Have healthcare workers got it all wrong in tackling teenage obesity?
Rates of overweight and obesity have risen markedly in adolescents in England over the last 15 years, show data at the 2025 European Congress on Obesity. The best way to address it is not so clear.
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MALAGA, SPAIN — The proportion of adolescents living with overweight or obesity in England rose by 50% between 2008 and 2023, show figures presented recently by UK researchers. The rise in overweight/obesity has resulted in marked increases in the early onset of conditions such as type 2 diabetes and polycystic ovary syndrome.
The research was presented in two related abstracts at the 32nd European Congress on Obesity (ECO) by Dinesh Giri, MD, PhD, from Bristol Royal Hospital for Children, and Senthil Senniappan, MD, PhD, from Alder Hey Children’s Hospital, Liverpool.
They were clear on where the blame for the stark figures lies: “Over the past 15 years, obesity in adolescents has risen significantly due to a combination of increased consumption of ultra-processed foods, sedentary lifestyles driven by excessive screen time, inadequate sleep and rising mental health challenges,” they write.
“Additionally, reduced opportunities for physical activity and socioeconomic disparities have further contributed to an environment that promotes unhealthy lifestyles.”
They add that “increased focus on weight-management in adolescence could lead to long-term improvement in overall health.”
Internalising failure
But what kind of a focus, and how should it be delivered? Those are the kinds of questions that preoccupy Professor Jason C.G. Halford, PhD C.Psychol, from the School of Psychology at the University of Leeds, and former president of the European Association for the Study of Obesity. He emphasized that many healthcare professionals do not understand the pressures that teenagers face, or the best way to reach out to them.
He told Medical News Insider that young people “tend to take their healthcare advice from YouTube and social media,” and even though the messages they are receiving are typically not valid, they see “all these images about people ‘successfully managing their weight’,” and believe that, if they could only do the same things, they will solve their problem.
Halford continued that, when they inevitably fall short, adolescents “will see themselves as failures,” which they tend to internalise, and so “reinforce the mental health issues that we have around obesity.”
“We know that adolescents are really vulnerable to mental health issues anyway,” he commented.
Misunderstood and maligned
However, the complexity of people’s relationship with their weight and how to manage it is frequently misunderstood by healthcare professionals.
Previous research by Halford and colleagues showed that people with obesity took an average of nine years to discuss their struggles with weight with a doctor, and when a discussion did take place, only 36% of people felt supported and 23% felt motivated by the conversation, while 17% reported embarrassment.
Moreover, healthcare professionals believed people with obesity lacked interest in and motivation for weight management, something the researchers said “must be challenged along with the blame culture of individual responsibility that is prevalent throughout society.”
In another study of nearly 5300 adolescents living with obesity, Halford and colleagues found that they were more likely to perceive their weight as above normal and more worried about its impact on their health than their caregivers. More than half had made a weight loss attempt.
Adolescents living with obesity in the study were most likely to say that their weight loss motivator was to be more fit/in better shape; however, healthcare professionals assumed that the primary motivator was improved confidence/social life.
The study also showed that “the biggest barrier for these adolescents living with obesity is their hunger,” Halford said, “but the healthcare professionals don’t understand the role of hunger and appetite driving everything,” and they thought that the problem was a lack of motivation and unhealthy eating habits.
Halford and colleagues concluded that there is a “need to improve communication” between adolescents living with obesity, their caregivers and treating healthcare professionals, as well as educational support on the experiences, challenges, and needs of these young people.
Living with obesity since childhood
For the current studies presented at ECO, the researchers used routinely collected healthcare data on people aged 12–17 years in England from the primary care Clinical Practice Research Datalink and the Hospital Episode Statistics database for the years 2008–2023.
They found that the prevalence of overweight and obesity increased from 22% in 2008–2010 to 33% in 2021–2023, an 11% absolute but 50% relative rise, with the vast majority of the adolescents having already lived with overweight or obesity in childhood.
Comparing 139,258 adolescents living with overweight, 140,990 with obesity and 560,789 with healthy weight, the researchers found that those with overweight and obesity were more likely to come from the most economically and socially deprived areas.
Ongoing risks
They also found that adolescents with overweight and obesity, over an average follow-up of six years, were more likely than those with healthy weight to develop obstructive sleep apnoea (when breathing stops and starts during sleep), type 2 diabetes, and liver disease linked to metabolic dysfunction, at rates three times higher for those with overweight and up to 12 times higher for young people with obesity.
Those with overweight were also twice as likely as healthy weight people to develop ‘prediabetes’, in which the person is at high risk of developing diabetes, and polycystic ovary syndrome, a common condition that affects how a woman's ovaries work, which can lead to symptoms such as infertility, acne and excessive hair growth, as well as, over the long term, diabetes and heart disease. In adolescents with obesity, the risk for prediabetes and for polycycstic ovary syndrome was four times higher.
The authors conclude that a reduction in body mass index during adolescence could have “long-term impact” on their risk of developing these associated conditions.
The study was funded by Novo Nordisk. Two co-authors of the abstracts are employees of Novo Nordisk. No other relevant financial relationships declared.
Liam Andrew Davenport is a medical reporter with more than 20 years’ experience covering a wide range of specialties and topics in the field.