Oral Presentation ESA-SRB-ANZOS 2025 in conjunction with ENSA

Longitudinal anthropometric and metabolic outcomes of a specialist multidisciplinary childhood and adolescent obesity service   (128577)

Jonathon Mallal 1 2 , Jacqui Curran 2 , Rae-Chi Huang 2 3 4
  1. University of Western Australia, Perth, WA, Australia
  2. Perth Children's Hospital, Perth, WA, Australia
  3. The Kids Research Institute, Perth, WA, Australia
  4. Edith Cowan University/Perth Children's Hospital, Joondalup, WA, Australia

Background

Healthy Weight Service (HWS) is WA’s tertiary paediatric multidisciplinary obesity service. Similar approaches have been associated with improved weight status, but understanding of predictors of efficacy is incomplete.

Aims

To determine (1) changes in weight status with intervention; (2) the impact of age, sex, socio-economic disadvantage, baseline weight status and the COVID-19 pandemic; (3) observed changes in secondary outcomes related to obesity and its complications.

Methods

Using service databases, children aged 2-16 ≥ two weight/height measurements between 2016-2022 were included.  Primary outcome was BMIz-score (2022 extended CDC).   Secondary measurements included Body fat percentage, Blood pressure z scores for age, sex and height, HbA1c Fasting glucose, OGTT (glucose, Insulin), C-peptide, lipids, liver and renal function.  Predictors included age, sex, Baseline BMiz-score, socioeconomic status (SEIFA) with confounders (treatment duration).  Statistical analysis: multiple linear regression and multivariate imputation by chained equations. 

Results

At baseline, 90% of patients (n=464) met CDC-defined severe obesity. The preschool (aged 2-5), child (aged 6-12) and adolescent (aged 13-16) subgroups comprised 25%, 49% and 26% respectively.

Change in BMIz of -0.19 (95% CI -0.26, -0.13, p < 0.001, N = 464) was observed. Multiple linear regression showed younger age and higher baseline BMIz were independently associated with larger reductions in BMIz.

Analysis stratified by age subgroup found admission in 2020 was associated with a worse outcome in the child sub-group (coefficient B = 0.36, 95% CI 0.16, 0.56, p < 0.001, n = 227) (Figure)68707fd299a85-Figure.jpg.

Among the secondary outcomes, a significant change was observed in creatinine and ALP.

Conclusions

Significant improvements in weight status as measured by BMIz were observed particularly in younger patients with the most severe obesity. Patients aged 6-12 admitted in 2020 had worse weight status outcomes, suggesting a negative impact of the early COVID-19 pandemic on weight status outcomes in this age group.