Globally 30% of young people under the age of 20 years are obese
Obesity is increasingly becoming a major global health concern, particularly among younger populations. Currently, around 30% of people under the age of 20 are classified as obese, which significantly raises their risk of developing poor health outcomes later in life. This trend underscores the pressing need to reassess and strengthen existing strategies to address obesity effectively.
Since the 1990s, the prevalence of obesity has been on the rise, with the World Health Organization (WHO) identifying it as a critical global health issue early on [1]. While many countries have implemented programs to address this growing concern [2], these interventions have primarily focused on adults and have largely cantered around behavioural education [3]. However, despite these efforts, obesity rates, particularly among children and adolescents, have continued to climb, with significant increases observed globally since the 1990s.
The double burden of malnutrition—where undernutrition and obesity coexist—compounds the challenge. While malnutrition is often associated with underweight individuals, obesity is a form of malnutrition that is less recognized but equally harmful [4]. Obesity is linked to an increased risk of chronic diseases such as hypertension, heart disease, and diabetes, which contribute to high morbidity and mortality rates [4]. This dual burden has significant implications for public health, as it requires a multifaceted approach to address both ends of the nutritional spectrum [4].
In the early 1990s, obesity was primarily seen as an adult issue, with relatively low prevalence among young people under 20 years old. However, the NCD-RisC study [4], reveals a troubling trend: obesity rates in children have risen sharply since the 1990s. This increase is evident across most countries, with only a few regions, such as South Asia and Sub-Saharan Africa, showing a decline in both underweight and obesity prevalence.
The rise in obesity is often attributed to a combination of decreased physical activity and increased consumption of processed foods. These factors are further exacerbated by socioeconomic and environmental issues, such as the availability of cheap, processed foods and the impact of climate change on agriculture, which limits access to fresh, organic produce. The recent COVID-19 pandemic has also played a role, as lockdowns and restrictions led to decreased physical activity and disruptions in food supply chains, contributing to the worsening obesity epidemic [4]. Over the past two to three decades, obesity intervention programs have primarily targeted adults, focusing on education and behavioural modification. However, as the NCD-RisC study [4] shows, these efforts have not succeeded in reducing obesity rates among adults, and more concerningly, they have failed to prevent the rise in obesity among the younger population.
The double burden of malnutrition—encompassing both obesity and underweight—presents a significant global health challenge. Currently, global obesity prevalence among adults is at an alarming rate, with notable differences 
between males and females. In the population under 20 years old, obesity prevalence has also surged, indicating a pressing need for a shift in intervention strategies. The time has come to critically review and revise our approach to obesity reduction on a global scale. The current focus on adults, while important, has not addressed the growing issue of obesity among younger populations. Future interventions must consider broader factors such as food sustainability and socio-economic conditions. Only by adopting a more comprehensive approach can we hope to curb the rising tide of obesity and ensure better health outcomes for future generations.
Primary Reference
4. Worldwide trends in underweight and obesity from 1990 to 2022: a pooled analysis of 3663 population-representative studies with 222 million children, adolescents, and adults. Lancet. Mar 16 2024;403(10431):1027-1050. doi:10.1016/s0140-6736(23)02750-2
Secondary Reference
1. James WP. WHO recognition of the global obesity epidemic. Int J Obes (Lond). Dec 2008;32 Suppl 7:S120-6. doi:10.1038/ijo.2008.247
2. Abay KA, Ibrahim H, Breisinger C. Food policies and obesity in low- and middle-income countries. World Development. 2022/03/01/ 2022;151:105775. doi:https://doi.org/10.1016/j.worlddev.2021.105775
3. Effects of Intensive Lifestyle Intervention on All-Cause Mortality in Older Adults With Type 2 Diabetes and Overweight/Obesity: Results From the Look AHEAD Study. Diabetes Care. Mar 21 2022;45(5):1252-9. doi:10.2337/dc21-1805
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