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The purpose of this inquiry was for the Health and Social Care Committee to identify:

• gaps/areas for improvement in existing policy and the current regulatory framework (including in relation to food/nutrition and physical activity)
• the impact of social and commercial determinants on obesity
• interventions in pregnancy and early childhood to promote good nutrition and prevent obesity.
• the stigma and discrimination experienced by people who are overweight/obese.
• people’s ability to access appropriate support and treatment services for obesity.
• the relationship between obesity and mental health
• international examples of success (including potential applicability to the Welsh context)

Our response

Childhood obesity is one of the biggest public health issues facing the UK. Nearly a quarter (24.85) of children in Wales aged 4-5 are living with obesity or are overweight. This is 2.1% lower than pre-pandemic 2018/2019 figures but remains higher than Scotland and many regions in England. 

Children living with obesity are at risk of ill health into adulthood, with 80% of obese young people remaining obese as adults. Children also report being stigmatised due to their weight, the impacts of which include bullying and poorer educational outcomes, increased risk of depression, anxiety, and social anxiety. 

Our recommendations

• The Welsh Government should promote policies to enable healthy choices and healthy behaviour. This includes addressing socio-economic factors that contribute to unhealthy weights and providing a suite of suitable support, information, and resources to engage and guide families from before conception. 
• Regional variations in services and support for children living with obesity needs to be addressed by Welsh Government.
• The Welsh Government should invest in early years nutrition within the first 1,000 days and ensure that there is a workforce able to deliver advice, support and guidance on breastfeeding and infant feeding in the community.
• The Welsh Government should ensure children in schools are receiving healthy nutritious food and consider the affordability of rolling out free school meals more widely.
• The Welsh Government should create active environments, green spaces and preserve community leisure facilities to address the decline in physical activity and increase sedentary behaviour. 
• All healthy weight initiatives should be evidence based and implemented carefully to avoid unintended consequences. 
• There is a significant difference between health boards. Cardiff and the Vale University Health Board has the lowest proportion of children overweight or obese (21.2%) whereas Hywel Dda University Health Board has the highest at 28.9%. The Welsh Government should ensure that every health board has a dedicated weight management services for children and young people to ensure equity of provision. The Welsh Government should also invest in areas of deprivation and regional disparity to reduce child obesity. 
• The Healthy Start scheme is a UK Government initiative available in Wales. The Welsh Government and NHS Wales should ensure that everyone with children between 0-3 is aware of the scheme and if appropriate, how to apply. The UK Government should also consider re-evaluating the amount provided per week to families.
• The Welsh Government should ensure there are an appropriate number of health visitors and infant feeding professionals to provide advice, support and education on the importance of appropriate nutritious feeding within the first 1000 days. This will embed healthy behaviours and support the prevention of obesity. 
• The food and drink provided in schools can make a positive contribution towards giving children and young people a healthy balanced diet and encouraging them to develop good eating habits. We are aware that Welsh Government is currently updating the food standards for maintained schools. It’s essential this takes into consideration the importance of nutrition within any revision of existing standards and how these standards are monitored.
• Mandatory calorie labelling on menus has been discussed as a possible option for Wales, having been rolled out in England. However, the evidence on the impact of out of home calorie labelling is still developing, and there is emerging evidence of the unintended impact on those living with an eating disorder. We encourage the Welsh Government to monitor and review the effectiveness of mandatory calorie labelling on out of home settings as well as the impact on those living with an eating disorder when considering if the policy would be appropriate to introduce in Wales.