Developing countries are yet battling a “new reality” of coexisting under- and overnutrition, referred to as the double burden. Patterns and trends of double burden vary with the degree of development or urbanization. The progress in undernutrition indicators is paralleled by a rise in overnutrition and noncommunicable diseases. The double burden is multifactorial and is driven by socioeconomic, demographic, and environmental changes. The impact of this dual burden manifests as increased costs for the management of physical impairment, chronic disease, loss of productivity, disability-adjusted life-years (DALY), and years lived with disability (YLD). Developing countries are keenly testing nutrition-specific and -sensitive strategies to curb the rising double burden. Identifying the drivers of double burden and relevant leaders to flag the double-duty actions is pragmatic. Partnering with food production and distribution sectors and training health workers and institutions will enable the reconstruction of policies in a progressive direction toward addressing the double burden.