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This expert opinion provides detailed guidance on assessing obesity in secondary paediatric practice. This guidance builds on existing recommendations from National Institute of Health and Clinical Excellence in the UK, and is evidence based where possible. Guidance is provided on which obese children and young people are appropriate to be seen in secondary care and relevant history and investigations, and guidance on when further investigation of causes and obesity-related comorbidity is appropriate.

The ‘First Thousand Days’ refers to the period from conception to the child’s second birthday. It is increasingly gaining traction as a concept to guide public health policy. It is seen as a crucial window of opportunity for interventions that improve child and population health. This review outlines the origin and growth of the First Thousand Days concept, and the evidence behind it, particularly in the areas of brain development and cognition; mental and emotional health; nutrition and obesity; programming and economic benefits. The review then describes UK experience of use of the concept to inform policy, and a recent government inquiry that mandates more widespread implementation.

Abstract:Background: The relationship between body-mass-index (BMI) during pregnancy and the risk of disease has been widely explored. The following study examined the relationship between self-esteem, disordered eating and body image to BMI during pregnancy.Methods: 110 women from Israel and the UK completed the following questionnaires: Sociodemographic details (self-reported age, education levels); the Rosenberg Self-Esteem questionnaire; the Dutch Eating Behaviour Questionnaire (DEBQ); and scales to assess body image and body image disturbance. BMI was calculated from antenatal records and classified as healthy weight (BMI <25 kg/m 2 ) or overweight (≥35 kg/m 2 ) using standard BMI cut offs. Spearman correlation, MannWhitney tests and linear regression modelling were applied to determine the relationship between variables and differences between countries and BMI categories.Results: Self -esteem did not differ from non-pregnant population levels. Frequency of high restraint (>3.5 DEBQ) was lower for UK healthy weight women. For both countries a high correlation was found between body image and BMI, with significantly higher body dissatisfaction for Israeli than UK women. Conclusions:Io piAgonocyz UH noR IiinA,C wnmAo'i ,AvA,i no iA,o-esteem did not differ from reported ranges for non-pregnant women, whilst poor body image and more restrained eating in healthy-weight women was found only in Israel.