Beyond diet and exercise: why sleep is the missing piece in childhood obesity intervention

Childhood obesity is a pressing global health concern, yet existing interventions often neglect a crucial factor: sleep. Insufficient and poor-quality sleep contribute to obesity by disrupting hormonal regulation, increasing appetite, and promoting unhealthy behaviours such as excessive screen time, irregular eating patterns, and physical inactivity. Research highlights that these behaviours act as shared determinants of both poor sleep and obesity. Despite this, sleep remains an underutilised component in obesity prevention strategies. This paper argues for integrating sleep into multi-component obesity interventions, focusing on modifying evening routines, regulating screen time, promoting chrononutrition, and addressing socioeconomic and psychological barriers. Future research should explore the long-term impact of sleep-focused interventions, while public health policies must prioritise sleep education in schools and community settings. A holistic approach, targeting sleep, diet, physical activity, and mental wellbeing, is essential to reducing obesity rates and improving the overall health outcomes of children and adolescents.