Caution urged over childhood obesity rates

New data from the National Child Measurement Programme (NCMP) shows the prevalence of children aged 10 to 11 years who are obese is down from 23.4 per cent in 2021/22 to 22.7 per cent in 2022/23, but it remains higher than pre-pandemic rates.

Meanwhile, obesity prevalence for children aged four to five years has fallen from 10.1 per cent in 2021/22 to 9.2 percent in 2022/23, the lowest since the start of the NCMP.

The NCMP is a mandated programme for all state-maintained schools in England. Each year children aged four to five, and those aged 10 to 11 have their body mass index calculated.

Tracey LeMay, Public Health lecturer at the University of East London, said the figures showing a decrease should be treated with caution.

The data is complex, and the government cannot take the credit with their policy for a drop in rates as it is far more multifaceted. The data only represents those measured. Participation rates must be considered, and local area level data explored.”

The data also shows significant disparities for children living in the most deprived areas, who are more than twice as likely to be obese than children living in the least deprived areas. East London had some of the highest rates of childhood obesity with almost 30 per cent of year six children in Newham being identified as obese.

Ms LeMay said action was needed to reduce widening inequalities. “The inequality gap is still a concern between ethnic groups and levels of deprivation. Severe obesity prevalence for children living in the most deprived parts of the country is up to four times higher compared with the least deprived, and this must be addressed as a priority.”

She has argued for a whole systems approach to be put in place, with local authorities using community knowledge in finding solutions rather than a national ‘one size fits all’. Ms LeMay has also called for efforts to reduce stigma around weight, with a universal approach to promoting healthier choices, regardless of a child’s BMI category.

“There has been greater emphasis on joined-up working between primary schools and health providers such as school nursing teams, physical activity providers, alongside the School Zone platform for teachers to embed healthy lifestyle resources.

“There have been good examples of collaborative working between education and health with children earning points for their class in ‘healthy missions’ which make it fun, while addressing aspects such as reducing sugar, oral health and increasing physical activity. NELFT and Dilkes Academy healthy lifestyle programme.

“However, core subjects such as English and Maths are often a school’s priority, so teaching staff will not always be able to prioritise delivering on the childhood obesity strategy. Schools have a difficult balancing act.”

LeMay said that the recent Health and Care Act 2022 , which supports collaborative working and a place-based approach puts community assets as integral for local solutions. Focusing on a neighbourhood’s strengths rather than the public health issue of childhood obesity, could build on grassroots approaches which seek to involve families and neighbourhoods,

“Success has been seen when children and families come up with their own healthy activities, where peer support, neighbourhood assets and insight, help create an inclusive intervention that children are excited to be a part of, and where weight or size doesn’t come into it, but the focus is on inclusivity and having fun.

“The wider determinants of health need to be considered. Do parents feel safe letting their children out to play? Are there affordable, healthy food choices near where they live?” Ms LeMay added.

Ms LeMay has implemented guidance to support professionals in having conversations with parents about their child’s weight, but she emphasises this is a sensitive topic where stigma, blame, social and cultural factors influence attitudes.

“Parents may not welcome being given the news that their child is overweight. Obesity prevalence is highest for black children. Black parents I have worked with shared that culturally, excess weight indicates wealth. There are many different factors to consider in a whole systems approach,” Ms LeMay added.