Nearly a quarter of children start school while being at risk of overweight or obesity

11 December 2019

Yesterday, NHS Information Services agency ISD Scotland published their 2018/2019 update on the BMI of Primary 1 children across schools in Scotland. In this blog we take a look at the new figures, summarising recent policy actions taken to tackle childhood obesity.

Overweight and obesity prevalence among Primary 1 children in Scotland

It was found that 22.4% of Primary 1 children are now at risk of overweight or obesity. From this, 12.2% are at risk of overweight specifically and 10.2% at risk of obesity.

This proportion has fluctuated slightly over the years, but does not differ from the start of the century: 22.4% of the Primary 1 pupils in Scotland were also at risk of overweight or obesity in 2001/02.

Inequalities in child healthy weight in Scotland are now substantial

Worryingly, the inequalities gap in the BMI of Primary 1 children is still widening, particularly with regard to risk of obesity. Children living in more deprived areas are slightly more likely to be at risk of overweight (12.8% in most deprived; 11% least deprived), but much more likely to be at risk of obesity than those in less deprived areas (13.7% most deprived; 6.5% least deprived).



The inequality gap has been widening since records began in 2001/2002; children from the most deprived areas are continuously more at risk, while overweight and obesity is decreasing in the least deprived areas.


Figure 1. Percentage of Primary 1 children at risk of obesity, by deprivation, school year 2018/19, all participating NHS Boards/Scotland


Governmental actions

Since mid-2018, the UK and Scottish Governments have outlined policies and plans that contribute to the ambition to halve childhood obesity by 2030.  Scottish Government’s Diet and Healthy Weight Action Plan also had a primary objective of reducing health inequalities. Earlier this year, the Scottish government set out Standards for the delivery of tier 2 and tier 3 weight management services for children and young people in Scotland. The standards aim to prevent and reduce childhood overweight and obesity and end the growing inequality gap.

NHS boards are currently in the process of evaluating and/or implementing childhood weight management services and prevention programmes that conform to the standards. There have also been commitments from UK and Scottish Government to improve the food environment through further restrictions on advertising, promotions and improved calorie labelling. However, most of these commitments have still to reach implementation stage.


Nearly a quarter of all children in Scotland enter primary school while at risk of overweight or obesity. Despite the overall figure remaining fairly constant since 2001/02, the risk of obesity has continued to rise in the most deprived areas and fall in the least deprived, revealing substantial inequalities in child healthy weight in Scotland. In 2019, the gap in obesity prevalence is now the widest it has been since records began.

A few months ago we looked at the rate of childhood obesity in Scotland using the new Scottish Health Survey data and found that overall rates had risen. This coupled with the Primary 1 data showing a widening inequalities gap is not good news. Childhood obesity remains an urgent public health challenge where we are currently on the wrong trajectory.

Data for the years ahead will show the impact of governmental actions on this gap and overall childhood overweight and obesity rates. However, current policies and programmes need to be evaluated and adjusted continuously. We appeal to the UK Government, Scottish Government and policy makers to act upon our calls to protect children from the obesogenic food environment.

Ambitious action is urgently required if we want to achieve a halving of childhood obesity by 2030, tackle the inequalities associated with childhood obesity and give every child in Scotland the best start in life.