The Scottish Health Survey 2024 - volume 1: main report
This report presents results for the Scottish Health Survey 2024, providing information on the health and factors relating to health of people living in Scotland.
Part of
10. Obesity
Rory McClelland
10.1 Introduction
Obesity is classified as having a Body Mass Index (BMI) of 30 kg/m2 or more[i]. It is described by the World Health Organisation as a complex multifactorial chronic noncommunicable disease characterised by excess adiposity that can have a detrimental effect on health[ii].
Obesity is linked to a range of health outcomes including type 2 diabetes, cardiovascular disease (CVD), hypertension, asthma and high cholesterol, having the potential to worsen existing conditions and/or to lead to new ones developing[iii,iv]. Research has also shown that more than 1 in 20 adult cancer cases in the UK in 2015 were linked to excess weight making obesity the second largest preventable cause of cancer[v].
Studies have indicated that there is an association between living with obesity and mental health issues such as depression, anxiety, eating disorders, low self-esteem and reduced quality of life[vi]. There is also evidence of a link between living with overweight and obesity in midlife and increased risk of dementia or Alzheimer’s disease in later life[vii]. The evidence also suggests that younger people in the UK are living with a higher BMI at an earlier age and staying at that higher BMI for longer[viii]. Living with obesity at a young age tends to continue into adulthood and places individuals at increased risk of developing conditions such as CVD and diabetes at a younger age[ix].
10.1.1 Policy background
The Population Health Framework[x] sets out a clear ambition to enable everyone to lead longer, healthier and fulfilling lives. This includes supporting people to achieve and maintain a healthy weight.
Maintaining a healthy weight is a key public health priority for Scotland. A Healthier Future: Scotland’s Diet and Healthy Weight Delivery Plan1 published in July 2018, sets out a vision where everyone has a healthy weight, including:
- Children have the best start in life – they eat well and have a healthy weight, including seeking to halve the prevalence of child obesity by 2030.
- People have access to effective weight management services.
- Leaders across all sectors promote healthy weight and diet.
- Diet-related health inequalities are reduced.
A new Diet and Healthy Weight Implementation Plan is being developed to support the Population Health Framework. This will contain a refreshed set of actions that will be published in due course.
The Scottish Government also provides funding to health boards to deliver adult and children’s weight management services, in line with the Public Health Scotland national standards[xi], and the 2018 Type 2 Diabetes Prevention Framework[xii]. This funding is permanently baselined as of financial year 2025/26, ensuring sustainable delivery of weight management services across all health boards in Scotland.
10.1.2 Reporting on obesity in the Scottish Health Survey
This chapter presents data on body mass index (BMI)[xiii] disaggregated for adults and children.
Figures are reported by age, sex and area deprivation.
An interactive data dashboard is also available presenting key indicators for Scotland, NHS Boards and local authority areas.
The area deprivation data are presented in Scottish Index of Multiple Deprivation (SIMD) quintiles. To ensure that the comparisons presented are not confounded by the different age profiles of the quintiles, the data have been age standardised. For detailed definitions of both SIMD and age-standardisation as well as terminology used in this chapter and for further details on the data collection methods for obesity, please refer to the Scottish Health Survey 2024 - Volume 2: Technical Report.
Please note that some caution should be exercised when interpreting data for 2021 within any time series data presented due to some methodological changes during the pandemic. Please see the 2022 Scottish Health Survey technical report for more information.
10.1.3 Comparability with other UK statistics
The Health Survey for England [xiv], Health Survey Northern Ireland[xv] and the National Survey for Wales[xvi] provide estimates of adult obesity prevalence in the other UK countries. These surveys are conducted separately and have different sampling methodologies, so adult obesity prevalence estimates across the surveys are only partially comparable.
The Health Survey for England and the Health Survey Northern Ireland provide estimates of child obesity prevalence in England and Northern Ireland. These surveys are conducted separately and have different sampling methodologies, so child obesity prevalence estimates across the surveys are only partially comparable.
10.2 Results
Summary points
In 2024:
- A third of adults (31%) were living with obesity in 2024, a similar proportion to 2023 (32%), with a significantly higher proportion of females (35%) living with obesity compared with males (27%). The mean BMI of adults in 2024 was 28.1 kg/m2, an increase from 27.1 kg/m2 in 2003.
- The highest prevalence of healthy weight was for adults aged 16-24 (58%) compared with 23%-38% of those in other age groups.
- Almost two-thirds of children (65%) were within a healthy weight range based on their BMI. This proportion has been in the range 64% - 72% since 1998.
- Just under a fifth of children (18%) were at risk of obesity, the same level as in 2021 and 2022 and the highest level in the timeseries (fluctuating between 13% and 18% between 1998 and 2024).
- A third of all children in 2024 were at risk of overweight (including obesity) (33%).
10.2.1 A third of adults were living with obesity in 2024
In 2024, around a third of adults (31%) were living with obesity, a similar proportion to that recorded in 2023 (32%) and an overall increase from 24% in 2003.
As in previous years, a significantly higher proportion of females (35%) were living with obesity compared with males (27%) in 2024.
In 2024, the mean BMI for adults was 28.1 kg/m2, the highest level in the timeseries and an increase from 27.1 kg/m2 in 2003. A higher mean BMI was recorded among females (28.6) compared with males (27.6) in 2024.
Figure 10A, Table 10.1
10.2.2 The highest prevalence of healthy weight was recorded for adults aged 16-24
Over half of adults aged 16-24 were in the healthy weight range in 2024 (58%) compared with 23%-38% of those in the other age groups.
