Child healthy weight

Addressing rising levels of obesity in the Scottish population is a priority for the Scottish Government. It is a key element in the drive to make Scotland a healthier and more successful country. Central to this mission is the need to break the established link between health problems in early life and adult disease later on. 

Although children and young people who are still growing may be able to ‘grow into’ their weight, overweight and obesity remain difficult conditions to treat. As well as support from professionals, families have a significant role to play. Families are best-placed to increase physical activity and encourage healthy eating among children and young people, thus improving physical and mental health and wellbeing. In addition, the steps they take also create opportunities for the whole family to spend time together, laying the foundations for healthy, active and fulfilling lives.

Child Healthy Weight and inequalities in the early years

Research shows that overweight children are more likely to become overweight adults.

This increases the risk of diseases such as type II diabetes, heart disease, high blood pressure and certain cancers.

A range of evidence based interventions and resources are available to help promote healthy weight in the early years.

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What are health inequalities?

The WHO defines health inequalities as "differences in health status or in the distribution of health determinants between different population groups."

For a general discussion of health inequalities and the early years, please see Inequalities in the Early Years.

Policy context

Activity in this area is consistent with commitments and priorities detailed in Preventing Overweight and Obesity in Scotland: A Route Map Towards Healthy Weight, The Early Years Framework and the National Parenting Strategy, Equally Well, Achieving our Potential, a range of NHS Scotland's Quality Indicators and is relevant to Scotland's national practice model for child-centred services - Getting it Right for Every Child (all external links).

Why is child healthy weight important?

Obese children are at greater risk of cardiovascular disease, diabetes, non-alcoholic fatty liver disease and psychological distress (SIGN Guideline 115: Management of Obesity (external link)).

Adults who were obese as children are more likely to be obese themselves and are at greater risk of associated health problems including cardiovascular disease, diabetes and cancer (Growing Up in Scotland - Overweight, Obesity and Activity (external link)).

In Scotland, nearly one in five (18%) boys and over one in ten girls (14%) aged 2-15 are obese (ScotPHO 2007: Obesity in Scotland - An epidemiology briefing (Download PDF - 2.4MB)).

The total cost to Scottish society of obesity in 2007/8 was estimated to be in excess of £457 million, including £175 million of direct costs to the NHS. This is projected to rise to £0.9 billion-£3 billion by 2030 (Preventing Overweight and Obesity in Scotland: A Route Map Towards Healthy Weight, (external link)).

What do we mean by child healthy weight in children under 2 years?

The weight of babies and very young children can and fluctuate widely. Midwives and health visitors monitor child weight and growth and development during this time.

They advise parents on issues around feeding, nutrition, and weaning and provide extra support and onwards referral should specialist help be required.

What do we mean by child healthy weight in children over 2 years?

Adult healthy weight is calculated using Body Mass Index (BMI = weight in kilograms divided by the square of the height in metres: kg/m2) and where obesity is defined as having a BMI of 30 or over.

Children’s BMI charts are completely different to the BMI charts used for adults - they still look at height and weight, but they are different for boys and girls and take into account their age.

In accordance with SIGN Guideline 115: Management of Obesity (external link) child healthy weight is assessed using BMI centile charts to compare his or her BMI with population standards among children who are the same age and sex.

BMI centile charts for children can be found in a child's hand-held notes (the 'red book') and in Happy Healthy Kids - a resource for professionals (external link).

The 27-30 month Child Health Review

All children in Scotland are offered a review of their development at 27-30 months of age by a Health Visitor that includes assessment of their weight, nutrition, and activity levels.

The review gives the opportunity to work with families and their children to improve child health.

Guidance on the 27-30 month child health review (external link).

Identifying those at risk

A range of risk factors should be considered, including higher birth weight, parental obesity, whether or not they live in a deprived area, whether or not they are a looked-after child and parental health and wellbeing.

As with adults, weight is affected primarily by intake of food and drink and levels of physical activity.

Please see our sections on early years inequalities and Physical Activity and on Nutrition and Inequalities in 0-3s.

Diagnoses of overweight and obesity are made using BMI calculations in conjunction with centile charts - see SIGN Guideline 115: Management of Obesity (external link).

For a fuller discussion of inequalities, see Inequalities in the Early Years.

A Pathway of Care for Vulnerable Families (0-3) (external link) sets out key contact points and interactions for those working with vulnerable families.

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Raising the issue of child healthy weight

Discussing issues around weight, both personally and that of their children, can be highly emotive for parents.

NHS Health Scotland has produced a series of resources and an e-Learning module for professionals to promote effective practice in this area.

For more information please see Health Scotland's Child Healthy Weight topic page (external link).

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