Endocrine Abstracts

It is important for a specialist weight management service to provide a holistic patient-oriented assessment and treatment plan. To achieve this goal, we performed a service evaluation of the characteristics of patients with extreme and complex obesity attending a specialist weight management service. Anonymised data on 126 patients who attended the Heart of England NHS Foundation Trust specialist weight management service were collected. The patients, with mean age 45.2±11.5 years and mean BMI 48.6±7.8 kg/m², were predominantly Caucasian (70.8%) and female (65.0%). Waist and neck circumference were 135.9±19.3 and 46.7±11.7 cm, respectively. The mean sleep duration was 6.3±1.9 h during weekdays and 6.5±2.0 h during the weekend, suggesting sleep deprivation. Hypertension (40.8%), diabetes mellitus (31.7%), dyslipidaemia (37.8%), and obstructive sleep apnoea (16.0%) were common co-morbidities in our patients. A high proportion of patients were on welfare benefits (55%) and the highest education level achieved was high school level (56.6%). Comfort (53.2%) and boredom (52.4%) eating were quite prevalent while depression (49.2%) and previous bullying (19.5%) were common psychological issues. Approximately a third (29.7%) was taking psychiatric medications. Skipping at least one meal per day (65%), particularly breakfast (63.8%) was common while 70.2% reported eating takeaway meals and 50.4% consuming carbonated drinks regularly. Just over-half reported engaging in some regular physical activity (58.4%), but commonly reported barriers included arthritis (20.7%), back pain (15.7%), and breathlessness (12.4%). The median time spent watching television was 3 h while 1 h was spent on computer use daily. The majority of the patients already had at least one weight loss attempt (71.4%) prior to attending the specialist service. In conclusion, these findings showed that management of extreme obese is complex involving multiple co-morbidities, and psychological and social challenges. Apart from treating cardiovascular risk factors; eating behaviour, psychological issues and barriers on physical state should be supported and addressed.