Abstract
BACKGROUND: Childhood obesity is a major public health issue, with significant variation across England. Understanding the causes of this variation can offer insights to improve practice. We aimed to identify areas diverging from national trends using data from 150 Local Authorities (LAs) in the National Child Measurement Programme (2007/08-2023/24). METHODS: Growth mixture models identified classes with distinct trajectory profiles. Logistic regression tested whether deprivation (Indices of Multiple Deprivation/Income Deprivation Affecting Children Index) and ethnicity predicted class assignment. RESULTS: For both Reception and Year 6, two trajectory classes emerged. Reception Class I: 'Moderate & Stable' (132/150, 88%); Class II: 'High & Declining' (18/150, 12%). Year 6 Class I: 'Moderate & Rapidly Increasing' (135/150, 90%); Class II: 'High and Gradually Increasing' (15/150, 10%). Assignment to Class II was associated with higher deprivation; a higher proportion of children from ethnic minority groups; and relative reductions in deprivation and shifts in school ethnic composition. CONCLUSION: A small number of LAs, predominantly in South-East England, have a less adverse trend in child obesity prevalence compared to the majority. Assignment to this group was associated with higher deprivation; a higher proportion of children from ethnic minority groups; and reducing deprivation and changing ethnicity over time.