The Healthy Weight Service (HWS) at Perth Children’s Hospital delivers tertiary-level outpatient care to children experiencing severe (>150% of 95th percentile BMI) or complex obesity. HWS provides comprehensive, evidence-based support tailored to the needs of each family.
Children <16 years may be referred to HWS with pre-diabetes, significant obesity-related complications, age under 24 months with concerning weight patterns, or complex contributing factors.
Our team includes Endocrinologist, Paediatrician, Nurse, Social Worker, Mental Health Nurse, Dietitian, Physiotherapist, Exercise Physiologist and Clinical Psychologist.
Our family-centred intervention begins with psychosocial telephone screening followed by a comprehensive in-person triage involving all team members. Ongoing care typically includes three-monthly follow-ups over the course of a year.
We offer personalised dietary and activity modification programs, support for neurodiverse children, families facing financial or social barriers, pharmacotherapy when clinically indicated and collaboration with other medical specialties to manage coexisting conditions.
HWS has historically (prior to GLP-1 agonist uptake) achieved a change in BMIz of -0.19 (95% CI -0.26, -0.13, p < 0.001, N = 464). Preschool (aged 2-5), child (aged 6-12) and adolescent (aged 13-16) subgroups comprised 25%, 49% and 26% respectively. Within our cohort 1.3% have known monogenic causes. Dietetic assessments show 100% of families improve their food choices and eating behaviours. Younger age and higher baseline BMIz were independently associated with larger reductions in BMIz. Analysis stratified by age subgroup showed a worse outcome in the child sub-group (coefficient B=0.36, 95% CI 0.16, 0.56, p < 0.001, n=227) during COVID (2020).
A strength is the rapport, trust and sustained engagement established with families. We face significant challenges due to high demand and limited staffing capacity. Despite this, we remain committed to expanding our reach by partnering with GPs and clinicians across Western Australia to deliver shared care for children and adolescents living with severe obesity-related complications.