Endocrine Abstracts

Introduction: Psychological and socioeconomic risk factors such as neurodiversity, learning needs and deprivation are associated with increased risk of childhood obesity. Increased socioeconomic deprivation is linked with higher psychological adversity. Improved understanding of the interaction between psychosocial risk factors and childhood obesity could change intervention approach; preventing poor adult health, deterioration of quality of life and reduced life expectancy.

Objective: Describe psychosocial characteristics of CYP with severe obesity.

Methods: Data reviewed from CYP seen in Portsmouth (PHU) and Southampton (UHS) CEW (Complications of Excess Weight) clinics between 2022-2024. Data included: deprivation score, WNB rate, neurodiversity, EHCP status, education attendance and children’s services involvement.

Results: 118 patients reviewed (51 PHU, 67 UHS). 55% (18/51) PHU and 33% (22/67) UHS patients had deprivation deciles in top 20% deprived UK neighbourhoods. WNB rates to hospital appointment across two years was high; in 17/51 33% PHU and 33/67 (49%) UHS WNB rate was more than 10%. Neurodiversity status (diagnosis/awaiting assessment of ASD/ADHD) indicated rates of 53% (27/51) PHU, 45% (30/67) UHS patients. 22% (11/51) PHU patients had ASD diagnosis, 42% (28/67) UHS patients. UK average 1% (NICE, 2020). UK average rates of EHCPs are 4.3% (Gov.uk, 2024). 25% (13/51) PHU patients had EHCPs, 16% (11/67) UHS patients. 13% (9/67) UHS patients were NEET, 6% (3/51) PHU patients. UHS school attendance data was unavailable. PHU indicated 38% CYP have attendance less than 80% compared to national average of 93% (Gov.uk, 2024). Highest previous known level of Children’s services support showed 24% (12/51) PHU patients and 13% (9/67) UHS patients had Child in Need plans; England average 3.4%. 18% PHU (9/51) patients and 7% (5/67) UHS patients had Child Protection Plans; England average is 0.4% (Gov.uk, 2024).

Conclusion: CYP in our CEW clinics have notably high rates of neurodiversity, EHCPs, NEET and lower school attendance compared to UK averages. Children’s services involvement is significantly higher in CEW patients. We hypothesise that multi-agency, cross-services joint working is essential to meet the complex needs of CYP with severe obesity. Further work is needed to explore the interaction of psychosocial and educational challenges of CYP with severe obesity to guide interventions.