Specialist clinics for children and young people living with obesity

Children and Young People living with obesity will receive intensive support in the coming months thanks to a pilot of 15 new specialist clinics set up by the NHS in England.

One thousand children a year, who are aged between two and 18 and experiencing health complications related to severe obesity, will be supported to lose weight through the new services.

Children will also receive specialist treatment and tailored care packages developed with their family, which could include diet plans, mental health treatment and coaching.

Early action can prevent long term health problems such as Type 2 diabetes, heart attacks, strokes and even cancer, which is better for patients and the NHS.

The rollout of the pilot delivers on the NHS Long Term Plan ambition to treat children for severe complications related to their obesity, avoiding the need for more invasive treatment.

Group sessions will be provided with a full clinical team, including support from dietitians, psychologists, specialist nurses, social workers, youth workers and a paediatrician to ensure all health needs of each child are met.

As well as providing expert treatment, the services will identify the factors causing obesity in children, considering their mental and physical health.

Obesity affects one in five children in the UK and can increase the likelihood of a child developing serious health issues such as Type 2 diabetes, liver conditions and early heart disease. Children living with obesity can also develop difficulties such as breathing problems, sleep issues and mental health problems, which can dramatically impact their quality of life.

In England, the number of children living with obesity doubles from the start of primary school to the end of primary school – with latest data showing that one fifth of children aged 10-11 are obese in England.

Amanda Pritchard, chief executive of the NHS in England said: “The pandemic has shone a harsh light on obesity – with many vulnerable young people struggling with weight gain during the pandemic.

“Left unchecked, obesity can have other very serious consequences, ranging from diabetes to cancer.

“This early intervention scheme aims to prevent children and young people enduring a lifetime of ill-health.

“The NHS Long Term Plan committed to take more action to help children and young people with their physical and mental health and these new services are a landmark moment in efforts to help them lead longer, healthier and happier lives”.

Lusanda, aged 17 from Dagenham, was severely obese, taking medication for high blood-sugar levels and struggling with liver problems. In 2019, he was referred to the Surgical Weight Management service for Young People at King’s College Hospital in order to address the health complications he was experiencing – but with support from dieticians, his family was able to support him to lose 40 kg (six stone) without surgery.

Lusanda’s mother, Hettie Sizibo, said: “Lusanda has autism and some learning difficulties, which means he doesn’t understand when he is hungry or full and he puts on weight very easily. He also does not like trying new foods so it had always been a struggle to give him healthy meals. The support we had from the dietician helped us keep a food routine and control his calories. His brothers and sisters helped too – they didn’t eat in front of him, which stopped arguments about snacks – and I was able to advise his school to stick to a strict eating plan so that he wasn’t getting more food than necessary.

“The difference has been incredible. As well as the weight loss, his liver has improved and his blood sugar levels are also better so he doesn’t have to take medication for this anymore.

“The lockdown has been really difficult for us, and his weight has crept up slightly, but we will be starting the process again so that he can lose more weight and be even healthier. The support I received was so helpful and it’s even helped me start my own weight loss journey. This experience has really helped the whole family”.

The 15 new services are based on an existing service in Bristol Royal Hospital for Children, which has been supporting children in the area since 2018. The Care of Childhood Obesity (CoCO) clinic has treated thousands of children from across the South West since its launch and delivers a multi-system approach to treatment that combines nutritional advice, psychological and social support with new medical interventions.

Professor Julian Hamilton-Shield, Professor of Diabetes and Metabolic Endocrinology at Bristol Royal Hospital for Children, which is part of University Hospitals Bristol and Weston NHS Foundation Trust, said: “Many children and young people with excess weight experience significant complications that can make them very unwell.

“Using a team of experts from many disciplines, including specialist dieticians, social support workers, and mental health professionals, we can pinpoint the exact causes of weight gain and create tailored treatment plans for each child to help accelerate weight loss and address the complications caused”.

Available evidence shows younger generations are becoming obese at earlier ages and staying obese for longer, putting themselves at greater risk for 13 different types of cancer, heart attacks, strokes and Type 2 diabetes. Children living in the most deprived areas are more than twice as likely to be obese than those living in the least deprived areas.

Obesity and its complications cost the NHS around £6 billion a year.

Background

The pilot scheme is based on an existing service in Bristol Royal Hospital for Children – the Care of Childhood Obesity (CoCO) clinic, which has treated thousands of children from across the South West

The 15 new centres will be based across the country in the following locations:

  1. Derriford Hospital
  2. University Hospitals Southampton is hosting a network across the South East
  3. Kent and Medway CCG there is an outreach clinic
  4. East London (Kings College London Hospital and Bart’s Health NHS Trust)
  5. West London Covered by Great Ormond Street Hospital, University College Hospital London and the Tavistock and Portman NHS Foundation Trust
  6. Addenbrooke’s Hospital
  7. Norfolk and Norwich University Hospitals
  8. Birmingham Women and Children’s
  9. Nottingham Children’s Hospital/Leicester Royal Infirmary
  10. Sheffield Children’s Hospital
  11. Alder Hey Children’s Hospital
  12. Royal Manchester Hospital
  13. Royal Preston
  14. Leeds Teaching Hospital
  15. South Tees Hospita

2.5 million children in England are affected by excess weight or obesity, with 1.22 million significantly obese and eligible for treatment according to NICE guidance.

Obesity prevalence (including severe obesity) was more than twice as high in year 6 (21.0% which equates to 103,362 children) compared to reception (9.9%, 39,404 children). This is taken from the NHS Digital: National Child Measurement programme published in October 2020.