Endocrine Abstracts

The Complications of Excess Weight (CEW) service is a Tier 3 NHS England programme providing specialised care for children and adolescents with obesity. Understanding weight trajectories prior to first appointments is essential for contextualising patient progress within CEW. This retrospective study analysed 176 children and young people referred to the Nottingham CEW service between January 2021 and April 2024, focusing on growth patterns before specialist intervention. Patient demographics, obesity-related comorbidities, and weight velocity from referral to first appointment were evaluated alongside socioeconomic deprivation indices. The cohort had a median age of 13.3 years, with 55% male and 48% from the most deprived quintile. At referral, 22% presented with one or more obesity-related complications, predominantly concentrated within the lower deprivation deciles (82% IMD 1–4). Weight velocity between referral and first appointment was categorised as weight gain (>1 kg/year), weight loss (<-1 kg/year), or weight maintenance (-1 to +1 kg/year). Seventy-nine percent gained weight with a median of 10.69 kg/year (IQR 8.32 kg/year), 16% lost weight with a median of -8.25 kg/year (IQR 23.24 kg/year), and 5% maintained stable weight with a median of 0.02 kg/year (IQR 0.74 kg/year). Females comprised 64% of the weight-loss group, contrasting with a male majority in the overall cohort. Chi-square analysis found no significant association between sex and weight loss when including those who maintained weight (P = 0.076), but a significant association was observed when comparing only those that gained or lost weight (P = 0.023), with males more likely to gain weight. Furthermore, patients aged 15–18 were significantly more likely to lose weight than age groups 0-5, 6-11 and 12-14 (P = 0.014). No significant relationship was found between deprivation status and weight change. Further analysis of the subset who lost weight between referral and first appointment showed considerable variability in their weight gain in the year prior to referral, ranging from -0.16 to 32.89 kg/year (median 4.69 kg/year). This suggests referral may serve as a critical intervention point in altering weight trajectories in a sub-set of patients, particularly older females.