesity Federation

An uneven picture

The spread of unhealthy weight is not even around the world and due to a complex interplay of factors affects some groups more than others.

Obesity in the US is also more prevalent among Hispanic children (26.2%) and non-Hispanic Black children (24.8%). By contrast, prevalence among non-Hispanic white children and non-Hispanic Asian children is 16.6% and 9% respectively.

Household income levels are also a strong predictor of obesity levels – obesity is more common among poorer households. For example, national data for England shows that the prevalence of 10- and 11-year-old children living with severe obesity was over four times as high for children living in the most deprived areas (9.4%) compared with those living in the least deprived areas (2.1%).

The prevalence of reception-aged children living with obesity1 in England during 2021-22 was over twice as high in the most deprived areas (13.6%)2 than in the least deprived areas (6.2%)3.
Obesity is more prevalent among children from poorer households and is highest in urban areas.Image: NHS Digital

The causes of obesity

On the surface, problems with weight may seem simple – the body stores excess energy from food as fat. The reality is obesity is a complex chronic disease which can be caused by many interlinked factors.

Many people, particularly in affluent countries, live in ‘obesogenic’ environments which encourage low levels of activity, sedentary behaviour, and the consumption of lots of fatty, oily, starchy and sugary foods.

Genetic disorders or medications may cause or predispose some individuals to unhealthy weight. Psychological factors can influence weight. And social deprivation also has a significant role to play.

The roots of obesity run deep
The World Obesity Federation identifies nine root causes of obesity.Image: World Obesity Federation

What is the impact on health?

Childhood obesity can lead to a number of physical and mental health problems and may have long-term implications.

Among these are metabolic disorders like diabetes, cardiovascular problems like high blood pressure or cholesterol, and respiratory problems like asthma. Extra weight can also lead to joint and muscular skeletal problems which affect mobility and the ability to do physical activities.

The World Health Organization estimates that at least 2.6 million people die each year as a result of being overweight or obese. Some research suggests that children with persistent severe obesity could have half the average life expectancy.

There is also a significant stigma associated with weight, and people with obesity may be subject to negative comments. Bias means people may link obesity with laziness, low intelligence, or poor hygiene.

Fear of this stigma can make people less likely to seek help for treatment or prevention. It is also correlated with disordered eating such as binge or restrictive eating or eating anxiety.

How has the proportion of adults who are overweight and obese changed over time?
In England during the pandemic, there was a noticeable increase in obesity among 10-11-year-olds.Image: Nuffield Trust

What can we do about it?

Given the complex causes of childhood obesity, tackling the issue needs to focus on more than just encouraging people to eat less and do more exercise. Families, schools, communities and policymakers need to work together to create a multifaceted response.

Promoting healthy lifestyle choices from an early age is key and one strand of this is helping improve education and access to information. This can include school and community programmes as well as public health campaigns.

Prevalence of obesity (BMI ≥ 30kg/m²) – Boys, 2022
There are 35 countries globally where more than a fifth of boys are obese.Image: Global Obesity Observatory

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