Abstract Introduction/Background
Severe, complex child obesity is increasing in England. In 2017, Camden and Islington Public Health, CCGs, UCL Hospital (UCLH) and the Brandon Centre developed an Enhanced Healthy Living Service (EHLS) to support families with complex obesity, alongside multi-disciplinary (MDT) case management for a stronger pathway.This aimed to examine the complexities of child weight, and (mental) health, and improve specialist obesity provision.MethodLed by the UCLH Consultant obesity lead, the MDT included obesity prevention, treatment, Social Services and primary care. It triaged families to specialist school nurses, the EHLS or UCLH by need and complexity.The psychologist-led EHLS used person-centred, systemic and behavioural approaches. Interventions included 1:1 therapy, consultation and case management (e.g. with child protection).
Results
Over 9 months, the MDT reviewed 66 cases and 55 families were referred to the EHLS. Engagement was high at 69%.The children were highly complex. 58% had significant mental and 39% physical health needs, 21% were on child protection, and 24% had experienced abuse/neglect. Domestic violence, parental mental health and learning difficulties were common.Up to 24 sessions were held per family, alongside 791 total case management actions. Outcomes were highly individual, including improved lifestyle, school attendance, exams, family communications, mental health and professional integration.
Conclusion
Viewing obesity as a medical-psychosocial issue unleashed new approaches and identified missed opportunities for support. Every EHLS case required bespoke support. Manualised interventions may not be effective for this population.　　 External funding details