Filter by topic
Filter by content type
  1. Home
  2. Work we do
  3. State of Child Health

State of Child Health 2026: Obesity

Health Policy team
Save as PDF
This indicator looks at the prevalence of children across the UK who are overweight or obese when they start primary school compared to when they finish by measuring a child’s body mass index (BMI).
Last updated
Post date
14 July 2026
Table of contents
Contents

This is one of 12 indicators in our State of Child Health resource.

What is the problem?

Childhood obesity is a significant public health challenge in the UK, as the prevalence of overweight and obesity amongst children and young people remains high.  In 2024-25 around a quarter of 4-5-year-olds were overweight or living with obesity in England (23.5%) and Scotland (24%). This was similar in Wales (27.3%) and Northern Ireland (25%) in 2023-24. These rates have not changed significantly in any of the four nations since this was first examined in the 2017 State of Child Health report.

See chart in full

However, rates of overweight and obesity for children have been steadily increasing by the time they finish primary school in England and Northern Ireland, with over a third of 10-11-year-olds in England (36.2%) in 2024-25, and 11–12-year-olds in Northern Ireland (34.67%) in 2023-24, classified as overweight or obese.

See chart in full

Behind these figures are stark health inequalities. Rates of obesity among 4-to-5-year-olds living in the most deprived areas were double (14.0%) that of to those living in the least deprived (6.9%) in 2024-25 in England. This trend continues as children start secondary school. The largest inequality is observed in severe obesity prevalence where 10–11-year-olds living in the most deprived areas are more than four times as likely to living with severe obesity (9.0%) compared to those in the least deprived (2.2%).

See chart in full

In Northern Ireland, 21.52% of primary one children living in the least deprived areas were overweight or obese, compared to 28.51% living in the most deprived areas. Among 11–12-year-olds, 29.97% of those living in the least deprived areas were overweight or obese, compared to 41.2% living in the most deprived areas. In Scotland, in 2024-25, children living in the most deprived areas (as measured by Scottish Index of Multiple Deprivation) were twice as likely to be at risk of obesity (16%) than children living in the least deprived areas (8%).

See chart in full

Ethnic disparities also exist. For example, in England, obesity prevalence was highest among children aged 10-11 from any other Black background (31.4%) and Black Caribbean (30.8%) in 2024-25, compared with 13.6% of Chinese children. In Scotland, children of Gypsy/Traveller (61%), African, Scottish African or British African (71%) and White Scottish ethnicity (75%) were less likely to have a healthy weight compared to the overall population (76%) in 2023-24.

See chart in full

There are also inequalities between urban and rural communities. In Wales, the proportion of children in rural areas living with overweight or obesity was 26.8%, compared to 25.0% in urban areas.  

Why does it matter?

Children living with overweight and obesity face an increased risk of adverse health outcomes.1 The origins of chronic illnesses due to excessive weight are established in childhood and include type 2 diabetes, cardiovascular disease (CVD), liver disease, obstructive sleep apnoea, common cancers, and musculoskeletal conditions.2 Moderate to severe obesity can also shorten life expectancy by 2-10 years.3 Children may also experience poorer mental health as a result of stigma due to their weight, the impacts of which may include bullying and poorer educational outcomes, as well as an increased risk of depression, anxiety, and social isolation.4

Drivers of poor outcomes

The drivers of obesity are a complex mix of factors influenced by the environments in which children grow up. Access to affordable and healthy nutrition has decreased and children are increasingly exposed to unhealthy food environments. Foods high in fat, sugar and salt are more readily available, and often cheaper than healthier alternatives, meaning children’s diets have become dominated by ultra-processed foods,5 which can set a lifelong preference for sweet and salty tastes due to overexposure in the early years. In contrast, predominantly plant-based diets rich in whole foods such as fruits, vegetables and legumes have been associated with healthier weight outcomes and improved dietary quality.6

Healthy foods are now nearly three times more expensive, calorie-for-calorie, than less healthy foods, leading to more than 1 in 4 children living in food insecure households in the UK.7 As a result, children in these households are more likely to consume cheaper foods high in fat, sugar and salt, and fewer fresh fruits and vegetables, increasing their risk of living with overweight and obesity. Limited access to nutritious school meals can further exacerbate these inequalities, particularly for children who rely on them as a key source of daily nutrition.8 Improving access to affordable plant-based whole foods could help address some of these inequalities by supporting healthier dietary patterns. In addition to this, people living in the most deprived urban areas are less likely to have access to green spaces, which reduces opportunities for physical activities to help maintain a healthy weight.9

Why we need to act now

Interventions in childhood are the crucial window for preventing obesity, as the cost of inaction on childhood obesity is great; children living with excess weight are at risk of carrying ill health into adulthood, as 80% of obese young people remain obese as adults.10 Earlier onset and more severe obesity increases the likelihood of developing co-morbidities and can shorten life expectancy.11

Treating obesity-related ill health is estimated to cost the NHS £12 billion annually, with additional productivity costs to the economy estimated at around £31 billion due to reasons including more people being unemployed and taking more sick days. Research estimates a total impact of obesity and excess weight on the economy and wider society to be £126 billion.12

A paediatrician's insight

From Dr Dita Aswani, Consultant Paediatrician specialising in Diabetes and Weight Management, and RCPCH Assistant Officer for Nutrition and Obesity

"Children’s obesity cannot be tackled in isolation or without addressing the wider determinants of health. Nor can it be understood outside the context of the family, community and life‑course it sits within — beginning in utero and continuing through early years, school and adolescence. We are now seeing conditions in children that were previously metabolic complications of adulthood and uncommon in paediatrics. Alongside the exponential rise in type 2 diabetes in under‑18s, younger children are presenting with insulin resistance, fatty liver disease, hypertension, sleep apnoea and worsening oral health."

