Evidence base for the prevention and management of child obesity

Obesity in childhood is a public health priority. The prevalence of overweight and obesity in children has increased since the mid 1990s, although prevalence is now stabilising. The National Child Measurement Programme shows that a third of 10–11 year olds in England are currently overweight or obese. Obesity increases the risk of poor physical health and mental health in childhood, and children who are obese are more likely to be obese in adulthood. Four tiers of services are recommended in the care pathway: universal prevention services; lifestyle weight management services often run in the community; specialist support from a clinical team; and surgery (in exceptional circumstances to over 12s). The current evidence on prevention indicates that interventions targeting schools and the home are promising, and reducing free sugar intake and sugar sweetened drinks is fast becoming a policy imperative. The evidence of the effectiveness of tier 2 weight management services is mixed, indicating that childhood obesity is hard to treat. Future research is turning to a whole systems approach to tackle childhood obesity. In this article we aim to outline how childhood obesity is measured, the scale of the problem globally and in the UK, the determinants and the consequences of childhood obesity. We will then give an overview of prevention and treatment interventions.