Poster Presentation ANZOS-ASLM-ICCR 2019

Impact and effectiveness of interventions for children with obesity: comparison of service models (#179)

Renee Neal 1 , Jennifer Cohen 1 2 , Shirley Alexander 1 , Elizabeth Calleja 1 , Megan Gow 1 , Caitlin McMaster 1 , Kyra A Sim 3 , Kathryn Williams 3 4 5 , Louise A Baur 1 4 6
  1. Weight Management Services, The Children’s Hospital at Westmead, Westmead
  2. School of Women’s & Children’s Health, UNSW Sydney, Kensington
  3. Charles Perkins Centre, The University of Sydney, Sydney
  4. Nepean Family Metabolic Health Service, Nepean Blue Mountains Local Health District, Kingswood
  5. Sydney Medical School, University of Sydney, Sydney
  6. Kids Cancer Centre, Sydney Children’s Hospital, Sydney

Introduction: There is currently no standard model for paediatric weight management services (PWMS) in Australia. We aimed to compare clinical effectiveness of PWMS in New South Wales (NSW), with and without multidisciplinary care, by assessing their impact on weight over time.

Methods: We conducted an audit of routinely collected clinical data from five PWMS in NSW. At baseline, three and six months; anthropometry was measured, and a questionnaire, assessing demographic data and weight related behaviours, was administered to parents of children/adolescents attending the services. Primary outcome was change in body mass index (BMI) expressed as a percentage of the 95th percentile (BMI% 95th percentile). Descriptive analysis was used to assess change in all weight measures.

Results: All PWMS used group and individual appointments. From all five PWMS, 267 patients (155 boys, mean age 9.7years) were assessed at baseline with a median BMI Z-score of 2.5 (IQR: 0.63) and a median BMI% 95th percentile of 135.8 (IQR: 36.9). At three and six months, 106 and 50 participants had clinical measures recorded. At three months, those attending multidisciplinary PWMS (n-=95), had an average reduction in BMI% 95th percentile of 5.7. Patients attending single discipline PWMS (n=11), had an average increase in BMI% 95th percentile at three months of 1.0. At six months, patients attending a multidisciplinary PWMS (n=50) had an average reduction of BMI%95th percentile of 10.1 from baseline. No clinical measures were recorded for patients attending a single discipline PWMS at six months.

Conclusion: Multidisciplinary services may be more effective than single discipline models in positively effecting weight status of children and adolescents attending PWMS.