Childhood Obesity Epidemic Shifts to Developing Nations, Creating 'Double Burden'

The epicenter of the global childhood obesity epidemic is shifting from wealthier nations to low and middle-income countries, creating a critical public health challenge alongside persistent undernutrition, according to a new report. The findings, from a project involving over 1,000 scientists and backed by the World Health Organization (WHO), show that the pace of rising obesity is now fastest in countries least equipped to handle the long-term healthcare costs.

A Shifting Epidemic

The study, published in the scientific journal *Nature*, tracked nutritional data for children aged 5 to 19 across 200 countries. It highlights a phenomenon known as the "double burden," where nations struggle with both undernourishment and a rapid increase in obesity, often within the same communities.

Key findings from the project include:

• Between 2023 and 2024, obesity rates among boys rose fastest in Peru, reaching 19% from less than 8% in 2010.
• For girls, the sharpest increases were seen in Tonga and Samoa.
• In Indonesia, obesity prevalence for both boys and girls saw its largest-ever absolute increase in 2024, rising by more than half a percentage point.

The View From Indonesia

Indonesia, the world's fourth most-populous country, now serves as a stark example of this trend. According to an analysis of the global data, it has become the most populous nation after China and the United States where the prevalence of obesity in children has officially overtaken undernutrition. This combined nutritional crisis now affects 20% of Indonesia's 60 million school-aged children.

Experts attribute the shift to a rapid "nutrition transition," where a history of food scarcity gives way to an abundance of cheap, highly processed foods high in fat and sugar. An analysis by the Access to Nutrition Initiative, shared with Reuters, found that only 21% of packaged food products sold in Indonesian grocery stores met an international "healthy" threshold, far below the average in other assessed countries.

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Economic and Health Consequences

The long-term consequences of this trend are severe, threatening to reverse decades of public health gains. Dr. Zulfiqar Bhutta, a global child health expert involved in the WHO-backed project, warned of an "absolute tsunami of non-communicable disease" including diabetes, heart disease, and asthma.

The economic fallout is projected to be substantial. The WHO predicts the global costs associated with overweight and obesity could reach $3 trillion annually by 2030. For Indonesia alone, the World Obesity Federation estimates these costs could surge from $17.5 billion in 2019 to nearly $47 billion by 2030, factoring in healthcare spending, lost productivity, and premature mortality.

Policy and Public Awareness Gaps

Despite the data, public health experts told Reuters that childhood obesity receives little attention from many governments. In an interview with the news agency, Indonesia’s health minister Budi Gunadi Sadikin acknowledged the rise but stated, "obesity is a problem that mainly happens in developed countries."

Policy measures such as a tax on sugar-sweetened beverages have been repeatedly postponed in Indonesia, and a new food labeling system is not yet mandatory. Aman Pulungan, a senior paediatric endocrinologist at the University of Indonesia, noted a critical awareness gap, stating, "Indonesians have no awareness that obesity could make us sick."