new york —
For many parents, those signs suggest a child is getting plenty to eat. Doctors say that assumption can be dangerously incomplete: children can carry extra weight while missing the vitamins, minerals, fibre and protein their bodies need to grow.
The paradox is becoming more visible as childhood overweight rises worldwide. The World Health Organization says more than 390 million people aged 5 to 19 were overweight in 2022, while more than 160 million in that group were living with obesity.
How can an overweight child be malnourished?
The answer lies in the difference between calories and nourishment.
A packet of crisps, a sugary drink or a fast-food meal can provide a large calorie load quickly. But these foods may offer little iron for healthy blood, calcium and vitamin D for bones, protein for repair and growth, or fibre for digestive health.
“Overweight and well nourished are not the same thing,” says Deepali Sharma, a clinical nutritionist at CK Birla Hospital in Delhi. A child may consume more energy than they need while falling short on nutrients that support immunity, development and bone strength.
This is part of what public-health experts call the double burden of malnutrition: different forms of poor nutrition appearing together, sometimes in the same child.
Why does weight not tell the full story?
Two children can consume a similar amount of food and have very different diets.
One may eat dal, vegetables, fruit, whole grains, curd, eggs, legumes, nuts and seeds. Another may fill up mainly on biscuits, sweetened drinks, refined carbohydrates and packaged snacks. Both may feel satisfied after meals. Only one may receive a broad enough mix of nutrients.
Dr Pawan Kumar, a paediatrician at Madhukar Rainbow Hospital in Delhi, says parents should not rely on weight or BMI alone. In children, BMI needs interpretation by age and sex, while growth patterns, sleep, activity, food quality and symptoms all matter.
A child who is frequently tired, struggles to focus, gets sick often or shows poor growth may need a closer nutritional assessment. Those signs do not prove a deficiency, but they are worth discussing with a paediatrician.
Why are nutrient gaps becoming more common?
Modern food environments make calorie-dense food easy to find and easy to eat. Products high in sugar, salt, unhealthy fats and refined carbohydrates can crowd out more nutritious choices, especially when meals lack variety.
WHO has warned that rising overweight and obesity now coexist with undernutrition and micronutrient deficiencies in many low- and middle-income countries, including across South Asia.
India’s Comprehensive National Nutrition Survey, which assessed more than 100,000 children between 2016 and 2018, found that overweight and obese children often had lower levels of nutrients including folate and vitamin B12. School-age children showed notable gaps in vitamin D, iron and zinc.
The message is stark: eating more does not automatically mean nourishing more.
Should parents put an overweight child on a strict diet?
Usually, the goal should not be harsh restriction.
If a child’s meals already lack quality, simply cutting portions can deepen nutrient shortfalls. Doctors instead recommend improving what reaches the plate: more fruit and vegetables, whole grains, legumes, dairy or suitable alternatives, nuts, seeds and age-appropriate protein.
That approach helps shift the conversation away from punishment and toward health. You are not trying to make every meal a calorie calculation; you are trying to make each meal work harder for your child.
Regular movement, adequate sleep and family meals with fewer ultra-processed foods can also support healthier long-term habits.
What should parents do next?
Start with one clear question: Is my child eating enough of the right foods?
Weight is only one part of the picture. A healthy child needs dietary variety, steady growth, energy, sleep, movement and appropriate medical support when symptoms raise concerns.
Supplements should not be given automatically based on a child’s weight. A clinician can assess whether testing, dietary changes or targeted treatment is appropriate.
The old image of malnutrition as a visibly thin child no longer reflects reality. A child can appear well-fed — even overweight — and still be quietly running short of what their growing body needs.