As in previous years, younger adults aged 16-24 recorded a significantly lower mean BMI (24.4 kg/m2) than the range recorded for adults aged 25 or older (27.9 kg/m2–29.3 kg/m2).
Figure 10B, Table 10.2
10.2.3 Prevalence of living with obesity was highest among adults in the most deprived areas in 2024
In 2024, the age-standardised prevalence of adults living with obesity varied by area deprivation, from 24% in the least deprived quintile to 36% each in the two most deprived quintiles.
The mean BMIs recorded followed a similar pattern, increasing from 27.1 kg/m2 in the least deprived quintile to 28.9 kg/m2 in the most deprived quintile in 2024.
Figure 10C, Table 10.3
10.2.4 Almost two thirds of children were within the healthy weight range in 2024
In 2024, almost two thirds (65%) of children were within a healthy weight range based on their BMI. This proportion has been in the range 64% - 72% since 1998. There was not a significant difference between males and females in 2024 (64% and 66% respectively).
Just under a fifth of children (18%) were at risk of obesity, the same level as is 2021 and 2022 and the highest level in the timeseries (this proportion has fluctuated between 13% and 18% since 1998.
Figure 10D, Table 10.4
10.2.5 A third of all children were at risk of overweight (including obesity) in 2024
A third of all children were at risk of overweight (including obesity) (33%) in 2024. Differences by age and sex were not significant.
Table 10.5
Table List
Table 10.1 Adult BMI, 2003 to 2024, by sex
Table 10.2 Adult BMI, 2024, by age and sex
Table 10.3 Adult BMI (age-standardised), 2024, by area deprivation and sex
Table 10.4 Children BMI, 1998 to 2024, by sex
Table 10.5 Children BMI, 2024, by age and sex
References and notes
[i] A Healthier Future: Scotland’s Diet & Healthy Weight Delivery Plan, Edinburgh: Scottish Government, (2018). Available at: A healthier future: Scotland's diet and healthy weight delivery plan - gov.scot
[ii] World Obesity Federation. Addressing weight stigma and misconceptions about obesity in Europe: Considerations for policymakers. Available at: https://s3-eu-west-1.amazonaws.com/wof-files/Weight_Stigma_Briefing_FINAL.pdf
[iii] Abdelaal M, le Roux, C and Docherty, N (2017). Morbidity and mortality associated with obesity. Annals of Translational Medicine; 5(7): 101: p.1. Available at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5401682/
[iv] Safei, M, Sundararajan, EA, Driss, M, Boulila, W and Shapi’i, A. (2021). A systematic literature review on obesity: Understanding the causes and consequences of obesity and reviewing various machine learning approaches used to predict obesity. Computers in Biology and Medicine, 136 (2021) [Online]. Available at: https://www.sciencedirect.com/science/article/pii/S0010482521005485
[v] Brown, KF et al. (2018). The fraction of cancer attributable to modifiable risk factors in England, Wales, Scotland, Northern Ireland, and the United Kingdom in 2015. Br. J. Cancer, 118, 1130–1141. Available at: https://www.nature.com/articles/s41416-018-0029-6
[vi] Sarwer, DB and Polonsky, HM. (2016). The Psychosocial Burden of Obesity. Endocrinology and Metabolism Clinics of North America, Vol 45(3), pp. 677-688. Available at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6052856/pdf/nihms980694.pdf
[vii] Flores-Cordero, JA, Perez-Perez, A, Jiminez-Cortegana, C, Alba, G, Flores-Barragan, A and Sanchez-Margalet. (2022). Obesity as a Risk Factor for Dementia and Alzheimer’s Disease: The Role of Leptin. International Journal of Molecular Sciences, Vol 23(9) [Online]. Available at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9099768/
[viii] Johnson, W, Li, L, Kuh, D, Hardy, R (2015). How Has the Age-Related Process of Overweight or Obesity Development Changed over Time? Coordinated Analyses of Individual Participant Data from Five United Kingdom Birth Cohorts. PLoS Med 12(5). Available at: https://pubmed.ncbi.nlm.nih.gov/25993005/
[ix] Balasundarem, P and Krishna, S. (2023). Obesity Effects on Child Health. National Center for Biotechnology Information [Online]. Available at: https://www.ncbi.nlm.nih.gov/books/NBK570613/
[xi] See: https://publichealthscotland.scot/publications/standards-for-the-delivery-of-tier-2-and-tier-3-weight-management-services-in-scotland/
[xii] See: https://www.gov.scot/publications/healthier-future-framework-prevention-early-detection-early-intervention-type-2/
[xiii] Data for 2022 are based on interviewer-administered measurements only for children. For adults in 2022, both self-reported and interviewer administered height and weight measurements were combined. Self-reported height and weight measurements were adjusted according to formulae developed by Public Health England for use on the Active Lives survey from Health Survey for England data. The formulae have the effect of increasing self-reported weight and decreasing self-reported height, particularly among older adults. In 2021, the telephone format of the survey meant that all adult and child measurements were self-reported. The measurements for adults were adjusted as described above. No equivalent adjustment factors were available for children and hence the analysis for children in 2021 was based on self-reported measures. Therefore, caution should be taken when comparing data with the 2021 and 2022 surveys.
[xiv] See: https://digital.nhs.uk/data-and-information/publications/statistical/health-survey-for-england
[xv] See: https://www.nisra.gov.uk/statistics/find-your-survey/health-survey-northern-ireland
Contact
ScottishHealthSurvey@gov.scot