Twenty countries are triply cursed: They have serious levels of malnutrition, diet-related anemia and obesity, according to the Global Nutrition Report published on Monday.

Only China, Vietnam and South Korea had no serious problems with any of the three indicators that health experts used as harbingers of poor nutrition: stunted toddlers, anemic young women and obese adults. The United States, Germany and 12 other countries have significant obesity.

Malnutrition has many causes beyond insufficient food, said the report by experts who were convened by the International Food Policy Research Institute in Washington. The causes include diarrhea spread by dirty hands and open defecation; a failure to breast-feed; and foods deficient in iron, vitamin A, folic acid and other micronutrients.

For every $1 spent to prevent babies from growing up physically and mentally stunted, a nation eventually saves $16, the report found.

In the United States, extra health care for one obese household member costs a family 8 percent of its income on average. In China, someone with diabetes typically has 16 percent less money at year’s end than someone without the disease.

The report is the third since health ministers at the 2012 World Health Assembly agreed on aggressive nutrition improvement targets for 2025, including specific reductions in obesity, Type 2 diabetes, stunting, low birth weight, women’s anemia and salt intake, and a 50 percent increase in exclusive breast-feeding for the first six months of life.

Donor countries give about $1 billion a year to fighting malnutrition, but the amount has not increased in recent years.

The report praised seven countries for making the most progress: Nepal for fewer stunted children, Suriname for fewer underweight children, Jamaica for fewer obese children, Peru for less female anemia and more breast-feeding, Nauru for fewer adults with a body mass index over 25, North Korea for fewer adults with a B.M.I. over 30, and Israel for less adult diabetes.