Purpose: This study investigated the most recent estimates of underweight, overweight, and obesity prevalence in Pakistani school-aged children and adolescents. Methods: A cross-sectional study was conducted using a convenience random clustered sampling approach with 3,551 Pakistani school children aged 9 to 17 years from 52 schools throughout seven districts in central Punjab province. The CDC US 2000 was used to define underweight (BMI < 5th percentile), overweight (85th ≤ BMI < 95th percentile), and obesity (95th percentile ≤ BMI) for different school grade cohorts (primary, middle, secondary, and higher secondary schools). As a trend test, the Chi-square test was used. A Spearman correlation analysis (r) was used to determine the correlations between demographic variables and weight status. A regression analysis was conducted to explore the predictive power of demographic factors in relation to body weight. Results: In Pakistani school-aged children and adolescents, the prevalence of underweight, normal weight, overweight, and obesity was 21.9%, 66.9%, 5.8%, and 5.4%, respectively. Significant correlations with body weight status were shown for individual demographic parameters (age, gender, school type, and school grade). Children in urban areas were more likely to be underweight, overweight, or obese than those in rural areas. Boys were found to have a lower BMI than girls. Accordingly, more boys than girls were underweight (odds ratio (OR) = 1.57, 95% CI: 1.33–1.85) and more girls had a higher risk of obesity than boys (OR = 1.39, 95% CI: 1.03–1.86). Lower grades showed more underweight (OR = 1.66, 95% CI: 1.39–1.99) whereas higher grades showed a higher risk of obesity (OR = 1.91, 95% CI: 1.41–2.57). Conclusions: In Pakistani school-aged children and adolescents, underweight, overweight, and obesity were prevalent. Compared with studies from 2011, the risk of overweight and obesity in Pakistan has decreased. However, this may also be due to the fact that students in Pakistan have a lower BMI compared to other countries. This issue has also been seen in the present study and is confirmed here by the high number of cases of underweight students. Future research studies should look into additional weight status correlates and factors. To evaluate the association between weight status and behavioral and other health variables, future research should use longitudinal or interventional designs.

Childhood overweight and obesity are increasingly prevalent in Pakistan, posing significant public health challenges. This study explores the associations of school-level factors and school sports facility parameters with overweight and obesity among children and adolescents in Pakistan. A cross-sectional study across seven random districts in Punjab province, Pakistan, was conducted using a representative multistage random cluster sample. Underweight (BMI < 5th percentile), overweight (85th ≤ BMI < 95th percentile), and obese (95th percentile ≤ BMI) were defined using the US Center for Disease Control (CDC) 2000 criteria. Statistical analyses including the Chi-square test, Pearson correlation coefficient, and linear regression were performed to investigate predictive characteristics. Logistic regression analysis assessed the simultaneous impact of several covariates on dichotomous outcomes, with 95% confidence intervals (CIs) computed and a significance level set at p < 0.05. The study included 4108 Pakistani school children aged 9 to 17 years (mean age = 13.92 years, 59.3% boys) from 62 schools. The prevalence of overweight and obesity was 19.4% and 10.7%, respectively. Findings revealed a concerning lack of physical education activities (60% reported 0 sessions per week), morning exercise (60%), and classroom exercises (66%) among school-aged children. Leadership attitudes toward physical education (β = 0.04, p = 0.006) and students’ satisfaction with the playground (β = 0.05, p = 0.015) showed significant associations with body weight status. Conversely, provision of physical education facilities, effective fund utilization for physical education, meeting school sports facility requirements, and weekend opening of school sports grounds did not significantly impact weight status. Satisfaction with the playground was significantly associated with a lower risk of overweight (OR 0.81, 95% CI 0.69–0.95, p < 0.05), indicating reduced overweight likelihood among students satisfied with school playgrounds. The study underscores significant gaps in promoting physical activity within school environments and highlights the urgent need for interventions to enhance physical education resources and sports facilities, aiming to create healthier school environments and reduce overweight and obesity prevalence among students. Further research and interventions are crucial for promoting lifelong physical activity habits and improving student health and well-being.

