Specialist NHS weight loss clinics help children experiencing severe obesity to lead healthier lives

Current findings from a comprehensive evaluation of Complications of Excess Weight (CEW) services – undertaken by Leeds Beckett University, Sheffield Hallam University, University of Leeds, University of Bristol and University of Sheffield – are presented this week at the European Congress on Obesity (EASO).

It found that the thousands of children and young people who receive multi-disciplinary support through CEW clinics maintain more weight loss over time, in comparison to patients who can only access support through separate community and general practice services.

The clinics were also successful in reaching children and young people attending CEW services from seldom-heard groups, such as those from more socioeconomically disadvantaged areas.

CEW clinics bring together specialist NHS doctors, nurses, psychologists, social workers, family support workers and dietitians to provide the tailored treatment needed by children and young people struggling from complications related to excess weight. This can include support with diet and lifestyle changes and to improve their mental health, access to specialist medication and addressing health complications related to obesity.

Professor Louisa Ells, co-lead for ENHANCE from the School of Health at Leeds Beckett University, said: “Our study provides important data to show that CEW services are improving the health of children and young people living with severe obesity and related health conditions.

“CEW services are providing compassionate, joined up, patient-centred specialist care that is tailored to the needs of children, young people and their families. This holistic, non-stigmatising approach is key to supporting all patients, including those who are underrepresented in other obesity services, which is critical to addressing the health inequalities associated with obesity.”

Dr Cath Homer, Associate Professor in Obesity and Public Health at Sheffield Hallam University and co-lead of the ENHANCE study, said: “Severe childhood obesity remains a major public health challenge in England, affecting approximately 15% of children aged between 2 and 15. Living with severe obesity during childhood and adolescence carries the risk that it will persist into adulthood, which would lead to an increased risk of many other serious health issues, including early onset cardiometabolic, respiratory, neurological and psychosocial problems, reducing people’s quality of life and life expectancy.

“The increasing prevalence of severe obesity and its complications amongst children and young people is fuelling rising demand for specialist support and treatment that goes beyond traditional community-based weight management services, and our research suggests that CEW services are an effective way to support patients for better health and weight management.”

Ibbie, a CEW service user, said: “The CEW clinic not only changed my life, but also completely changed the way I see myself and my future. When I first came to the clinic, I was in a very negative place and terrified of being judged for my weight and appearance. Instead, I was met with kindness, understanding and support.

“The team took every aspect of my wellbeing into account, including my mental health and supported me every step of the way. Thanks to their support, guidance and care, I have now lost seven stone. I truly couldn't have achieved this without them, and I will always be grateful for everything they have done for me!”

Since being piloted by the NHS in selected areas since 2021, over 6,000 children and young people in England have received treatment through CEW clinics. The research team says the evidence supports the clinical need for national access to this kind of multidisciplinary service as the most effective way to help children and young people develop the behaviours that will help them lose weight and reduce the likelihood that they will go on to develop complications from excess weight in the future.

Professor Julian Hamilton-Shield, from the University of Bristol, said: “When the new CEW clinics were first announced, some questioned whether they might increase health inequalities. Our evidence is quite the reverse, demonstrating remarkable reach within those underserved communities typically less inclined to access NHS services, such as ethnic minorities, those with the most material deprivation and the neurodiverse.”

Professor Simon Kenny, NHS England’s National Clinical Director for Children and Young People, said: “This research demonstrates the positive impact NHS CEW clinics are having for children and young people with severe obesity, while also highlighting the challenges these individuals face. The NHS is committed to providing early support to help limit excess weight gain and prevent associated long-term health complications for people affected by obesity.”

The ENHANCE evaluation is part of NIHR-funded project looking at best practice in CEW clinics, through speaking to those accessing and delivering the service, to outline ways they can be improved for patients and their families.

It is evaluating outcomes of patients attending the clinics, patient demographics, treatment and support offered, patient experiences and cost-effectiveness. Current findings from the project include:

• Patients at CEW clinics are supported to maintain more weight loss over time, when compared to patients who can only access support through separate primary care services.

• CEW services are reaching children who are typically underserved by existing weight management services. Over half of patients attending clinics had highly complex medical complications and neurodevelopmental needs, many of which benefitted from early weight loss intervention. The clinics also work with more children and young people from minority ethnic groups and more deprived socioeconomic areas, suggesting that they can provide support for patients from more seldom-heard groups.

• Research suggests that the use of specialist weight loss medication, known as GLP1s, are effective for significant weight loss in adolescents when offered as part of a specialist multidisciplinary treatment plan offered by CEW services.

• CEW services show the need for patient support from multi-disciplinary teams, with ongoing and tailored patient-centred care being instrumental for children, young people and their families.