The Philippines is facing a nutrition crisis that is moving in two directions at once.
In a March 4, 2025 joint release from the World Health Organization, UNICEF and the National Nutrition Council, data shows that nearly 1 in 10 Filipino children and almost 4 in 10 adults are now overweight or obese.
Meanwhile, based on the 2023 National Nutrition Survey presented by the Department of Science and Technology’s Food and Nutrition Research Institute, 31.4% of Filipino households still experienced moderate to severe food insecurity.
Those figures place excess weight and food deprivation in the same national picture. Hence, the country’s nutrition problem is no longer just about hunger or just about obesity, but about how poor diet quality is feeding both chronic disease and vulnerability to infection.
The double burden in one country
Public health experts describe this as the “double burden of malnutrition,” and the Philippines fits that definition with unusual clarity. According to WHO’s 2024 fact sheet on malnutrition, malnutrition includes undernutrition, micronutrient deficiencies, overweight, obesity and diet-related noncommunicable diseases.
The same WHO fact sheet said that in 2022, 2.5 billion adults worldwide were overweight, including 890 million living with obesity, while 390 million adults were underweight. In other words, the world is no longer dealing with two separate nutrition stories, one about too little food and the other about too much.
Nevertheless, in countries like the Philippines, the sharper issue is that diets can be filling without being nourishing, leaving people exposed to disease at both extremes.
The latest Philippine survey data reinforce that tension. Based on FNRI’s December 2024 summary of the 2023 National Nutrition Survey, 23.6% of Filipino children under 5 were stunted and 15.1% were underweight. The same summary said obesity among adults remained “alarmingly high” at 39.8%, with higher prevalence among women at 45.4% and among urban dwellers at 44.5%. That means the country is carrying child undernutrition and adult obesity at the same time, not one after the other.
Furthermore, the same survey summary reported that food insecurity remained concentrated among larger households, rural families and poorer households, showing that diet risk in the Philippines is still shaped by inequality.
READ: Tuberculosis in 2026: What Filipinos Need to Know
A diet problem, not just a weight problem
What ties these trends together is not simply the amount of food people eat, but the quality of that food.
The DOST-FNRI’s June 2024 write-up based on the 2021 Expanded National Nutrition Survey explains that Filipino adults consumed only 58 grams of vegetables and 17 grams of fruit per day on average, levels the agency said were inadequate.
Meanwhile, the March 2025 WHO-UNICEF-NNC release warned that children are growing up in food environments where unhealthy food is often easier to access than nutritious options. It cited a UNICEF study finding that more than a third of packaged food for infants and young children contained added sugars or sweeteners, while another UNICEF study found that 99% of more than 1,000 analyzed social media ads for selected food products promoted unhealthy items.
Consequently, the country’s nutrition challenge is deeply tied to the food environment itself, not just to personal choice.
The adult numbers show how far that problem has already progressed. Based on the 2023 National Nutrition Survey report on adults aged 20 to 59, FNRI found that 39.8% of adults were obese using Asia-Pacific BMI classification, while 57.1% were overweight or obese under the same standard.
The same report showed a clear sex gap, with obesity affecting 45.4% of women and 35.2% of men. In addition, high waist circumference among adults reached 14.2%, another warning sign for metabolic risk.
These are not cosmetic indicators. They are markers of a food system and lifestyle pattern that increasingly pushes Filipinos toward diabetes, hypertension and cardiovascular disease.
From obesity to diabetes
That shift matters because obesity is not just excess body weight; it is a disease risk factor. According to WHO’s obesity and overweight guidance, obesity raises the risk of cardiovascular disease, stroke, type 2 diabetes, musculoskeletal disorders and some cancers.
Meanwhile, WHO’s November 2024 diabetes fact sheet said the number of people living with diabetes rose from 200 million in 1990 to 830 million in 2022, with prevalence rising faster in low- and middle-income countries than in high-income countries. The same WHO fact sheet said early diagnosis is important because symptoms of type 2 diabetes can be mild and may go unnoticed for years.
