Weight concern and desire for weight loss support in adolescents: Results from a large cross-sectional school survey.

Background: Excess weight and weight concern among adolescents can lead to adverse physical and psychosocial health consequences. This study aims to examine levels of weight concern, desire for weight support, and their associations in adolescents. Methods: A cross-sectional survey was conducted in 80 English secondary schools as part of the 2023 OxWell Student Survey. Weight concern was measured on a 4-point scale, and desire for weight support with yes/no/I don't know response options. Data was analysed using mixed-effects logistic regression adjusting for gender, year group, ethnicity, and deprivation, with school ID as a random effect. Results: Of 34,245 respondents (aged 11-18 years), 41% reported some level of weight concern, which was more common among older adolescents, those of White ethnicity, and those from deprived backgrounds. Girls, gender non-disclosing, and gender diverse young people were significantly more likely than boys to report weight concern with gender diverse young people having eight times higher odds of weight concern. Thirty percent of young people expressed a desire for weight management support, with modest increases by age but minimal variation by ethnicity or deprivation. Weight concern was strongly associated with desire for support. Conclusion: This study found that weight concern is widespread among UK adolescents, with around one in three expressing a desire for weight management support. These findings reveal a substantial unmet need, as current services targeting only those with overweight or obesity fail to address the broader weight-related distress experienced by many young people.