National evaluation of 39 complications of excess weight (CEW) clinics: exploring how innovation in design has been determined by individual and population health inequities

Catherine Homer; Louisa Ells; Nivedita Aswani; James Nobles; Jamie Matu; Adam Martin; Taya Zabula; Paige Davies; Neil Wright; Caroline Steele; Julian Hamilton-Shield

doi:10.1530/endoabs.111.P64

P64

Prev Next

Section Contents Cite

Endocrine Abstracts (2025) 111 P64 | DOI: 10.1530/endoabs.111.P64

BSPED2025 Poster Presentations Obesity 1 (8 abstracts)

National evaluation of 39 complications of excess weight (CEW) clinics: exploring how innovation in design has been determined by individual and population health inequities

Catherine Homer ¹ , Louisa Ells ² , Nivedita Aswani ³ , James Nobles ² , Jamie Matu ² , Adam Martin ⁴ , Taya Zabula ⁴ , Paige Davies ² , Neil Wright ³ , Caroline Steele ⁵ & Julian Hamilton-Shield ⁶

Author affiliations

¹Sheffield Hallam University, Sheffield, United Kingdom; ²Leeds Beckett University, Leeds, United Kingdom; ³Sheffield Children’s Hospital, Sheffield, United Kingdom; ⁴University of Leeds, Leeds, United Kingdom; ⁵Leeds Teaching Hospitals, Leeds, United Kingdom; ⁶University of Bristol, Bristol, United Kingdom

Background: Metabolic complications affecting adults are experienced by many CYP due to increasing prevalence of obesity from an early age. An NHS England pilot has funded specialist multi-disciplinary team (MDT) paediatric weight management services, to deliver holistic person and family centred care to CYP living with severe and complex obesity. Support is tailored to family and socioeconomic context, at individual and local population level. MDT interventions aim to improve BMI and prevent, identify early, treat and reverse associated medical and psychosocial complications. This study analyses physical and mental health outcome measures, and evaluates operational creativity through different service models, MDT composition and relational approach.

Methods: The evaluation will understand: 1) How CEW services vary 2) Experiences of CYP and families attending clinics 3) Which modes and components of support have the greatest impact or value for CYP 4) How clinics tailor care to protected characteristics for inclusion, equity, respect, cultural sensitivity, and to counter discrimination. 5) Whether CEW services are cost effective.

Results: There is rich variety in delivery models and MDT composition including non-clinical roles such as citizens advice and family support. Weight loss medications (GLP-1s) are not commissioned at all clinics. Beyond medical and psychological treatment there is support spanning home, school and community, and to safeguard against risk of harm. Data for over 5000 patients has been analysed. Ethnic minority representation and deprivation are greater than baseline population figures for UK CYP. 24% had autism spectrum disorder. Of patients assessed 30% had liver disease and 21% had sleep apnoea, Emerging data of BMI SDS reduction from first to last appointment supports metabolic improvement of clinical significance.

Conclusions: CEW clinics are serving CYP who are typically underrepresented in health services, tailoring care to meet global needs of CYP living with obesity. Initial data suggests that the most deprived have greater improvements in BMI. Clinics directly support NHS Long Term priorities of prevention, equity, CYP mental health, and use of GLP-1 medicines with wraparound care. A national CEW service specification and quality standards framework to support future commissioning and roll out of specialist CYP obesity services will be developed.