Based on the global analysis by Zhou and colleagues published in The Lancet in 2024 and highlighted by WHO on World Diabetes Day, more than 800 million adults worldwide were living with diabetes in 2022. Hence, the metabolic consequences of poor diet are no longer distant possibilities; they are already part of a global and Philippine health emergency.
For the Philippines, that matters even more because diabetes does not stay confined to the noncommunicable disease column. WHO TB Knowledge Sharing Platform discusses that people with diabetes were found to have a 1.9 times higher risk of developing tuberculosis than those without diabetes. WHO also notes that longer duration of diabetes and more severe hyperglycaemia are linked to greater TB risk.
On the other hand, people with diabetes are often discussed in public health as a separate high-risk group from people with undernutrition. In reality, both belong to the same nutrition story. Likewise, a country with rising obesity and diabetes is also a country that may be making itself more vulnerable to TB.
Meanwhile, undernutrition still drives infection
Based on WHO’s 2024 factsheet Tuberculosis and malnutrition, malnutrition is the leading attributable risk factor for tuberculosis infection. The same factsheet said the risk of acquiring TB increases by 13.8% for each unit decrease in body mass index, although that relationship is not maintained at the extremes of BMI. It also described the relationship between TB and malnutrition as bidirectional: malnourished individuals are at greater risk of contracting TB, while TB itself is a catabolic disease that can cause or worsen malnutrition.
In addition, WHO said malnutrition impairs immune function in multiple ways, helping explain why people who are undernourished are less able to resist infection.
The broader global TB picture underscores why that matters. According to the WHO Global Tuberculosis Report 2025, eight countries accounted for two thirds of global TB cases in 2024, and the Philippines alone accounted for 6.8%. WHO also estimated 10.7 million TB cases worldwide in 2024.
Meanwhile, WHO’s 2025 TB fact sheet said that globally in 2024, an estimated 0.97 million new TB cases were attributable to undernutrition and another 0.93 million were attributable to diabetes. Those figures place undernutrition and diabetes alongside smoking, alcohol use disorders and HIV as major drivers of TB risk.
Consequently, the Philippines is confronting TB in the middle of a nutrition transition that is worsening risk from both ends.
READ: TB Prevention at Home: Why It Starts at the Dining Table
What Philippine research is already seeing
Philippine clinic data show that this overlap is not abstract. In the 2020 Scientific Reports study, “Patterns and predictors of co-morbidities in Tuberculosis: A cross-sectional study in the Philippines,” White and colleagues examined TB outpatients in Metro Manila and Negros Occidental. The study reported that among 634 individuals with BMI measurements, 36.6% were undernourished.
It also found that diabetes prevalence reached 9.2% among 589 patients tested, and that 52% of those diabetes cases had been previously undiagnosed. The authors said the study provided the first published estimates of the prevalence of malnutrition and diabetes among people receiving anti-TB treatment in routine outpatient TB clinics in the Philippines.
Furthermore, the findings suggest that TB services are already seeing both undernutrition and hidden metabolic disease in the same patients.
That is precisely why the phrase “from obesity to TB” is not an exaggeration. A poor-quality diet can contribute to obesity and, over time, to diabetes.
Meanwhile, undernutrition and food insecurity continue to weaken immunity and increase susceptibility to infection. Those pathways may look different, yet they converge in one of the country’s most persistent infectious disease burdens.
Based on WHO’s latest guidance, people with compromised immune systems, including those with undernutrition or diabetes, have a higher risk of falling ill with TB.
Hence, nutrition is not a side note in disease vulnerability. It is one of the clearest bridges connecting chronic disease and infectious disease in the Philippines today.
Screening has to look both ways
This overlap also changes what prevention should look like. According to WHO’s diabetes fact sheet, early diagnosis can be accomplished through relatively inexpensive blood glucose testing, and the best way to detect diabetes early is through regular check-ups and blood tests.
Meanwhile, WHO’s tuberculosis fact sheet says common TB symptoms include prolonged cough, chest pain, weakness, fatigue, weight loss, fever and night sweats.
