Complications from excess weight clinic (CEW)

Our CEW clinic was part of a national pilot project funded by NHS-England. There is currently a national evaluation of CEW services and we await their findings and future recommendations.

There is currently no CEW provision for families living in North Central London ICS (London boroughs Camden, Islington, Haringey, Barnet and Enfield). Commissioners are currently considering future options for future CEW services.

There is currently no NHS funding for weight loss medications or bariatric surgery in young people under 18 years and doctors cannot offer these at present. We hope that this will change soon.

Please consider other support for your patient:

1. Community Weight management services in Camden, Islington, Haringey, Barnet and Enfield
2. Early help pathways including youth work, family support workers
3. Social care for disability, child in need or safeguarding concerns
4. Mental health pathways where mental health difficulties are driving eating behaviours and suspected eating disorders
5. Neuro-developmental pathways where suspected autism is driving eating behaviours

Referrals for medical assessment should be based on medical needs:

1. GP for screening of causes and complications where diabetes or thyroid disease are suspected (both are rare)
2. Referral to local DGH general paediatrics:
   1. Early onset severe obesity (zBMI more than three by five years) for genetic testing (R149 gene panel)
   2. Concerns of a genetic condition (early onset obesity, dysmorphic features, growth abnormalities, developmental abnormalities)
   3. Features of underlying endocrine condition such as Cushing disease.