Research funded by the NIHR ARC Oxford and Thames Valley has revealed important new evidence about the true cost of childhood weight issues to the NHS – finding that underweight children need comparable medical support as those who are severely obese.
The study, led by Dr Olu Onyimadu whose DPhil was supported by ARC OxTV, provides the first national picture of healthcare costs linked to children's weight. Using NHS electronic health records from more than 268,000 children aged 2–15 across England, the team found that childhood weight issues cost the NHS an estimated £340 million each year.
Key findings
The research tracked healthcare use in the year before and after children had their weight measured in GP practices, revealing:
- Four to five-year-olds with severe obesity had the highest excess costs at £472 per yearGirls with severe obesity cost more than boys (£253 vs £138 annually)
- Healthcare use was substantially higher after weight was measured for underweight children, and moderately higher for children with severe obesity
- Only White children showed clearly higher healthcare costs across all unhealthy weight groups
Dr Onyimadu, from the Nuffield Department of Primary Care Health Sciences, said: "This work suggests we may have been looking at this the wrong way. It's not just obesity that drives costs. Underweight children may need comparable support and generate similar costs per capita to the NHS. We need to think about the full spectrum of unhealthy weight when planning services."
Supporting evidence-based commissioning
The findings come at a critical time as the government implements its 10-year health plan, which emphasises a shift from treatment to prevention. The research offers NHS decision-makers clear evidence about where to target resources.
Professor Stavros Petrou, co-senior author and NIHR Senior Investigator, said: "These numbers give commissioners and practices the evidence they need to make the case for weight-management services. Early intervention across the weight spectrum could generate substantial savings while improving children's health."
The ethnic variations revealed in the study could help the NHS target support more effectively, addressing health inequalities.
Professor Mara Violato, co-senior author based in Oxford Population Health, added: "With 27% of children aged 2–15 living with overweight or obesity, plus those affected by underweight, we are looking at a huge opportunity for preventive care. These detailed cost breakdowns by age and sex can help clinical and budgetary service planners identify which children to prioritise."
Practical implications
The research suggests that once a child's weight issue is identified, the NHS responds with additional support – but this only works if appropriate services exist. The findings strengthen the economic case for investing in both prevention programmes and weight-management services in primary care.
For commissioners and practices developing business cases for new services, the study provides robust evidence to demonstrate value for money. Because the methodology aligns with UK clinical standards, the findings are directly applicable to NHS decision-making.
The research team emphasised that these cost estimates can now be used to assess whether specific weight-management programmes offer value for money, helping the NHS make informed decisions about which interventions to fund.
The study is published in JAMA Network Open.
Read the full paper: https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2840038
About the research team
This research was funded by the NIHR ARC Oxford and Thames Valley. Dr Onyimadu and Dr Astbury were additionally supported by the NIHR Oxford Biomedical Research Centre and the NIHR Oxford Health Biomedical Research Centre. Professor Violato was partially supported by the NIHR Oxford Health Biomedical Research Centre. Professor Petrou was supported by an NIHR Senior Investigator Award.