Read more from Dita

"A major challenge is that many children, young people and families do not know where to find support that feels safe and non‑judgemental. Weight stigma — including within healthcare — undermines trust. Families often describe feeling blamed for circumstances shaped by powerful external forces: ultra‑processed foods that are cheap, convenient and socially expected among peers, attention-driven algorithms built to maximise screen time and advertising exposure, limited safe spaces for activity, and the rising cost of fresh, healthy food. These are active and harmful drivers of weight gain and relapse, and their effects are neither minor nor easy for families to avoid.

"Children and young people frequently move between services without their growth being monitored, risk factors for metabolic conditions being recognised, or advice being tailored to their circumstances. A more coherent, preventative approach is both possible and necessary, by improving how we connect with partners, and build confidence in poverty‑aware, culturally informed and neurodiversity‑affirming practice.

"To make progress, paediatric services need stronger links with maternity, health visiting, education, public health, primary care and community partners. Neighbourhood MDTs offer a real chance to bring these perspectives together so we can intervene earlier, provide holistic, compassionate support, and align messaging and practical help across agencies rather than each part of the system working alone.

"For paediatricians, several actions could meaningfully reduce childhood obesity prevalence. First, make growth measurement routine at every contact and explain centiles clearly and compassionately. Avoiding the conversation does not protect families; it simply delays support. Second, take time to understand the child’s context before offering advice. Ask and listen to understand what is realistic and achievable for this family. Third, recognise obesity as a chronic, relapsing condition influenced far more by environment than by individual choice.  

"Finally, paediatricians have a powerful role as advocates. We understand better than most how poverty, housing, schooling, food marketing and digital exposure are shaping children’s health and well-being. Using our collective voice to influence local and national policy is essential, because a single sector approach alone cannot shift the dial. Consistency and shared understanding matter, and by working more deliberately with maternity, health visiting, education and community partners, we can build a more joined-up system that supports families early."

Recommendations

England
  • Build on the success of the Soft Drinks Industry Levy and introduce fiscal levers to mandate reformulation of unhealthy food and drinks to help reduce babies, children and young people’s sugar and salt intake.  
  • Strengthen restrictions on the promotion of foods high in fat, salt and sugar by expanding them to include outdoor advertising, sponsorship, radio and sports, and close the brand advertising loophole.  
  • Fund local authorities to maintain and expand access to sports and leisure facilities for children and young people, including preserving green spaces, swimming pools and community leisure facilities.
  • Introduce mandatory colour-coded front-of-pack labelling for all packaged foods, aligned with the Nutrient Profile Modelling to support families to make healthier food and drink choices. 
Scotland
  • Fund local authorities to maintain and expand access to sports and leisure facilities for children and young people, including preserving green spaces, swimming pools and community leisure facilities.
  • Expand BMI data collection in primary schools to include additional age points to strengthen health surveillance and support timely, targeted interventions.
  • Commit to universal, free, nutritious school meals for all children in primary school to help reduce diet-related inequalities, support early obesity prevention, and promote healthy eating.  
  • Deliver and strengthen HFSS promotion restrictions to reduce children and young people’s exposure to unhealthy food environments. 
Wales
  • Continue to deliver free school meals for all primary school children and expand this to secondary school children, starting with students from households claiming Universal Credit. Ensure that all school meals meet healthy and nutritious standards.  
  • Fund local authorities to maintain and expand access to sports and leisure facilities for children and young people, preserving of green spaces, swimming pools, and community leisure facilities, and promoting movement and exercise in schools.  
  • The Welsh Government should deliver a successor plan to Healthy Weight Healthy Wales to ensure early interventions and support for families. Detailed within a successor plan should be a requirement for all Health Boards have a level 3 specialist service. 
Northern Ireland
  • Provide full multi-year funding for the new Healthy Futures Obesity Strategic Framework (2025).  
  • Align obesity prevention with the Healthy Child, Healthy Future early years model and ensure that nutrition and physical activity guidance are consistently delivered by health visitors and early years practitioners.  
  • Develop, implement and invest in child-centred healthy living strategies, including the promotion of initiatives that enable affordable healthy eating, active travel and physical activity.  
  • Fund regional, evidence-based child weight management services, with consistent access across all HSC Trusts, and strengthen weight management pathways for children already living with obesity. Local authorities and HSC Trusts should commission targeted programmes in high-risk areas, including community nutrition initiatives, subsidised physical activity opportunities and enhanced early family support.   

This is one of 12 indicators in our State of Child Health resource.