A child finishes dinner, asks for something sweet and settles down with a phone while the adults around the table return to their own screens. Nobody considers this an unusual evening.
But when the same pattern repeats day after day, with little physical activity and sugary snacks becoming routine, the habits shaping a child's health may be forming almost unnoticed.That is part of the challenge behind childhood obesity: it rarely comes down to one food, one habit or one decision. And treating it cannot begin and end with a prescription.On October 7, the World Health Organization (WHO) released its global guidelines specifically addressing the management of obesity in children and adolescents.
The recommendations place greater emphasis on healthy eating, physical activity, behaviour change and support from caregivers, rather than treating medicines or surgery as the default solution for children.For Indian families, the advice raises a practical question: how can these recommendations fit into everyday life, where school schedules, tuition classes, long commutes, screen time and family food traditions all influence what children eat and how much they move?
Childhood obesity is rising, and the numbers are difficult to ignore
According to the WHO, an estimated 400 million children and adolescents aged 5–19 years were overweight worldwide in 2024.
Of these, 170 million were living with obesity.India is also facing a growing challenge. According to figures cited by UNICEF India from the National Family Health Survey (NFHS), overweight and obesity among children under five increased from 1.5% in NFHS-3 (2005–06) to 3.4% in NFHS-5 (2019–21). Among adolescents, the reported prevalence of overweight and obesity also rose between these survey periods.
Why Indian families need to get involved?
A child's routine is shaped by what happens at home. The food available in the kitchen, whether family members eat together, how leisure time is spent and whether parents make time for movement can all influence a child's habits.Dr Vivek Jain, Chairperson of the Paediatrics Department Development and Principal Director of Paediatrics at BLK-Max Super Speciality Hospital, New Delhi, says Indian families can begin with small, sustainable changes rather than drastic restrictions.“Childhood obesity needs an approach that goes beyond medicines and diet plans. Proper nutrition, physical activity, adequate sleep and family support all have a role to play.
For Indian families, making small changes to everyday routines can be the first step,” he says.This approach also helps avoid a common mistake: treating the child as the only person who needs to change. If a child is told to eat differently while everyone else continues to consume sugary drinks and packaged snacks regularly, healthy habits may be difficult to sustain.Dr Deepak Sharma, Senior Director and Head of Paediatrics and Neonatology at Yatharth Super Speciality Hospital, Faridabad, Sector 88, says families need to create an environment in which healthier choices become part of everyday life.“Children’s eating habits, activity levels and approach to food are greatly influenced by what they see at home. Family involvement should therefore be central to managing childhood obesity,” he says.
1. Keep traditional Indian meals, but rethink how they are prepared
Healthy eating does not require Indian families to replace familiar meals with expensive health foods or follow restrictive diets. Everyday foods such as dal, roti, vegetables, seasonal fruits, curd and other suitable dairy products can contribute to a balanced diet.Dr Jain recommends prioritising home-cooked meals containing vegetables, fruits, pulses, whole grains and adequate sources of protein. He also cautions against forcing children to finish everything on their plates or putting them on restrictive diets.2. Stop using sweets as a reward for good behaviourIn many Indian households, food is an expression of affection. Sweets are offered to celebrate achievements, chocolates may reward good behaviour, and favourite snacks can become a way to comfort a child after a difficult day.Dr Sharma says parents should consider other ways of expressing affection, such as spending time with their children, playing together, reading or doing an activity they enjoy.
3. Make physical activity part of family life
For a child who spends most of the day sitting in a classroom, travelling to tuition and completing homework, telling them to exercise more may not be enough. Families need to make movement enjoyable and practical.Dr Jain suggests encouraging children to play outdoors, cycle, dance or participate in sports.
The activity should suit the child's age, interests and abilities. The goal is to build a routine that can be maintained, not to punish a child for gaining weight.The WHO recommends that children and adolescents aged 5–17 years average at least 60 minutes a day of moderate-to-vigorous physical activity across the week. This can include walking, running, cycling, active games and sports.
4. Pay attention to screen time and sleep
A child's health routine is not only about food and exercise.
Sleep and sedentary behaviour also matter, and the WHO includes both in its approach to managing childhood obesity.Dr Sharma recommends limiting screen use during meals and helping children make healthier choices through the routines established at home.Families can begin with realistic boundaries: eating together without phones, setting a consistent bedtime and creating opportunities for activity between schoolwork and recreational screen time.
5. Never turn a child's weight into a source of shame
One of the most important parts of childhood obesity care is how adults talk about it.Dr Sharma stresses that weight alone is not an adequate measure of a child's health. A healthcare professional needs to assess the child's growth trajectory, medical history, nutrition and physical development before deciding whether intervention is necessary.“Weight alone is not an adequate measure of health,” he says, adding that children should not be made to feel ashamed of their bodies or forced into dramatic diets.
6. Understand where medicines fit into the WHO guidance
The WHO's emphasis on lifestyle changes does not mean that medicines are always inappropriate. It means that treatment must be matched to the child's age, needs and clinical circumstances.For children under 10, the new guidance prioritises comprehensive lifestyle and behavioural interventions rather than routine weight-loss medication. For adolescents aged 10–19 living with obesity, pharmacological treatment may be considered in specific circumstances after a structured, supervised programme of lifestyle modification has failed to achieve the desired results.
Surgery is reserved for carefully selected adolescents with severe obesity under strict conditions.These decisions should be made by qualified healthcare professionals. Parents should not give children weight-loss medicines, start restrictive diets or attempt rapid weight reduction without medical guidance.
7. Look beyond the home
Dr Sharma points to the role of schools and communities in encouraging sports, short walks and outdoor activities.
Where playgrounds are scarce, schools can introduce active breaks and provide opportunities for movement during the day.For Indian families, the first step does not have to be an expensive diet plan or a complicated exercise schedule. It can begin with the food served at dinner, the time spent playing, a more consistent bedtime and a decision to stop making comments about a child's body.The WHO's message is not to replace every medical intervention with lifestyle advice. It is to make sure children receive the right care, while building the family support and healthier environments they need to thrive.