Childhood obesity is rising, driven largely by changing diets and increasingly sedentary lifestyles, with health experts warning that the trend could fuel long-term risks such as diabetes and heart disease if not addressed early.

Six percent of children under five in Rwanda are overweight, according to the Rwanda Demographic and Health Survey. The figure has remained relatively stable over the past two decades, hovering between five and seven percent.

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The United Nations Children's Fund (UNICEF) warns that overweight and obesity are becoming a major global threat to children’s health, driven by increased consumption of highly processed foods, low physical activity, and rising screen time.

Worldwide, nearly 40 million children under the age of five are overweight—about six percent of that age group. Among older children and adolescents, the burden is significantly higher, with more than 340 million aged five to 19 affected, accounting for nearly 18 percent globally.

What is driving childhood obesity?

Dr François Uwinkindi, Director of the Non-Communicable Diseases Division at the Rwanda Biomedical Centre (RBC), says childhood obesity has no single cause but is shaped by an environment that increasingly discourages healthy eating and physical activity.

He points to rapid urbanisation and dietary change as key drivers in Rwanda.

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"As more Rwandan families move to Kigali and other growing towns, traditional diets based on beans, vegetables, sweet potatoes, and sorghum are being replaced by processed snacks, sugary drinks, white bread, and fast foods that are cheaper, more convenient, and heavily marketed,” he said.

He added that across Africa, urbanisation, sedentary lifestyles, and dietary shifts are the main contributors to rising overweight and obesity rates.

Screen time is also playing a growing role. Children who spend several hours daily on televisions, smartphones, and tablets tend to burn fewer calories, while also being exposed to aggressive advertising for unhealthy foods. At the same time, many urban areas lack safe, accessible play spaces such as parks and playgrounds.

Early childhood feeding practices also matter. According to the expert, early introduction of complementary foods, inadequate exclusive breastfeeding, and overfeeding in infancy can shape a child’s metabolism in ways that increase the risk of weight gain later in life.

What happens if obesity is not addressed?

Childhood obesity is not just a risk factor for adulthood obesity, it already affects health in early life.

Dr Uwinkindi notes that conditions once seen mainly in adults, such as type 2 diabetes, high blood pressure, and fatty liver disease, are now being diagnosed in children as young as 10.

Other common complications include joint pain, sleep apnoea, and mental health challenges linked to stigma and peer pressure.

In the long term, childhood obesity increases the risk of heart disease, stroke, several cancers, kidney failure, and premature death. These non-communicable diseases are already placing growing pressure on Rwanda’s health system and economy.

What can parents do?

Dr Uwinkindi says parents remain the first line of defence in preventing childhood obesity, starting with simple daily choices.

He recommends encouraging water instead of sugary drinks such as sodas and packaged juices, which are among the strongest dietary drivers of obesity.

Families are also urged to prioritise traditional diets. "Cook beans, isombe, vegetables, umutsima, and fresh fruit. These are nutritious, affordable, and protective,” he said.

He further advises limiting processed snacks such as chips and biscuits to occasional treats, restricting screen time to no more than two hours per day for school-aged children, and promoting at least 30–60 minutes of active outdoor play daily.

Exclusive breastfeeding for the first six months is also highlighted as a key preventive measure, helping to regulate healthy appetite development in early life. Regular growth monitoring at health facilities can also help detect early signs of overweight and allow timely intervention.

Role of schools

Schools, which spend more time with children than most institutions, also play a critical role in prevention.

Dr Uwinkindi recommends healthier school food environments, including replacing sugary drinks and fried snacks in school canteens with water, fruit, and nutritious local foods, and regulating what vendors sell around school premises.

He also calls for compulsory physical education lessons every week, even during academic pressure periods, and encourages short movement breaks between classes.

Integrating nutrition education into science and life skills subjects from primary through secondary school can further strengthen awareness on healthy eating, food labels, and portion sizes.

"Engaging parents through school health clubs and meetings can help shift household behaviours without stigmatising children who are already overweight,” he said, adding that Rwanda’s School Health Programme can be strengthened to expand nutrition and physical activity components across all levels.