Malaysian children gaining excess weight before primary school, disrupting sleep and learning

 

SOME Malaysian children carry more than just extra weight, showing signs of serious health issues that often go unnoticed.

According to Oriental Melaka Straits Medical Centre consultant paediatrician Dr Ng Hui Ying, this extra weight amounts to childhood obesity, appearing even in preschool and primary school children, which in turn affects sleep, attention and learning.

In fact, the American Academy of Pediatrics (AAP) reported that there are 14.4 million children and adolescents are obese, making it one of the most common chronic conditions.

In Malaysia, the Clinical and Experimental Pediatrics, published in 2025, further showed that prevalence of obesity rose from 8.4% in 1990 to 14.5% in the 2020s, with 30% of children considering having excess weight, with roughly around one in three adolescents being obese or overweight.

“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,” Dr Ng commented.

“Infants or young children who gain weight rapidly may need evaluation for underlying risk factors.”

Screening for obesity

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Paediatricians use body mass index (BMI) charts to identify weight. For children under five, overweight is more than two standard deviations above the World Health Organisation (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.

Obese children should be screened, while overweight children with two or more risk factors may need further evaluation, Dr Ng elaborated.

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.

If left untreated, obesity can lead to heart disease, diabetes, liver problems, and emotional challenges.

Signs of obesity include high blood pressure, darkened skin patches, and attention difficulties. Children with a family history of diabetes, maternal diabetes during pregnancy, abnormal birth weight, excessive thirst, or daytime sleepiness are at higher risk.

Without treatment, obesity can lead to heart disease, diabetes, liver problems, and emotional challenges.

Social issues

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Meanwhile, research has further indicated that children with overweight or obesity are more likely to be bullied at school and face higher risks of depression and anxiety, highlighting the importance of early intervention.

According to Dr Ng , 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 choice and eating habits. Local data are also concerning: The NHMS 2024 shows 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. Children with shorter sleep duration shows higher risks of obesity

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“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,” Dr Ng continued.

“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.”

At the same time, routine paediatric check-ups provide opportunity to assess weight, identify underlying causes, and plan interventions.

“Obesity is a chronic condition that needs ongoing care,” she said, adding that families must also 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.” ‒  Focus Malaysia