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CYP Weight Management (previously COCO)

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Checked: 05-08-2025 by Jenny Henry Next Review: 04-08-2027

Overview

CYP Weight Management provides a complex Tier 3 and Tier 4 weight management service for children in BNSSG.

For information on tier 1 and 2 services please see Weight management for children (tier 1 and 2)

Referral Criteria

Referral criteria

Children must be over 2 years of age and under 16 years old. They must reside in Bristol, North Somerset, or South Gloucestershire.
BMI > 3.3 SDS OR >99.6th centile with a complication related to excessive weight OR a confirmed diagnosis of type 2 diabetes mellitus (regardless of BMI)
Diagnosed or suspected Monogenic cause of obesity*

*Genetic causes of obesity - a genetic cause for obesity should be suspected in individuals with severe early-onset obesity (before age five) accompanied by excessive appetite (hyperphagia). A striking family history of early-onset obesity or parental consanguinity (related parents) also raises suspicion. Other signs can include developmental delays, behavioural issues, endocrine problems like adrenal insufficiency or hypothyroidism, and sometimes dysmorphic features or congenital malformations (1,2).

How to Refer

Refer to Bristol Royal Hospital for Children via eRS, general endocrinology highlighting they are Obesity or COCO.

Referrals will be triaged by Dr Dinesh Giri & Prof Julian Hamilton-Shield (Paediatric Endocrinology). If the referral is accepted the family will be contacted and placed on the waiting list. If the referral is declined, a letter will be sent to the referrer and the family.

Please note the current waiting time is approximately 10 months although this is subject to change.

Resources

(1) Monogenic obesity — Knowledge Hub

(2) Genetic obesity: an update with emerging therapeutic approaches

Efforts are made to ensure the accuracy and agreement of these guidelines, including any content uploaded, referred to or linked to from the system. However, BNSSG ICB cannot guarantee this. This guidance does not override the individual responsibility of healthcare professionals to make decisions appropriate to the circumstances of the individual patient, in consultation with the patient and/or guardian or carer, in accordance with the mental capacity act, and informed by the summary of product characteristics of any drugs they are considering. Practitioners are required to perform their duties in accordance with the law and their regulators and nothing in this guidance should be interpreted in a way that would be inconsistent with compliance with those duties.

Information provided through Remedy is continually updated so please be aware any printed copies may quickly become out of date.