Is the UK Government’s childhood obesity programme working?

How has the UK Government’s National Child Measurement Programme (NCMP), designed to tackle childhood obesity, impacted child and parent mental health?

The Queen Mary University of London has researched England’s National Measurement Programme (NCMP), an intervention designed to tackle childhood obesity, to better understand the experiences of parents and their children categorised as ‘overweight’ and ‘very overweight’.

The results conclude that the current programme may actually harm the children it aims to help.

What is the UK Government’s National Child Measurement Programme (NCMP)?

The UK Government’s National Child Measurement Programme (NCMP) records the height and weight of school children in England. Its purpose is to gather relevant data so the government can understand long-term trends in childhood obesity. This information is used to inform national and local initiatives.

Through the programme, primary school-aged children are weighed and measured at school by visiting health professionals. Their Body Mass Index (BMI) is calculated, and the results are issued to parents to advise whether their child has been categorised as:

• ‘Underweight’
• ‘Healthy weight’
• ‘Overweight’
• ‘Very overweight’

The Queen Mary study is the first to focus on childhood obesity as experienced by children and parents

The Queen Mary study is the first to focus on the experiences of children and parents who were categorised as ‘overweight’ or ‘very overweight’.

The study analysis pointed to a significant degree of concern exhibited by these families regarding the potential mental health impact on their children.

Perhaps most prominently, the label of ‘overweight’ or ‘very overweight’ triggered the child’s overnight awareness of body weight. This permanently altered their relationship with food and their relation to their peers.

What is the mental health impact on overweight and obese children?

Taking part in the programme designed to reduce childhood obesity was an emotionally significant moment for many children who were told they were above a healthy weight.

Those children reported feeling anxious and embarrassed about getting weighed, the result, and the potential for teasing. Some parents dismissed the result.

Are potential mental health disorders and unhealthy dieting behaviours more dangerous than the weight itself?

Many parents expressed concern that the potential for mental health disorders, eating disorders and unhealthy dieting behaviours in the future was “far more dangerous than the weight itself”, and their priority was the child’s happiness.

These concerns are not unfounded – the study cites an analysis of the impact of weight-related conversations on children, which found that being encouraged to lose weight, teasing, and weight-related criticism was associated with poorer self-perceptions, increased dieting and dysfunctional eating behaviours.

Further research is needed to understand whether parents’ concerns are being borne out in the long term and to find ways to mitigate any negative effects of the programme. In some areas of England, efforts have been made to change the wording of the results letters issued to families, for example, to avoid using stigmatising words like ‘overweight’ and ‘obese’. But these measures are locally driven and vary across the country.

Is the National Child Measurement Programme in its current form causing some children harm, how can this be mitigated, and how does it balance against the positive use of the data the programme produces?

The Queen Mary authors say policymakers need to thoroughly consider the questions that their findings raise: is the National Child Measurement Programme in its current form causing some children harm, how can this be mitigated, and how does it balance against the positive use of the data the programme produces?

The NCMP generates valuable insights, but it requires policy and actions – beyond those which can be taken by families acting alone – to halt and reverse the rising proportion of children who are an unhealthy weight.

Childhood obesity strongly linked to child poverty

Childhood obesity levels are very high, and they are on the increase.

What is extremely important to remember is that childhood obesity is strongly linked to child poverty. It begs the question, do initiatives like this actually help children? Or does it further stigma and promote unhealthy body image and eating disorders?

According to this study, there is little evidence that initiatives to change the behaviour of individual families are successful in reducing childhood obesity at a population level.

Policy approaches to tackling obesity, including the soft drinks industry levy, and extending eligibility for free school meals as recommended in the National Food Strategy independent review, may be much more ethical and effective.

The food industry and poverty must be addressed

Dr Meredith K.D. Hawking, lead author and Research Fellow at Queen Mary University of London, commented:

“Many parents have legitimate concerns about the impact the National Child Measurement Programme might have on children’s self-perception and food practices as they grow older. More research is needed to understand whether these concerns are borne out in the long term and to find ways to mitigate them if the programme is to continue.

‘Without meaningful regulation of the food industry or measures to address poverty, parents will be unsupported in their efforts to help children live healthier lives’

“To improve child health, the Government must act on the evidence the NCMP and other sources are producing. We know that childhood obesity is a strong indicator of child poverty. Without meaningful regulation of the food industry or measures to address poverty, parents will be unsupported in their efforts to help children live healthier lives.”