CHILDHOOD obesity, appearing even in pre-school and primary school children, often affects sleep, attention, and learning, said a consultant paediatrician.
Dr Ng Hui Ying, from Oriental Melaka Straits Medical Centre, said some of these children carry more than just extra weight, showing signs of serious health problems that often go unnoticed.
“Malaysia’s children are facing early-onset obesity, even before primary school. Weight is still a sensitive topic for families, and avoiding the discussion can delay screening and intervention.
“Infants or young children who gain weight rapidly may need evaluation for underlying risk factors,” said Dr Ng.
According to the American Academy of Pediatrics (AAP), some 14.4 million children and adolescents are obese, making it one of the most common chronic conditions.
A 2025 meta-analysis in Malaysia in Clinical and Experimental Pediatrics revealed that the prevalence of obesity rose from 8.4% in 1990 to 14.5% in the 2020s, with 30% of children considered to have excess weight - roughly around one in three adolescents are obese or overweight.
For children under five, overweight is more than two standard deviations above the WHO growth median, while obesity is more than three.
For ages five to 19, overweight is more than one standard deviation above the WHO reference median, while obesity is more than two.
Dr Ng said obese children should be screened, while overweight children with two or more risk factors may need further evaluation.
“Risk factors include high blood pressure, appearance of darkened skin patches in skin folds, excessive thirst, passing urine too often, snoring at night with daytime somnolence and difficulty paying attention.
“Children are at higher risk if they have a family history of diabetes, hypertension and heart attack, maternal diabetes during pregnancy and abnormal birth weight,” she said.
If left untreated, obesity can lead to heart disease, diabetes, liver problems, and emotional challenges.
Research shows children who are overweight or obese are more likely to be bullied at school and face higher risks of depression and anxiety, highlighting the importance of early intervention.
Dr Ng added that most cases are driven by lifestyle factors shaped by the child’s environment, but genetic, hormonal, or metabolic causes must also be considered, particularly in children under five.
She also points to everyday habits driving obesity, including diet, screen time, and physical activity.
The AAP found children who watch more than two hours of TV daily face a 42% higher risk of obesity, as screen time encourages sugary and processed foods, reduces activity, and shortens sleep duration.
Screen time exposure affects families' food choices and eating habits.
According to Dr Ng, the National Health and Morbidity Survey (NHMS) 2024 shows that only half of children eat all five food groups daily, 63% of adolescents drink more than one sugary beverage a day, and 75% exceed fat intake.
Two in five eat both dinner and a heavy supper weekly.
“Family habits matter just as much. Children are more likely to reach a healthy weight when parents respond to hunger and fullness cues, model good habits, and maintain routines.
“Encouraging balanced meals and regular physical activity helps them self-regulate eating, stay active, and offset the risks of sedentary behaviour and high-calorie intake,” Dr Ng added.
At the same time, routine paediatric check-ups provide an opportunity to assess weight, identify underlying causes, and plan interventions.
“Obesity is a chronic condition that needs ongoing care,” she said.
Families must be involved from the first consultation to make lifestyle changes sustainable for both the child and the household.
Early detection and family-based lifestyle changes can prevent lifelong health problems, so parents should not delay conversations about weight, sleep, and nutrition with their child’s doctor, added Dr Ng. – March 11, 2026
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