Childhood malnutrition can no longer be understood solely as undernutrition.

UNICEF’s Feeding Profit report marks a historic turning point: in 2025, obesity among school-aged children and adolescents surpassed underweight worldwide for the first time.

According to the report, 188 million children and adolescents aged 5 to 19 were living with obesity, and global prevalence increased from 3% in 2000 to 9.4% in 2025, while underweight prevalence declined from nearly 13% to 9.2%.

This shift forces us to abandon outdated concepts of childhood nutrition and recognize that we are now facing a double burden: the persistence of undernutrition in certain settings alongside the rapid expansion of excess weight across nearly the entire world.

From a medical perspective, overweight refers to unhealthy excess body weight for age, sex, and height; obesity represents a more severe condition associated with increased risk of insulin resistance, hypertension, dyslipidemia, fatty liver disease, type 2 diabetes, and future cardiovascular disease.

Its pathophysiology cannot be reduced to simply “eating too much.” Neuroendocrine mechanisms, genetic susceptibility, sleep patterns, stress, sedentary behavior, and — above all — obesogenic food environments all play critical roles.

UNICEF emphasizes that many children are continuously exposed to inexpensive, ultra-processed, calorie-dense foods that are aggressively marketed, while healthier options remain less accessible and less affordable.

The report analyzed data from more than 190 countries, integrating household surveys, modeled estimates, projections, and polling data. For children and adolescents aged 5 to 19, it used coordinated data from NCD-RisC and projected recent trends in obesity and underweight prevalence.

Its central findings are epidemiologically compelling:

Obesity now exceeds underweight in every region except sub-Saharan Africa and South Asia, while digital advertising for sugary beverages, snacks, and fast food reaches the majority of surveyed youth populations.

UNICEF proposes concrete measures including:

Restrictions on unhealthy food marketing
Improved front-of-package labeling
Healthy taxes and subsidies
Protection of school food environments
Strengthening nutritional surveillance systems

My interpretation as a pediatrician and epidemiologist is straightforward: this problem is no longer merely clinical — it is structural.

If healthcare systems continue waiting until children arrive with established obesity, interventions will come too late.

Real prevention requires public policies addressing schools, marketing, food pricing, food availability, and social protection systems.

Moreover, this nutritional transition is directly linked to the prevention of metabolic disease: every year lost during childhood increases the risk of diabetes, hypertension, and liver damage appearing at progressively earlier stages of life.

This publication is both a warning and a roadmap.

Institutional Source

UNICEF. Feeding Profit: How Food Environments Are Failing Children.

UNICEF Press Release on the 2025 Child Nutrition Report.