Prevalence of Overweight and Obesity Among Children Younger Than 5 Years in India

Importance Evidence is lacking on long-term trends across Indian states and union territories (UTs) and on the attainability of the 2030 Global Nutrition Target (GNT) goals within these specific regions. Objectives To estimate the trends in overweight and obesity among children younger than 5 years across 36 states and UTs in India between 2006 and 2024 and to assess the feasibility of achieving the GNT of restricting the overweight burden to 5% or less by 2030. Design, Setting, and Participants For this cross-sectional study, microdata and aggregate data were used from the 4 most recent waves of the National Family Health Survey (repeated cross-sectional surveys conducted between January 1, 2006, and December 31, 2024). The analysis included individual-level samples of 41 306 children in 2006, 225 002 in 2016, and 201 687 in 2021, alongside aggregate estimates of overweight from the 2024 wave. Data were analyzed in January and updated in July 2026. Main Outcomes and Measures Following World Health Organization definitions of overweight and obesity in children younger than 5 years (overweight is defined as weight for height >2 SDs above the World Health Organization median and obesity as >3 SDs), their prevalence and standardized annualized changes for 5 timeframes (2006-2016, 2016-2021, 2021-2024, 2006-2021, and 2006-2024) were computed. Additionally, the fractional logistic regression was used to model national and state-level overweight trajectories, forecasting probability of achieving the 5% or less 2030 GNT threshold. Results The final sample included 467 995 children (241 645 [51.6%] male, 226 350 [48.4%] female) aged 0 to 59 months from NFHSs conducted between 2006 and 2021. Mean (SD) child age remained consistent from 2006 to 2021: 30.1 (17.1) months in 2006, 30.1 (17.0) months in 2016, and 29.9 (17.2) months in 2021. Between 2006 and 2021, the prevalence of overweight increased from 1.55% to 3.42%, whereas obesity prevalence increased from 0.50% to 1.30% before overweight prevalence decreased to 1.3% in 2024. Although India was projected to sustain the 2030 overweight target nationally, 9 states and UTs (Arunachal Pradesh, Assam, Himachal Pradesh, Jammu and Kashmir, Kerala, Mizoram, Nagaland, Sikkim, and Tripura) maintained a low to moderate probability of adherence. Conclusions and Relevance In this cross-sectional study of Indian children younger than 5 years from 2006 to 2024, a historical overweight increase reversed in 2024. However, profound subnational disparities remained, suggesting that targeted regional interventions are needed to achieve the 2030 GNT.