Prevalence and age-related trends of overweight and obesity among Saudi children aged 2-14 years during the COVID-19 pandemic: A retrospective cross-sectional study.

Background: Childhood obesity is a growing public health crisis in Saudi Arabia, which was intensified by the COVID-19 pandemic. This study mapped the prevalence and trends among clinic-attending children to inform prevention strategies. Methods: A retrospective cross-sectional analysis of electronic records for 28,275 Saudi children (aged 2-14 years) attending primary care clinics in Saudi Arabia's Eastern Province (2018-2024). Body mass index (BMI) was classified according to the Centers for Disease Control criteria (overweight: 85th-95th percentile; obesity: ≥95th percentile), excluding secondary causes. Crude and age-standardized prevalence rates were calculated by age, sex, and year using R software. Results: Mean age was 5.46 years (51% female). Overall, obesity prevalence was 12.3% (higher in males: 13.1% vs. 11.5% females), rising from 6.2% (ages 2-3 years) to 23.8% (ages 12-14 years). Overweight prevalence was 10.5% (7.3%-17.2% by age). Both reached their highest observed values in 2020 (obesity: 19.1%; overweight: 14.5%), with year-to-year variation thereafter. Conclusion: Age-related increases underscore the obesogenic environments among Saudi youth, with COVID-19 amplifying these risks. Findings highlight the need for resilient, Vision 2030-aligned prevention strategies focusing on early intervention and equity.