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Study analyzed 268,231 children aged 2–15 years (2014–2020).
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Severe obesity incurred £190 ($274) in annual excess NHS costs per child.
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Underweight status also drove high costs at £164 ($236) per child.
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National costs of childhood overweight/obesity estimated at £273 million yearly.
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Girls with severe obesity had higher costs (£253) than boys.
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Highest costs occurred in 4–5-year-olds with severe obesity (£472).
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Findings support preventive interventions targeting childhood weight.
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