Increasing numbers of young children in England are overweight or obese, and the prevalence is twice as high in the most deprived areas as more affluent places, according to an alarming new report.
The study by NHS Digital (2022), based on information taken from the National Child Measurement Programme for 2021-22, found that 13.6% of reception-aged children in areas of social deprivation were obese, compared with 6.2% in the least deprived areas. When it came to ‘severe obesity’ the figures were 4.5% and 1.3% respectively.
This disparity is also evident in Year 6 pupils with 31.3% of the age group living with obesity in deprived areas, compared with 13.5% in better-off areas. Overall, 9.4% of this cohort were severely obese – more than four times higher than children living in well-off areas, on 2.1%.
The National Child Measurement Programme (NCMP) – overseen by the Office for Health Improvement and Disparities and analysed and reported by NHS Digital – measures the height and weight of children in England annually. It provides data on the number of children in reception and Year 6 who are underweight, healthy weight, overweight, living with obesity or living with severe obesity.
…13.6% of reception-aged children in areas of social deprivation were obese, compared with 6.2% in the least deprived areas. When it came to ‘severe obesity’ the figures were 4.5% and 1.3% respectively.’
The prevalence of reception-aged children living with obesity had been relatively stable since 2006-07 but saw a 4.6-percentage-point increase from 9.9% in 2019-20 to 14.4% in 2020-21, which was the main year of the Covid-19 pandemic. It raises questions about how families coped with accessing food during the school shutdown. Meanwhile, underweight prevalence was highest in London for reception-aged children at 1.9% and Year 6 at 1.7%.
Among the oldest primary-aged cohort, the prevalence of children living with obesity increased slowly from 19.0% in 2010-11 to 21.0% in 2019-20, and then increased by 4.5 percentage points to 25.5% in 2020-21.
School nurse, Carrie Norman, who works with schools in the north-west of England, said the figures were ‘extremely worrying’.
‘We see the implications of this on visits to schools, with even young children – who should be very active at this age – struggling with shortness of breath and a lack of motivation to do physical activity,’ Carrie said. ‘Studies suggest that children continue to consume far too much sugar and this, coupled with a sedentary lifestyle, is a major cause of these rises. Obesity in childhood tends to continue into adulthood, bringing a whole new set of avoidable health problems.
‘It raises questions, too, about how well families ate during the pandemic, when children had no access to free school meals.
‘However, what happens during many children's years in primary school is also concerning, with levels of obesity rising as they progress through their education. We need to look at how and why children are becoming more overweight and what we can do about it. Is it what they're eating, a lack of exercise or a combination of both? We need to ask ourselves what we can do to work with vulnerable families, especially now during the cost-of-living crisis.’
Earlier this year, the government published an updated version of its Childhood Obesity – applying All our Health guidelines to help health professionals, including school nurses, to prevent ill health and promote wellbeing as part of their everyday practice (Office for Health Improvement and Disparities, 2022).
The prevalence of reception-aged children living with obesity in 2021-22 was highest in the North-East (11.4%) and the West Midlands (11.3%). It was lowest in the South-East (8.7%), South-West (8.9%) and East of England (9.2%).
For Year 6, the prevalence of children living with obesity was highest in the North-East (26.6%), the West Midlands (26.2%) and London (25.8%). It was lowest in the South-West (19.8%), the South-East (20.0%) and the East of England (21.4%).
‘…the government really should be leading with some effective policies and measures in places for how to tackle this problem.’
Urban areas fared worse overall for both age groups, but this varied by local authority. For reception-aged children, this ranged from 5.4% in Richmond upon Thames to 14.9% in Sandwell. In Year 6, the range was from 12.4% in Surrey, to 34.0% in Sandwell.
Children's ethnicity also played a part in the likelihood they were overweight. Black children in both reception (16.2%) and Year 6 (33%) had the highest prevalence, and Chinese children the lowest in both reception (4.5%) and Year 6 (17.7%). The most underweight children were Asian pupils in both reception (4.3%) and among the older cohort (3.3%).
The NCMP was launched in the 2005-06 academic year and now holds 16 years of reliable data. The year 2006-07 was the first that the data is considered to be robust due to low participation in 2005-06, so this is the earliest year that comparable data for obesity prevalence among reception-aged children is available. 2009-10 is the first year that the obesity prevalence figures are robust for Year 6 schoolchildren.
The NCMP is a key element of the government's approach to tackling childhood obesity. Every year more than one million children in state primary schools are measured. Special and independent schools are not included in the exercise.
Midlands GP, Dr Jacqui Bradley, said: ‘The rise in obesity in all groups is increasingly evident, and this is a major concern especially in children and young people. Primary pupils who are overweight are prone to health problems, increased school absence and social problems, such as bullying. They are also more likely to suffer from poor self-esteem, which can affect academic performance and behaviour at school.
‘With all this data now available, with comparisons over many years, we can see the trends and the government really should be leading with some effective policies and measures in places for how to tackle this problem. This will only escalate as the children grow into adults, when obesity is known to be a contributing factor to diabetes, blood pressure problems and heart disease. It can also affect immunity.
‘With the country in the grip of a cost-of-living crisis, it is more important than ever to ensure that children are eating nourishing meals, and that families are not relying on fast food, which sometimes lack the balanced diet they need.’