Proportion of youth at a healthy weight try

The proportion of young people of healthy weight in England trying to lose weight has almost tripled, from around 1 in 20 to almost 1 in 7, reveals an analysis of 20 years of annual health survey data, published in line in Archives of childhood illnesses.

But reported slimming attempts among children of all weights have increased, particularly among those who are overweight and obese, outpacing not only the increase in excessive weight gain during this period, but also the supply of services to meet demand, according to the analysis.

The prevalence of overweight and obesity in English children has risen steadily over the past decades: one in three children in the UK is now overweight or obese, as defined by the BMI-Z score, used for children who are still growing.

Childhood obesity became a UK government priority in 2004, but there is relatively little information on the number of children who take part in NHS weight management programs and/or attempt to lose weight.

To fill this knowledge gap, the researchers analyzed data from 34,235 children aged 8 to 17 who took part in the National Representative Annual Health Survey for England from 1997 to 2016: 8 waves of the survey included questions about weight loss.

The survey reported on social and demographic characteristics potentially associated with weight loss attempts, including age, gender, ethnicity and household income. Height and weight were measured by trained nurses during a home visit.

Analysis of the responses showed a significant increase over time in the overall proportion of children reporting weight loss attempts – from about 1 in 5 (21.5%) in 1997-1998 to more than 1 in 4 (26.5%) in 2015-2016 – one in five between 8 and 12 years old and one in three between 13 and 17 years old.

The absolute prevalence of weight loss attempts increased across all weight categories between 1997-8 and 2015-16, outpacing the proportion of children gaining excess weight.

The proportion trying to lose weight increased from 9% to more than 39% among overweight people and from just under 33% to almost 63% among obese people. And it nearly tripled among children at a healthy weight, from more than 5% (1 in 20) to almost 14% (1 in 7) over the same period.

The largest increase in the prevalence of weight loss attempts occurred in 2011-2012 and was apparent across all weight categories. For example, from 2009-2010 to 2011-2012, the prevalence increased from 13% to nearly 49% among overweight children and from 38% to 81% among obese children.

Among older children (13-17 years), the frequency of weight loss attempts increased from just over 4% to 57.5% among those who were overweight, and by nearly 31, 5% to nearly 82% among those who were obese, between 2009–10 and 2011–12.

The 2011-2012 survey year was also the first to find evidence of a notable proportion of healthy-weight children reporting weight loss attempts, rising from 0% the previous year to slightly more. by 15%. Similar trends were also apparent in younger children (8 to 12 years old).

Coincidentally, this date marked the start of individual weight feedback to parents or caregivers as part of the National Child Measurement Program, the researchers note.

The absolute prevalence of reported weight loss attempts was generally higher among girls than boys, but the increase over time was only significant for boys. Similarly, the absolute prevalence of weight loss attempts was higher in older children than in younger ones and increased significantly over time in older children.

Attempts to lose weight were higher among children from ethnic minorities than among white children in both age groups, and higher among children from low-income households.

Current overweight/obesity, ethnicity and household income were all independently associated with weight loss attempts in young children, while gender was also a factor in older children.

“Increased efforts to lose weight among overweight or obese children may imply some success in communicating the importance of weight control to this group,” the researchers write.

But they add: ‘It is concerning that the increase has not been accompanied by an increase in the provision of weight management services in England, creating the risk of unsupervised and potentially inappropriate weight control behaviour.

“Meanwhile, the increase in weight loss attempts among children at a healthy weight raises concerns and suggests that greater attention is needed to appropriately target weight control messages.”

They conclude: “Further research is needed to understand the drivers of weight loss attempts among young people at a healthy weight and to reduce their occurrence. Youth obesity policies need to be sensitive to reduce the risk of encouraging inappropriate weight control practices.

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About Geraldine Higgins

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