Scottish youngsters are among the fattest in the developed world, according to new figures. Italy and Malta are the only countries with a higher number of overweight children, an NHS Scotland report reveals.
One in five 12-year-olds in Scotland are clinically obese - double the previous estimate - the figures show.
This compares with England and Wales and America, where one in seven 15-year-olds are obese, the Scottish Executive's health watchdog found.
Obesity problem
The report also reveals that one in 10 Scots children aged 12 are classed as severely obese and one in three are overweight.
This compares with France and Sweden, where only 18% are overweight and Germany, where the figure is 15%.
In the Netherlands 13% of children are overweight and in Slovakia the figure is 10%, according to the research.
The figures reveal a far worse obesity problem than was indicated in a previous study, which found just one in 10 Scots primary school pupils to be obese.
The Clinical Outcome Indicators report by NHS Quality Improvement Scotland, focuses on obesity rates in children of secondary school age.
The chief medical officer for Scotland said that the obesity epidemic was down to life choices.
Dr Mac Armstrong said: "The report highlights serious problems. It's not so much a wake-up call as an alarm bell which every single one of us should heed.
"Issues like obesity and smoking during pregnancy are fundamentally about people and the choices they make as individuals and parents.
"We can only reduce the levels of obesity if people make the choices that promote their own health."
The Scottish Executive launched a multi-million pound healthy eating campaign in January to try to tackle the obesity epidemic.
But less than 1% of Scots have contacted the healthy living helpline in the nine months following its launch.
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We can only reduce the levels of obesity if people make the choices that promote their own health. 
