More than 16,000 overweight or obese children have taken part in a government weight-loss initiative in the past three years, according to new figures, but experts have raised concerns about how effective the programme has been.
The statistics show that health boards exceeded their target of 14,910 "child healthy weight interventions" between April 2012 and March 2014, with a total of 16,820 delivered across Scotland in that period.
The scheme is part of the government's strategy to tackle childhood obesity, and aims to change behaviour in overweight and obese young people aged 2-15 and their families through sessions focusing on diet and physical activity. But doctors and parents remain concerned that the approach fails to adequately help those most in need of support.
According to an evaluation report published by NHS Health Scotland last October, only limited numbers of participants have access to specially tailored group or individual sessions. The rest are taught in classes at school.
Professor Charlotte Wright of the Royal College of Paediatrics and Child Health said that although the government deserved credit for taking action to tackle obesity, the huge target had presented a challenge to health boards. As a result, the majority of children received sessions delivered in the classroom, which provided a cost-effective way to reach such large numbers.
These sessions were "preventative", she said, but did not allow for a focus on children who were already overweight.
She added: "That isn't treatment. It is just a drop in the ocean. Group sessions are essential for the most affected children. For those very overweight children, something has got to be done."
Professor Wright said that some extreme cases of "enormously overweight" children existed, but that there was "nothing to offer them".
Group sessions, unlike classroom sessions, include parents, something Professor Wright insisted was essential. "That is the weakness of the school programme," she said. "How is a young child supposed to lose weight if their parents don't play along?"
A spokeswoman for the Scottish Parent Teacher Council said that in-school interventions could have a short-term effect but would not necessarily change a family's eating habits.
She explained: "Education for families is vital but even more important is the way this is delivered. It is counterproductive to preach at parents and tell them that they or their children are obese. It is also not useful to tell parents they should be feeding their children more fruit and vegetables, as many families struggle to afford this and often opt for the cheapest, not necessarily the healthiest, options when shopping.
"Family cooking lessons or advice on how to cook healthily on a budget have often been successful," she added.
The NHS Health Scotland report also found differences in the impact of interventions. Although children taking part in sessions learned key concepts around healthy lifestyles, it says, "not all positive impacts on dietary choices were seen as long-lasting in children that attended school interventions".
A Scottish government spokeswoman said that health boards meeting and exceeding their targets had to be welcomed. But she added: "There is also far more to do. We are continuing to fund child healthy weight interventions and work directly with producers and retailers to promote healthy food options through the Supporting Healthy Choices programme.
"We are also increasing opportunities for children to get involved in sport and physical activity, through Active Schools and our target of all primary children having two hours of PE lessons a week."