Aims Our aim was to assess the numbers of obese children and young people(CYP) eligible for assessment and management at each stage of the NICE (National Institute for Health and Clinical Excellence) childhood obesity pathway in England. Current surveillance estimates of obesity are not useful for assessing potential clinical burden on primary/secondary care.

Methods We created a model of the UK population using data on CYP 2–18 years from Health Surveys for England from 2006– 2013. Data: height, weight, lipids, HbA1c, blood pressure, deprivation, ethnicity, family history, musculoskeletal problems and psychological distress (General Health Questionnaire (GHQ)). We combined data across years to maximise the sample. We used guidance from NICE (2006) and UK expert consensus (OSCA guidelines: ADC 2012) to identify the potential burden on services if all eligible children were assessed and treated. England population data were obtained from ONS(2014).

Results The table shows the proportions eligible for each stage of the obesity pathway and the corresponding population estimate (95% confidence intervals) for England.

Conclusions Large proportions of CYP are eligible for secondary referral, anti-obesity drugs and bariatric surgery, likely far in excess of treatment availability. This mismatch is particularly marked in deprived CYP. Current guidance is flawed, with higher proportions eligible for higher stages in the pathway. Needs-based and evidence-based planning of CYP obesity services is required to reduce inequalities.