The focus, when it comes to children and incorrect weight, tends to be with those who are overweigh or obese. A new study suggests that the focus also needs to be oriented towards those children who are assessed as being underweight.
Specifically, Oxford University research reveals need to support children across entire weight spectrum – not just those with obesity.
The UK National Health Service (NHS) incurs an estimated £340 million in additional healthcare costs annually due to weight-related health problems in children – but it is not just obesity driving the costs. New research from the University of Oxford reveals that underweight children need comparable medical support as those who are severely obese, challenging assumptions about childhood health priorities.
The new study was funded by the National Institute for Health and Care Research (NIHR) and it provides 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. It found that childhood weight issues – affecting around 2.5 million children – cost the NHS an estimated £340 million each year.
Importantly, the research shows that healthcare costs rise sharply after a child’s weight is formally recorded, suggesting that identifying weight issues triggers additional medical support – but only if appropriate services are in place.
The research tracked healthcare use in the year before and after children had their weight measured in GP practices, revealing the additional costs (‘excess costs’) compared to healthy-weight children. It was found that:
- 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.
“This work suggests we may have been looking at this the wrong way,” said Dr Olu Onyimadu, lead researcher.
Onyimadu adds: “It’s not just obesity that drives costs. Underweight children may need comparable support and generate similar costs per capita to the NHS. We need to think about the full spectrum of unhealthy weight when planning services.”
Decision makers
The findings come at a critical time as the government implements its 10-year health plan, which emphasises a shift from treatment to prevention. The research offers NHS decision-makers clear evidence about where to target resources.
It is hoped these numbers will give commissioners and practices the evidence they need to make the case for weight-management services. This is important since early intervention across the weight spectrum could generate substantial savings while improving children’s health.
Ethnicity
The ethnic variations revealed in the study could help the NHS target support more effectively. White children consistently showed higher excess costs when overweight or obese compared with children from other ethnic backgrounds – insights that could help address health inequalities.
Parents
For parents, the findings indicate that concerns about children being too thin are just as valid as worries about excess weight. The research shows that once weight issues are identified by GPs, children typically receive more medical support – from nutritional advice to mental-health services – highlighting the importance of regular check-ups.
Social services
For commissioners and practices developing business cases for new services, the study provides the robust evidence needed to demonstrate value for money. Because the methodology aligns with UK clinical standards, the findings are directly applicable to NHS decision-making.
The research appears in JAMA Network Open and it is titled “Child Body Mass Index and Health Care Costs in England”.
