Undernutrition has long been associated with stunted growth, frailty, and lack of access to adequate food. However, health experts now warn that the issue has taken on a new dimension — undernutrition is increasingly linked to obesity and diabetes, creating what researchers call the “double burden of malnutrition.”

According to UNICEF’s latest Child Nutrition Report, the global prevalence of obesity among school-age children and adolescents surpassed underweight levels for the first time in 2025. This shift signals a growing crisis that threatens the health, productivity, and future potential of children, communities, and entire nations.

The report points to unhealthy food environments as a major driver of rising obesity rates among children. Cheap, calorie-dense foods and sugar-laden drinks are marketed aggressively, often overshadowing healthier choices. “When we think of undernutrition, we usually picture thin children or adults who haven’t grown properly. But in today’s world, undernutrition can also lead to obesity,” explained Dr. Rajeev Jayadevan, Chairman of the Scientific Committee at IMA Cochin.

He noted that individuals from poorer backgrounds often purchase low-cost foods high in sugar and fat but lacking essential nutrients. “Sugary soft drinks, for example, are heavily advertised by celebrities and sold cheaply, yet they fuel obesity and diabetes,” Dr. Jayadevan added.

The risks extend across generations. Undernourished mothers often give birth to children predisposed to obesity later in life, especially when food becomes plentiful. This phenomenon was reflected in a recent Cell Metabolism study, where Indian researchers studied rats subjected to undernutrition over 50 generations.

These rats displayed metabolic abnormalities — including higher insulin levels and deficiencies in vitamin B12 and folate — which persisted even after dietary conditions improved.

Dr. Sanjeev Galande, Dean of the School of Natural Sciences at Shiv Nadar University, and one of the study’s authors, said, “In India, the paradox of undernutrition heightening the risk of obesity and diabetes is often explained through the concept of the ‘double burden of malnutrition.’ Early-life undernutrition conditions the body to conserve energy and store fat efficiently, leading to long-term metabolic changes.”

Once exposed to high-calorie diets and sedentary lifestyles — increasingly common in modern India — these individuals face a significantly higher risk of obesity, type 2 diabetes, and related non-communicable diseases.

Experts further warned that lack of physical activity, along with smoking and alcohol use, worsens the problem. To combat this growing threat, they called for stronger measures to make nutritious, affordable food widely accessible and to regulate the aggressive marketing of unhealthy products.

“Without urgent action, the legacy of undernutrition may continue to haunt India and other developing nations, not through hunger alone, but through an epidemic of obesity and diabetes,” the experts cautioned.