Almost a Quarter of UK GPs Report Obesity in Children Aged Four and Under

Key Takeaways:

• Nearly one in four UK GPs report seeing children aged four and under where obesity is a clinical concern, with cases identified even in infancy.
• Most GPs find conversations about weight with children and parents difficult, citing fear of distress, stigma and complaints.
• The survey also raises concerns about inappropriate private access to GLP-1 weight loss medicines among adults who do not meet eligibility criteria.
  
  
  

Growing concern among family doctors

Almost a quarter of UK general practitioners report seeing children aged four or under who are living with obesity, according to a new survey of family doctors. The findings point to what respondents described as an “alarming” escalation of childhood obesity presenting at ever younger ages.

The research found that almost half of GPs, 49 per cent, have seen boys and girls up to the age of seven with obesity, including a small number of children younger than one year old. These early presentations raise concerns about long-term health consequences and the pressures faced by primary care clinicians in addressing weight sensitively and effectively.

Survey scope and headline findings

The survey, conducted by MDDUS, asked 540 family doctors about their experiences of managing obesity, the rapid growth in the use of weight loss medications, and the implications of widespread overweight and obesity for the NHS.

Almost one in four respondents, 23 per cent, said they had seen children aged zero to four where obesity was a clinical concern. Across childhood more broadly, 81 per cent of doctors reported seeing obesity in children between the age of 12 months and 11 years.

Dr John Holden, chief medical officer at MDDUS, said:
“These findings are an alarming confirmation of the growing crisis of childhood obesity across the country and the very real difficulties this creates in everyday GP consultations.”

Challenges of discussing weight with families

Despite the scale of the issue, most GPs reported significant difficulty in raising concerns about weight with children and their families. Four in five doctors, 80 per cent, said they find it somewhat or very challenging to talk to the parents of a child under 16 living with obesity about their weight and health. Only 10 per cent said they found such conversations easy.

Nearly two thirds of respondents, 65 per cent, also reported difficulty speaking directly with young people themselves about weight, with just 20 per cent describing those discussions as easy.

Doctors cited multiple reasons for this hesitation. Conversations with parents are often constrained by concerns that parents may become upset, reported by 72 per cent, angry, reported by 47 per cent, or may make a complaint, reported by 24 per cent. A further 74 per cent worried that such discussions could cause shame or stigma. Similar concerns were reported when speaking with children, including fears that conversations about weight could contribute to disordered eating behaviours.

The wider determinants of childhood obesity

Respondents highlighted that obesity is shaped by complex and interrelated factors, including poverty, limited access to nutritious food, and fewer safe or affordable opportunities for children to be physically active. These realities, the survey suggests, shape how GPs approach discussions about weight.

Dr Holden said GPs therefore approach these conversations “with care and empathy for families under pressure”. He added:
“When parents feel judged or blamed, conversations can quickly become emotionally charged and, as our members tell us, can lead to complaints from distressed or angry parents.”

Calls for stronger prevention measures

Katharine Jenner, executive director of the Obesity Health Alliance, said the findings underline a failure to protect children early in life.

She said that the high numbers of GPs seeing infants and very young children with obesity “is another sign we’re letting children down before they even start school. If we’re serious about prevention, it has to begin in the earliest years, otherwise the damage follow them through life.”

Jenner called for a stronger focus on prevention, including reformulation of food and drink products to improve their nutritional quality, tighter restrictions on the marketing of products high in fat, salt and sugar, and better support for families facing structural and financial barriers to healthy eating.

Concerns over private access to weight loss drugs

Alongside childhood obesity, the survey also explored GP experiences of adult patients using weight loss medications inappropriately. Doctors reported that some adults who should not be using GLP-1 weight loss drugs are obtaining them through deception from private pharmacies.

These include people with eating disorders, such as anorexia or bulimia, and people already taking other medications that could interact adversely with so-called “fat jabs” and pose risks to their health.

It is estimated that around 1.5 million people in Britain are using GLP-1 medicines for weight loss, the majority having obtained them privately rather than through the NHS, where eligibility criteria are strict.

One GP told the survey that GLP-1s are being “accessed privately pretty indiscriminately by many people whose body mass index is not in the obese category”. Another described a patient with a history of anorexia nervosa who had also obtained the drugs privately. Overall, 67 per cent of family doctors said they had seen patients using GLP-1s despite not meeting eligibility rules.

These findings raise questions about how rigorously private pharmacies are carrying out appropriate checks, including assessments of medical history and potential drug interactions, before supplying weight loss medications.

Implications for the NHS and future care

The vast majority of GPs surveyed said obesity is likely to be a defining public health challenge during their careers, with 92 per cent agreeing with that statement. An even higher proportion, 95 per cent, believe obesity will significantly affect the NHS’s ability to deliver care.

However, views on weight loss injections were more mixed. While 59 per cent of respondents believe such medications will ultimately save the NHS money, 22 per cent disagreed.

Government response

The Department of Health and Social Care did not comment directly on the survey findings. A spokesperson said:
“Every child deserves the best possible start in life, which is why this government is taking decisive action to tackle childhood obesity.

“We are restricting junk food advertising on television before 9pm and online, a move expected to remove up to 7.2bn calories per year from children’s diets; while giving local authorities new powers to stop fast food shops opening outside schools.

“Through our ten-year health plan, we’re shifting the focus from sickness to prevention to create a healthier nation.”

CCH insight:

This study highlights the considerable challenges that primary care practitioners face in addressing obesity in young children. It is a very sensitive issue, and there may also be cultural attitudes that see overweight children as beautiful or healthy. Unfortunately, healthcare professionals in the UK are not trained to deal with obesity and the unique challenges it presents. It requires a very sensitive approach, communicating with parents in a non-judgemental way, highlighting the role of the obesogenic environment and finding ways to support behaviour change at a family level. On the positive side, if this can be achieved, an entire family can benefit from these interventions, not just the child with excess weight.