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Complications of excess weight seen in two tier 3 paediatric weight management services: an observational study
  1. Katherine Hawton1,2,
  2. Louise Apperley3,
  3. Jennifer Parkinson3,
  4. Meghan Owens3,
  5. Claire Semple1,
  6. Lauren Canvin1,
  7. Alanna Holt1,
  8. Shelley Easter1,
  9. Kate Clark3,
  10. Kim Lund3,
  11. Ellie Clarke3,
  12. James O’Brien3,
  13. Dinesh Giri1,2,
  14. Senthil Senniappan3,
  15. Julian P H Shield2,4
  1. 1Bristol Royal Hospital for Children, University Hospitals Bristol and Weston NHS Foundations Trust, Bristol, UK
  2. 2University of Bristol, Bristol, UK
  3. 3Alder Hey Children’s Hospital, Liverpool, UK
  4. 4NIHR Bristol Biomedical Research Unit in Nutrition, University of Bristol, Bristol, UK
  1. Correspondence to Dr Katherine Hawton; katherine.hawton{at}bristol.ac.uk

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.

  • Obesity
  • Endocrinology
  • Growth

Data availability statement

Data are available on reasonable request. The datasets used and/or analysed during the current study are available from the corresponding author on reasonable request.

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Data availability statement

Data are available on reasonable request. The datasets used and/or analysed during the current study are available from the corresponding author on reasonable request.

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Footnotes

  • KH and LA are joint first authors.

  • Contributors All authors contributed to patient care and patient data collection. KH and LA analysed the patient data and drafted the initial manuscript. All authors read and approved the final manuscript. JPHS is the guarantor of this work.

  • Funding Research undertaken by JPHS is supported by the NIHR Biomedical Research Centre at University Hospitals Bristol and Weston NHS Foundation Trust and the University of Bristol. The views expressed by those authors and not necessarily those of the NIHR or the Department of Health and Social Care. The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.