Childhood Obesity among School-Aged Children (5–15 Years): Epidemiology, Determinants, Assessment Strategies and Public Health Implications in Urban India

Abstract

Background. Childhood obesity is escalating globally and in India, yet locality‑specific evidence is sparse. Understanding the epidemiology, risk factors and health consequences among apparently healthy school‑aged children is crucial for targeted interventions.

Methods. A narrative review of peer‑reviewed literature was conducted to synthesise data on the prevalence, determinants, assessment methods and consequences of overweight and obesity among children aged 5–15 years, with a focus on India. Global and Indian databases were searched for cross‑sectional studies, systematic reviews and guidelines.

Results. The global pooled prevalence of obesity among children and adolescents <18 years is ~8.5%. Low‑ and middle‑income countries show rising trends; high‑income countries still have the highest prevalence. In India, national surveys report overweight/obesity prevalence of 3–4% among under‑five children and ~8–9% among older children. Regional studies reveal wide variability: overweight/obesity ranges from 1% to >30% depending on socioeconomic status and urban/rural setting. Risk factors consistently include consumption of energy‑dense foods, frequent intake of sugar‑sweetened beverages, irregular meals, physical inactivity, long screen time, shorter sleep and high socioeconomic status. Waist‑to‑height ratio and waist circumference augment body‑mass‑index (BMI) in identifying metabolic risk. Childhood obesity is associated with clustering of metabolic risk factors, type 2 diabetes, non‑alcoholic fatty liver disease and psychosocial problems. Multi‑component school‑based interventions, promotion of physical activity, healthy diets and reduction of junk foods are effective preventive strategies.

Conclusions. India is experiencing a transition from under‑nutrition to over‑nutrition. Despite evidence of increasing overweight/obesity among school‑aged children, there remains a paucity of locality‑specific data. Continued surveillance and context‑specific interventions are needed to curb the growing epidemic, justifying local prevalence studies such as the planned survey in Sarvodaya Nagar, Lucknow.