6219 Obesity, epilepsy and obesogenic medications in young people

Objectives Obesity is a key public health priority. Obesity established in adolescence often continues into adulthood.¹ Young people with epilepsy have risk factors for developing obesity, such as being prescribed an obesogenic medication and limitations on exercise and independence related to their epilepsy diagnosis. The aim of this project was to assess the identification of obesity and the use of obesogenic medications in a sample of young people with epilepsy. Methods As part of a quality improvement project we undertook a retrospective review of the clinic notes of young people accessing an adolescent epilepsy clinic over a 6 month period from December 2022 to May 2023. Data was gathered on prescribed medications that may contribute to obesity as well as the presence of other epilepsy co- morbidities. We also determined the proportion of patients with obesity and whether they received investigation for obesity related co-morbidities and were any interventions to manage obesity offered. Results A consecutive sample of 59 patient records were reviewed. 19 patients were excluded from further analysis as there was insufficient information or uncertain diagnosis of epilepsy. 45% (n=18) of patients were classified as obese, however this was not identified as a co-morbidity on any clinic letters. Of the obese patients 50% (n=9) were prescribed an obesogenic anti-epileptic medication. Further screening investigations performed was limited: 33% (n=6) of patients had a blood pressure measurement, 50% (n=9) a liver function test, 0% (n=0) a lipid profile and 16% (n=3) had a HBA1C test. Only 22% (n=4) of obese patients were offered further intervention in the form of lifestyle advice. Conclusion As per NICE guidance young people with epilepsy should have an individualised medication treatment strategy, developed with the young person, which takes into account a range of factors.² One factor could be obesity. We suggest that patients being commenced on an obesogenic anti-epileptic medication should have the risks discussed and alternative treatment strategies considered if obesity is present. All patients presenting to clinic are at risk of obesity; as part of holistic care this should be actively thought about and if present the associated co- morbidities screened. Management would include lifestyle advice and appropriate referral to community or specialist obesity service providers. This project highlights the need for updated national guidance on epilepsy care as there are no current practice standards in place for the prevention, identification, assessment and management of obesity in epilepsy care for young people. References NICE guideline [PH47] Weight management: lifestyle services for overweight or obese children and young people. Published October 2013 Section 2. NICE guideline [NG217] Epilepsies in children, young people and adults. Published: 27 April 2022 section 4.1.1.