Background
Trials have demonstrated that childhood obesity treatments are effective, although to varying degrees. Some childhood treatment programmes are less effective (e.g. lifestyle programmes), while others are deemed more effective but invasive (e.g. bariatric surgery).
However, we know relatively little about the most effective way to implement childhood obesity treatment at a population level, that is: which children would benefit most from treatment and at what age. It would also be valuable to better understand where investment in treatment would be best placed, i.e. at lower management tiers (e.g. tier 1; low cost, less effective but greater reach) or higher tiers (e.g. tier 4, bariatric surgery; effective but expensive and low reach).
Aims
A review of weight management services for children and adults was included in Chapter 3 of the Childhood Obesity Plan. This project will provide evidence for the extent to which implementing alternative weight management interventions at a population level might impact upon the achievement of the childhood obesity target.
Analytic work will also help to identify the potential impact of children’s weight management services (as per the NICE obesity pathway) on outcomes including overall obesity prevalence, prevalence by deprivation quintile and impact on more or less extreme definitions of obesity and various groups of children, including indicators of comorbidities.
Methodology
For these analyses, we will use the following data sources: Southampton Women’s Survey (SWS), Millennium Cohort Study (MCS), Understanding Society (US), and Health Survey for England (HSE).
In all datasets, we will identify children with a range of weight status categories (overweight, obese and extreme obesity), in addition to obesity comorbidities where available (including indicators of mental health/well-being, and early indicators of cardiovascular disease risk, such as blood pressure). Level of risk for obesity will be identified across the population using sociodemographic data (e.g. deprivation, ethnicity, income, and region).
Evidence from systematic reviews would be used to identify pooled or best estimates of the effectiveness of various treatments or interventions by age or other factors (e.g. deprivation) if reported. Effect sizes will be used to estimate the reductions in obesity prevalence that might result from interventions at a population level in each of the datasets and according to age. We will also use the estimated effect sizes from reviews to provide estimates of potential benefits from treatment for indicators of comorbidities on obesity. Findings will then be extrapolated to map treatment options to the population, dependent on level of risk and eligibility according to NICE guidance.
Timing
- Analyses expected to be completed by autumn 2021
- Academic papers to follow
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The NIHR Policy Research Unit in Healthy Weight is part of the NIHR and hosted by UCL.