Endocrine Abstracts

Introduction: Childhood and adolescent obesity are a rising global problem. Overnutrition leading to obesity may contribute to concerns regarding potential neglect prompting a social care (SC) referral. Approximately 18% of the 549 children and young people (CYP) managed by our weight management (WM) service have some form of SC involvement. We undertook an audit to determine whether SC involvement had a positive effect in CYP severely overweight under our service.

Methods: We identified 15 children in whom neglect was a concern and where their weight was a major, but typically not the only, contributory factor. Data were collected on weight and BMI at start of SC involvement, then at 6 and 12 months. Growth Analyser was used to calculate BMI SDS.

Results: The mean age when first referred to WM was 8.4yrs (60% female). Three CYP had ongoing SC input. The mean age of SC involvement when under the WM service was 10.1yrs (n = 15) with a median BMI SDS of 4.2 (range 3.5-5.4), and a median BMI of 39.5 (Range 29.3 – 54.9) kg/m². After 6 months (n = 14), median BMI SDS was 3.9 (3.7-5.1), median BMI was 40.8 (28.5-57.5) kg/m². 43% demonstrated a decrease in BMI, with a mean decrease in BMI for this cohort of -2.6 kg/m². At 1 year (n = 15) median BMI SDS was 3.9 (3.3-5.2) and median BMI was 37 (27.2-55) kg/m². 40% demonstrated a decrease in BMI from the point of SC involvement with a mean decrease in BMI for this cohort of- 4.5 kg/m². Table 1 below demonstrates mean values. Whilst receiving SC support (n = 15), 20% of our CYP were on Metformin, 20% on Orlistat and 13% on Semaglutide.

Discussion: Our data suggest that a year is needed to fully realise the benefit of SC involvement on BMI. Not all individuals lost weight. It was difficult to determine whether the magnitude of weight loss (BMI SDS -0.3) differed from our wider clinic population.