G123(P) Obesity in children and young people with learning disability – Are we following NICE guidance?

Aims Obesity among children and young people is increasing. There is limited UK data on obesity in children and young people with learning disability (LD). We aimed to determine the prevalence of obesity within a LD population and audit current practice in line with NICE obesity guidance 2006 (CG43). Methods Review of medical records of all pupils attending a local special educational needs (SEN) secondary school (n = 264). Data collected were audited against NICE obesity guidance 2006. Audit standards required that height and weight of children and young people are to be measured at most recent contact and BMI calculated. Where weight and height were available; BMI was calculated from the most recent recorded in the health record and plotted on age and sex specific UK-WHO 1990 growth charts. Where BMI was ≥91 st centile, data were checked for compliance with NICE recommendations (Table 1). Results Mean age at time of audit was 16.3 years (SD ± 2.3). BMI data were obtained for 205 pupils. Forty percent were overweight (BMI 91 st -98 th centile; n = 34) or obese (BMI ≥ 98 st centile; n = 47). The majority of children and young people (86%) had weight measured at the most recent clinical contact but few (8%) had BMI calculated (Figure 1). Results of data audited against NICE guidance 2006 for overweight and obese patients are shown in Table 1. Conclusion Forty percent of children and young people with learning disability were overweight or obese. This is higher than published reports for the general population of a comparable age. BMI was not routinely measured in clinical practice which may have led to poor identification of overweight/obese patients. This may partly explain our findings of poor adherence with NICE guidance. Including BMI measurement as part of routine practice may improve recognition and management of overweight/obesity. As community weight management programmes may not be tailored to the needs of children and young people with learning disability we suggest a multi-component weight management programme for this population could be delivered through SEN schools.