Complications of excess weight seen in two tier 3 paediatric weight management services: an observational study

Katherine Hawton*, Louise Apperley, Jennifer Parkinson, Meghan Owens, Claire Semple, Lauren Canvin, Alanna Holt, Shelley Easter, Kate Clark, Kim Lund, Ellie Clarke, James O'Brien, Dinesh Giri, Senthil Senniappan, Julian P H Shield

*Corresponding author for this work

Research output: Contribution to journalArticle (Academic Journal)peer-review

Abstract

Background
Children and young people living with severe obesity experience a range of complications of excess weight (CEW); however the prevalence of complications is not well defined. We have evaluated baseline characteristics and CEW of patients from two UK tier 3 paediatric weight management services.

Methods
All new patients aged 2–17 years seen from March 2022 to February 2023 were included. Baseline demographic data was collected, and patients screened for CEW. PedsQL-4.0 questionnaires were used to assess health-related quality of life (HRQL).

Results
185 patients were included, median age 14.3 years (range 3.3–18.0), 50.8% were girls. Of the patients, 73.8% were white British, with a significant excess of patients living in the most deprived decile (41.4%). Median body mass index SD score was +3.55 (IQR 3.11–3.90) and median body fat was 49.3% (IQR 42.3%–55.1%). Autistic spectrum disorder, attention deficit hyperactivity disorder and learning difficulties were vastly over-represented.

Dyslipidaemia was the most common (51.6%) complication, followed by hypertension (28.9%), metabolic dysfunction-associated steatotic liver disease (17.8%), obstructive sleep apnoea (9.0%) and idiopathic intracranial hypertension (4.3%). Mean glycated haemoglobin was 35.0 mmol/mol (IQR 33–38). 8.1% had type 2 diabetes mellitus. Many of these complications were detected through screening in CEW clinics.

Both child-reported (mean 51.9/100) and parented-reported (47.8/100) HRQL scores were low. Mental health problems were common: 26.2% with anxiety and 7.7% with depression.

Conclusions
This study demonstrates the significant and profound mental and organ-specific pathology resulting from severe obesity in childhood, highlighting the clinical necessity for CEW clinics. A rigorous approach to identify complications at an early stage is essential to improve long-term health outcomes.
Original languageEnglish
JournalArchives of Disease in Childhood
Early online date30 Oct 2024
DOIs
Publication statusE-pub ahead of print - 30 Oct 2024

Research Groups and Themes

  • Nutrition and Behaviour

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