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The Health Thread

The Growing Crisis of Adolescent Obesity in Nepal : Causes, Consequences, and Solutions

Written by Liza Nagarkoti , Public Health Researcher | Nutrition Specialist,  BSc Nursing, MA(Nutrition), Project Officer (Health) LWF Nepal

Introduction

Nepal is facing a silent but dangerous shift in its public health landscape. While undernutrition remains a critical issue, a new epidemic is emerging: adolescent obesity. My recent research conducted among 72 students at a Kathmandu school revealed that 11.1% were obese and 9.7% overweight—a troubling trend that mirrors global patterns of worsening metabolic health among youth (Sitaula et al., 2023). This article explores the root causes of this crisis, its long-term consequences, and evidence-based solutions to safeguard Nepal’s next generation.

The Dietary Crisis: How Modern Eating Habits Are Harming Youth

One of the most alarming findings from my study was the dramatic shift in adolescent diets. 71.34% of students regularly consumed fast food, while a staggering 91.97% drank sugary beverages (Khatri et al., 2021). These foods, high in refined sugars and unhealthy fats, contribute directly to weight gain and metabolic disorders. Equally concerning was the prevalence of chocolate consumption—79.2% of students ate chocolates frequently, with 26.4% indulging four or more times per week.

The decline of traditional Nepali meals—rich in whole grains, lentils, and vegetables—has been replaced by processed snacks and calorie-dense foods. Equally problematic is meal skipping, reported by 13.9% of participants, with breakfast being the most frequently missed meal (31.97%). Research shows that skipping breakfast slows metabolism by 15-20% and leads to overeating later in the day (American Journal of Clinical Nutrition, 2019).

Why does this matter? Poor dietary habits in adolescence set the stage for lifelong health problems, including type 2 diabetes, heart disease, and fatty liver disease (WHO, 2020). Without intervention, Nepal risks a surge in preventable chronic illnesses.

The Sedentary Lifestyle Epidemic: Screens over Sports

Physical inactivity is another major driver of adolescent obesity. While 90.3% of students claimed to exercise, deeper analysis revealed that 51.4% engaged in less than 30 minutes of daily physical activity—far below the WHO’s recommended 60 minutes per day.

A key contributor to inactivity is excessive screen time. My study found that 52.8% of students spent at least one hour daily on phones, TVs, or computers, with 4.2% exceeding three hours. Research from Harvard University confirms that each additional hour of screen time correlates with a 2% increase in BMI (Harvard School of Public Health, 2021).

Even though 86.1% of students walked to school, this activity alone was insufficient to offset the sedentary behaviors dominating their free time. Only 15.3% participated in school sports, highlighting a critical gap in structured physical education programs.

The consequences? Inactive youth face higher risks of obesity, poor bone development, and mental health struggles like anxiety and depression (Journal of Adolescent Health, 2022).

Family and Socioeconomic Factors: Hidden Influences on Obesity

My research uncovered surprising links between family structure and obesity risk. Students from nuclear families (58.3%) had higher obesity rates than those from joint or extended families. This may be due to:

  • Fewer shared household chores, reducing daily physical activity
  • Greater reliance on convenience foods in busier, smaller households
  • Less communal eating, which traditionally encourages balanced meals

Socioeconomic status also played a role. Wealthier students were 2.3 times more likely to be obese, likely due to:

  • Higher pocket money expenditure on junk food (UNICEF Nepal, 2021)
  • Increased access to smartphones and streaming services, promoting sedentary behavior
  • Attending private schools, where canteens often sell more processed snacks

The Consequences: A Lifetime of Health Risks

Adolescent obesity is not just a cosmetic issue—it’s a ticking time bomb for Nepal’s healthcare system. Obese teens face:

Metabolic Disorders

Type 2 diabetes risk increases by 30% (WHO, 2020)

Higher blood pressure and cholesterol levels, leading to early heart disease

Psychological Harm

Lower self-esteem and higher rates of depression (Journal of Pediatrics, 2021)

Social stigmatization and bullying, affecting academic performance

Economic Burden

Lifetime healthcare costs for obese individuals are 42% higher (The Lancet, 2022)

Lost productivity due to obesity-related illnesses

Solutions: A Multi-Pronged Approach

  1. School-Based Interventions
  • Replace junk food in canteens with affordable, nutritious options like fruits and nuts
  • Mandate 30 minutes of daily physical activity (e.g., morning exercises or sports periods)
  • Integrate nutrition education into science and health curricula

Example: Japan’s school lunch program, which provides balanced meals and nutrition lessons, has kept childhood obesity below 5% (UNICEF, 2023).

  1. Family and Community Actions
  • Revive family meals with traditional, home-cooked dishes like dal-bhat-tarkari
  • Limit screen time to under 2 hours/day and encourage outdoor play
  • Community cooking workshops to teach quick, healthy recipes
  1. Policy Changes
  • Tax sugary drinks and junk food, as Mexico did (reducing soda consumption by 12%)
  • Improve urban walkability with sidewalks and safe parks
  • Ban junk food ads targeting children, following Chile’s successful model

Conclusion: A Call to Action

Nepal stands at a crossroads. Without urgent action, adolescent obesity will escalate into a public health disaster. But the solutions are clear:

  • Schools must lead with healthier meals and daily exercise
    Parents can model better habits by reducing screen time and cooking nutritious meals
    Policymakers should legislate changes, from junk food taxes to improved sports facilities

The time to act is now. By working together, we can ensure Nepal’s youth grow up healthy, active, and free from preventable diseases.

