The World Obesity Federation (WOF) has said that without drastic action, half a billion children will be grossly overweight by 2040, calling on governments to urgently start creating healthier environments, reports The Guardian.
The agency said that for the first time in history, more children globally are obese rather than underweight.
Last year, worldwide, about 180m children were obese – 1.08m of those being South African, aged between five and 19 – but these latest figures from the WOF suggest that by 2040, about 227m of all five- to 19-year-olds will be obese and more than half a billion overweight.
According to the federation’s 2026 world obesity atlas, that would mean that at least 120m school-age children would have early signs of chronic disease caused by their high body mass index (BMI).
Someone is classed as obese if their BMI is 30 or above, and overweight if it is above 25.
Johanna Ralston, the World Obesity Federation’s chief executive, said the increase in childhood obesity worldwide showed a failure to take the disease seriously. “It is not right to condemn a generation to obesity and the chronic and potentially fatal non-communicable diseases that often go with it,” she said.
The report found that 27m five- to 19-year-olds in the US have high BMI, behind only China (62m) and India (41m). That equates to two in five US children being obese or overweight.
In Britain, about 3.8m children have high BMI – a record, making it among the worst performing countries in Europe, with around twice the numbers of overweight and obese children as in France and Italy.
The report estimates that by 2040, 370 000 children aged five to 19 in the UK are expected to have signs of cardiovascular disease, and 271 000 are estimated to show signs of hypertension.
The report identifies significant regional inequalities. The 10 countries where more than half of school-age children are overweight or have obesity are all in the western Pacific region or the Americas, while the fastest growth in obesity rates is predominantly in low- and middle-income countries.
According to the report, in South Africa this year, 247 000 children aged between five and 19 have BMI-attributed hypertension: 2.36m children between 10 and 19 are currently overweight or obese.
By 2040, 717 000 South African children are likely to be suffering from BMI-attributed metabolic dysfunction-associated steatotic liver disease (MASLD), formerly known as Non-Alcoholic Fatty Liver Disease (NAFLD), adds the report, calling for greater efforts to create healthy environments, including sugar taxes, limits on junk food advertising and policies to help children lead more active lives.
Global experts welcomed the findings.
Dr Kremlin Wickramasinghe, regional adviser for nutrition, physical activity and obesity at the World Health Organisation, said that childhood obesity was a “failure of environments”.
He called for mandatory, rather than voluntary, marketing restrictions or front-of-pack labelling. “The majority of governments are allowing the food industry to target children without restriction,” he said. “What we need is the political will to take action and stand up to industry interference.”
Katharine Jenner, executive director of the Obesity Health Alliance, said childhood obesity was “not inevitable”. “The projected rise in early signs of heart disease and hypertension should be a wake-up call about the long-term consequences of continued government inaction,” she said.
Call for access to GLP-1 drugs
The WOF report points out that most obese people live in low and middle-income countries (LMICs) – yet these are the populations least likely to have access to the GLP-1 medicines transforming treatment outcomes in wealthier countries.
Health Policy Watch reports that between 2010 and 2022, obesity more than doubled across all LMICs and tripled in low-income countries.
But GLP-1 drugs are “currently prohibitively expensive, prone to massive repeated supply shortages, and unavailable from state clinics and most medical aids”, according to South African clinicians Dr Francois Venter and Dr Nomathemba Chandiwana.
Only four of the 20 countries most affected by rising obesity rates cover the drugs in their public health systems, shows the Economist Impact’s World Obesity Response Index, while only Britain covers all four forms of evidence-based obesity care – nutrition counselling, intensive behavioural therapy, medications, and metabolic and bariatric surgery – through public insurance.
Canada, China, Mexico, Nigeria, Rwanda and South Africa offer no national-level coverage of any of these interventions.
“Without deep price reductions and scalable care systems, obesity treatment will remain out of reach, and health systems will continue to absorb the far higher costs of untreated disease,” according to the Medicines Patent Pool.
However, access to GLP-1 medicine should improve as the key compound patents for semaglutide (Wegovy) expire within the next few months, with generic medicine poised to enter the market.
While medicine is key to reducing obesity, so too are policy measures to rein in the industries that promote ultra-processed food that drives the condition.
Key interventions are high taxes on ultra-processed food and sugary drinks; front-of-package warning labels on food high in sugar, salt and fat; and restrictions on marketing these products to children.
Of the 20 most affected countries, only one – Mexico – taxes both unhealthy foods and drinks, shows the Global Obesity Response Index. Only Brazil, Canada, and Mexico require front-of-package nutrition labelling.
See more from MedicalBrief archives:
Childhood obesity tied to early, serious health issues – SA study
Parenting styles linked to children's weight – UK study
Why obesity should be treated as a chronic disease in South Africa
SA facing diabetes ‘pandemic’ as cases soar among young people
Schoolchildren’s obesity legacy from Covid – UK study