LAUSR

INTRODUCTION Epidemiological transition has brought us to the ‘age of manmade diseases’, with previously lethal infectious conditions supplanted by chronic disorders. Childhood poverty can rightly be regarded as a manmade disease. Obesity, strongly linked to child poverty, has its roots in a society characterised by gross inequalities. In 2018, a striking 30% (around 4 million) of children in England were living in relative poverty, once housing costs were taken into account. This makes us one of the worst countries in the Organisation for Economic Cooperation and Development in this respect. Obesity reflects an income gradient, with adolescents with the lowest family income being 4.1 times more likely to be affected than those in the highest income quantile. This disparity can already be seen in year 6 pupils (aged 10–11 years), with groups experiencing the highest deprivation having more than twice the proportion of obesity compared with those from the wealthiest background: 26.9% vs 11.4%, respectively. This finding clearly indicates that obesity and poverty are deeply intertwined, raising questions about the mechanisms involved and how this situation might be remedied. Worryingly, the percentage of children living in relative poverty in the UK is projected to increase to 36.6% in 2021, necessitating urgent action. The government’s simplistic strategy (focusing on food labelling and advertising) fails to address the underlying issue of childhood poverty; therefore, a multidisciplinary ‘whole system’ approach to childhood obesity is advocated.