REFERENCES

  1. Sitaula, D., et al. (2023). Prevalence and associated factors of adolescent obesity among rural school adolescents in Nepal. Global Health, Epidemiology and Genomics.
  2. Khatri, E., et al. (2021). Risk factors for overweight among adolescents in peri-urban Nepal. PLOS ONE.
  3. WHO. (2020). Guidelines on physical activity for children and adolescents.
  4. UNICEF Nepal. (2021). Adolescent Nutrition and Lifestyle Survey.
  5. The Lancet. (2022). Global economic burden of obesity-related diseases.

Navigating the Complex Terrain of Patient-Doctor Dynamics in Nepal: A Comprehensive Examination

Written by Liza Nagarkoti , BSc Nursing, MA(Nutrition), Project Officer (Health) LWF Nepal

In Nepal, the pervasive issue of assaults on healthcare professionals is deeply embedded in a complex web of socio-cultural, legal, and systemic challenges. The repercussions of such incidents extend beyond the immediate harm caused, affecting patient care, exacerbating communication breakdowns, and perpetuating a culture of fear and mistrust. This comprehensive examination delves into the multifaceted nature of this problem, drawing insights from both the local context and successful initiatives in advanced countries.

Understanding the Complex Dynamics:

Assaults on healthcare professionals in Nepal find their roots in a historical context of weak rule of law and a culture of impunity that emerged post the civil war era. The lack of trust in formal dispute resolution mechanisms has normalized violence, endangering both doctors and patient care. Communication breakdowns further compound the issue, with inadequate practitioner communication skills contributing to patient dissatisfaction and, in extreme cases, violence. The existing power dynamics within the medical institution, where patients are often discouraged from questioning doctors, widen the gap between healthcare providers and those seeking care.

International Perspectives: Learning from Success Stories:

To address Nepal’s healthcare challenges, lessons can be drawn from successful initiatives in advanced countries that have effectively tackled patient-doctor dynamics.

  1. Improved Patient-Doctor Communication:

Proposal: Implementing patient education programs to enhance understanding of medical conditions, treatment plans, and potential outcomes.

Rationale: Fosters a collaborative relationship, reduces misunderstandings, and empowers patients to actively participate in their healthcare.

  1. Community Engagement Programs:

Proposal: Collaborating with local communities to raise awareness about the challenges faced by healthcare professionals and promoting a sense of shared responsibility for community health.

Rationale: Builds mutual respect, addresses misconceptions, and establishes a supportive community environment.

  1. Patient Feedback Systems:

Proposal: Introducing structured patient feedback systems that allow individuals to provide feedback on their healthcare experiences, encouraging continuous improvement.

Rationale: Provides a platform for patients to express concerns, promotes transparency, and contributes to a culture of accountability.

Patient-Centric Innovations:

  1. Patient-Centric Technology Integration:

Proposal: Embracing digital solutions to enhance patient engagement and streamline communication. Implementing telehealth options, mobile applications for appointment scheduling, and virtual health education sessions.

Rationale: Integrating technology not only improves accessibility but also empowers patients with valuable health information and options.

  1. Cultivating Patient Advocacy Groups:

Proposal: Encouraging the formation of patient advocacy groups that work collaboratively with healthcare providers to address concerns, share experiences, and contribute to continuous improvement.

Rationale: Fosters a sense of community, provides a platform for constructive dialogue, and ensures that patient voices are heard in healthcare decision-making.

Ensuring Doctors’ Well-being:

6. Mental Health Support for Healthcare Professionals:

Proposal: Establishing mental health support programs tailored for healthcare professionals, including counseling services, peer support networks, and stress management initiatives.

Rationale: Recognizing the emotional toll of the profession, prioritizing mental health promotes resilience and helps prevent burnout.

  1. Training in De-Escalation Techniques:

Proposal: Integrating comprehensive training in de-escalation techniques as part of medical education, ensuring that healthcare professionals are equipped to handle tense situations with patience and empathy.

Rationale: Building skills in conflict resolution contributes to a safer work environment and better patient-doctor interactions.

Building Bridges between Patients and Doctors:

  1. Collaborative Decision-Making Workshops:

Proposal: Organizing workshops that bring together healthcare professionals and patient communities to engage in collaborative decision-making scenarios, fostering mutual understanding and empathy.

Rationale: Promotes shared decision-making, enhances trust, and bridges the gap between patient expectations and medical realities.

  1. Continuous Medical Ethics Education:

Proposal: Incorporating ongoing medical ethics education into the curriculum for healthcare professionals, emphasizing the importance of ethical conduct, empathy, and patient-centered care.

Rationale: Ensures that healthcare professionals are equipped with the ethical foundations necessary for compassionate and patient-focused practice.

Strategic Implementation and Monitoring:

10. National Healthcare Ombudsman Office:

Proposal: Establishing a National Healthcare Ombudsman Office responsible for impartially investigating complaints from both patients and healthcare professionals, ensuring fair resolution and accountability.

Rationale: Provides an independent mechanism for conflict resolution, upholding the rights of both parties.

In conclusion, addressing assaults on doctors in Nepal requires a nuanced and inclusive approach that prioritizes the well-being of both patients and healthcare professionals. The proposed solutions, spanning communication improvements, patient-centric innovations, and initiatives to ensure the mental well-being of healthcare professionals, aim to create a culture of transparency, mutual respect, and shared responsibility. By learning from successful initiatives in advanced countries and tailoring these insights to Nepal’s unique context, the healthcare system can undergo a transformative shift toward a safer and more collaborative environment. Embracing these multifaceted solutions not only ensures the safety of healthcare professionals but also fosters improved patient care and communication. As Nepal endeavors to build a healthier and more resilient nation, the emphasis must be on building bridges, cultivating understanding, and fostering a sense of shared responsibility within the healthcare ecosystem.