Obese and undernourished: The Philippines’ hidden nutrition crisis

Job-related stress from a previous night-shift position in 2014 drove 34-year-old accountant Achilles Comboy into an unhealthy daily routine.

“Sobrang stressful niya na halos [walang] pahinga, [walang] tulog. So, ang panlaban sa antok ay pagkain talaga. As in, lahat kinakain ko. Wala halos exercise kasi nga pang-gabi (night shift),” he said.

(It was so stressful that there was hardly any rest or sleep. So, food was really my way of fighting off drowsiness. I ate everything. I hardly exercised because I was on the night shift.)

Years later, the consequences caught up with him. In 2019, Comboy was diagnosed with end-stage kidney failure, which put him on emergency dialysis. He also developed an enlarged heart and pulmonary edema, or a buildup of fluid in the lungs. He underwent a kidney transplant in 2025 and has been taking medications for it ever since.

Before that, Comboy had already been living with obesity for years, weighing 106 kilograms at 177 centimeters (or about 5’8) — above the healthy-weight range of about 58 to 70 kilograms based on body mass index cutoffs.

“Doon ako tumaba nang tumaba nung nagka-work ako,” he said. (That’s when I kept gaining weight — after I started working.)

Comboy’s experience reflects a broader shift in the country’s nutrition landscape.

Josie Desnacido, Department of Science and Technology–Food and Nutrition Research Institute (DOST-FNRI) senior research specialist, said that the Philippines is already experiencing a “double burden of malnutrition,” now at opposite extremes of the nutrient crisis.

Forms of undernutrition such as stunting, wasting, underweight, and chronic energy deficiency have been on a downward trend for years now.

However, overnutrition has steadily risen by 218% in adolescents, the highest increase across all age groups, from  2003 to 2025 – driven by increasing rates of overweight and obesity.

Prevalence — or the percentage of the population who are obese and overweight — has also increased significantly across multiple age groups.

In its 2025 update to the 2023 National Nutrition Survey, the FNRI recorded the highest obesity and overweight prevalence across all years in all age groups except children 0-59 months (measured by overweight-for-height).

Obesity and overweight prevalence in adults are the highest in 2025 at 43.1, followed by children aged 5 to 10 years old at 16.

Desnacido mentioned multiple reasons that impact how people manage their diet. These include increasing urban populations, economic development that affects prices of goods, and the rise of hybrid and work-from-home employment setups.

“Our dietary pattern has changed over time,” Desnacido said in a mix of English and Filipino.

According to her, many Filipinos choose sweet, salty, or greasy ready-to-eat meals and fast food over healthier home-cooked options. She added that even those who eat nutritious food often consume oversized portions.

Obesity and overweight are chronic conditions caused by excessive calorie intake. It increases an individual’s vulnerability to noncommunicable diseases such as type 2 diabetes, stroke, hypertension, and more.

Growing obesity risks in PH

While both obesity and overweight are rising, the increase in obesity prevalence is particularly concerning. 

An individual is classified as obese when his or her body mass index reaches 25 kilograms per square meter (kg/m²) and above, according to Asia Pacific cutoffs of the World Health Organization.

Obesity prevalence in Filipino adults dramatically increased from 39.8 in 2023 to 44.5 in 2025, translating to two in five people being obese.

Several regions also recorded obesity rates significantly higher than the national average.

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2025 National Prevalence (based on WHO Asia-Pacific BMI cut-offs) --

2023 National Prevalence (based on WHO Asia-Pacific BMI cut-offs) --

Prevalence

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Childhood obesity is likewise on the rise, a trend that Desnacido primarily attributes to growing sedentary habits, or having little to no physical activity.

Now a health advocate who has lost over 20 kg, Comboy said its chronic nature can put children at greater risk later on: “Simula pagkabata pa lang, ‘pag hindi talaga siya naagapan, kalalakihan nila ’yung obesity.” (If the condition isn't addressed early on — starting in childhood — they will grow up with obesity.)

Factors affecting obesity prevalence

What is driving the increase? Desnacido pointed to several contributing factors.

Obesity prevalence by place of residence in the Philippines

This chart visualizes the obesity prevalence between urban and rural residents in the Philippines. Select an age group below to highlight specific data.

