UK NSC recommendation on obesity screening in children- a consultation response

In 2018 we responded to the National Screening Committee's recommendations on obesity screening in children. We acknowledged the lack of strong evidence on routine weight monitoring, but noted there is growing consensus that actions with face validity should be considered. Assessing weight status in early childhood is an essential part of a coordinated approach to obesity prevention.

You can find out more information the recommendations from the National Screening Committee.

Our response: 

  • While we acknowledge there is a lack of strong evidence supporting routine weight monitoring, we would like to highlight the fact that this is not the same as evidence of lack of effectiveness. There is growing consensus that actions should be considered if they have face validity. 
  • A number of systematic reviews have shown that weight status in early childhood is an important predictor of overweight and obesity in later life and of health and mortality risk across the life course. It can lead to increased risk of a whole host of conditions including Type 2 diabetes, high blood pressure and cardiovascular disease.
  • Recognising overweight and obesity in children is a problem; it is estimated that a third of parents in England are unable to recognise that their children are overweight.
  • A single growth measurement (ie height, weight and calculated BMI (body mass index) measured at a distinct point in time) is difficult to interpret without the ability both to view trends and to compare with the population, and what is normal. This is only achieved by comparison of a child’s data with age and sex appropriate norms (eg on growth charts). The obesity thresholds for adults (eg BMI of 30kg/m2) are essentially meaningless in children – who need their BMI assessed for age and sex to identify overweight and obesity.

Our recommendations

  • There is currently no financial incentive for GPs to measure children, while measuring the BMI of an adult is an established element of the Quality and Outcomes Framework that provides additional payments to GPs. This is clear discrimination against children, and should be a priority for the NHS.
  • Assessing weight status in early childhood is an essential part of a coordinated approach to childhood obesity prevention, and for individuals it is key to taking action to help children stay on or return to a healthy weight across their life.
  • We recommend the reinstitution of universal monitoring of child weight and growth from infancy to adolescence, particularly in England. Measuring should begin from birth, the beginning of the critical first two years of a child’s life, to its final years of attending secondary school.

We respond to a wide range of consultations to ensure that the College’s position, and ultimately children’s health, is represented. Members can get involved in current consultations by contacting the Health Policy team: