Background: The Weight Management Service (WMS) at the Royal Children’s Hospital is Victoria’s only dedicated paediatric obesity service. In 2019, overwhelming demand for the service prompted change from a medical to Allied Health led model of care and referral criteria were modified to focus on youth with neurodevelopmental or physical disabilities or obesity-related comorbidities. This resulted in increased medical and psychosocial complexity of the population attending this service.
Aims: To describe the medical and psychosocial complexity of patients attending the WMS.
Methods: This was a cross sectional analysis of all patients attending the WMS for an initial or review appointment between 2019 and 2020. Records were reviewed retrospectively to obtain historical data. Outcomes collected included: demographics, referral information, anthropometry and patient medical and psychosocial history which were analysed descriptively.
Results: Data were collected for 413 patients. Of referral sources, 57% were external (70% of these from General Practitioners) and 43% internal. The most common neurodevelopmental disabilities were autism spectrum disorder (17%) and intellectual disabilities (15%), 29% of patients were eligible for the National Disability Insurance Scheme. Genetic abnormalities associated with obesity were present in 9% of patients. The most prevalent obesity-related comorbidities were non-alcoholic fatty liver disease (35%) and obstructive sleep apnoea (OSA, 21%), 26% of those with OSA required home continuous positive airway pressure respiratory support. 34% of patients had depression and/or anxiety. Psychosocial vulnerabilty factors included: single parent households (30%), parental mental health concerns (23%), issues with school engagement (18%), involvement of child protection services (15%), family violence (14%) and housing vulnerability (11%).
Conclusions: Young people with obesity attending the WMS have a range of developmental, metabolic and mental health comorbidities and are at risk of psychosocial vulnerability. These factors require a multidisciplinary approach, with adequate clinical resources, to address the medical and psychosocial complexities of this population.