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Obesity is a serious health condition. It is defined as carrying too much body fat for your height and sex. A person is considered obese if they have a body mass index or BMI (weight in kilograms divided by the square of their height in metres) of 30 or greater.
Obesity is a causal factor in a number of chronic diseases and conditions including high blood pressure, heart disease, type 2 diabetes and, overall, it reduces life expectancy by an average of nine years. There has been a steady rise in the number of children aged 2-10 who are obese—from 9.9% in 1995 to 13.4% in 2004. Such children are more likely to be obese adults.
The rise in obesity prevalence adds a significant financial burden to the NHS. It is estimated that obesity already costs around £1 billion a year and the UK economy a further £2.3 to £2.6 billion in indirect costs. If current trends continue, by 2010 the annual cost to the economy could rise by another £1 billion a year.
In 2004 a Public Service Agreement target (PSA) was established, shared between the three Departments of Health, Education and Skills and Culture, Media and Sport:
"to halt, by 2010, the year-on-year increase in obesity among children under 11 in the context of a broader strategy to tackle obesity in the population as a whole."
Other than a proposed social marketing campaign, there are no ring-fenced funds nor are there any specific programmes to tackle child obesity. Instead the approach being taken by the Departments is to influence existing and forthcoming programmes that have a bearing on the diet and lifestyle of children:—of these there are four main programmes—School Meals, the School Sport Strategy, the Healthy Schools Programme and the Children's Play initiative.
In addition to these programmes, the Departments are seeking to influence the food industry to reduce the levels of fat and sugar in foods targeted at children and to encourage a more responsible approach to the marketing of these types of foods.
The delivery chain to tackle child obesity is complex and the Departments have found it difficult to communicate across the network of organisations involved. Important messages on diet and lifestyle have yet to get through to parents and children as clearly or as effectively as required.
To date, there has been little comprehensive, published research on the effectiveness of prevention and treatment strategies for child obesity and, consequently, the Departments have so far done little to intervene directly with individual children who are obese or at risk of becoming so or their parents. The National Institute of Health and Clinical Excellence has put out for consultation comprehensive guidance on prevention and treatment which they plan to publish in December 2006 and the Department of Health has issued a Care Pathway and a Weight Loss Guide to General Practitioners.
Performance against the PSA is to be measured by the annual Health Survey for England. The latest data from that survey is from 2004, and with no interim measures, the three Departments cannot determine what progress has been made against the target to date. But, with little concrete action yet taken, much will need to be achieved in the remaining three and a half years if the target is to be met.
On the basis of a Report by the Comptroller and Auditor General,[1] we took evidence from the three Departments on three main issues: progress against the PSA target, the involvement of parents and influencing organisations.
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