Background: A multidisciplinary team (MDT) intervention may improve severe obesity in children through education and life-style change.
Objective and hypotheses: MDT intervention leads to improvements in clinical measures of obesity.
Method: Participants were selected by criteria: <16 years old; BMI >3.5SDS or BMI >2.5 SDS with obesity-related co-morbidity. Children and their families, attended intervention sessions over 1013 weeks. Height, weight and resting heart rate (RHR) were measured at beginning (T1) and end of the intervention (T2). Participant records were examined for anthropometric measures at referral (T0) and the most recent (T3) date available. Scottish Index of Multiple Deprivation (SIMD) was used to assess socio-economic status of families. BMI SDS was calculated using UK 1990 data.
Results: Of 174 children referred to the service, 32 fulfilled the criteria. F:M ratio was 24:8 and T1 median (range) age was 8.25 (2.015.42) years. 20/31 (64.5%) families came from the most deprived quintile and >80% came from the lower two quintiles, this was similar to those referred to the service but not suitable for the intervention. Median (range; n) BMI SDS was T0-3.67(2.55.3; 32), T1-3.58 (2.144.7; 18), T2-3.51(1.784.84; 18) and T3-3.62(3.34.3; 15). Although BMI SDS was not different at T2 (P=0.7) it had improved or remained stable in 16/18 (89%) while two participants increased BMI SD (0.18, 0.41), maternal BMI also improved in 6/10. The rate of change in BMI SDS improved in patients completing the programme compared to the interval preceding the programme from −0.16 to −0.31 although not significant (P=0.13). Comparing the programme completors to non-completors there was no significant difference in change in BMI SDS from the start of the programme to T3 (P=0.8). However median (range) RHR changed significantly from 115(90148) to 91(72152) over the same period (P=0.01).
Conclusion: Deprived areas seem to be at greatest need of childhood obesity management and MDT interventions have a role. Short term programmes may not reduce BMI SDS, but improvements in RHR suggest improvements in cardiovascular risk.
10 - 12 Sep 2016
European Society for Paediatric Endocrinology