The latest childhood obesity statistics are profoundly disappointing: A new study published last week in The Lancet paints a clear picture of an unhealthy present and worrisome future: Across four decades, child obesity increased tenfold around the world — from 11 million children in 1975 to 124 million in 2016 —  even as the number of undernourished children remains higher, at 192 million.

No country is, perhaps, a better case study of these conflicting health risks than India, home to 40% of the world’s children — a figure that encompasses both the second-highest population of obese children in the world, as well as one of the highest concentrations of undernourished children. And the country’s future will be telling: In the next five years, the researchers say, the global number of obese children and teens will likely surpass those underweight; assuming India doesn’t buck the trend, the country is set to face new, widespread and chronic health challenges — like diabetes (for which Indians are already at higher risk) and high blood pressure — among an increasingly youthful workforce.

The spread of childhood obesity “is a huge problem that will get worse,” Harry Rutter told the BBC. Rutter is an obesity researcher with the London School of Hygiene and Tropical Medicine. “We have not become more weak-willed, lazy or greedy. The reality is the world around us is changing.”

Increasing wealth around the world has led to changed behaviour and food supplies that drive the spread of child and teen obesity. In the West, where some of the least nutritious food is the most affordable, childhood obesity is a problem of poverty; in India, child and teen obesity crosses class. Family life is becoming increasingly sedentary; children are turning to screens for entertainment, rather than the traditional, physically active play. Traditional diets rely on overcooked foods, sugary ladoos and chai, while newer but no less Indian diets are embracing processed versions of classics, childhood obesity crosses class. (Even when healthy eating is possible and prioritized, there is some evidence that suggests raw food stuff simply isn’t as nutritious as it was in earlier decades.)

It will be a hard shift to focusing on undernourishment alone to simultaneously combating obesity. It will take changes in funding and policy, messaging and programming, but encouragingly, India can learn (both what to do and what not to do) from the West, where the study found childhood obesity rates have plateaued in recent years after a long and sharp ascent. Ultimately, it may be worth remembering that in the end, efforts to solve both childhood undernourishment and obesity boil down to making sure kids have access to enough, healthy food — less a battle on two fronts, perhaps, than two sides of the same coin.

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