The Nepean Blue Mountains Family Obesity Service (NFOS) was set up in 2016 to deliver multidisciplinary healthcare to those with obesity across the lifespan. This file audit was carried out to identify the demographics, clinical characteristics and basic health outcomes of adult patients referred to the NFOS in the first six months of operation. Of the 83 patients referred to NFOS, 71 were included in the audit (8 patients did not attend any appointments, 2 attended the initial group session only, 1 was outside our local health district and 1 was excluded due to missing data). At the time of audit, 20 out of 71 patients were lost to follow up (28%).
There were 53 female and 18 male patients that attended, with an average age of 50.5 years (range 18-73). Referrals originated from GPs (n=65), endocrinologists (n=4) and cardiologists (n=2). Ethnicity included Caucasian (n=64), Aboriginal (n=3), Indian (n=2), Fijian-Indian (n=1) and Peruvian (n=1). The average weight of the patients was 143.1kg (range 95.4-288.8), average height was 1.678m (range 1.511-1.912), average BMI was 50.7kg/m2 (range 34.7-97.6) and average waist circumference was 145.3cm (range 116-276). Some of the most common co-morbidities in these patients were diabetes mellitus, hypertension, hyperlipidaemia, sleep disordered breathing and chronic pain.
All patients received multidisciplinary care with dietitian, physiotherapist, clinical psychologist, nursing and medical appointments. VLED was initiated in 16 patients. Any form of weight-modulating pharmacotherapy was initiated in 35 patients, including 23 on metformin, 18 on GLP-1 analogues, 1 on phentermine and 1 on topiramate, and 11 patients were identified as surgical candidates.
The adult arm of our service has seen patients with a wide spectrum of obesity, medical co-morbidity and treatment suitability. An ongoing challenge includes balancing weight loss interventions with management of complex medical co-morbidities and a high rate of patient attrition from clinic.