Purpose This study aims to determine the current prevalence of overweight and obesity among children and adolescents in the Northern Region of Saudi Arabia and to document the double burden of malnutrition in a region experiencing rapid socioeconomic transition. Design/methodology/approach A cross-sectional study analyzed electronic medical records from primary healthcare centers (PHCs) across the Northern Region of Saudi Arabia. A total of 1,191 participants aged 6–18 years were enrolled between August 2023 and November 2024. Body mass index (BMI) was classified according to World Health Organization (WHO) percentile criteria. Findings Among 437 children (6–13 years), combined overweight/obesity prevalence was 26.3%. Among 754 adolescents (14–18 years), it was 32.9%. Female children showed significantly higher overweight rates than males (19.3% vs 14.8%, p 0.001). A high underweight prevalence (23.1%) was observed among adolescents, indicating the double burden of malnutrition. Research limitations/implications The cross-sectional design and recruitment from PHC attendees preclude causal inference and limit generalizability to the wider population. Practical implications These findings provide essential baseline data for developing integrated, culturally sensitive interventions that address both undernutrition and overnutrition within the Saudi Vision 2030 framework. Social implications The coexistence of underweight, overweight and obesity within the same population reflects the complex nutritional transition in developing nations and calls for comprehensive multilevel public health strategies. Originality/value This study provides the first systematic assessment of the double burden of malnutrition in the Northern Region of Saudi Arabia using WHO criteria, filling a regional gap in national data and supporting targeted policy development.
Almutairi et al. (2026) studied this question.