I grew up in a country where food was always made from scratch. There was no dining out, carry out, drive through or fast food. It was mostly real food, from real ingredients. People were healthier and very few were overweight. Things have changed and it’s happening all over the world. People work more and have less time for cooking, they chose convenience either because of lack of time or because many times it’s cheaper. In many countries, people heavily rely on carbs to fill them up, but that comes with a price. At the same time, people have more sedentary lifestyles, spend more time in their car, in front of a computer or TV and less time exercising or doing physical work.

2.1 billion people (almost 30% of the world’s population) are either obese or overweight. Obesity is affecting both developed countries and developing ones. Childhood obesity is one of the most serious public health challenges of the 21st century. The substantial increase in childhood obesity is mainly caused by an increased consumption of foods with high levels of sugar and the lack of physical activity. Unlike most adults, children and teenagers don’t have a choice when it comes to the environment in which they live or the food they eat. Their fate lies in our hands and we need to make sure they have a long and healthy future.

15. GREECE

When you think of Greece, gyros and spinach pie might come to mind. But if you traveled there, you know there’s more to it. Their restaurants offer Greek salads made with delicious fresh vegetables, lots of seafood options, high-quality olive oil, fresh cheese and the famous Greek yogurt.

So it might come as a surprise to many that Greece is the leader when it comes to the number of overweight and obese kids. Greece used to be on the list of healthy countries thanks to the Mediterranean diet: olive oil, legumes, fruits and vegetables, seafood, good quality dairy. The word “diet” actually comes from the Greek word “diaita”, which means “way of life”. Unfortunately, there aren’t that many Greek people who follow this way of life anymore.

Obesity has become a serious issue since the beginning of the financial crisis in 2010. Things were so bad that many people couldn’t afford to buy healthy food and had to turn to cheap and fattening alternatives.

Over 40 percent of children and teenagers in Greece are overweight. If you ask Greek kids what their favorite foods are, don’t be surprised if they answer hamburgers and pizza. And with junk food being much cheaper than fresh food, things are not looking very good for the Greeks.

14. ITALY

With 36 percent of all children being overweight or obese, Italy is number 2 on the list. Yet another country famous for their Mediterranean diet. Yes, they eat a lot of pasta and pizza, but that is not the cause of the increasing obesity rate. Italy’s young generation is consuming more processed foods, more fast food, and more sugary sweets and beverages. And advertising targeted at the young and innocent is one of the factors that are contributing to this change. In 2011, Coca-Cola launched a campaign that used nostalgic images of families having dinner in an attempt to get Italians to replace the traditional wine and water with the popular fizzy drink. But the Italians wouldn’t have it. Many parents accused the company of promoting unhealthy eating habits. However, in the end, the evil prevailed. Italians have switched from shopping at small delis and bakeries to supermarket chains where many of their foods of choice are imported. Children spend most of their time on electronic devices and parents, concerned about the dangers of the modern world, discourage them from spending time playing outside.

13. NEW ZEALAND

Around 36 percent of New Zealand’s children (about a third) and teenagers are overweight or obese. A lot of them already suffer from type 2 diabetes and fatty liver disease and things are only getting worse.

Again, one of the culprits are advertising companies. A recent analysis of 96 hours of TV programming concluded that more than half of food commercials were for unhealthy food.

A study of 239 children and teenagers with weight issues showed that a third of them spent more than 3 hours a day in front of a TV or computer. Two-thirds of them had an abnormally increased appetite for food and half of them were not satisfied after a meal.

Their adult population isn’t doing much better, either, ranking third behind U.S. and Mexico. Low quality, high-calorie food is cheap in New Zealand and many poor people turn to this due to the lack of knowledge. Some medical experts believe that the government should ban advertising unhealthy food to children and should increase taxes on high-calorie foods. But we all know that is not going to happen

12. SLOVENIA

Number 4 on the list is this Central European country, known for its mountains, ski resorts and lakes and now for a very high number of overweight and obese children: 32 percent.

Traditional Slovenian cuisine has been influenced by its neighbors: Austria, Italy, Croatia and Hungary, so most popular foods are goulash, chicken paprikash, pasta and potato dishes, dumplings and buckwheat porridge. Although they sound like high-carb meals, they are still better than highly processed junk foods. Slovenian pediatricians believe that the young generation is allowed to eat whatever they want, instead of being guided towards healthier foods.

Surprisingly, although its childhood obesity rate is so high, Slovenia was ranked one of the best countries for children to live in, based on an index that takes into consideration diet, access to education, child mortality, child weddings, child labor, adolescent pregnancy and regional conflicts. Basically, children in Slovenia still have a chance to a great life, as long as they listen to their parents and eat their vegetables.

