The Childhood Obesity Crisis: How Early Years Settings Can Make a Difference
In 2025, the world crossed a sobering threshold: obesity among children and adolescents aged 5-19 surpassed underweight for the first time in human history with 1 in 10 children obese. This global shift reflects a significant change in dietary habits and declining physical activity. In the UK, the statistics are particularly concerning with nearly 1 in 4 children aged 2 to 15 years old overweight or obese. Childhood obesity rates have risen steadily for decades, with children from disadvantaged backgrounds disproportionately affected. But with challenge comes opportunity: early years settings are uniquely positioned to influence young children’s nutritional foundations before patterns become embedded.
Understanding the Scale of the Problem
Childhood obesity isn’t simply about weight, it’s about health, wellbeing, and opportunity. Obese children are more likely to become obese adults, and obesity in adulthood carries serious health consequences from type 2 diabetes, heart disease, certain cancers, joint problems, and mental health challenges.
The causes are complex and interconnected: readily available and often lower in cost, heavily marketed ultra-processed foods high in sugar, fat, and salt; portion sizes that have increased dramatically over recent decades; reduced physical activity as children spend more time in cars and with screens; and socioeconomic factors that make healthy food and active lifestyles less accessible for some families.
However, obesity isn’t inevitable. The early years, approximately birth to age five, represents a critical window when eating habits, taste preferences, and relationships with food are established. What happens during this period greatly influences lifelong patterns.
Why Early Years Settings Matter
Children in childcare settings can consume a substantial portion of their daily nutritional intake, often 50-75% in these environments. For children attending full-time, settings provide breakfast, lunch, snacks, and sometimes dinner. The quality and quantity of food provided has a direct, immediate impact on children’s nutrition.
But settings’ influence extends beyond the meals served. They shape children’s attitudes toward food, their willingness to try new foods, their understanding of portion sizes, and their developing sense of what constitutes “normal” eating. These less tangible influences may ultimately matter more than any individual meal.
Settings also interact regularly with families, positioning them to support parents in providing good nutrition at home. This partnership approach helps to instill healthy habits beyond the setting’s walls.
The Challenge of Ultra-Processed Foods
One major driver of childhood obesity is the prevalence of ultra-processed foods in children’s diets. These foods are typically cheap, convenient, heavily marketed, and engineered to be hyper-palatable and now constitute a substantial portion (some have estimated 50% or more!) of what many children eat.
Ultra-processed foods include sugary cereals, fruit flavoured yogurts loaded with sugar, processed meat products, biscuits, cakes, crisps, white bread, sweetened drinks, sugar free products where the sugar is often replaced with sweeteners and many pre-packaged “children’s meals.” If you take a look at the ingredients on the back of the pack and see ingredients you couldn’t find in your cupboards at home, it’s likely ultra-processed. These foods tend to be high in calories, sugar, salt, and unhealthy fats while being low in essential nutrients.
Research consistently shows that diets high in ultra-processed foods are associated with increased obesity risk. Take a look at this recent three part series by The Lancet if you want to dive into this topic more (https://www.thelancet.com/series-do/ultra-processed-food). These foods are easy to over consume because they’re often soft in texture and designed to override natural satiety signals making them so palatable and easily digested that one can consume far more calories than they need without feeling satisfied.
Early years settings can counteract this trend by prioritising whole, minimally processed foods: fresh fruits and vegetables, whole grains, lean proteins, pulses, and dairy products. When children eat mostly whole foods during childcare hours, they’re exposed to different flavours, textures, and satiety patterns that can shape lifelong preferences.
Portion Sizes and Appetite Regulation
Another factor in childhood obesity is the gradual increase in portion sizes. What’s considered a “normal” portion has grown substantially over recent decades, particularly for snacks, drinks, and treat foods.
Young children have innate appetite regulation abilities. They generally eat according to internal hunger and fullness cues rather than external prompts. However, consistently large portions, pressure to “clean the plate,” or using food as reward can override these internal signals, teaching children to eat beyond their needs.
Settings can support healthy appetite regulation by offering age-appropriate portions, allowing children to serve themselves where possible (family-style dining), never forcing children to finish food, and trusting children to eat according to their hunger. This approach respects children’s internal regulation and prevents the pattern of eating past their own cues that contributes to obesity.
The EYFS nutrition guidelines provide clear portion size recommendations: roughly a child’s fist-size serving for main meals and smaller portions for snacks. Following these guidelines helps ensure children receive adequate nutrition without excessive calories.
