Oxford research reveals that underweight children incur healthcare costs comparable to those with obesity, challenging current health priorities and highlighting the need for comprehensive children’s weight management strategies
A groundbreaking study by the University of Oxford has unveiled unexpected revelations about childhood weight and healthcare costs in England. By delving into NHS records for hundreds of thousands of children, researchers have challenged existing assumptions about the primary burdens on care services, shedding new light on the impact of both underweight and overweight conditions on the health system.
The findings are published in JAMA Network Open and funded by the National Institute for Health and Care Research (NIHR).
The cost of underweight and obese children in England
The NHS incurs around £340m in additional healthcare costs annually due to weight-related health problems in children, but obesity is not the only driver of rising costs. The research is the first national picture of healthcare costs linked to children’s weight, using NHS electronic health records from more than 268,000 children aged 2-15 across England.
The research linked rising healthcare costs after a child’s weight is formally recorded, suggesting that identifying weight issues triggers additional medical support.
The researchers tracked healthcare use in the year before and after children had their weight measured in GP practices, revealing the additional costs compared to healthy-weight children:
- Four to five-year-olds with severe obesity had the highest excess costs at £472 per year
- Girls with severe obesity cost more than boys (£253 vs £138 annually)
- Only White children showed clearly higher healthcare costs across all unhealthy weight groups.
- Healthcare use was substantially higher after weight was measured for underweight children, and moderately higher for children with severe obesity.
Dr Olu Onyimadu, the lead author from Oxford’s Nuffield Department of Primary Care Health Sciences, underlines the need for a comprehensive approach to unhealthy weight. He suggests that the findings of this research could revolutionise healthcare planning, as they indicate that it’s not just obesity that drives costs. Underweight children may require comparable support and incur similar costs per capita to those of the NHS. This insight could reshape how we plan and deliver services.
Professor Mara Violato, co-senior author based in Oxford Population Health, added: “With 27% of children aged 2-15 living with overweight or obesity, plus those affected by underweight, we are looking at a huge opportunity for preventive care. These detailed cost breakdowns by age and sex can help clinical and budgetary service planners identify which children to prioritise.”
Children’s weight-management programs provide good value for money
The findings indicate that concerns about underweight children are valued the same way as concerns about obese children. Once GPs identify children’s weight issues, children typically receive more medical support, from nutritional advice to mental-health services, highlighting the importance of regular check-ups.
The researchers highlighted that these cost estimates can now be used to evaluate whether specific weight-management programs provide good value for money. This will assist the NHS in making informed decisions regarding which interventions to fund. They also noted that BMI measurements are not consistently recorded for all children in primary care, and future research will investigate these patterns over longer time periods.
