Oral Presentation Australian and New Zealand Obesity Society Annual Scientific Conference 2024

Characterising support needs of adolescents with obesity participating in a dietary intervention (#72)

Cathy Kwok 1 , Louise A Baur 1 , Eve T House 2 , Kaitlin Day 3 , Megan Gow 1 , Mary Kate Inkster 4 , Sarah Lang 3 , Natalie B Lister 1 , Hiba Jebeile 1
  1. Children's Hospital Westmead Clinical School, The University of Sydney, Westmead, NSW, Australia
  2. Institute of Endocrinology and Diabetes, The Children's Hospital at Westmead, Westmead, NSW, Australia
  3. Nutrition, Dietetics & Food, Monash University, Melbourne, VIC, Australia
  4. Department of Paediatric Endocrinology and Diabetes, Monash Children's Hospital, Clayton, VIC, Australia

Introduction: Treatment-seeking adolescents with obesity may have dietetic, psychological or medical needs that require further support. This secondary analysis characterises additional support needs of adolescents in the Fast Track trial.

Methods: Fast Track to Health was a 52-week multi-site RCT conducted between 2018 and 2023 in Australia, comparing intermittent energy restricted and continuous energy restricted diets following a very low energy diet in adolescents with obesity and ≥ 1 obesity related complication. The intensive behavioural weight management intervention was delivered by a multidisciplinary team. Alongside routine medical and dietetic reviews, symptoms of depression and eating disorder risk were assessed via questionnaires and monitored during regular dietetic sessions. Additional support was provided by the study dietitian, paediatrician or psychologist if needed or if requested by participants. Deidentified clinical notes for each support visit were independently coded by two reviewers to identify the content of each session.

Results: Of 141 adolescents enrolled in the study, 51 (36.2%) attended at least one additional support session with the study dietitian, paediatrician, and/or psychologist. Number of additional reviews per adolescent ranged from 1 to 13, with most (n=31) having one visit. Most common initial referral reasons were participant requested reviews (n=15), clinician-requested reviews following routine depression and eating disorder screening (n=12) or monitoring in dietetic sessions (n=10). The most common support reason included general psychological review (e.g., to review depression questionnaires) (n=14), general dietetic review (e.g., to discuss meal plans) (n=11), anxiety (n=11), motivation and/or support during COVID-19 lockdowns (n=11) and body dissatisfaction and weight or shape concerns (n=6). Additional support sessions were mean (SD) 46 (25) minutes in duration.

Conclusion: Some adolescents accessed further support, particularly for psychosocial reasons. Understanding additional needs of adolescents with obesity in weight management settings is important in ensuring appropriate care, allocation of resources and provision of referrals.