Semaglutide treatment for children with obesity: an observational study.

OBJECTIVE: To assess efficacy and tolerability of semaglutide as a weight loss treatment for children living with comorbid obesity. DESIGN: Retrospective observational study of the first 50 children from a weight management service treated with semaglutide for at least 6 months. SETTING: A tertiary paediatric multidisciplinary weight management clinic in a UK hospital. PATIENTS: Aged 10-18 years old with a body mass index (BMI) SD score (SDS) >2 with a weight-related comorbidity (including insulin resistance (defined as homeostatic model assessment for insulin resistance >4), type 2 diabetes, metabolic-associated fatty liver disease, obstructive sleep apnoea or hypertension). INTERVENTIONS: Once-weekly injectable semaglutide titrated over 8 weeks to a final dose of 1 mg in addition to dietary and lifestyle advice. MAIN OUTCOME MEASURES: Primary outcome measures were change in weight, BMI SDS and percentage body weight. Secondary outcomes were side effects and cessation of treatment. RESULTS: After 6 months of treatment, statistically significant decreases in BMI SDS (0.32±0.27, p<0.001) and body weight (7.03±7.50 kg, p<0.001) were seen. Mean percentage total weight loss was 6.4±6.3% (p<0.001). For the 14 patients for whom 12-month data were available, statistically significant decreases were seen in mean BMI SDS (0.54±0.52, p<0.001). Mean body weight decreased by 9.7±10.8 kg (p<0.001). Percentage total weight loss at 12 months was 8.9±10.0% (p<0.001). Mild gastrointestinal side effects were common. One patient developed gallstones. Five patients discontinued treatment due to side effects. CONCLUSION: Semaglutide appears to be a safe and effective weight loss adjunct when used in a multidisciplinary weight management clinic.

Predicting risk of underconfidence following maternity leave.

OBJECTIVE: To determine what factors affect paediatric trainee confidence on return to work after maternity leave. DESIGN: Information was collected anonymously via an online survey from trainees who had taken maternity leave. SETTING: The survey was distributed centrally to each UK deanery. MAIN OUTCOME MEASURES: Trainee confidence was rated retrospectively using self-assessment. RESULTS: 146 paediatric trainees from 12 out of 13 deaneries completed the survey. 96% of trainees experienced an initial lack of confidence, with 36% requiring 3 months or longer for their confidence to return. Prolonged lack of confidence was associated with longer time out of training, training stage, returning part-time, less frequent engagement with educational activities and lack of recognition by supervising consultant. CONCLUSION: We propose a scoring system using the above risk factors, the MoTHER score (Months out, Training stage, Hours worked on return, Educational activities, Recognition by consultant), which can be used to identify trainees who are at higher probability of experiencing reduced confidence on return to work.

Patients' and health-care professionals' awareness of cost: a multicentre survey.

Delivering cost-effective health care within the constraints of public funding is the goal of the NHS. In this study 248 health-care professionals and patients across six different hospitals were surveyed to ascertain their cost awareness. Cost awareness was poor across all groups.