The National Child Measurement Programme (NCMP) figures for the 2020-2021 school year revealed a 4.5 percentage point increase in the proportion of children who were obese. In reception classes, the proportion of children aged four and five who were obese jumped from 9.9% in the 2019-20 school year to 14.4% in 2020-21.
There was a similar rise among Year Six pupils, those aged ten and 11, from 21% to 25.5%. The increases are the biggest annual rise since the programme began in 2005 and presage a corresponding rise in all the health problems associated with being overweight – heart disease, diabetes, stroke and cancer.
It is, though, probably worth throwing in a cautionary word at this point, because the figures for the two years are not strictly comparable. In 2019-2020 the data reflected a fairly comprehensive review of height and weight measurements involving about a million children.
But the impact of the pandemic last year meant local authorities were directed they only need take measurements from a representative sample of schools within their area.
As result the 2020-2021 data, although statistically weighted to reproduce a fully national picture, actually involved only about 300,000 pupils.
Nevertheless, taking aside the ‘ifs’, ‘buts’ and ‘maybes’ of the statisticians, there was enough of an increase in the figures to worry child health experts.
Dr Max Davie, officer for health improvement at the Royal College of Paediatrics and Child Health, said lockdowns ‘may have been a key factor’ in the rise in obesity rates. “This sharp increase in obesity levels across childhood is alarming,” he said.
Tam Fry, spokesman for the National Obesity Forum, reacted by saying: “The figures are staggering and even worse than we feared. They will likely end any hope that the government’s target to halve child obesity by 2030 will be met.
“For two years we have had reports of children increasingly being kept at home because of Covid restrictions, endlessly snacking on junk food on top of the amount they regularly eat at meal times, and prevented from being able to play with their friends to burn off excess calories.”
He added that even when children had been able to go back to school, catering standards in many canteens ‘had collapsed’ with caterers serving up ‘less-than-healthy lunches’.
That last claim was firmly rejected by Jacquie Blake, national chair of LACA, who said of the latest measurement data: “We are concerned by the increasing levels in childhood obesity, and as outlined in the National Food Strategy, a hot healthy school meal for every child is key to tackling this epidemic.
“That is why LACA believes that as many children as possible should have access to a school meal that is nutritionally balanced, which combined with an active lifestyle should deliver positive health outcomes for children.”
The NCMP was set up by the Tony Blair-led Labour Government in 2005 as part of national efforts to reduce childhood obesity. It involves local authorities in England measuring children in mainstream state-maintained schools in their area, the programme running between September and August to coincide with the academic year.
The idea was that local authorities, once armed with accurate data from their own areas, would be better placed to target services and local action. The annual figures would also enable them to monitor progress.
The motivation behind the action was the concern among health experts at the rising demand for expensive healthcare interventions that they were seeing at the time. It was based on the understanding that child obesity is a good indicator of adult obesity, which in turn could lead to the poor health outcomes that were fueling that demand.
The results since have seen a series of rises in the numbers who are overweight or obese, punctuated by years when the levels merely plateau.
Overall, the proportion either overweight or obese in 2020-21 was 27.7% in reception and 40.9% in year 6. That means four in ten children leaving primary school are at increased risk of serious health conditions.
Just as worrying for child health experts as the rising prevalence of obesity among children, is the disturbing continuation of the trend that the proportion of unhealthy weight children grows as they progress through primary school. The figures show the number of obese children at age five nearly doubles by the time this same group reaches Year 6.
As the proportion that are merely overweight stays roughly the same, it is the share of healthy weight children that drops to account for this increase.
Caroline Cerny, from the Obesity Health Alliance, says the figures highlight ‘the need for a relentless drive on improving children’s health’.
But she believes the jump seen over the last two years has been an effect of the lockdown restrictions on children.
“There are several aspects of the pandemic that are likely to have contributed to this increase in child obesity levels,” she said.
“But it is very clear from data showing increases in sales of confectionery, biscuits and fast food that junk food companies used the opportunity to keep their unhealthy products centre stage in children’s minds. We need to break the junk food cycle to improve children’s health.”
Her concerns are echoed by Nikki Joule, the policy manager at Diabetes UK, who also warns of the potentially devastating consequences as a result of weight gain during the pandemic.
“This new data, which shows that two-fifths of children aged 10-11 in England are living with overweight and obesity is hugely concerning, and it underlines why urgent action is needed to improve children’s health.
“Living with obesity significantly increases your risk of type 2 diabetes, a condition which is known to have more severe and acute consequences in children and young people,” she said.
The data, though, highlights another important point, which is that the unhealthy weight gain isn’t spread around evenly. It is worse in some areas than in others, there are differences too in the extent to which different ethnicities are affected and there is even a noticeable gap in the figures between boys and girls.
Children living in the most deprived areas were much more likely to be obese than those in the least deprived areas. For instance, 20.3% of Reception children living in the most deprived areas were obese, almost three times as many as the 7.8% of those living in the least deprived areas.
In Year 6, the figures showed 33.8% of pupils living in the most deprived areas were obese compared to 14.3% of those living in the least deprived areas.
If you dig slightly deeper into the data, it shows that severe obesity prevalence was almost four times as high for Reception-age children living in the most deprived areas (7.6%) than for children living in the least deprived areas (1.9%).
Among Year 6 children severe obesity prevalence was over five times as high for children living in the most deprived areas (10.6% as against 1.8% respectively).
There are regional variations too. The prevalence of obesity in 2020/21 was below the average in the South East (12.6%) and the South West (12.9%), while it was higher Yorkshire and the Humber (15.3%), London (15.3%) and the West Midlands (15.9%).
And boys have a higher obesity prevalence than girls for both age groups. In Reception, 14.8% of boys were obese compared to 14.1% of girls, while in Year 6, 29.2% of boys were obese compared to 21.7% of girls.
The data also show ethnicity differences. Obesity prevalence was highest for black children in both Reception and Year 6, while it was lowest for Chinese children in Reception and for white and Chinese children in Year 6.
It all paints a fairly bleak picture, so what can be done to improve things? In the immediate aftermath of the release of these latest NCMP figures NHS England said it was establishing 15 specialist clinics to help children with severe obesity tackle their weight.
Tam Fry glumly noted that at the levels reported the 15 new clinics were ‘very sadly, going to be quite insufficient to cope with the numbers who now will need help’.
And Graham MacGregor, professor of cardiovascular medicine at Queen Mary University of London and Chairman of Action on Sugar pointed out: “Once a child becomes obese, it is highly likely that they will be obese for the rest of their lives with all the consequences of premature cardiovascular disease, type 2 diabetes and many cancers.”
He still, though, wanted efforts to be made. “The Government must now act to control the food industry and come forward with coherent plans to prevent and reverse this unfortunate situation,” he said.
He did not specify what form this action should take, but for Katharine Jenner, campaign director of Action on Sugar and Salt, what needs to be done is clear.
She said: “This is a wake-up call for government to tackle the food industry head-on.
“No amount of willpower or education could override the food industry’s merciless advertising to families with snacks, confectionary and takeaways during lockdown.
“We need our food to be healthier, affordable and accessible to all, and for it to be promoted responsibly.
“The National Food Strategy provided a clear route forward, including proposing a landmark sugar and salt reformulation tax, and we need the government to make it happen now.”