11. UNITED STATES

In spite of what everyone in the world would have suspected, the U.S.A. is only number 5 on the list, with a rate of 30 percent. It is not uncommon for people to blame genetics for their weight issues, but let’s face it, if your parents ate unhealthy food all their life and you are just following in their footsteps, it’s not genetics, it’s poor lifestyle choices.

The obesity rate in American children has tripled since 1963. It was precisely in the 60s that The Sugar Association started pushing ads promoting sugar as being healthy and even helpful when trying to lose weight!

Statistics are frightening. Only 2% of American children eat a healthy diet. The healthcare costs related to childhood obesity amount up to $14 billion every year. A typical child spends between 4 and 5 hours a day watching TV, using the computer or playing video games. About 16% of the total calories in kids’ diets comes from added sugar and a significant amount is in the form of high fructose corn syrup.

10. MEXICO

In the past 20 years, overweight issues and obesity rates among Mexican children have increased by nearly 40%. The adult population is doing just as bad. Mexicans have transitioned from a diet rich in corn and beans to one high in sugar and unhealthy fats. They have also switched from manual labor jobs to more sedentary, urban jobs and to a lifestyle that comes with terrible eating habits.

Physicians are concerned that the same people who are malnourished are the ones who are becoming obese. Many poor and uneducated people don’t realize how big of a problem this is until it’s too late.

It is not uncommon for a Mexican mother to call her child “gordito” (an affectionate name for an overweight person) and in many cultures, a chubby child was preferred to a thin one. Ubaldo, a ten-year-old from a poor neighborhood in Mexico City weighs 169 pounds. When he was about 6, he was skinny and his mother kept pushing him to eat. By the time he was eight he was already putting on a lot of weight and things did not stop for years. When he ended up in the emergency room, in 2011, he was suffering from sleep apnea, he couldn’t stay awake and his skin was turning blue.

9. HUNGARY

Hungary is another surprise on the list. And more so, since they are fighting child obesity and child malnutrition at the same time. A study conducted by the World Health Organisation (WHO) in 2010 concluded that 11.5 percent of children aged between 10-12 suffer from malnutrition, while 12.1 are obese.

In order to help children get more nutrients, the School Fruit Programme launched by the European Community in 2009, brings fruit to over 2,000 schools for over 500,000 children. The program intends to get school children to enjoy fruit, so they could have healthy eating habits as they grow into adulthood.

In an attempt to keep people away from unhealthy foods and get some money into the healthcare system, Hungary instituted a “fat tax” in 2011 that applied to high fat, sugar and salt foods. Hungary was not the only country to come up with such taxes, but their taxing program was the most comprehensive in the world at the time.

8. PORTUGAL

In Portugal, too, obesity is one of the biggest public health problems. About 29 percent of the country’s children and adolescents have weight issues. This is just another country that was severely impacted by the financial crisis. Poverty drives people to eat cheaper, low-quality foods. The crisis has also caused a lot of anxiety and depression, which also lead to sleeping disorders. The stress, unhealthy eating and lack of sleep, all contributed to the increasing number of overweight and obese people.

It’s not all bad news since a 2015 study found that children in Portugal eat more fruit than any other Europeans.

7. CHILE

About 50 years ago, Chile’s biggest challenge when it came to nutrition issues was malnutrition. Now 67 percent of people older than 15 are overweight or obese and about 27 percent of the younger population is in the same situation. Chile’s consumption of sugary drinks hit an all-time high. In order to help consumers make educated decisions about their purchases, the Ministry of Health developed labels for high-calorie products and for those with a high content of fat, sugar, and sodium. This is part of a bigger plan that includes several other measures intended to inform consumers about what processed foods contain. For example, the products with the black label cannot be advertised to children under 14 or include toys. The government thinks this plan will help school-age children and in this case, peer-pressure could be a positive thing. Instead of giving weird looks to a kid who brought real food at school, they will point out at the ones eating products with the black label. At least that’s the plan, but who knows if this will work. This plan is obviously not flawless and labeling soda products with sugar, but not labeling the ones with artificial sweeteners is only one of the issues. Sugar replacements are just as bad and there are numerous studies that show they even cause weight gain.

6. SPAIN

About 24% (nearly a quarter) of all kindergarten children aged 5-6 years old are now overweight and obese, placing Spain towards the top of the list, for this age category. The result is part of a survey conducted in six sample countries: Poland, Spain, Greece, Bulgaria, Germany, and Belgium. The study also showed that a quarter of all the Spanish children surveyed have a television in their bedroom. Combine that with easy, unlimited access to the snack cupboard and that’s how the problems begin.