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She explained that urban areas offer "greater convenience," enabling residents to easily order meals online or rely on ride-hailing apps instead of walking. Regions with larger urban populations tended to have higher obesity prevalence, based on the FNRI rates.

While convenience opens healthier options, people still opt for unhealthy food, or in some cases, eat too much. This is evident in the proliferation of fast food chains and the eat-all-you-can culture.

From Comboy’s experience, Filipinos would mostly reach for salty or sweet foods. “So sa tingin ko talaga, may kakulangan sa pagpili ng pagkain. Kasi bakit ’yung iba…nagiging healthy pa rin?”

(I really think there’s a shortcoming in food choices. Because why is it that some people still manage to stay healthy?)

Comboy also said that social media increasingly influences unhealthy food consumption, as food bloggers and celebrities participate in mukbang (eating broadcast) videos and promote many dining establishments.

Ultimately, the risk of overweight and obesity further skyrockets when people do not burn off their calories after eating, Desnacido added.

The percentage of adults and older persons insufficiently physically active slightly decreased in 2025, while it increased among adolescents.

Physical inactivity is defined as engaging in less than 60 minutes of moderate- to vigorous-intensity physical activity per day among adolescents aged 10–17, or failing to meet the adult recommendations of at least 150 minutes of moderate-intensity or 75 minutes of vigorous-intensity physical activity per week.

Despite slight changes this year compared to 2023, the trend remained constant across all age groups since 2018. There have been no significant shifts since the FNRI started tracking physical inactivity.

Desnacido said that without physical activity, fat accumulates in the body and increases the risk of obesity.

Comboy also noticed that children and adults spend excessive hours on digital devices rather than staying active. He then urged parents to guide their children toward better nutrition and healthier diet habits.

The wealthier, the riskier

Another factor in obesity prevalence is access. FNRI data revealed that as people gain more means to buy food, obesity risk increases.

The prevalence distribution across wealth statuses in the survey demonstrated that obesity rates increase alongside growing financial capacity.

Obesity prevalence by wealth quintile in the Philippines

This chart visualizes the obesity prevalence across Philippine wealth quintiles. Select an age group below to highlight specific data.

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Richer families have more purchasing power that grants them access to unhealthy foods. 

“They have a greater quantity and wider variety of foods to buy,” Desnacido said.

“Kaya ng mayayaman na bumili ng masustansyang pagkain, pero sila rin ang kayang bumili ng mga pagkain na mahal [at] unhealthy,” she added. (The wealthy can afford to buy nutritious food, but they are also the ones who can afford to buy expensive, unhealthy food.)

More vulnerable Filipinos

If the trend continues, the Philippines could face a substantial increase in noncommunicable diseases. 

“More obesity-related illnesses can mean higher healthcare costs, reduced productivity, disability, [and] premature mortality,” Desnacido said.

In the Philippine Plan of Action for Nutrition from 2023-2028, the Philippines aims to reduce obesity and overweight prevalence per age group per year:

• Children under five (0-59 months old): Reduce from 3.9% (2021-2022) by 1.9% per year
• School-age children (5-10 years old): Reduce from 14% (2021-2022) by 2.2 percentage points per year
• Adolescents (10-19 years old): Reduce from 13% (2021-2022) by 2.133 percentage points per year
• Adults (20 years old and above): Reduce from 38.6% (2018-2019) by 3.4 percentage points per year

By 2025, no age bracket had reached its target, though children under five remained nearest to theirs.

Comboy, also an auditor of the Obesity Philippines Association, called for more active action from the government and health sector. “Mas okay talaga ’yung prevention kaysa d’on sa nagre-react na… Bigyan [sana] nila ng magandang program din ang obesity. Kasi chronic disease na rin siya eh.”

(Prevention is truly better than just reacting to the problem. They really ought to implement a good program for obesity, too, since it is a chronic disease.)

Desnacido emphasized that the Philippines needs “bold commitments” to mitigate obesity risks through a multisectoral strategy encompassing environment, transportation, economy, and health awareness.

She encouraged the public to follow the Pinggang Pinoy (Filipino plate) guide, a food plate model designed to determine proper food portions per meal per age group, along with regular exercise, to achieve a balanced diet.

“There should be variety; there should also be moderation,” said Desnacido. – Rappler.com