Rise in obesity among children in England may be slowingBMJ 2009; 339 doi: https://doi.org/10.1136/bmj.b4568 (Published 04 November 2009) Cite this as: BMJ 2009;339:b4568
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The recent report from the National
Heart Forum1 used data from the Health Survey for England
to predict the prevalence of childhood obesity to the year 2020, and concluded
that although obesity rates among children have been increasing, the rate of
increase has slowed since about the year 2000. Available data from the same source2
show similar trends for adults (aged 16 years or over; see Figure).
In 1993-2001, the average body mass
index of adults in England, standardised by age and sex, increased by about 0.12
kg/m2 per year (95% CI: 0.10-0.13) but after 2001 the rate of
increase was substantially slower, at 0.04 kg/m2 per year (0.01-0.07).
The proportion of adults who were overweight or obese (body mass index greater than or equal to
25 kg/m2) follows a similar pattern, with a slower rise after 2001
than before, which is evident in most age groups for both sexes.2
The figure shows the full time period for which nationally representative data on body
size have been collected annually in the Health Surveys for England.
It is difficult to envisage a scenario under which the differences in the
trends between the earlier and later periods could be artefacts of survey
methods. Although weighting for non-response was introduced in the Health
Surveys for England from 2003 onwards, their analyses4 show that this had only a small
effect on estimates of mean body mass index. There appears to be at least one
anomalous value, in 1999, that is unexplained ('boost' samples of ethnic
minorities were taken in the 1999 and 2004 surveys, but were reported not to
have been included in these data5). However, if body mass index had
actually continued to grow after 2001 at the rate seen earlier, increasingly
large sampling biases would be required to produce the observed data. Such
biases seem unlikely, as does the prospect that these results could have arisen
That the rise in overweight and obesity appears to
have slowed among adults as well as children is a welcome development. Of
course, slower growth in recent years does not preclude future rises, and trends in
particular groups could differ from those of the population as a whole. Data from future
Health Surveys for England will help shed further light on these changes, but it will
be some time before their public health consequences become clear.
Benjamin J. Cairns, Elizabeth A. Spencer, and Valerie Beral FRS
Cancer Epidemiology Unit, University of Oxford, Richard Doll Building, Roosevelt Drive, Oxford OX3 7LF, UK.
- K McPherson, M Brown, T Marsh and T Byatt. Obesity
Trends for Children Aged 2-11: Analysis from the Health Survey for England
1993-2007. National Heart Forum. Available online: http://www.heartforum.org.uk/Publications_NHFreports_Obesity_RecentTrendsinChildren.aspx
(accessed 3 November 2009).
- Joint Health Surveys Unit. Health Survey for England
2007: Adult Trend Tables 2007 [computer file]. London:
The Health and Social Care Information Centre; 2008. Available online: http://www.ic.nhs.uk/statistics-and-data-collections/health-and-lifestyles-related-surveys/health-survey-for-england/health-survey-for-england-2007-latest-trends-%5Bns%5D
(accessed 27 February 2009).
- Office for National Statistics, 2001 Census: Standard
Area Statistics (England and Wales)
[computer file]. ESRC/JISC Census Programme, Census Dissemination Unit, Mimas (University of Manchester).
- R Craig and J Mindell,
editors. Health Survey for England 2006: Adult Trend Tables 2006 [computer
file]. London: The Information
Centre; 2007. Available online: http://www.ic.nhs.uk/statistics-and-data-collections/health-and-lifestyles-related-surveys/health-survey-for-england/health-survey-for-england-2006-latest-trends
(accessed 4 April 2009).
- Health and Social Care Information Centre. Health
Survey for England 2004: Latest Trends. London:
Health and Social Care Information Centre; 2005. Available online: http://www.ic.nhs.uk/webfiles/publications/hlthsvyeng2004upd/HealthSurveyForEnglandTrend161205_PDF.pdf
(accessed 6 November 2009).
Competing interests: No competing interests