ESPE Abstracts

Background: Childhood obesity remains a significant public health concern, with weight management programmes to date only showing limited success. This project aims to evaluate initial first year outcomes for our Complications of Excess Weight (CEW) Service based at our tertiary paediatric centre. Children and young people with significant obesity in our region and referred to the service, receive tier 3 weight management support, including intensive lifestyle and psychosocial assistance both through clinics and in the community, including support delivered at home. Patients accepted into the CEW service are less than 16 years at referral with a Body Mass Index Standard Deviation Score (BMI SDS) >3.3 or BMI >98^th centile with 2 obesity associated complications.

Methodology: Using routinely collated data, demographic details were recorded and mean and median BMI SDS were measured at baseline (programme entry), and after 6 months and 12 months intervention for all participants. Changes in BMI SDS were compared. A fall of 0.25 BMI SDS was considered clinically significant.

Results: A total of 277 patients had accessed CEW services up until the end of August 2023. The majority were of white ethnicity (44%), from the most deprived decile (43%) and were secondary school aged (45%). Twelve-month follow-up data was available for 54 patients (19.5%). Mean and median BMI SDS outcomes were compared between baseline and 12 months. Mean BMI SDS fell by 0.20 over 12 months across the whole cohort. Females achieved better results than males, with a 0.21 mean decrease in BMI SDS, while males had a 0.18 mean BMI SDS decrease. When broken down by age, pre-school aged children lost a mean BMI SDS of 1.26, while primary school aged children lost a mean BMI SDS of 0.40, demonstrating clinically significant BMI SDS loss. Secondary school aged children did not demonstrate clinically significant results. Those who were prescribed medications Liraglutide or Semaglutide (n = 7), showed considereably greater BMI SDS reduction than those not prescribed medication (mean BMI SDS loss of 0.21 with medication compared to mean BMI SDS gain of 0.01 without medication).

Conclusion: These preliminary results for children aged 11 years and younger are encouraging, but there is still a need to consider strategies to improve outcomes, particularly in adolescents and to determine if positive results are sustained.