Comprehensive Family-Based Weight Management Intervention for Children with Complex Health Needs: Service Evaluation, Tier 3 Children Weight Management Service
This service evaluation of a family-based weight management intervention for children with complex health needs demonstrated effectiveness in promoting healthy eating behaviours. Parent feedback confirmed the acceptability and feasibility of this Tier 3 programme within this population.
Comprehensive Family-Based Weight Management Intervention for Children with Complex Health Needs: Service Evaluation, Tier 3 Children Weight Management Service
Dr AB Sirin-Ayva, Alaa Adwan, Dr Ranjana Babber, James Roast, Dr Sophie Edwards, Prof Paul Gately
Introduction
Children living with complex health needs (CHN) such as autism spectrum disorder (ASD) are at greater risk of excess weight gain. The contributing factors to obesity this group includes selective eating patterns, disordered sleep, obesogenic medication, as well as social challenges impacting participation in physical activity. The gold-standard intervention for weight loss in children is family based intervention.
Morelife, Medway and Swale online weight management service offers 1:1 support for children with a BMI ≥98th centile. Families are given tailored support and advice in line with evidence based guidance. Sessions are offered weekly for the first 12 weeks, with regular check-ins thereafter. This intervention offers a multidisciplinary approach, with families having access to a specialist nurse, specialist dietitian, registered nutritionist and psychotherapist.
Methods
Feedback and outcomes were gathered through an online questionnaire sent to parents upon joining the program. This questionnaire included validated tools including the Child Eating Behaviour Questionnaire (CEBQ). Weight measurement included weight reported by parents.
Results
Of the total referrals made to our specialist weight management service, 31 participants (39%) had a diagnosis of ASD or ADHD with a mean age of 11 years. The responses to initial questionnaire on child eating behaviour recorded that all of these children ‘never’ or ‘rarely’ enjoyed a variety of food, ‘always’ refused new foods at first, and are ‘always’ or ‘often’ difficult to please at mealtimes. The flexible appointment times and remote phone consultations and individualised support facilitated 100 % retention rate, high engagement with their scheduled appointments.
Feedback from families of children with CHN reported several positive changes, including increased willingness to try new foods, improved quality and variety of foods, and improved energy and concentration levels at school. Weight measurement outcomes suggested some improvements with weight loss ranging from 2.5- 3Kg.
Conclusion
Whilst children living with CHN exhibited common difficulties around food, the service proved effective in cultivating positive changes to promote healthy eating guidelines and established acceptability and feasibility of family based intervention in this group.
Conflict of Interests: None
References:
1. Dhaliwal KK, Orsso CE, Richard C, Haqq AM, Zwaigenbaum L. Risk Factors for Unhealthy Weight Gain and Obesity among Children with Autism Spectrum Disorder. International Journal of Molecular Sciences. 2019 Jul 4;20(13):3285.
2. Matheson BE, Drahota A, Boutelle KN. A Pilot Study Investigating the Feasibility and Acceptability of a Parent-Only Behavioral Weight-Loss Treatment for Children with Autism Spectrum Disorder. Journal of Autism and Developmental Disorders. 2019 Aug 14;49(11):4488–97.