The Role of Sugary Drinks
Liquid calories from sugary drinks represent a significant, often overlooked contributor to childhood obesity with sugar drinks accounting for around 6% of a 4 year old’s daily sugar intake. Fruit juice, squash, flavoured milk, and other sweetened drinks provide substantial calories without satisfying hunger, meaning children consume these calories in addition to food rather than instead of it.
The September 2025 EYFS guidelines now explicitly state that only water and milk should be offered to children. This restriction directly addresses sugary drink consumption, a welcome and highly effective obesity prevention strategy and hopefully also leading to a reduction in tooth decay.
Settings implementing this policy help normalise water as the default drink. Children who routinely drink water rather than expecting sweet drinks develop preferences for water that will have long term benefits. They also avoid the blood sugar spikes and crashes associated with sugary drinks that can affect behaviour, concentration, and appetite patterns.
Physical Activity Integration
While nutrition is crucial, physical activity also plays a vital role in preventing obesity. Active children burn more calories, develop stronger muscles and bones, and establish activity patterns that tend to persist into adulthood.
Settings should provide multiple daily opportunities for physical activity: outdoor play with space for running, climbing, and active games; indoor movement activities, particularly on days when outdoor play isn’t possible; and integration of movement throughout the day, not just during designated “active time.”
The link between activity and nutrition matters too. Children who are very active have higher energy needs and larger appetites. Ensuring these children receive sufficient food to fuel their activity is as important as preventing overconsumption in less active children.
Supporting Healthy Weight Without Stigma
Addressing childhood obesity requires enormous care to avoid stigmatising children or creating unhealthy relationships with food and body image. Settings should never comment on children’s body size, weight, or appearance, discuss dieting or weight loss in front of children, label children as “overweight” or treat them differently, or restrict food access for children perceived as heavier.
Instead, promote health for all children through nutritious food accessible to everyone, regular physical activity as fun and normal, positive messages about food as fuel and enjoyment, and respect for body diversity.
If genuinely concerned about a child’s weight, either unusually high or unusually low, approach the family privately and sensitively, focusing on health and wellbeing rather than appearance. Recommend GP consultation if appropriate, but never diagnose or provide medical advice.
The Socioeconomic Dimension
Childhood obesity in the UK disproportionately affects children from lower-income families. This isn’t about parents caring less about nutrition, it’s about structural factors that make healthy eating more challenging: higher costs of fresh produce relative to processed foods, limited time for food preparation for parents working multiple jobs, reduced access to safe outdoor play spaces in some neighbourhoods, and higher concentration of fast-food outlets and convenience stores in disadvantaged areas.
Settings serving children from disadvantaged backgrounds play an especially critical role. They may provide the most nutritious, substantial meals children receive. They may offer the safest, most accessible physical activity opportunities. They can connect families to resources like Healthy Start vouchers.
Approach this sensitively. Never make assumptions or judgments about families. Offer information and support universally, recognising that all families, regardless of resources, want what’s best for their children.
Practical Prevention Strategies for Settings
Several evidence-based strategies help settings prevent obesity while supporting all children’s health:
- Serve whole, minimally processed foods emphasising vegetables, fruits, whole grains, and lean proteins, shifting towards more non-meat protein sources such as beans, which are filling and packed full of nutrients (and often less costly than meat protein).
- Make water freely available throughout the day and serve only water and milk.
- Follow EYFS portion guidelines and allow children to regulate their intake.
- Provide regular, structured physical activity opportunities.
- Avoid using food as reward, punishment, or comfort.
- Educate children about food and nutrition in positive, age-appropriate ways – get them involved in recognising less familiar food types in their natural and cooked states and set up vegetable washing and cutting stations so they can be more involved in the preparation of snacks and meals giving them a real sense of pride.
- Partner with families through sharing recipes, packed lunch ideas, nutrition information, and encouragement.
- Model healthy eating and positive attitudes toward food and activity.
These aren’t special “anti-obesity” measures, they’re simply good practice that supports all children’s health and development while specifically addressing obesity risk factors.
The Long View
Childhood obesity is a complex public health challenge without simple solutions. Individual settings cannot reverse societal trends single-handedly. However, every setting can ensure that during the hours children are in their care, they receive good nutrition, regular activity, positive food experiences, and messages that support lifelong health.
For many children, these hours represent a substantial portion of their waking lives during crucial developmental years. The cumulative impact of consistent, high-quality nutrition provision and positive food culture should not be underestimated.
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About the Author
Holly Richards is the founder of Lunchbox Lab, an app empowering nurseries and schools to create tasty meals complying with the EYFS Nutrition Guidelines and School Food Standards. She is currently studying for a Masters in Applied Nutrition at City University, is a board director for Whole School Meals and a mum of three young children.