Those of us working in the many strands of the mental health industry have seen it coming for years. Now The Lancet has confirmed it: today’s teenagers are in the grip of a full-blown health crisis. By 2030, nearly half a billion adolescents worldwide are expected to be overweight or obese — not just at risk, but already living with the consequences of being severely overweight during their most vulnerable, formative years.

Alongside this obesity epidemic, there’s a parallel surge in mental health diagnoses of conditions such as depression, anxiety, ADHD and autism. Rather than cigarettes and alcohol, the most significant health risks for young people are now weight gain and psychological problems. The report claims that “funding for adolescent health and wellbeing is not commensurate with the magnitude of the challenge and is not targeted to the areas of greatest need.” It says that “specific funding for adolescent health accounted for only 2·4% of total development assistance for health in 2016–21, despite adolescents accounting for 25·2% of the world population.”

The instinctive response from professionals is always to call for more: more diagnoses, more medication, more interventions. Yet what if the answer isn’t more, but less? Less medicalisation, less screen time, less processed food, and less denial about the kind of society we’re choosing to raise our children in.

When we step back and look at the bigger picture, it becomes painfully clear that we’re raising children in a profoundly unhealthy environment. Screen-based, sedentary lives are paired with high-calorie, low-nutrient snacks. This is the age of digital overload, physical inertia and constant consumption. We’ve created an obesogenic culture, a world that makes unhealthy choices the default. Chemists sell crisps and chocolate at the till. Treats are almost always food-based and ultra-processed. And when the physical and mental consequences inevitably appear, we rush to offer therapy, diagnoses and pills.

The teenagers with whom I work often describe feeling anxious, disconnected, and overwhelmed. Many struggle to socialise, not just because their friendships exist mostly online, but because they haven’t had the chance to properly develop real-world social skills. Some turn to food for comfort and to mental health labels for explanation.

Medication can compound the problem, with side effects like weight gain, emotional numbing, and reduced libido. Teens become even less inclined to leave their rooms as they lack motivation and sexual energy. Screen-based socialising becomes the path of least resistance; but this is a lonelier, less exciting, more disconnected life.

Therapy and diagnoses can bring genuine relief, and sometimes the support is both appropriate and necessary. But, too often, the clinical framework becomes a way to sidestep the bitter truths that we all need to confront in adolescence: that life is unfair, and we can only do our best with what we have.

When the majority of teens are struggling, we can’t keep framing it as individual pathology. Wellbeing requires effort and, crucially, discipline — a word now increasingly viewed as outdated or even oppressive. But we can’t keep cultivating an unhealthy lifestyle and expecting healthy outcomes.

Anyone who has carried excess weight during adolescence knows how it can strip away many of the joys of that stage of life. Obese teens often feel ashamed, find it harder to understand how other people could be attracted to them, and begin to internalise “being fat” as part of their identity. Climbing out of that mindset and into a healthier lifestyle is incredibly hard. And the difficult but healthy way of doing so — eating well and exercising regularly — is being replaced by the medicalised option of weight-loss jabs.

If we truly want to help teenagers, we need to start by being honest about what’s hurting them. We all know that good mental health is built on the basics: regular sleep, home-cooked meals, time outdoors, real friendships, and a sense of meaning and purpose. None of this is new, but all of it is increasingly rare.

Obesity isn’t just a health issue: it’s a warning that something is deeply wrong with how our young people are living. It is a symptom of a culture that has lost its way.

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Stella O’Malley is a psychotherapist and bestselling author. She is Founder-Director of Genspect, an international organisation that advocates for a healthy approach to sex and gender.

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