NHS England: Almost one in ten children obese in first year of school

Obesity levels among children starting their first year of school have increased to almost one in ten, according to new NHS figures published today.

The National Child Measurement Programme, which measures the height and weight of school children in England each year, found that the proportion of four and five-year-olds who are obese rose to 9.6% in 2023/24.

In the previous year, 9.2% reception-aged children were classified as obese (2022/23) but the latest figure remains below the pre-pandemic level of 9.9% in 2019/20.

The report also found that the proportion of ten and eleven-year-olds living with obesity fell to 22.1% in 2023/24 from 22.7% in 2022/23, but remains higher than the pre-pandemic level of 21.0% in 2019/20.

The NHS spends around £6.5 billion a year on treating obesity-related ill health across all age groups in England and has introduced a range of innovative services to support children and families to improve their health.

This includes 30 specialist clinics which are seeing thousands of children aged between two and 18 who are experiencing health complications related to severe obesity. The clinics provide support through specialist treatment and tailored care packages developed with a child's family, which could include diet plans, mental health treatment and coaching.

Professor Simon Kenny, NHS England's National Clinical Director for Children and Young People, said: “These latest figures continue to concern me as they show almost one in ten children are now classified as obese in their first year of school.

“Obesity can have a major impact on a child's life – it affects every organ in the body and is effectively a ticking health timebomb for the future by increasing a child's risk of type 2 diabetes, cancer, mental health issues and many other illnesses.

“The NHS is committed to helping young people and families affected by extreme weight issues with tailored packages of physical, psychological and social support, including our 30 specialist weight-loss clinics spread across the country to ensure that every child can access support if they need it.

“But the NHS cannot solve this alone and continued action from industry, local and national government, and wider society together with the NHS is essential to help create a healthy nation.”

The National Child Measurement Programme is overseen by the Office for Health Improvement and Disparities (OHID) and is analysed and reported by NHS England and OHID.

The annual report provides data on the patterns and trends in the prevalence of underweight, healthy weight, overweight, obesity and severe obesity among children in reception (ages 4 and 5) and year 6 (ages 10 and 11).

Levels of obesity in reception-aged children living in the most deprived areas (12.9%) were more than double those in the least deprived areas (6.0%).

Similarly, obesity among year 6 children was 29.2% in the most deprived areas, compared with 13.0% in the least deprived areas.

The proportion of underweight year 6 children rose to 1.7% in 2023/24 - up from 1.6% in 2022/23. Underweight children in reception remained at 1.2%, the same level as in 2022/23.

In 2023/24, the majority of children in reception (76.8%) and year 6 (62.5%) were a healthy weight.

Read the full report here.

Notes for editors

• This is a press release that refers to official statistics and is handled in line with T3.8 of the Code of Practice for Statistics.
• NHS England must be credited as the source of these figures. Regional data is available in this report.
• The obesity prevalence includes severe obesity.  
• Children are measured in reception (aged 4–5 years) and year 6 (aged 10–11 years) in mainstream state-maintained schools in England. Independent and special schools are excluded from the analyses in this publication.
• In this year's publication, there were 560,720 reception aged children measured and 606,863 year 6 children.
• The BMI classification of each child is derived by calculating the child's BMI centile from the British 1990 growth reference (UK90). This approach is recommended by The National Institute for Health and Care Excellence (NICE). The National Child Measurement Programme (NCMP) uses the BMI classification for population monitoring classification is as follows:  
• • BMI centile <=2: Underweight  
  • BMI centile >2 and <85: Healthy weight  
  • BMI centile >=85 and <95: Overweight  
  • BMI centile >=95: Obesity  
  • BMI centile >=99.6: Severe obesity (Note: “Severe obesity” is a subset of “Obesity”. Children with a BMI centile of between 95 and 100 are classified as “Living with obesity” and those with a BMI centile of between 99.6 and 100 are classified as “Living with severe obesity”).   
• The population monitoring cut offs for overweight and obesity (85^th and 95^th centiles) are lower than the clinical cut offs (91st and 98th centiles for overweight and obesity) used to assess individual children; this is to capture children in the population in the clinical overweight or obesity BMI categories and those who are at high risk of moving into the clinical overweight or clinical obesity categories.
• The COVID-19 pandemic affected how much NCMP data was collected and this is described in more detail in the report. The NCMP usually measures the height and weight of over one million children in England annually. In 2020/21, due to the coronavirus (COVID-19) pandemic disrupting the collection, a sample of 300,000 children were measured. Statistical weighting was applied to the data to ensure the sample is reflective of the population measured by NCMP in England in previous years and comparable. Details of this are in the Methodology and Data Quality section of the 2020/21 publication. The 2019/20 NCMP collection was incomplete because no measurements were taken after March 2020, when schools were closed as part of the response to the COVID-19 pandemic. Data quality work on the 2019/20 data established that it is comparable to earlier years at the England level. The 2018/19 school year was the last complete collection of NCMP data that was unaffected by COVID-19.
• The NCMP is a key element of the Government's approach to tackling child obesity by annually measuring over one million children and providing reliable data on the prevalence of children living with obesity.
• The cost of obesity to the NHS was calculated by the Department of Health and Social Care via Government plans to tackle obesity in England – Department of Health and Social Care Media Centre.
• Geographical analyses including deprivation in this report are primarily based on the postcode of the child's home address.
• Deprivation has been defined using the Index of Multiple Deprivation (IMD). IMD is the official measure of relative deprivation for Lower Super Output Areas (LSOAs) in England and ranks every LSOA in England from most deprived to least deprived and divides them into 10 equal groups. In the NCMP report, the most and least deprived areas mean the most deprived 10% and least deprived 10% of neighbourhoods respectively.