Searchable abstracts of presentations at key conferences in endocrinology
Endocrine Abstracts (2021) 78 P47 | DOI: 10.1530/endoabs.78.P47

BSPED2021 Poster Presentations Obesity (7 abstracts)

Evaluating a tertiary paediatric multidisciplinary weight management service

Meera Shaunak , James Barratt , Stephanie Kerr & Nikki Davis

University Hospital Southampton, Southampton, United Kingdom

Introduction: The Tier 3 paediatric weight management service at University Hospital Southampton comprises a Paediatric Endocrine Consultant, a Clinical Nurse Specialist and Specialist Dieticians. Children may be referred if they have an endocrinopathy, metabolic co-morbidity or obesity syndrome. We offer at least two years of engagement within the service prior to discharge.

Service Evaluation: Twenty-six Tier 3 patients were under follow-up between 1st January 2018 and 1st April 2020. The median age at first appointment was 9.8 years (1.7 – 17.2 years), with 54% of patients male and 23% of Asian ethnicity. The average BMI SDS at the first appointment was 3.7. In terms of background, 27% had learning difficulties, ASD or ADHD or CAMHS involvement, 23% had hyperphagia, 19% had underlying chronic disease including kidney disease, airways disease and cancer and 15% had a genetic cause of obesity including T21, MC4R mutation and Bardet-Biedl Syndrome. In terms of co-morbidities, 46% were diagnosed with insulin resistance, 35% with obstructive sleep apnoea, 31% with non-alcoholic fatty liver disease, 19% with dyslipidaemia, 8% with polycystic ovarian syndrome and 4% with pre-diabetes (impaired fasting glycaemia or impaired glucose tolerance). A family history of high BMI, Gestational Diabetes Mellitus or Type 2 Diabetes Mellitus was common (52%). Seven patients (27%) received social services support. Eight patients (31%) received metformin and five patients (19%) were admitted for weight management. Of those discharged due to poor engagement, the average change in BMI SDS was -0.4. Of those remaining under follow-up, the average change in BMI SDS was -0.8. There were three to four MDT contacts per patient per year. The overall was not brought (WNB) rate was 15%.

Discussion: This service evaluation demonstrates: 1) these patients have complex health and social needs, with a high incidence of obesity-related co-morbidity, CAMHS and social services involvement and family weight/metabolic problems. 2) BMI improved by an average of 0.4 – 0.8 SDS under the current service structure, a metabolically meaningful improvement. 3) Patients are receiving significant specialist input every year, yet the overall WNB rate is high, highlighting the pressing need to work on patient and family engagement.

Volume 78

48th Meeting of the British Society for Paediatric Endocrinology and Diabetes

Online, Virtual
24 Nov 2021 - 26 Nov 2021

British Society for Paediatric Endocrinology and Diabetes 

Browse other volumes

Article tools

My recent searches

No recent searches.