Inpatient stay to improve and sustain weight outcomes as part of holistic weight management strategy in Tier 3 children

Jodi Wood; James Law; Rachel Williams; Emma Woodward-Smith; Joanna Dove; Hannah Bone; Lauren Snow; Jade Henriques; Leandra Geyser; Pooja Sachdev

doi:10.1530/endoabs.111.P141

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Endocrine Abstracts (2025) 111 P141 | DOI: 10.1530/endoabs.111.P141

BSPED2025 Poster Presentations Obesity 2 (7 abstracts)

Inpatient stay to improve and sustain weight outcomes as part of holistic weight management strategy in Tier 3 children’s obesity service

Jodi Wood ¹ , James Law ¹ , Rachel Williams ¹ , Emma Woodward-Smith ¹ , Joanna Dove ¹ , Hannah Bone ¹ , Lauren Snow ¹ , Jade Henriques ¹ , Leandra Geyser ¹ & Pooja Sachdev ^1,2

Author affiliations

¹Nottingham University Hospitals NHS Trust, Nottingham, United Kingdom; ²University of Nottingham, Nottingham, United Kingdom

Introduction: The Complications of Excess Weight (CEW) service is an NHS-England pilot for children and young persons (CYP) living with severe childhood obesity, aiming to reduce associated complications. Thirty centres in England deliver care using a multidisciplinary team (MDT) approach Alongside the usual MDT input, an inpatient admission is offered to those with difficulty achieving weight stabilisation. This provides an intense period of management for the patient and family, can demonstrate change is feasible and informs safeguarding. The families receive healthy eating advice, exercise information, and are shown examples of age-appropriate meals and portion sizes. Special consideration is given to family circumstances and additional needs of the child/family. Patients are admitted for 10-12 days opposite the nursing station in a designated ward. An individualised package supports the inpatient stay. The parent and CYP sign a contract that checks understanding of the process and outlines expectations.

Methods: Data were collected for all patients who had had an inpatient stay between 1st May 2024 and 30th June 2025 from their electronic patient record, including age, gender, duration of stay, weight/BMI change during admission and weight change following admission with median (range) calculated.

Results: Six children, median age 10.7 (range 6.0- 12.2) years, completed an inpatient stay. Median length of stay was 11 (9-12) days during which time there was 2.3 kg (1.3-2.8) weight loss (2.6% (1- 4.3)). Patients continued to lose further weight, data available, for up to 3 months after admission (0.35 -3 kg). Two patients then gaining weight compared to discharge between 4-6 months, two below discharge weight and two data not yet available.

Conclusion: All patients lost weight during their admission allowing families to see this was possible. Difficulties were identified around availability of healthy choices on hospital menus, poor documentation of diet, prioritizing elective admissions, parental agreement for admission and MDT capacity to provide intense input. Weight loss during the admission is not sustained in the long-term demonstrating the difficulty in enabling persistent behaviour change.