Endocrine Abstracts

In England, Tier 3 weight management services known as Complications of Excess Weight (CEW) clinics have been formed to support the high numbers of children living with severe obesity and facing significant physical and mental health complications. Social prescribing helps connect families to local community services which can provide additional, non-medical support. This could include referral to physical activity groups and to information services, such as Citizen’s Advice. Whilst social prescribing is commonly used in adult services it has not yet been formally used in children’s weight management. Based on research showing that families accessing CEW are living in the most deprived areas of the country and experience complex needs, including low self-esteem, confidence and social isolation, social prescribing may be a helpful way to provide additional holistic support to patients and their families. This research used a realist approach, which aims to understand how social prescribing may (or may not) work in CEW clinics. 20 interviews were conducted with staff from a CEW clinic, linked community-based services and CEW patients to explore theories of how social prescribing may work in this setting. Social prescribing was noted to be helpful in providing peer support opportunities for CEW families. Referral to information services was reported to help address wider social barriers, meaning that clinical staff could focus on weight and comorbidity management. CEW clinicians commonly referred young people to physical activity groups but faced challenges in finding accessible activities. Mapping work demonstrated that of 933 community-based services local to one CEW clinic, only 19 met the specific needs of children living with severe obesity. This highlights a need for more consistent investment towards community services to offer more accessible, sustainable opportunities for children with complex health and social needs. Engagement with social prescribing was supported by a family support worker in the CEW team, who met with families through home visits and spent time building trust with patients. This person-centred approach was reported to be important for improving families’ mental health and quality of life outcomes; however future research may be needed to explore the long-term impacts of this.