In addition, WHO’s tuberculosis-and-malnutrition guidance says nutritional assessment and counselling are critical steps in identifying undernutrition or obesity in people with TB. In practical terms, that means health screening can no longer move in silos. Adults with rising weight, central obesity or other metabolic warning signs need early screening for diabetes, while people with persistent cough, unexplained weight loss or prolonged fatigue need prompt TB assessment together with nutritional evaluation.
One unfinished food story
The latest evidence leaves little room for complacency. Based on the 2023 National Nutrition Survey, many Filipino households still struggle to secure enough nutritious food, even as adult obesity remains high and unhealthy food environments continue to expand.
Meanwhile, based on WHO’s latest TB reporting, the Philippines remains one of the countries carrying the heaviest TB burden in the world.
And so those facts reveal a harder and more human truth: the country’s food problem is producing two different kinds of illness from the same broken foundation. One path leads to obesity, diabetes and metabolic disease. The other leads to undernutrition, weakened immunity and greater vulnerability to TB.
Nevertheless, both begin with the same basic question of what food is available, affordable and normalized in everyday Filipino life.
That is why nutrition policy has become disease policy. Front-of-package labeling, stronger controls on the marketing of unhealthy food to children, better access to nutritious food, earlier diabetes detection and integrated nutritional support in TB care are no longer separate conversations. They are part of the same public health response.
Furthermore, the Philippine data now show that waiting until disease becomes visible is already too late for many families. The country is no longer choosing between fighting obesity or fighting TB. It is being forced to confront how one poor diet landscape can feed both.
Photo by Patrick Fore on Unsplash
References:
Department of Science and Technology–Food and Nutrition Research Institute. (2024). 2023 National Nutrition Survey: Adults 20–59 years old. https://enutrition.fnri.dost.gov.ph/uploads/7_2023_NNS_ADULTS.pdf
Department of Science and Technology–Food and Nutrition Research Institute. (2024, June 14). Pinoy adults, older persons need to consume more fruits and veggies – DOST-FNRI. https://fnri.dost.gov.ph/index.php/publications/writers-pool-corner/57-food-and-nutrition/870-pinoy-adults-older-persons-need-to-consume-more-fruits-and-veggies-dost-fnri
Department of Science and Technology–Food and Nutrition Research Institute. (2024, December). Updates December 2024. https://www.fnri.dost.gov.ph/images/sources/FNRIUpdates2024/Updates_December2024.pdf
White, L. V., Edwards, T., Lee, N., et al. (2020). Patterns and predictors of co-morbidities in tuberculosis: A cross-sectional study in the Philippines. Scientific Reports, 10, Article 4100. https://doi.org/10.1038/s41598-020-60942-2
World Health Organization. (2024, March 1). Malnutrition. https://www.who.int/news-room/fact-sheets/detail/malnutrition
World Health Organization. (2024). Tuberculosis and malnutrition. https://www.who.int/docs/librariesprovider2/default-document-library/booklet_200424.pdf
World Health Organization. (2024, November 14). Diabetes. https://www.who.int/news-room/fact-sheets/detail/diabetes
World Health Organization. (2025). Global tuberculosis report 2025: TB incidence. https://www.who.int/teams/global-programme-on-tuberculosis-and-lung-health/tb-reports/global-tuberculosis-report-2025/tb-disease-burden/1-1-tb-incidence
World Health Organization. (2025). 1.1 Background and burden of TB and diabetes. TB Knowledge Sharing Platform. https://tbksp.who.int/en/node/2884
World Health Organization. (2025, October 24). Tuberculosis. https://www.who.int/news-room/fact-sheets/detail/tuberculosis
World Health Organization, UNICEF, & National Nutrition Council. (2025, March 4). Stronger food policies needed to combat obesity in the Philippines. https://www.who.int/philippines/news/detail/04-03-2025-stronger-food-policies-needed-to-combat-obesity-in-the-philippines
