Healthy Weight Among Children and Young People

This topic area covers statistics and information relating to healthy weight among children and young people in Hull including local strategic need and service provision. Further information relating to Healthy Weight among Adults is given under Lifestyle Factors within Adults. Information relating to wanting to lose or gain weight was collected in Hull’s Young People Health and Wellbeing Surveys, and height and weight was recorded in Hull’s Adult Health and Wellbeing Surveys, and full reports are available under Surveys within Tools and Resources.

This page contains information from the Office for Health Improvement & Disparities’ Fingertips. Information is taken ‘live’ from the site so uses the latest available data from Fingertips and displays it on this page. As a result, some comments on this page may relate to an earlier period of time until this page is next updated (see review dates at the end of this page).

Headlines

• Children’s height and weight are routinely measured as part of the National Child Measurement Programme (NCMP) during reception year (Year R – aged 4-5 years) and Year 6 (aged 10-11 years) and has been since 2006/07 (except for 2020/21 due to the COVID-19 pandemic).
• For the 2023/24 school year, the majority of Year R and Year 6 children in Hull were a healthy weight with 72.9% of Year R children and 56.^% of Year 6 children being a healthy weight. Few Year R (0.5%) or Year 6 (1.1%) children were underweight.
• Among children in Year R for the 2023/24 school year, 26.4% were either living with overweight or obesity. This is an increase in the last year, although the rate is lower than it was between 2015/16 and 2021/22. There was also an increase across England, but the prevalence is statistically significantly higher in Hull than England (22.1%). Furthermore, the inequalities gap between Hull and England has increased in the last year. Overall, 780 Year R children were living with excess weight in Hull.
• One in eight (12.5%) Year R pupils were living with obesity in 2023/24 (of which 3.4% were severely obese) which is an increase on 2022/23 when it was 11.5% (with 3.1% living with severe obesity). There was also an increase across England, but the prevalence is statistically significantly higher in Hull than England (9.6% for obesity including 2.6% living with severe obesity). Furthermore, the inequalities gap between Hull and England has increased in the last year. Overall, 355 Year R children were living with obesity in Hull including 100 Year R children who were living with severe obesity.
• Among Year 6 children, 42.2% were either living with overweight or obesity in 2023/24 which was an increase in the previous year. The rates are second highest since 2006/07 when NCMP began. There was a reduction in England (to 35.8%), so the inequalities gap between Hull and England has increased in the last year. Overall, 1,400 Year 6 children were living with excess weight in Hull.
• Just over one-quarter (27.9%) of Year 6 children were living with obesity in 2023/24 (of which 7.8% were severely obese), and this was an increase from 2022/23. The percentages were statistically significantly higher than England, and as the prevalence decreased for England in the last year (22.1% for obesity and 5.5% for severe obesity), the inequalities gap has increased in the last year. Overall, 925 Year 6 children were living with obesity in Hull including 260 Year 6 children who were living with severe obesity.
• The prevalence of obesity is more than twice as high among children living in the most deprived tenth of areas of England compared to children living in the least deprived tenth of areas of England for 2023/24, so it is not particularly surprising that the prevalence estimates are so high in Hull with its very high levels of deprivation. For children living with obesity, Hull is ranked as joint 12th highest among England’s 151 upper-tier local authorities (range 5.7% in Wokingham to 13.9% in Hartlepool) for Year R, and ranked joint 7th highest for Year 6 children (range 13.3% for Richmond upon Thames to 31.0% in Sandwell).
• Local analyses have also shown large differences across Hull’s 21 electoral wards and by local deprivation fifth particularly among Year 6 children.
• A ‘paired analysis’ has been completed on 2,873 children who were measured in reception year in 2016/17 and their weight classifications were compared with their measurements six years later in Year 6 in 2022/23. There was a very strong association between weight in reception year and weight in Year 6. Children living with excess weight in reception year were much more likely to be living with excess weight in Year 6, and the likelihood was much higher among those living with obesity or severe obesity in reception year. Overall, half of children (52%) were a healthy weight in both reception year and Year 6, but one-fifth had moved from a healthy weight in reception year to living with excess weight in Year 6. A further 6.5% were living with excess weight in reception year but were a healthy weight in Year 6. One in five (20%) children were living with excess weight in both reception year and Year 6, and 9.4% of these children remained in the same excess weight category (overweight, obese or severe obesity), 2.2% had moved to a lower weight category in Year 6 but still had excess weight, and 8.9% had moved to a higher weight category in Year 6.
• Boys and children living in the most deprived three-fifths of areas of Hull were more likely to be living with excess weight or living with obesity in Year 6 even after taking into account their weight classification in reception year. Boys also had an increased likelihood of living with severe obesity in Year 6 after taking into account their reception year weight classification. However, children living in the most deprived areas of Hull had no increased risk of living with severe obesity in Year 6 (they may have had an increased risk compared to children living in the least deprived areas of Hull but this was because they had higher levels of excess weight in reception year – they had no increased risk above that).

