Endocrine Abstracts

In June 2021, NHS England commissioned 15 Complications from Excess Weight (CEW) services to pilot Tier 3 paediatric weight management services in England. This study aimed to assess initial patient experiences / responses to weight management strategies delivered in a single CEW service between January-June 2022.

Methodology: We conducted an online survey to assess patient experiences, motivators and barriers to healthy lifestyle change in 45 patients seen. 38 patients / carers were successfully contacted by phone (maximum 2 contacts) and provided with the online survey-link and a pseudo-anonymised patient identifier. A survey response rate of 66% was received. Additionally, 12 patients who had been seen face-to-face at a 3-month review had auxology from hospital records calculated for mean change in BMI-SDS from first appointment to follow-up.

Results: The survey found 44% (n=18) and 34.8% (n=23) reporting cost as a barrier to eating healthily and engaging in physical activity respectively. Over a quarter (28%, n=18) had autistic spectrum disorder / learning difficulties which contributed to dietary and exercise limitation. Over a third (44%, n=23) reported mobility as a barrier to physical activity. Approximately two thirds (64%, n=25) reported weight-related bullying, nearly half (48%, n=25) felt uncomfortable talking about their weight and 44% (n=25) said their weight had negatively impacted their mental health. 60% identified improvement to mental health as a motivator (n=25) to making lifestyle change. In 12 patients (mean BMI SDS 3.84) seen at 3 month follow up, a mean change in BMI-SDS – 0.12 was achieved (males -0.40SDS, females -0.15SDS, primary school age -0.35SDS, secondary school age +0.10SDS). Although gender and school age differences were noted, these were not statistically significant.

Conclusions: Cost is seen as a significant barrier to healthy lifestyle change and weight management services need to look at cost effective ways of motivating patients to eat healthily and exercise effectively. Autism / learning difficulties and mobility issues also feature as significant barriers to standard management, requiring specific and tailored interventions to achieve successful lifestyle change. Finally, poor mental health is a common finding in this cohort that requires intervention to achieve better holistic outcomes for patients.