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Lockdown measures during the COVID-19 pandemic contributed to sharp increases in the number of obese and overweight primary school children in England that could lead to additional healthcare costs running into millions of pounds over their lifespan, researchers have estimated.
Previous research has suggested that children were at particular risk of weight gain in 2020-2021 as schools closed, organised sport was cancelled, and opportunities for physical recreation were curtailed. Pandemic restrictions may also have caused a deterioration in healthy eating habits, disrupted sleep, and increased children’s screen time, according to researchers at the University of Southampton who carried out the investigation.
The researchers used data on childhood BMI from the National Childhood Measurement Programme for children aged 4-5 years in reception classes and those aged 10-11 years who were finishing their primary education.
The analysis found that prevalence of overweight and obesity among children in reception year rose from 9.9% in 2019-2020 to 14.4% in 2020-2021, and decreased to 10.1% in 2021-2022, returning to the pre-pandemic trend.
However, overweight and obesity prevalence in children aged 10-11 years persisted and was 4% higher than expected. This increase meant that 55,838 more primary schoolchildren could have become overweight or obese during the pandemic, with 16,752 of those being severely obese, according to the research.
Obesity Increase Disproportionately Affected Deprived Communities
The increase was twice as high among children from the most deprived areas of the country compared with the least deprived, with particularly high rates among those from Black and South Asian backgrounds.
Study co-author Keith Godfrey, professor of epidemiology and human development at the University of Southampton, explained to Medscape News UK: “We think that in the older children, the obesity is more embedded, in that the health-related behaviours which underlay the COVID-associated rise were more persistent. So, in young children, they go back to better diets and more physical activity, whereas by the end of primary school, once the children have changed their behaviours, they are much less likely to go back to the healthier behaviours that they had before.”
An Issue of Social Justice
The authors of the study, published in PLOS ONE, estimated that the additional healthcare cost for this cohort could amount to £800 million for treatment of persistent obesity and other long-term conditions such as type 2 diabetes, hypertension, and coronary artery disease.
The wider costs to society could amount to £8.7 billion, according to the researchers. “The NHS costs of obesity are about a fifth of the total costs to society through sickness absence, and all the rest of it that goes with it,” said Godfrey.
The study authors concluded: “Our data raise profound social justice, equity, and financial concerns, with pressing implications for individuals, policymakers, and UK society. Obesity prevalence in the most deprived areas of England is now more than double that in the least deprived and the gap has been widening over time.”
Katharine Jenner, director of the Obesity Health Alliance, who was not involved in the study, told Medscape News UK that the small decline in overweight and obesity prevalence among younger primary schoolchildren suggested that improvements were possible, “but they will not drop further without political will from the highest levels of government”.
Jenner commented: “We have laws in place that could immediately help children in disadvantaged circumstances to grow up healthily, such as only allowing healthier food to be on price-promotion, advertised on TV, or online. But the government has needlessly delayed them coming into force until the end of 2025 – leaving more and more children to suffer the consequences of inaction.”
Godfrey said: “Frankly, the measures that are currently in play are not sufficient to reverse these worrying trends – which are ongoing – in the disparities in childhood obesity between those living in the most and least advantaged areas.”
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