Senior doctors are identifying school attendance as a significant, previously overlooked factor in the ongoing battle against childhood obesity. This observation comes from specialist NHS Complications from Excess Weight (CEW) clinics across England, where almost all children receiving treatment are not attending school.
Ibbie, 16, from Doncaster, whose weight problems worsened during Covid-19 lockdowns after she stopped attending secondary school, is one of over 6,000 children treated at these clinics. By age 12, she weighed nearly 22 stone (140kg) and was diagnosed with liver damage, being told she might need a transplant if she did not lose weight.
Childhood obesity rates saw a notable increase during the pandemic lockdowns, with the proportion of overweight and obese 10 and 11-year-olds rising from 35% to 41%. Although these levels have since decreased, they have not returned to pre-pandemic figures. Government data indicates that one in 10 children starting school in England is obese, a figure that increases to one in five by the time they leave primary school.
Prof Ken Ong, lead clinician at Cambridge University Hospital's CEW clinic, suggests that missed school time during the pandemic contributed to higher obesity levels due to worse diets, less physical activity, and increased isolation. The proportion of persistently absent pupils in English state schools has risen from 10% in 2019 to 18%.
Doctors theorise that school absence may contribute to obesity through diet and exercise. School canteens have regulations for healthier food, unlike home environments, and studies show children are generally more active on school days. Dr Catherine Falconer, a researcher with the UK Health Security Agency, noted strong evidence that attending school positively impacts health, including the physical activity of walking to school.
While the science is still developing and other factors like ultra-processed foods are also considered important, scientists speaking to the BBC express confidence that school absence plays a key causal role in some cases. Prof Simon Kenny, NHS England's national clinical director for children and young people, highlighted that many of these children are not only absent from school but also from wider society.