In scientific terms, all of the obesity is an enigma, but it is particularly difficult to understand when you come across an obese seven or eight-year-old. Is it genetic or is it the parenting? Is it a disease or is it a lifestyle choice? These questions are never too far from the mind of any sufferer of obesity but take a whole new meaning when the patient is a child.

When an adult suffers from obesity, we can say it is a lifestyle choice but how can you say that for a five-year-old? Why is this child able to eat to his detriment? Why is his food intake regulation not working? Since we cannot realistically apportion the blame on a child, most of us would blame the parents.

But the central question still persists. Why are these parents able to overfeed their children, if that is what they are doing? Most children will not put even a spoonful in their mouth if they don’t want to. Why not these children? What is going on here that separates these children from the rest? And is it logical to expect these patients to take food away when the child is demanding it, pleading for it?

Our job, as parents, is to feed our children. We will go hungry if need be to ensure our little ones are fed. But the concept that we could feed our children too much would be alien to most Indian parents as it was to our counterparts in the West ten years ago. But it is no longer a foreign problem that Indians could comfortably ignore.

If you don’t believe me, I suggest you watch the BBC Documentary “India’s supersize kids”. Indian children are no different to kids in richer countries and if you present them with the same environment, the end result unsurprisingly will be exactly the same. Slowly but surely, kids in India are now being exposed to the same fast food and the processed food culture that is now rampant in the West.

India is a large and diverse country where a large number of children are growing up in homes without enough food.

Obesity is not a problem for those children. In fact, the problem they face is exactly the opposite – a lack of nutrition. Their situation is made even worse by periodic episodes of diarrhoea and malaria that they will inevitably suffer. It is as if these diseases are a part of the growing up process for these children.

Access to clean water and a hygienic environment that rich kids in both India and developed countries take for granted is not something these children are blessed with. They do not have access to enough food to grow into healthy adults and a large number would manifest this in the form of stunted heights and underdeveloped physique. This, in my opinion, is the reason for a large number of relatively short individuals in our country and a lower average height in comparison to, say, Caucasians. I do not think that racially Indians are short people.

Our ancestors, if you care to examine historical pictures and texts, were not short. It’s just that, in modern times, far too many of our children either do not have enough food or face too many infectious diseases that prevent them from growing into the tall, healthy individuals that our genes are programmed for.

But at the same time, an increasing number of our children, mainly those from the richer sections of the society, are now obese. A study from northern India reported a childhood obesity prevalence of 5.59% in the higher socio- economic strata compared to 0.42% in the lower socio- economic strata. That is now, but don’t forget – and this we know from Western countries – obesity tends to migrate to lower socio-economic classes. So, it is a matter of time, when kids in lower socio-economic classes will also face this problem and they will not have access to advanced medical help either.

For many obese adults, the problem starts during childhood. I agree for most the problem starts much later but there is no shortage of people who’ve always been “big”. I often hear “We are a family of big people”; or “All my sisters and brothers are obese too”; or even “I don’t ever remember being small.” Though undeniably, some of these families might carry a responsible gene (and we are beginning to find some of those genes now), I suspect the majority have just developed an acceptance of obesity. They have a particular eating habit or lifestyle where each one feeds into the others’ choices without feeling guilty. After all, they’ve all got bad genes!

Though it can have very serious consequences for all age groups, the implications can be far reaching when children and teenagers are affected by obesity. It has the potential to completely ruin their lives even before they have had a chance to establish relationships and careers. That is why it is all the more important to understand the determinants of childhood obesity and seek to modify them wherever possible.

The statistics

Approximately 20% of children in India are either overweight or obese. At a global level, it is estimated that some 268 million (15.8%) school-aged children (age 5 to 17.9 years) will be either overweight or obese in 2025, which is up from 219 million (13.9 percent) in 2010. China will have most overweight and obese children in the world (48.5 million) by 2025, followed by India (17.3 million), and the United States (16.7 million). The same researchers estimate that by 2025, the number of children considered “obese” would rise to 91 million (5.4 percent) worldwide, up from 76 million (4.8 percent) in 2010.

It is an undisputed fact that our children are getting heavier. In the USA, the average weight of a child has risen by more than five kilograms within three decades, to a point where a third of the country’s children are now overweight or obese. And this is not without its health and social consequences. The incidence of high blood pressure, liver problems, diabetes, and a number of medical and psychological conditions that were almost non-existent in children a few decades ago is rising.

When it comes to developing countries like India, we simply do not have the resources to deal with the aftermath. If the worst predictions come true, we will not have a young population that can work and look after the old; we will have a young population that will need looking after itself. It will truly challenge the mindset that you should have as many children as possible so that you are looked after when old.

Excerpted with permission from Fight With Fat, Kamal Mahawar, Fingerprint! Publishing.