A new UNICEF report highlights dietary challenges facing children around the world. A key takeaway? Industrial ag and climate change are compounding malnutrition.

The proportion of children between the ages of 5 and 19 who are overweight nearly doubled between 2000 and 2016, according to a new UNICEF report on children and food—a jump that highlights the way that nutritional challenges have evolved in the past two decades. No longer is “hunger” the central problem of our food system, if it ever was. Instead, industrialized agriculture and climate change are posing new barriers to a healthy diet, including increased global availability of junk food, loss of agricultural productivity, and nutrient deficiencies. Rates of overweightness have risen in every continent, and UNICEF projects at least 43 million children under the age of five will be overweight in 2025.

This year’s report, titled “State of the World’s Children,” is focused on nutrition for the first time since 1998. Past reports have touched on education, gender, and children with disabilities. 

The skyrocketing prevalence of obesity is one of the most conspicuous differences between this report and the report from two decades ago. “[Overweightness] is sometimes seen as a problem only in wealthy countries, but it is striking just how much it now also affects low- and middle-income countries and how rapidly the problem is growing,” the report reads.

Brian Keeley, editor in chief of the report, stressed in a phone interview that this uptick should ring alarm bells for policymakers.

“There isn’t much of a track record of countries reversing overweight and obesity,” Keeley said. “You really need to be thinking about prevention if you’re going to deal with this problem. Turning it around is very difficult.”

The rise of overweightness has been well-documented in recent years. Earlier this month, the World Obesity Federation forecasted that 254 million children between the ages of 5 and 19 would be obese by 2030, up from 158 million currently. In September, public health nonprofit Trust for America’s Health reports that obesity has reached historic levels domestically, with nine states seeing adult obesity rates over 35 percent for the first time.

But even as we continue to spill ink over overconsumption, other forms of malnutrition remain a major dietary hurdle for children globally. The report uses a few key measures to illuminate its scope, including conditions known as stunting, wasting, and hidden hunger.