The weight of routine
How everyday habits are fuelling childhood obesity
The beginning of a new school year is one of those periods when parenting becomes particularly deliberate. We consider the school our children attend, the subjects they will pursue, the books they need and, increasingly, the devices required to support their education. We organise transportation, uniforms, extracurricular activities and, where resources allow, additional lessons. All of this is done with the future in mind. We understand that decisions made during childhood can have consequences many years later.
We need to bring that same sense of deliberateness to their health.
The findings of the 2026 Global School-Based Health Survey (GSHS) give us good reasons to do so. In 2010, 21.7 per cent of Jamaican adolescents surveyed were overweight. That figure increased to 23.3 per cent in 2017 and has now reached 31.7 per cent.
The trajectory for obesity is even more striking. In 2010, six per cent of adolescents surveyed were living with obesity. Sixteen years later, that figure is 15.3 per cent. We should consider what that increase represents.
Behaviour develops within an environment
It is tempting to treat childhood obesity simply as a problem of individual behaviour: Children eat too much of the wrong food and exercise too little. There is some truth in that, but it is an incomplete explanation. Behaviour develops within an environment, and the environment in which Jamaican children are growing up has changed considerably.
Ultra-processed foods and sugary drinks are readily available. Screens occupy more of our waking hours. Entertainment that once required children to leave the house and move increasingly requires little more than a device and an Internet connection.
The survey reflects some of these changes. Physical activity among students declined from 23.2 per cent in 2017 to 19.6 per cent in 2026, while sedentary behaviour of more than three hours per day increased from 56.4 per cent to 68 per cent. More than 70 per cent of students surveyed reported getting less than eight hours of sleep.
Diet presents another challenge. Some 41.3 per cent of students said they had eaten no fruit in the seven days before the survey. Only 27.5 per cent reported eating vegetables one or more times per day.
Together, these findings describe a pattern that should concern us — less movement, more sedentary time, insufficient sleep, and diets that too often fall short of what developing bodies require.
Most parents know what constitutes a healthier choice. The difficulty is often not knowledge, but consistency. One sugary drink is unlikely to determine a child’s health. Neither is an occasional fast food meal, a bag of chips after school, or an evening spent on a tablet. The problem is when the occasional becomes routine.
A sweet drink becomes the expected accompaniment to a meal. Highly processed snacks become a regular feature of the lunch kit. Fast food moves from convenience to habit. Screen time gradually consumes time that might otherwise have been spent moving or sleeping.
Parents, guardians have considerable influence
None of this happens dramatically. There is rarely a moment when a parent decides to establish an unhealthy lifestyle for a child. Habits are formed through repetition until what was once the exception becomes normal.
This is where parents and guardians have considerable influence.
Children, particularly younger ones, do not construct their environments independently of adults. They consume much of what is purchased for them, take to school what is packed for them, and learn what is normal from what they repeatedly experience at home.
This is not an argument for assigning blame. Childhood obesity is influenced by the price and availability of food, the school environment, commercial marketing, opportunities for physical activity, household circumstances, and public policy.
Government cannot ask families to make healthier choices while ignoring whether those choices are practical and affordable. Schools cannot teach good nutrition while creating an environment in which the least nutritious options are the easiest to obtain. Industry also has a place in the discussion about what is marketed and sold to children. Responsibility is shared but parents and guardians still have considerable influence, and the home is where many lifelong habits first take root.
The return to school provides a useful opportunity to examine those habits because the school term restores routine. Bedtimes become more regular. Meals are planned differently. Lunch kits return. After-school schedules are reorganised.
It helps to decide what we want that routine to look like before an unhealthy one establishes itself by default. Water can become the usual drink rather than a sugary alternative. Fruits and vegetables can feature more regularly in meals and lunch kits. Treats need not disappear, but they should remain treats. Parents who provide lunch money should have some idea of what their children are purchasing at school.
Movement should also be expected as part of a child’s day. That does not require every child to become an athlete. The concern is that physical activity is gradually being displaced from children’s lives.
The same is true of technology. Phones, tablets, and computers are now integral to modern education and social life. The issue is not whether children should use them but whether their use is displacing physical activity and sleep.
The finding that 70.2 per cent of students surveyed reported less than eight hours of sleep should concern us for reasons beyond weight. Sleep is important to physical health, development, concentration, and academic performance. There is irony here. We can become deeply concerned about a child’s performance at school while overlooking some of the basic behaviours that help that child to learn and develop.
As minister of health and wellness I am conscious that much of the public discussion is about health facilities and the health system itself: hospitals, health centres, specialist services, medicines, equipment, and the professionals who provide care. Those investments are essential but no health system, irrespective of how well-resourced, can substitute for prevention.
If the prevalence of overweight and obesity among our adolescents continues on its present trajectory the consequences will eventually present themselves in greater risk of diabetes, hypertension, and other non-communicable diseases, and in a health system required to treat more chronic illnesses.
Our response, however, must not become a preoccupation with children’s appearance. Children should not be ashamed of their bodies, nor should weight become a measure of worth, discipline or character. Stigma is neither an effective nor an acceptable public health intervention.
Objective is to have healthier children
The objective is not to produce thinner children; it is to produce healthier ones. The Ministry of Health and Wellness will continue to pursue the policy interventions required to support this. The School Nutrition Policy and Jamaica Moves are part of that work. Schools, communities, and industry must also be engaged because the environment around them shapes the choices available to families.
But there are decisions made every day in homes across Jamaica that no ministry can make on behalf of a family. What is purchased at the supermarket, what goes into a lunch kit, how much time a child spends on a device, and what time that child goes to sleep are largely determined within the home.
At this time of year parents make considerable sacrifices because they want their children to be prepared for the future. Education is rightly at the centre of that preparation. Health belongs there, too.
A child’s academic prospects matter. So does whether that child enters adulthood with habits that protect or undermine his/her health.
The latest figures tell us that, collectively, we need to pay greater attention to the latter. This school year is a good place to start.
Dr Chris Tufton is Jamaica’s minister of health and wellness. E-mail:cctufton@gmail.com