Endocrine Abstracts

Background: The Complications of Excess Weight (CEW) Service, is a tier three weight management service for children and young people (CYP), providing a holistic approach for those with, or at risk of complications due to excess weight. We aimed to better understand the health and social care needs of patients referred to a CEW service over the initial two years of operation.

Methods: Data was collected at baseline (first appointment) as part of routine clinical care. This included age, ethnicity, education status and social care involvement. Health complications related to obesity were also documented. Body mass index standard deviation score (BMISDS) was calculated at baseline and at 6-month intervals. A BMISDS reduction of 0.25 was considered clinically significant. Reasons for discharge were recorded.

Results: Over the two years, 408 CYP had access to the service. The majority were of secondary school age (182 (44.6%)). 142(34.8%) were discharged during the two years. At baseline, 58(15.7%) had obstructive sleep apnoea, with 20 (5.4%) needing ventilatory support, 74(20%), had suspected obstructive sleep apnoea, 3 were pre-school age. 8 (2.2%) patients had type 2 diabetes mellitus and 57(15.4%) had metabolic dysfunction-associated steatotic liver disease (MASLD). The frequency of complications increased with age. 85(22.97%) patients at baseline, were either currently or previously receiving support from Social Care. 5(1.4%) patients had diagnosed depression and 9(2.4%) anxiety, with a further 24(6.5%) having suspected/ self-reported anxiety. School attendance data was available for 142 patients; 7(4.9%) were not in any education or employment. Of those discharged; 17(12.2%) had achieved clinically significant weight loss,11 (7.9%) completed 2 years in the service without a clinically significant BMI reduction,33(23.7%) did not engage and 38(26.7%) never attended a first appointment.

Discussion: The CEW service sees CYP with considerable medical and social complexity. Engagement with the service is not optimal. Consideration should be given to how the service is portrayed to CYP and their families at referral and how better engagement can be encouraged and supported to improve outcomes.