Classrooms can be new frontline in fight against childhood obesity: Experts

As childhood overweight and obesity emerge as an increasingly important public health concern in India, experts say the fight cannot be confined to hospitals and clinics, and must extend to classrooms, school canteens, playgrounds and home.

The experts said schools, where children spend a substantial part of their waking hours, can play a crucial role in shaping food choices, encouraging physical activity and health habits at an age when lifelong habits are being formed.

Dr Anirban Mandal, consultant, Paediatric Intensive Care at Sitaram Bhartia Institute of Science and Research, said schools have a much larger role to play in preventive healthcare than we have traditionally recognised.

"Because children spend a significant portion of their developmental years in the classroom, the lifestyle patterns established there -- ranging from dietary choices and sedentary behaviour to structural nutrition literacy --directly shape their lifelong metabolic health," Dr Mandal said.

However, pediatric experts cautioned that interventions must never revolve around restrictive dieting or weight stigma, which can severely harm a child's psychological development.

"Our clinical goal is never to foster weight obsession or body anxiety in growing children. Instead, our focus must remain strictly on promoting healthy linear growth, balanced nutrition, restorative sleep, and joyful daily movement," Dr Mandal emphasised.

"Schools can powerfully support this by replacing hyper-processed foods high in sugar, salt, and unhealthy fats with nutrient-dense options, safeguarding robust daily physical activity, and integrating age-appropriate wellness education into the core curriculum," he said.

Dr Pankaj Hari, Head of Department of Paediatrics at AIIMS Delhi, said that childhood obesity is no longer something that can be dismissed as a phase that children will simply outgrow.

"Excess weight during childhood can be accompanied by insulin resistance, abnormal lipid levels, fatty liver disease and high blood pressure, increasing the risk of diabetes and cardiovascular disease later in life.

"Prevention therefore has to begin during the school years rather than after a child becomes an adult," said Dr Hari.

According to the World Obesity Atlas 2026, India has the second-highest number of children living with overweight or obesity globally, with around 41 million children affected. In 2025, nearly 14.9 million Indian children aged five-nine years and more than 26.4 million adolescents aged 10-19 years were estimated to be living with overweight or obesity.

The growing concern has also prompted policy action in India. An ICMR-NIN-led policy framework has called for measures to create healthier food environments for children, including action around school canteens, unhealthy food availability and marketing targeted at children.

Experts, however, cautioned against stigmatising children who are overweight or obese, saying weight-based teasing can affect mental health and discourage children from participating in physical activities.

Dr Neha Joshi, senior consultant, Paediatrics at Sitaram Bhartia Institute of Science and Research, said schools should not be expected to replace parents or healthcare professionals, but they can become an important bridge between the two.

"Health literacy should be viewed as an essential part of education because a child who learns to understand food, fitness, sleep and preventive healthcare is better equipped to make informed choices throughout life," she said.

Dr Rajni Sharma, Professor of Paediatrics at the Division of Paediatric Endocrinology at AIIMS, Delhi, stressed that health and education cannot be treated as two separate silos and called for schools to create environments where healthy choices become easier and more natural for children.

"There is a need to provide nutritious food in school canteens and not keep junk food, so that children can learn about healthier food choices. They should also be encouraged to bring healthy food as tiffins from home. Even healthy food can be made in a tasty manner," she said.

Schools should also monitor screen time and encourage children to be physically active, Dr Sharma said, noting that prolonged sedentary behaviour and unhealthy eating habits can contribute to obesity.

Even in high schools, physical activity and sports should remain an important part, she said.

Dr Sharma said efforts to promote healthy lifestyles among children must also involve parents, as children are unlikely to sustain healthy habits if the messages and practices at home and school are contradictory.

In various scientific studies, regular physical activity and exercise, including running, have been found to improve academic performance by improving concentration, she said.

Physical activity should be routine in schools including higher classes, where focus generally shifts to academics.

"Physical activity should not be restricted to competitive sports. Walking, cycling, outdoor games and active play can all contribute to healthier routines," she said, adding that adequate sleep is equally important for maintaining metabolic health.

She emphasised that schools can play a crucial role in shaping children's habits early in life by integrating healthy eating, regular physical activity, adequate sleep and reduced screen time into their daily routines.