The Population Affected – Why Is It Important?

There are certain risks associated with being underweight or overweight.

Children and adults who are underweight or have poor nutrition have an increased risk of malnutrition, vitamin deficiencies, or anaemia, osteoporosis from too little vitamin D and calcium, decreased immune function, fertility issues caused by irregular menstrual cycles, and growth and development issues, especially in children and teenagers.

Excess weight in childhood is a significant health issue for children, young people, and their families. It can have serious implications for the physical and mental health of a child, which can then follow into adulthood. Children and young people who are living with excess weight are more likely to become adults with excess weight.

Excess weight among adults can reduce life expectancy by between three and ten years, depending on the severity of the obesity. Excess weight increases the risk of numerous daily problems and health conditions as well as increased complications within pregnancy. Excess weight can cause health issues and increase physical inactivity, but also can affect self-esteem and underlying mental health. In children and young people, it could increase bullying and impact negatively on their education and ultimately their future employment prospects. The cost of being overweight and obese to society and the economy is estimated to be £27 billion per year. The cost could increase to just under £50 billion in 2050 if obesity rates continue to rise.

The burden of excess weight falls hardest on children from lower income families.

The National Child Measurement Programme (NCMP) has been running since the school year 2006/07. Virtually all children in reception year (Year R) aged 4-5 years of age and all children in the last year of primary school (in Year 6) aged 10-11 years have their height and weight measured. The programme was affected during the COVID-19 pandemic. For England overall, participation rates are normally around 95%, but was 75% for the 2019/20 school year as schools closed in March 2020. Analysis revealed that figures for 2019/20 were comparable to previous years at national and regional levels. Local authority rates for 2019/20 were not as robust, and some estimates were unreliable. Hull was one of the local authorities not affected as all children in Hull had already been measured by March 2020. In 2020/21, local authorities were asked to collect a representative 10% sample because it was not feasible to expect a full NCMP collection so late into the academic year. This enabled national and regional estimates of children’s weight to be published, but no information at local authority level. The collection for 2021/22 was not affected, although the response rate in 2021/22 at 92% overall was slightly lower than pre-pandemic levels.

Given that children of different ages and genders grow and develop at different rates, the method used to define weight classification in UK children differs to the methods used for adults. The body mass index (BMI) is still used for children which is calculated as weight (in kilograms) by the square of height (in metres), but the BMI value is compared to reference sample measurements gathered in 1990 which takes into consideration age and gender (Cole and Freeman). These are referred to as UK 1990 growth reference charts.

• Underweight is based being lower than the 2nd centile (bottom 2% in 1990).
• Healthy weight as between the 2nd centile and less than the 85th centile (83% of population in 1990).
• Overweight as on or above the 85th centile (15% of population in 1990).
• Living with obesity as on or above the 95th centile (5% of population in 1990).
• Living with severe obesity as on or above the 99.6th centile (0.4% of population in 1990).

These thresholds are lower than clinical thresholds as these thresholds are used for monitoring at the population level and include more children who are within the ‘at risk’ of moving into the excess weight categories with the intention being that the ‘at risk’ cohort is known and can potentially have interventions to reduce their body mass index centile.

The Hull Picture

Prevalence Estimates of Excess Weight

The Office for Health Improvement & Disparities’ Fingertips presents the percentage of children living with being underweight, a healthy weight, overweight, obesity and severe obesity as well as excess weight among children aged 4-5 years in reception year (Year R), and aged 10-11 years in Year 6 from the National Child Measurement Programme (NCMP) based on the local authority of where that child lives.

In the 2023/24 school year, over one=quarter of children in Year R in Hull are living with excess weight including 12.0% who were living with obesity (which included 3.4% who were living with severe obesity). Very few Hull children in Year R were classified as underweight.

