6498 Review of the characteristics of children and young people at level 3 weight management medical clinic and reflecting on service model and investment areas

Objectives To review the characteristics of children and young people assessed at medical clinic of level 3 weight management service To reflect on the service model evolution and investment area Methods Data (demography, BMI Z score, Welsh index of Multiple Deprivation (WIMD) quartile ranks, incidence of behaviour disorders, co-morbidities and complications) for children and young people (CYP) under the age of 18 years assessed at level 3 weight management medical clinic over 6-month period were collected retrospectively from the service database and electronic patient records. Results Total of 47 CYP were seen during the period after level 3 weight management service was launched. The numbers seen were affected by the initial administration developments and family attendance rate. 60% of the CYP were female with median age of 12.42 years at the time of review. The median BMI Z score was +3.594. WIMD 2019 quartile rank was checked according to family postcode and identified that 44% of the families were from areas ranked 1 (most deprived), 30% from 2 (second most deprived), 9% from 3 (second least deprived) and 17% from 4 (least deprived). 19% of children were found to have formal diagnosis of behaviour disorders out of which most were diagnosed with autistic spectrum disorder. 17% of children were on the diagnosis pathway for behaviour disorders and 6% had behaviour concerns reported by the family. Co-morbidities existed in 57% of children out of which majority were identified as having learning difficulty. 40% of children were found to have complications of obesity and the most common complication was non-alcoholic fatty liver disease (NAFLD) at 12.5% followed by obstructive sleep apnoea (OSA) 8.3%, hypertension 4.2%, idiopathic intracranial hypertension (IIH) 2.1% and polycystic ovary syndrome (PCOS) 2.1%. 12.5% of CYP were still awaiting blood tests at the time of review. Conclusion Nearly half of CYP had behaviour disorders or concern around this and similar percentage of children grew up in the most deprived areas and already had one or more complications. This is alarming given the median age. With rising number of childhood obesity, the impact this would have on NHS in near future will be immense. Authors believe children weight management services should be one of the most prioritised areas of integrating 'health' and 'social' care and economical investment on this integration will have great positive financial returns as well as better population health.