Health Survey for England, 2022 Part 2

This report examines the prevalence of overweight and obesity among children in 2022.

Detailed tables accompanying this report can be accessed here.

• Among children aged 2 to 15, the prevalence of obesity was 15%, the prevalence of overweight (including obesity) was 27%.
• 21% of children aged 8 to 15 were trying to lose weight, while 5% were trying to gain weight.

Overweight and obesity in childhood are associated with an increased risk of overweight and obesity in adulthood, and earlier onset of non-communicable diseases such as Type 2 diabetes and cardiovascular diseases (Source: World Health Organization, 2021). A meta-analysis found that 55% of children who were living with obesity remained so into adolescence. 80% of adolescents who were living with obesity, also experienced obesity as adults (Source: Simmonds et al. 2016). Obesity also causes health problems in childhood, being a risk factor for Type 2 diabetes, dyslipidaemia, asthma and other conditions and socio-emotional consequences (Source: Sahoo et al. 2015).

A universal categorisation cannot be used to define childhood overweight and obesity prevalence because boys and girls have different growth patterns at each age. Overweight and obesity prevalence for children aged 2 to 15 is therefore estimated using age, categorised in six-month bands, and the sex-specific UK National BMI centiles classification (Source: Cole, TJ. 1990). This classification gives the BMI threshold separately for boys and girls for each age above which a child is considered overweight or obese. The classification estimates were produced by calculating the proportion of boys and girls who were at or above the 85th (overweight) or 95th (obese) BMI centiles of the 1990 reference population. The proportion below these thresholds were classified as healthy weight or underweight. For some analysis the healthy weight and underweight groups are combined, due to low base sizes in the underweight group.

Assessment of a child’s weight category compares the actual BMI with BMI centiles on published growth charts, using sex and age in six-month bands (extracted from the date of interview minus the date of birth). Presentation of the results is based on the age at last birthday, which is the HSE standard.

This section presents trends in children’s mean height and mean weight by age and sex from 1995 onwards, except 2020 when measured height and weight was not obtained and 2021 where they were measured in the health visit for a smaller sample of participants. Height and weight were measured during the interviewer visit. Infants (aged 0 to 1) were first included in the survey in 2001, with the weight of infants aged 6 weeks or older being measured.

Trends in children’s height are shown for the period 1995 to 2019 and 2022, based on children aged 2 to 15. Trends in children’s weight are shown for the period 1995 to 2000, based on children aged 2 to 15, and from 2001 to 2019 and 2022, based on children aged 0 to 15.

In 2022, boys and girls aged 2 to 4 were a similar height (101cm). Boys subsequently grew faster, so that by age 13 to 15, they were taller than girls (167.7cm compared with 162.4cm). Weight did not differ significantly by sex, and increased in a similar way for boys and girls, from 9.7kg for all infants aged under 2, to 56.3kg for children aged 13 to 15.

For more information: Tables 14 and 15

In 2022, 15% of children aged 2 to 15 were living with obesity, and 27% were overweight or living with obesity. Differences between boys and girls were not statistically significant.

Obesity prevalence in children aged 2 to 15 increased from 12% in 1995 to 19% in 2004 before declining to 16% in 2008 and remaining between 14% and 17% since that time. Throughout the period, obesity prevalence was generally higher among children aged 11 to 15 than children aged 2 to 10.

Overweight (including obesity) followed a similar pattern, increasing from 25% in 1995 to 34% by 2004 and decreasing slightly after that.

For more information: Tables 16 and 17

The chart above shows obesity prevalence averaged over three years, between 1995 and 2019; and the single-year prevalence in 2022. Averaged data is plotted on the middle year. 

Note that 2021 data are not directly comparable with other years due to changes in survey methodology and response rates, and as such are excluded from the 3 year averages above.

The English Index of Multiple Deprivation (IMD) is a measure of area deprivation, based on 37 indicators, across seven domains of deprivation. IMD is a measure of the overall deprivation experienced by people living in a neighbourhood, although not everyone who lives in a deprived neighbourhood will be deprived themselves. To enable comparisons, areas are classified into tertiles (thirds). Other analysis in this report uses quintiles (fifths) but due to the smaller sample size for children tertiles have been used here. For further information about the IMD, see the HSE 2022 Methods.

The prevalence of childhood obesity varied by area-deprivation. Children in the most deprived tertile had around double the prevalence of obesity (21%) of those in the least deprived or middle tertiles (11% and 10% respectively).

For more information: Table 18

To establish the BMI category of children’s parents or guardians, data for adults who took part in the HSE interview was linked to their children’s records if they were the legal parent or guardian of the child and lived in the same household. Due to small base sizes in the underweight group, healthy weight and underweight are combined for this analysis.

Children’s overweight and obesity was strongly related to that of their (legal, co-habiting) parents. Among children whose mothers were a healthy weight or underweight, 7% were living with obesity and 19% were overweight or living with obesity. Among children whose mothers were overweight or living with obesity, 20% were living with obesity and 32% were overweight or living with obesity.

Among children whose fathers were a healthy weight or underweight, 4% were living with obesity and 10% were overweight or living with obesity. Among children with fathers who were overweight or living with obesity, 12% were living with obesity and 26% were overweight or living with obesity.

For more information: Tables 19 and 20

During the interview, children aged 8 to 15 were asked the following as part of the self-completion questionnaire:

• At the present time are you trying to lose weight, trying to gain weight, or are you not trying to change your weight?

The majority of children aged 8 to 15 (74%) were not trying to change their weight. 21% were trying to lose weight, and this was more common among those who were overweight or living with obesity (43%) than those who were neither (12%). 5% of children were trying to gain weight, and this was more common among boys (8%) than girls (1%).

For more information: Table 21

During the interview, children aged 8 to 15 were asked questions about their perception of their own height and weight as part of the self-completion questionnaire.

• Given your age and height, would you say that you are…
  • About the right weight
  • Too heavy
  • Or too light?
  • Not sure

The majority of children felt that they were ‘about the right weight’ (58%), with the next most common answer being ‘not sure’ (27%).

Perceptions of own weight were related to children’s BMI. While only 1% of those who were a healthy weight or underweight felt that they were too heavy, this increased to 25% of those who were overweight, including obese. 7% of children felt they were too light.

For more information: Table 22

To establish the parent’s or guardian’s perception of their children’s weight, data for adults who took part in the HSE interview was linked to their children’s records if they were the legal parent or guardian of the child and lived in the same household.

During the interview, parents of children aged 2 to 15 were given a self-completion questionnaire, which asked:

• Given your child’s age and height, would you say that your child is…
  • About the right weight
  • Too heavy
  • Or too light?
  • Not sure

86% of children were felt to be ‘about the right weight’ by their mothers. This was more common where the child was a healthy weight or underweight (89% of mothers), and less common where the child was overweight or living with obesity (72% of mothers perceiving their child to be about the right weight).

A minority of children (8%) were felt to be too heavy by their mothers. 7% of children were perceived to be too light by their mother.

Due to a smaller number of resident fathers than mothers in the survey sample, estimates of father’s perception of children’s weight were too imprecise to include.

For more information: Table 23