Registered dietitian and associate professor in nutrition Dr Hilda Mulrooney offers advice on the challenges of managing overweight and obesity in children
GPs need to be able to recognise overweight and obesity in children and intervene appropriately, but this can be a complex and sensitive issue to tackle. Our latest featured CPD learning module will guide you through the key issues, to gain understanding of:
- The changing prevalence of childhood overweight and obesity
- The risk factors, including the contribution of genetics and environment
- How to assess for overweight and obesity in children
- The physical and psychological implications
- How to raise the issue with parents, when to request investigations and which weight management services to refer to
- The limited role of pharmacological treatments and surgery
- How to support children and parents motivated to make lifestyle changes, and when to refer to a paediatrician
Q What is the prevalence of childhood overweight and obesity, and how has this changed over the years?
A The latest data suggest that more than one in four Reception aged children (four-five years) and more than one in three Year Six children (10-11 years) in England are affected by overweight and obesity (27.7% and 40.9% respectively).1
It is not equally distributed; obesity prevalence is approximately doubled in most- compared with least-deprived children, and affects boys more than girls, older children more than younger and black children more than other ethnic groups. Obesity-related co-morbidities such as type 2 diabetes mellitus and dyslipidaemia are also known to disproportionately affect some ethnic groups (for example, those of south Asian origin), at lower body mass index (BMI) than that diagnostic of obesity in Caucasians.2 This appears to be driven by higher abdominal and ectopic fat distribution. Lower cut-off points for waist circumference and BMI for adults of south Asian and Chinese origin for public health interventions have been proposed.3 This suggests that preventing childhood obesity in these groups may be particularly important.
The Covid pandemic has had an influence, with an approximately 4.5% increase in prevalence of obesity in both age groups in 2020/21, which is worrying. Before that, levels of obesity in Reception children were relatively stable, while those in Year Six children were gradually increasing. The data are collected every year by measuring weights and heights of children in those two groups in mainstream state-maintained schools in England, so we will be able to see if this pandemic-associated rise is sustained over time. Annual statistics can be found by looking at the most recent National Child Measurement Programme (NCMP) data.1
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Dr Hilda Mulrooney is a registered dietitian and is Associate Professor in Nutrition at Kingston University London