Physical inactivity, coupled with excessive use of processed and junk food, is causing overweight and obesity problems in Nepal, as the nation grapples with malnutrition problems for decades.

These problems have affected not only the elderly and adult populations but also very young children.

The World Health Organization (WHO) has prioritised preventing childhood obesity through its 24-hour Movement Guidelines for Early Years (2019), which recommends a balance of physical activity, limited screen time, and sufficient sleep.

The guidelines recommend that children under five engage in at least 180 minutes of physical activity daily, at least 60 minutes of moderate-to-vigorous (MVPA) physical activity, no more than 1 hour of sedentary screen time, and 10-13 hours of sleep per day.

However, a recent study shows that only one in ten (10 percent) children met all these guidelines (three hours of physical, less than one hour of screen time and 10 to 13 hours of sleep daily).

The pilot study was carried out between June and August 2023 under the International Study of Movement Behaviours in the Early Years (SUNRISE) initiative in Waling Municipality (urban) and Biruwa Rural Municipality (rural) of Syangja district in Gandaki Province.

According to the report, only three of five (60 percent) met the guideline of 180 minutes of daily physical activity, 79 percent met 60 minutes of moderate-to-vigorous physical activity, and nearly 60 percent limited their screen exposure to under one hour daily. Sleep patterns were relatively better, with 81 percent of children meeting the recommended duration of 10-13 hours.

The study, which involved 100 children aged 3–4 years, aimed to evaluate the proportion of preschool children meeting the WHO-recommended guidelines. The children's height, weight, executive functions (hand, eye, and brain coordination and function), and motor skills were measured, according to Narayan Subedi, the principal investigator.

Other studies carried out in the past also show that obesity has emerged as a major public health problem in Nepal, impacting not only children, but also adolescents and adults.

The Nepal Demographic and Health Survey-2022 carried out by the Ministry of Health and Population shows that 35 percent of women and six percent of adolescent girls in the country are obese.

Obesity and underweight are both forms of malnutrition and are detrimental to people’s health in many ways.

The World Health Organization said that many low- and middle-income countries like Nepal are now facing a ‘double burden’ —under-nutrition as well as a rapid upsurge in obesity-related cases, particularly in the urban areas.

The UN health agency said children in low—and middle-income countries are more vulnerable to inadequate prenatal, infant, and young child nutrition. At the same time, it said children are being exposed to high-fat, high-sugar, high-salt, energy-dense, and micronutrient-poor foods, which tend to be low not only in terms of cost but also in nutrient quality.

These dietary patterns, combined with lower levels of physical activity, result in sharp increases in childhood obesity.

Nutritionists in Nepal said that obesity problems, which have been emerging as a major public health problem, could lead to an epidemic if not addressed promptly. They say that the problems have become so uncontrolled that one can see obese people in every home and neighbourhood.

“Physical inactivity and consumption of highly processed and junk foods are driving overweight and obesity problems,” said Dr Keshab Bhattarai, a nutritionist. “Many people, including policymakers, may not take the problems seriously, but it could lead to a serious health epidemic in the coming days. Obesity and overweight problems increase the risk of several non-communicable diseases, including cardiovascular and diabetic problems at a young age.”