Hundreds of four-year-olds are among over 6,000 children treated at specialist NHS weight-loss clinics, according to new data published by NHS England for the first time. Since the first Complications from Excess Weight (CEW) clinic opened in 2021, the network of 39 clinics across England has treated 6,497 children and teenagers aged from four to 17. Of those, 423 were just four years old, weighing an average of 33kg (5st 3lbs) – the same weight as a typical 10-year-old. A further 1,088 were aged between five and eight, 1,791 were aged nine to 12, and 3,137 were aged 13 to 17. The age of 58 children is unknown.
All of the children were classified as “extremely” overweight for their age. To be referred to a CEW clinic, a child must be sent by a GP, community or hospital paediatrician, or childhood mental health services, and must have a BMI above the 99.6th percentile as well as an illness linked to their excess weight. The clinics provide individualised, holistic care including family-based therapy, behavioural coaching, dietary strategies and mental health support. About 400 children have been prescribed weight-loss jabs as part of their treatment plans. An analysis of just under 6,000 of these children, due to be presented at the European Congress on Obesity in Istanbul, found that those treated at CEW clinics were on average 10kg lighter two years later than children who saw only their GP or community health teams.
Health complications found in treated children
The same analysis, conducted by researchers from Sheffield Hallam University, Leeds Beckett University, the University of Leeds, the University of Bristol and the University of Sheffield, reveals the serious medical conditions already present in these young patients. More than one in six (17%) had high blood pressure, and a similar proportion had abnormal fat levels in their blood. Some 6% had been diagnosed with type 2 diabetes – a condition that childhood obesity quadruples the risk of developing by age 25. Between 1994 and 2013, 654 children and teenagers in the UK were diagnosed with type 2 diabetes, with rates rising from 6 per 100,000 annually to 33 per 100,000 annually. The new data shows the crisis has deepened, with even younger children affected.
Just under 30% of the children treated at CEW clinics had metabolic dysfunction-associated steatotic liver disease (MASLD), formerly known as fatty liver disease. MASLD is now the most common liver condition in UK children, affecting an estimated one in 10 children and teenagers overall, but rising to one in three among those with obesity. Left untreated, it can lead to liver damage, scarring and eventually liver failure in adulthood. Seventeen per cent of the children had obstructive sleep apnoea, a respiratory condition that can severely disrupt sleep and quality of life. The study also found a high prevalence of mental health and neurodevelopmental conditions: about 9% had deliberately self-harmed, and the same proportion had anxiety. A significant number were neurodivergent – just under 30% had autism, about 12% had attention deficit hyperactivity disorder (ADHD), and a further 24% had a learning disability. The proportion of young people with obesity who have emotional difficulties is around twice that observed in those with a healthy BMI.
The scale of the problem reflects wider national trends. In 2022, 15% of children aged two to 15 in England were living with obesity, and 27% were overweight or obese. Prevalence rises sharply with age, reaching 19% among 11- to 15-year-olds. In the 2023-24 school year, 9.6% of reception-aged children (four to five) and 22.1% of Year 6 children (10 to 11) were obese. The link with deprivation is stark: in 2024, among 11- to 15-year-olds, 8% in the least deprived areas were living with obesity, compared with 30% in the most deprived areas. Obesity costs the NHS around £6.5 billion a year.
Expert calls for action
Experts described the figures as extremely worrying. Katharine Jenner, executive director of the Obesity Health Alliance, said: “These figures should be a wake-up call. All parents want their children to grow up healthy, yet seeing children as young as four needing specialist NHS treatment for their weight highlights just how early the drivers of poor health are taking hold. Children today are growing up surrounded by unhealthy food at almost every turn, leaving families struggling against a system that stacks the odds against healthier options. The fact that some children are already developing high blood pressure, type 2 diabetes and early signs of heart disease at such a young age underlines why prevention has to begin in the earliest years of life.”
Dr Helen Stewart, officer for health improvement at the Royal College of Paediatrics and Child Health, said: “It’s extremely concerning that we are seeing more and more children being treated at CEW clinics. Unfortunately, high levels of obesity continue to cause significant health problems in our young people, particularly impacting children from the most disadvantaged backgrounds, where children with obesity are at higher risk of chronic illnesses, mental health issues and potentially even a shorter lifespan.”
Professor Simon Kenny, national clinical director for children and young people at NHS England, noted the success of the clinics in turning lives around: “Severe obesity can impact all aspects of a child’s life – affecting their physical health, mental wellbeing and confidence – so it is fantastic that NHS CEW clinics are helping thousands of children and young people turn their lives around. In some cases, these clinics are helping children who could otherwise face a life cut tragically short – dying decades too soon – to look ahead to a full and healthy life.” He added that childhood obesity remains one of the biggest public health challenges facing the country. The government has introduced measures including the Soft Drinks Industry Levy in 2018, which research suggests contributed to an 8% relative reduction in obesity in Year 6 girls, and a ban on junk food adverts before 9pm on television and online at all times from January 2026, expected to remove up to 7.2 billion calories from children’s diets annually. However, some experts argue the advertising ban has been watered down by industry lobbying. Jenner concluded: “Healthier food should be easier, cheaper and more available for everyone, no matter where they live.”