Endocrine Abstracts

Objectives: The Tier 3 Weight Management (WM) service is a comprehensive pathway for people with a Body Mass Index (BMI) >40 or >35 with complications. This study aimed to describe the clinical characteristics and outcomes in patients referred to the WM service in Birmingham and Solihull (BSol).

Methods: This was a retrospective health service evaluation of adults consecutively referred to the BSol WM service from March 2017 to April 2018. Data was extracted from electronic health records of patients at baseline and at 12 months. Data was analysed using PrismV6 and presented as mean (SD) or median (IQR) depending on data distribution.

Results: 421 referrals (71.7% female; mean age 42 years (12.72) were received. Referral weight was 128.55 kg (131-146.825); BMI 45.6 (41.75-51.1). Common co-morbidities identified were: mental health diagnosis 67.6%, hypertension 32%, obstructive sleep apnoea 32%, type 2 diabetes 29.3%, hyperlipidaemia 14.7% and hypothyroidism 9.74%. 14% females had polycystic ovary syndrome. 61.3% were taking antidepressants 320 patients attended the 1st appointment and 110 completed 12-months follow up implying a 65.6% dropout rate. 61 patients lost weight from baseline, 4 patients remained at the same weight while 45 patients gained weight. The median % weight loss was -4.08 (-6.43 to -2.32). 37.7% of patients lost >5% body weight and 13.1% lost >10% of body weight. 72 patients were referred for bariatric surgery after 12 months regardless of weight loss.

Conclusions: Most patients achieved significant weight loss but a notable proportion did not lose weight or had weight gain. The high drop-out is typical of WM services in the UK. 65% of patients who completed the service were referred for surgery. The remainder either achieved their weight loss goals, were not interested or had contraindications for bariatric surgery. The high proportion of mental health disorders and comorbidities in this group is important in designing future services.