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Are initiatives to reduce childhood obesity working?

Posted on 11 July 2011 by Louise Marryat, previous member of staff .
Tags: children and young people, NHS Scotland, National Childhood Obesity Week, Scottish Centre for Social Research, Scottish Health Survey, child obesity, health and lifestyle

Last week saw Mend’s second annual National Childhood Obesity Week - to raise awareness of the dangers of being above a healthy weight in childhood.

Scotland has one of the worst obesity records amongst developed countries. The estimated cost to the NHS in Scotland of obesity and related illnesses in 2007/8 was more than £175 million. No surprise then that tackling obesity is a key priority for the public health sector in Scotland.

The Scottish Government’s commitment to this issue is underpinned by the National Performance Framework’s national indicator on child healthy weight which is being monitored via the Scottish Health Survey commissioned by the Scottish Government and run by ScotCen. The indicator measures the reduction in the rate of increase in the proportion of children with their Body Mass Index outside the healthy weight range.

An NHS Scotland HEAT target was established in 2008/09 to deliver more than 6,300 child healthy weight interventions by March 2011. This led to the setting up of a variety of prevention and/or treatment services for overweight and obese children by NHS Boards across Scotland and more than 8,400 interventions were delivered during the target period.

But to what extent are these initiatives having an impact on child obesity in Scotland? The Scottish Health Survey can help answer this question.

Patterns in the proportion of children who are overweight and obese are different for boys and girls. For boys, the prevalence of being overweight or obese has fluctuated, first rising from 28% in 1998, to 32% in 2003, and then to 36% by 2008 but then declining notably between 2008 and 2009 to 29%. A difference between two years of this magnitude is unusual and, although statistically significant, may reflect sample fluctuation rather than a true population difference.

The pattern for girls, on the other hand, was very different - 28% of girls in 1998 were overweight or obese as were 27% in 2009, with rates in the intervening years being very similar.

Looking at overweight and obesity prevalence in 2009 in more detail, 14% of all children were overweight, 6% obese, and 8% morbidly obese. Rates of being overweight appear to be pretty much the same across all age groups (13.%-15%), whereas obesity (excluding morbid obesity) increases slightly with age, and morbid obesity prevalence more than doubles between the youngest and oldest children (from 5% in the youngest to 11% in the oldest).

So what’s the evidence telling us?

  • There’s clearly still a problem with childhood obesity in Scotland. But recent data suggests that the problem doesn’t appear to be growing and rates may, in some cases, be starting to come down.
  • More evidence is needed to demonstrate the impact of the new Healthy Weight interventions and to clearly identify falling rates, rather than fluctuations.
  • It’s important to target initiatives at both the early years, to keep children at a healthy weight, and at older children when they reach their teens, to maintain that healthy weight, and to prevent overweight children becoming obese or morbidly obese.

The next Scottish Health Survey Report is due to be published in September 2011 and will include new figures on Scottish Obesity rates. Time will tell whether the interventions are targeting the right groups and stemming the tide of childhood obesity.

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