The majority (72.9%) were a healthy weight.

In Hull in the 2023/24 school year, more than four in ten Year 6 children are living with excess weight including over one-quarter who were living with obesity (which included 7.8% who were living with severe obesity).

The prevalence of the BMI categories is illustrated in graphical form below for Hull for 2023/24 comparing Year R and Year 6 children.

Trends Over Time

As mentioned earlier, all children were not measured 2020/21 due to the COVID-19 pandemic and only a 10% sample was collected so the trends nationally could be reported. Between 2019/20 and 2020/21, the prevalence of excess weight among Year R children across England increased from 23.0% to 27.7% with a fall back to 22.3% in 2021/22 and to 21.3% in 2022/23. A very similar pattern was observed among Year 6 children where 35.2% were classified as living with excess weight in 2019/20 which increased to 40.9% in 2020/21 before falling back to 37.8% in 2021/22 and to 36.6% in 2022/23. Across England, it was also noted that the increases in the prevalence were much greater among areas of high deprivation. Thus it is likely that the prevalence of excess weight increased in Hull considerably between 2019/20 and 2020/21. It is also reasonable to assume that these affects would be present among younger children too, which would potentially impact on the prevalence for future years. This would mean that any change in the prevalence in Hull needed to be greater than England to achieve pre-pandemic levels.

The number of children in different weight classifications have been rounded to the nearest five within Fingertips.

Year R (Aged 4-5 Years)

The total number of children in reception year who are underweight is small so it would be expected that there was some year-on-year variability in the percentage over time, although the percentage remained relatively steady at 0.5% and 0.6% between 2014/15 to 2019/20. The percentage has been slightly higher for 2021/22 (0.9%) and 2022/23 (0.7%) but has decreased back to 0.5% for the 2023/24 school year.

The percentage of Year R children in Hull who are classified as being underweight has been consistently lower than in the region and England.

There were only around 15 Hull children in Year R who were classified as being underweight for the 2023/24 school year.

The percentage of Year R children in Hull who are classified as being a healthy weight has been consistently lower than in the region and England. The percentage in Hull was 4% lower than England in 2006/07 and remained around that level for a number of years, although the gap between Hull and England increased for 2015/16 when the percentage in Hull was 7% and the difference remained at this level or increased to 2021/22. For the latest year 2023/24, the difference between Hull and England has reduced in that the gap is now 3.9 percentage points or 5%.

There were 2,150 children in Year R who were classified as being a healthy weight for the 2023/24 school year.

The percentage of Year R children in Hull who are living with excess weight (excluding those living with obesity) has been consistently higher than in the region and England.

There was a relatively high percentage for both Hull and England in 2019/20, but the percentage overweight has decreased in 2021/22. However, the percentage has increased the last two years. However, whilst this measure is included on Fingertips, it does not portray the true levels of excess weight when it does not include obesity.

There were 425 Year R children who were living with excess weight in 2023/24 (not including those living with obesity).

A similar pattern occurred for the prevalence of obesity in Year R children as healthy weight but with the pattern reversed. The prevalence in Hull has been consistently higher than England with a larger difference between Hull and England since 2015/16. Whilst the prevalence in Hull decreased between 2021/22 and 2022/23, it has increased in the last year, although the latest percentage at 12.0% is lower than the high observed for 2021/22.

The percentage has also increased across England in the last year.

The prevalence of obesity in Hull among Year R children is 2.4 percentage points or 25% higher than England.

There were 355 Year R children who were living with obesity in 2023/24.

The prevalence of severe obesity in Year R was around 3% between 2006/07 and 2015/16, but has increased since then to a peak of 4.8% in 2021/22. The prevalence decreased markedly to 3.1% for 2022/23, but has increased to 3.4% for the latest school year 2023/24.

There had also been a steady increase in the prevalence nationally although the rate of increase was much lower. For 2023/24, there is a difference of 0.8 percentage points or 31% between Hull and England.

There were 100 Year R children who were living with severe obesity in 2023/24.

The prevalence of excess weight in Hull has been consistently higher than England since 2006/07 when the NCMP began, but the difference between Hull and England increased for the 2015/16 school year and the inequalities gap remained high. The prevalence in Hull has increased over time and reached a peak of 29.2% in 2018/19. The prevalence in Hull decreased slightly between 2018/19 and 2021/22 with a larger decrease between 2021/22 and 2022/23, although the rate has increased for 2023/24. The pattern nationally has been reasonably similar to the trends for Hull although much smaller year-on-year changes.