In many cases, children are simply copying their parents’ behavior: no exercise, watching TV for hours or spending time on an electronic device, all while snacking on unhealthy foods.

Another study conducted between 2008 and 2012 on more than 74 million children aged up to 18 says that Spanish children are given 3.5 times more antibiotics than children in other European countries. And this is where things get interesting. In 2012, British researchers discovered that children exposed to antibiotics at an early age are more likely to become overweight later in life. Just one more proof that factors leading to obesity are many times more complex than we think.

5. INDONESIA

Indonesia is another country where obesity rates are increasing at an upsetting rate. Arya Permana, considered the fattest child in the world, is the youngest person to have had gastric sleeve surgery. Before the surgery, he weighed 420 lbs, about six times more than other children his age. He lost 70 lbs thanks to the surgery and is expected to lose another 220 in the next year. His parents were desperate to help him and signed him up to an exercise program and even put him on a diet, but they were still feeding him high-calorie and greasy foods. His meals consisted of two packets of noodles, two eggs, a pound of chicken and rice. It took a very long time for his parents to finally realize how serious the situation was and to take measures.

4. KOREA

In South Korea, just like in many other countries, a few decades ago, a baby with plump cheeks and chubby legs was considered a beautiful, healthy baby. Nowadays, people might give you ugly looks, recommend that you take your child to a specialist or even be blunt and say “your baby is very fat”.

Again, in a different age, being curvy or even overweight was a sign of prosperity, so it was more common in people with a very good financial situation. Today, in Korea, the obesity rate is higher among children from low-income households. In many of these situations, the parents are obese themselves and when this is the case, children are 2.8 times more likely to become obese than the average child from parents of average weight. When both parents work, children are left to feed themselves on their own, so they go for pizza, hamburgers, instant noodles and snacks.

3. ISRAEL

In 2013 one out of every five children was suffering from obesity. The once very numerous neighborhood stores that only sold basic staples and fresh produce have been replaced by supermarkets with shelves upon shelves of sugary and high-calorie foods. On top of that, now children have access to soda and snack machines in most schools, so that has become their main choice for lunch. Israel is considered a very child-centered society with parents being either too permissive or too authoritarian. Children are either spoiled and allowed to eat whatever they want or get an extra portion or they are told “You’ve had enough to eat”. None of this approaches works and it seems that the focus should be on educating parents and helping them learn how to help their children.

In 2008 the Israeli Ministry of Health started a campaign to show employers why it’s important to enable employees to express their milk in the workplace. Healthy habits should start very early since studies have shown that breastfed babies tend to be less obese in childhood.

2. CHINA

Thirty years ago, it was almost impossible to find one obese child or teenager in a group of 100. In 2014, one in 6 boys and one in 11 girls were obese. China is yet another country that has adopted a Western lifestyle.

A Chinese company is doing its part in trying to get people to lose weight: they are offering 100 yuan (about $15) to their employees for every kilogram they lose.

Lu Zhi-hao is one of the most obese children in China. At four, he already weighs 136 pounds. He has recently been put on a diet, which reduced his daily intake from 3 bowls of rice per day to just one. Of course, that doesn’t come easy for the boy. At school, when he finishes his lunch, he begs his classmates for more food; when he doesn’t get any, he tries to steal it. He often gets punched in the face for it, but that doesn’t seem to scare him.

1. INDIA

World Bank data shows that India has one of the world’s highest demographics of children suffering from malnutrition. At the same time, India is facing another significant problem: an increasing rate of childhood obesity (14.4 million children!)

A family in the western Indian state of Gujarat has three times more issues than others: three morbidly obese kids, ages 6, 5 and 4. The children eat so much food, that their father, who earns just 500 Rupees a day (about $8) had to take loans of up to 10,000 Rupees just to be able to afford their daily meals. Their hunger never ends and they cry and scream if they are not fed, so their mother has to spend all day in the kitchen.

In 2015, the oldest, who was 5 at the time weighed 80 pounds, the 4-year-old weighed a little over 100 lbs and the 3-year-old weighed 35 pounds. Through an online campaign they raised enough money for their children to have weight loss surgeries, and even though they all initially lost some weight, now they all weigh even more than before. Their parents are desperate and say they would do anything to help them, but they keep feeding them biscuits, crisps, and soda on a daily basis. Now the father is trying to sell one of his kidneys so he could afford to seek help from specialists.

Sources: aljazeera.com, dailymail.com, huffingtonpost.com, thesun.co.uk