Objectives Obesity is a major public health concern for children and young people. The prevalence of obesity has increased significantly in recent years and currently affects one in four children living in England.¹ Obesity disproportionately affects children and young people with chronic health conditions, including those with learning disabilities.² However, there is limited UK data on rates of obesity in young people with neurodevelopmental disorders. This audit aimed to identify the prevalence of obesity amongst young people within a special educational needs setting and to compare current practice against national guidance.

Methods Methods included retrospective review of clinic notes for young people attending a special educational needs secondary school between August 2021 and March 2022. Body mass index (BMI) was calculated using the most recent growth measurements and classified by centile using UK-WHO growth charts. In cases where BMI was above the 91st centile for age, data was audited against NICE guidance on the identification, assessment and management of obesity (CG189).

Results 38 adolescents were identified. Mean age at time of audit was 14.6 years (range 12–20 years) with a male predominance (97%, n=37). All patients had a diagnosis of autistic spectrum disorder (ASD) and 52% (n=20) had diagnosed learning disability (LD). Weight and height were documented for the majority of patients (95%; n=36). BMI was not documented in the clinic letter for any of the cohort. 50% patients were overweight (BMI 91st-98th centile; n=2), obese (BMI 98th-99.6th centile; n=4) or severely obese (BMI >99.6th centile; n=13). For the overweight and obese cohort, excess weight was acknowledged in the majority of cases (79%, n=15) and dietary and lifestyle advice provided. Blood pressure was recorded for 58% patients (n=11). No patients completed the blood investigations recommended by NICE. One patient was referred to a dietician.

Conclusions Adolescents with ASD are at increased risk of being overweight and obese compared to the general population, as evidenced by our audit. Whilst recognition of excess weight was well-documented, BMI was not routinely measured and blood investigations were rarely undertaken. We suggest implementing a local guideline to standardise the assessment and management pathway and creating a family information leaflet tailored specifically for young people with neurodevelopmental conditions.

References

1. NHS Digital, National Statistics. National Child Measurement Programme: England, 2020/21 school year. 2021

2. Maiano C, Hue O, Morin AJS, Moullec G. Prevalence of overweight and obesity among children and adolescents with intellectual disabilities: a systematic review and meta-analysis. Obesity Reviews 2016;17(7):599–611.