Healthy weight, healthy Bangkok

The health of children living in the city is deteriorating, with many of them struggling with an excess of fat, obesity and certain related health conditions.

An analysis of the annual check-ups of over 220,000 students in 437 schools under the Bangkok Metropolitan Administration (BMA) reveals that about 21.65% youngsters suffer from excessive weight, with those at the primary levels the most affected. And some are already showing signs that could indicate they are at risk of certain chronic diseases.

The findings suggest that their health and well-being are negatively impacted by a poor diet and a lack of physical activity. This suggests that health and physical education classes and sports day activities at school would not be sufficient to help them maintain a healthy weight and good health.

The BMA’s Department of Education has worked with a health advocacy network led by the Thai Health Promotion Foundation (ThaiHealth), Nudge Thailand and Novo Nordisk Pharma Thailand in a bid to help children manage their weight gain.

Last month, they officially rolled out a complete school-based weight management curriculum, which is part of the Bangkok: City for Better Health initiative intended to promote healthier urban lifestyles and combat obesity.

“The launch of the curriculum was a team effort. It’s designed to tackle childhood obesity by empowering children and families through education, healthy eating and physical activity,” said Bangkok governor Chadchart Sittipunt.

He was speaking in a special event at which the BMA, the Royal Danish Embassy and Novo Nordisk Pharma Thailand signed a Memorandum of Understanding as part of the city’s initiative. The ceremony took place on November 5 at the Danish Ambassador’s Residence in Bangkok’s Sathorn District.

The governor urged residents to stay active and move more, stressing that an inactive lifestyle can increase the risk of obesity, which is a major risk factor for many chronic diseases such as heart problems and diabetes.

The school-based weight management curriculum is set to be fully implemented in the second semester of the 2025/2026 academic year, with 18 schools taking part in the pilot implementation. It’s expected to expand to cover all 437 schools citywide within the next four years.

In fact, the curriculum is an updated and improved version of the “Don’t Let Children Become Obese,” program, which was initiated in 2023. The content has been modified to maximize student participation and help them take full advantage of the learning activities.

The modified version focuses on nutrition, a healthy balanced diet, reading food labels and a portion guide. Other topics include physical activity, energy balance, rest and quality sleep, emotional well-being, the importance of outdoor activities and the impact of excessive screen time. Active learning techniques are designed to boost students’ engagement and motivation.

The classes require an additional 10 one-hour sessions over one academic year.

An alarming health issue

Childhood obesity is one of the fastest-growing health problems in the world. Unicef says that worldwide, children are more likely to be obese than underweight for the first time ever.

Its new child nutrition report reveals the prevalence of obesity among children and adolescents aged five to 19 years, which in 2025 rose to 9.4%, surpassing the 9.2% of children classed as being underweight.

One in 10 or around 188 million children and adolescents are living with obesity. Ultra-processed and fast foods can be blamed for the rise in overweight children.

In Thailand, the number of overweight and obese children has doubled in the past 25 years, making the country rank third worst in ASEAN in terms of child obesity behind only Malaysia and Brunei, according to the World Obesity Federation.

The federation warns that if this trend continues, more than 60% of Thai children are likely to be overweight or obese by 2035.

Childhood obesity has been linked to the increased risk of developing type 2 diabetes, cardiovascular diseases and some cancers in adulthood.

Empowering children and family to live healthier lifestyles

Danai Wangboonchai, ThaiHealth’s manager of Art and Culture for Health Promotion, noted that the curriculum is geared toward the whole family, engaging children and adults in education, healthy eating habits, and physical activity to enable them to adopt positive change.

It also provides them with skills for a healthier and more constructive lifestyle over the long term.

“The core curriculum focuses on improving students’ and adults’ attitudes towards learning and activities., and promoting healthy eating behaviors, which are crucial for maintaining a healthy weight,” he said.

He noted that the family-based intervention is instrumental in maintaining health and preventing obesity, saying many children gain more weight during a school break than in the academic year.

“Many manage to bring their weight loss on track, shedding some kilos during the term, only to regain the kilos lost during the school breaks,” he explained.

Danai noted that an active learning approach allows students to actively participate, work with others and apply the concepts they have learned to the real world, saying that some students struggles to participate and many have no idea how to put the knowledge into practice.

The modified curriculum, he added, is also equipped with activities that connect home and school, engaging parents in students’ education and activities whether through at-home activities or classroom visits to help develop a healthy mindset and eating behaviors.

For the “fridge tour of healthy food for children”, for instance, children and their family members are asked to work together at home on a food tour, taking a good look inside their fridges and observing what they eat daily.

They then write the items in a diet logbook and classify what constitutes healthy food and what is classified as junk.

“The activity can inspire parents to stock their fridge with healthy food to ensure that children have access to a good diet. We also invite parents to come to the classroom and share their healthy recipes. That can inspire other parents,” Danai said.

Biting into better health

Supaporn Saengsamarn, former principal of Surau Saikongdin School, said the student-centered approach and practical activities tend to boost students’ engagement and make them respond better, thereby helping them better manage their weight.

She explained that the curriculum reduced the number of students who are overweight from 5.6% in the first semester of 2023 to 3.2% in the second semester of 2024. Weight loss success among the teachers, she added, is a happy by-product of the curriculum implementation.

“It’s been a great success,” Supaporn said.

Located in Bangkok’s Minburi District, the Surau Saikongdin School, one of pilot schools for the school-based weight management curriculum, has rigorously implemented the program since 2023 to help children eat well and be active, while boosting the family involvement in students’ activities.

According to the principal, the school has created a comprehensive range of activities and tools to help the students maintain a healthy weight and improve their well-being. It includes a morning exercise routine with music, an extra evening workout session, healthy cooking classes and eat-well games.

“We have specifically designed the extra session for students carrying excess weight to help them move more. It may help them burn extra calories,” she said.

Homemade dumbbells made by the plastic water bottles project were also created to inspire them to work out and practice resistance training at home, while a gym dance contest has been successful in improving students’ health and fitness and promoting strength and flexibility.

Reading food labels is taught to help them eat more smartly. A diet logbook is provided for each student to track what and how much they eat and drink at home.

Healthy school breakfasts and lunches featuring lots of vegetables but less sodium and sugar are offered to students to help them manage their weight better and reduce their risk of certain chronic diseases.

In addition, sessions on healthy eating delivered by public health authorities are also arranged for parents and caregivers to help them choose foodstuffs wisely.

Supaporn expressed concern that children are consuming too much salt and sodium, which can put them at risk of certain illnesses later in life. The main sources of excessive sodium are snacks and processed foods.

“Children love potato chips. They may taste good but they are laden with sodium and unhealthy fat. We ask them to look at the food label for nutritional content. They seem surprised by the high level of sodium. Now, they understand why they need to cut down on these snacks,” she said, adding that reading food labels is an important skill for children and adults in developing a healthier eating habit.

She noted that many of the school’s students consume instant noodles for dinner as it’s convenient, citing data from students’ diet logbooks.

“We write in the log books and suggest that the family add vegetables to the noodles, plus some light fruit to make the meal nutritious. We work closely with students’ families to support their well-being and make them healthier,” Supaporn said.