There were 780 Year R children who were living with excess weight in 2023/24.

Year 6 (Aged 10-11 Years)

The prevalence of Year 6 children who are classified as underweight has been relatively variable over time ranging from 0.5% to 1.2% although the highest prevalence estimates have occurred in the last six years with the prevalence 1% or higher.

In the 2023/24 school year, there were 35 Year 6 children in Hull who were classified as underweight.

The majority of Year 6 children in Hull are a healthy weight (just over six in ten children) although the percentage reduced to below 60% for the first time in 2021/22. The latest percentage of 56.6% for 2023/24 is the second lowest since NCMP began.

The percentage in Hull has been consistently lower than England and the region.

In 2023/24, there were 1,875 Year 6 children who were classified as having a healthy weight.

A similar percentage of Year 6 children are living with excess weight (excluding obesity) in Hull compared to England, and this has been relatively consistent between 2006/07 and 2022/23. The percentage of Year 6 children who are living with obesity is higher in Hull compared to England, so whilst the percentages overweight in Hull is similar to England, it means that there has been a shift in Hull with the ‘healthy weight’ category reducing and the ‘living with obesity’ category increasing in Hull. Thus whilst this measure is included on Fingertips, it does not portray the true levels of excess weight when it does not include obesity.

In the 2023/24 school year, there were 475 Year 6 children who were living with excess weight (not including those living with obesity).

There was a steady increase in the prevalence of Year 6 children living with obesity for both Hull and England between 2006/07 and 2019/20 with the prevalence in Hull being statistically significantly higher than England for all years except 2013/14.

Between 2019/20 and 2021/22, there was an sharper increase in the prevalence for England and a much sharper increase for Hull, and whilst the prevalence reduced for 2022/23, it has increased in the last year 2023/24. The percentage for 2023/24 is the second highest since NCMP began.

In contrast, the prevalence in England has reduced slightly in the last year.

In the 2023/24 school year, there were 925 Year 6 children who were living with obesity.

A very similar trend over time occurred for severe obesity as for obesity, although there was more year-on-year variability in Hull, and the increase over time has been greater.

Between 2006/07 when NCMP began, the prevalence of severe obesity in Hull has doubled from 3.9% to 7.8% for 2023/24.

The prevalence in 2023/24 is the second highest since NCMP began with 7.8% of Year 6 children in Hull living with severe obesity. In contrast to Hull, the prevalence has decreased for England in the last year.

In the 2023/24 school year, in Hull, there were 260 Year 6 children who were living with severe obesity.

The prevalence of excess weight in Year 6 for Hull has increased from 37.6% (2019/20) to a new high of 42.7% in 2021/22, the highest observed since the NCMP began. This is a much greater rate of increase from pre-pandemic levels than seen nationally and the inequality gap between Hull and England was at its highest level in 2021/22, at 4.9 percentage points. Whilst the prevalence deceased in Hull in 2022/23, the prevalence increased in 2023/24 to 42.2%.

The prevalence of excess weight among Year 6 children in Hull is the second highest it has been since NCMP began having increased by 24% between 2006/07 when it was 34.0%.

The inequalities gap has also increased over the entire period. In 2006/07, the prevalence in Hull was 2.3 percentage points or 7% higher than England, but for 2023/24 the prevalence in Hull is 6.4 percentage points higher or 18% higher than England. With the reduction in prevalence in England in the last year, the inequalities gap has widened in the last year.

In the 2023/24 school year, there were 1,400 Year 6 children who were living with excess weight in Hull. Even though the prevalence estimates reduced in Hull between 2021/22 and 2023/24, the total numbers are the highest they have been since NCMP began in 2006/07.

Geographical Spread Across Hull’s Wards

It is possible to examine the prevalence of excess weight and obesity for each ward in Hull. Information below is presented for three years combined for the period 2019/20 to 2022/23 (as data for 2020/21 is not included due to low numbers measured during the COVID19 pandemic).

Year R – Obesity 2019/20 to 2022/23 combined

The percentage of reception year children who were obese varied across Hull’s 21 wards from 10.1% (West Carr ward) to 17.7% (University ward) over the three year period 2019/20 to 2022/23.

Year R &