Background: Overweight and obesity in children and adolescents are pressing global public health concerns, including in Pakistan, where prevalence rates are rising. The long‐term health implications of these conditions underscore the need for targeted interventions during childhood and adolescence and periods when health behaviors are strongly influenced by external factors such as school, neighborhood, peers, and family.Purpose: This study aimed to evaluate the relationship between physical activity (PA), physical education (PE), and overweight/obesity in school‐aged children and adolescents (ages 9–17) in Pakistan and to investigate their impact on obesity within this population.Methods: A population‐based cross‐sectional study was conducted with a multistage random cluster sample of 4108 school‐aged children and adolescents from seven districts in Punjab, Pakistan. Overweight and obesity were assessed using World Health Organization (WHO) guidelines. Statistical analyses, including χ² tests, Pearson correlation, linear regression, and logistic regression, were performed to examine the predictive characteristics and the impact of covariates on dichotomous outcomes. Statistical significance was set at p < 0.05, with 95% confidence intervals (CIs).Results: The study included 4108 students (mean age = 13.92 years, 59.3% boys). The prevalence of obesity was 10.7% and overweight was 19.4%. A significant portion of students—83.8% of girls and 70.0% of boys—did not engage in at least 60 min of moderate to vigorous physical activity (MVPA) on more than 2 days per week. Urban students (79.2%) and those in private schools (79.3%) were particularly inactive. PA two times a week or less was strongly associated with higher obesity risk (OR: 3.47, 95% CI: 2.28–5.30, p < 0.001).Conclusion: This study underscores the critical need to enhance PA opportunities in schools and communities in Pakistan, particularly for girls, to address the rising rates of overweight and obesity.

Purpose: The association between Unhealthy Behaviors (Smoking, Drinking Alcohol, and Tobacco Use) and body mass index (BMI) is a significant public health concern due to their roles as preventable risk factors for cardiovascular disease and various other conditions. Despite numerous previous studies, no consensus has emerged regarding the effect of Unhealthy Behaviors on BMI. Therefore, we conducted a novel study to evaluate the relationship between Unhealthy Behaviors and BMI in Pakistani school-aged children and adolescents aged 9 to 17 years. Methods: A cross-sectional study was conducted involving 4108 Pakistani schoolchildren aged 9 to 17 years from 62 schools across seven districts in central Punjab province. Body mass index (BMI) categories were defined using the CDC US 2000 growth charts: underweight as 85th to < 95th percentile, and obese as equal to or greater than the 95th percentile. The Chi-square test was employed to analyze categorical variables, and the Pearson correlation coefficient (r) was used to determine correlations. 95% confidence intervals (CI) were calculated, and statistical significance was set at p < 0.05. Results: The prevalence of weight, overweight, and obesity among the participants was 19.4%, 10.7%, and 10.7%, respectively. Smoking within the last 7 days showed an odds ratio (OR) of 1.79 (95% CI: 0.91-3.55) for overweight status, while the use of tobacco products other than cigarettes demonstrated an OR of 1.61 (95% CI: 1.03-2.52) for overweight. Drinking alcohol within the last 7 days was associated with an OR of 2.78 (95% CI: 0.43-5.05) for obesity. Witnessing someone smoke in front of students for three or more days was associated with an OR of 0.90 (95% CI: 0.76-1.07) for overweight. Additionally, having a father or male guardian who smokes showed higher odds ratios for overweight, with an OR of 1.21 (95% CI: 1.02-1.44). Conclusion: This study sheds light on the alarming prevalence of overweight and obesity among Pakistani school-aged children and adolescents, emphasizing the need for urgent intervention. Nonetheless, it is reassuring to find relatively low rates of smoking and alcohol consumption within this demographic. The majority of students are not involved in these unhealthy behaviors, and importantly, no significant associations were observed between these behaviors and weight status. These findings underscore the effectiveness of ongoing initiatives aimed at promoting healthy lifestyles and discouraging smoking and alcohol consumption among young individuals.

This study examines the relationship between parental support and involvement in sports and the prevalence of overweight and obesity among Pakistani children and adolescents aged 9-17 years. Using a cross-sectional design, the study used a multistage random cluster sample from 62 schools with 4,200 students. Data from 4,108 participants (97.8%) were analysed, with 92 (2.2%) excluded due to incomplete information. Body weight status was assessed according to WHO guidelines. Results showed that among 3,371 students (mean age = 13.74 years, 58.2% boys), higher parental support and involvement in sports were significantly associated with healthier weight status. Descriptive statistics showed that 15.8% of the children were underweight, 57.1% had a healthy weight, 16.8% were overweight and 10.3% were obese. Significant associations were found between parental encouragement to exercise and weight status (χ2 = 13.39, p = 0.005). Logistic regression showed that parental encouragement (B = 0.138, p < 0.001) and financial support (B = 0.099, p < 0.01) were positively associated with healthier body weight. In contrast, lack of involvement was associated with higher rates of obesity.