A Pasifika health leader says high obesity rates in the Pacific are not new, but an increase in childhood obesity is concerning.
A study on worldwide trends in underweight and obesity, just published in The Lancet medical journal showed that the highest rates of obesity for women were in Tonga and American Samoa, and Nauru and American Samoa for men.
The report, spanning 1990 and 2022, found the rate of obesity quadrupled among children and adolescents.
Sir Collin Tukuitonga - who is associate professor, associate dean Pacific and a research director at Auckland University's medical school - said the results for children were especially concerning.
"The local data here will show that two-thirds of young Pacific girls are obese, overweight. There's increasing trends in childhood obesity.
Sir Collin said obesity was a longstanding fight for Pacific nations.
"The problem of course is that it's so difficult to tackle, and it's all to do with our food systems, how people are not as active as they used to be."
Zero Hunger is one of the United Nations' Sustainable Development Goals, which deems both obesity and being underweight as forms of malnutrition.
"There is a need throughout the world for social and agricultural policies and food programmes that address the remaining burden of underweight while curbing and reversing the rise in obesity by enhancing access to healthy and nutritious foods," it said.
The Lancet report said there was an urgent need for major changes in how obesity is tackled.
Obesity can increase the risk of developing many serious health conditions, including heart disease, type 2 diabetes and some cancers.