Paediatric Obesity

Useful Management Information

+ Useful management information

  • Use BMI charts to monitor growth.   Interpretation of BMI values in children and adolescents aged 2–18 years is based on sex-specific BMI percentile charts.  Ensure that the same chart is used over time to allow for consistent monitoring of growth.
  • Growth of children less than 2 years of age is monitored using World Health Organization (WHO) growth charts. (Australian practice)
  • While waist circumference may not have a place in screening for overweight and obesity in children and adolescents, a waist circumference that is greater than half the height suggests a need for more thorough weight assessment.
  • Consider involvement of other professionals (e.g. aboriginal health worker, multicultural health worker, interpreter) to facilitate communication
  • If you have a reason to suspect a child in Queensland is experiencing harm, or is at risk of experiencing harm, you need to contact Child Safety Services:
  • In the majority of cases it is thought inappropriate for children to wait more than 6 months for an outpatient initial appointment
Minimum Referral Criteria

Category 1
(appointment within 30 calendar days)

  • Hypertensive > 95% for age with appropriate size cuff (BP centile by age and height)
  • Type 2 diabetes
  • Severe obstruction in sleep with repeated arousals and distress
Category 2
(appointment within 90 calendar days)
  • An underlying medical or endocrine cause is suspected, or there are concerns about height and growth velocity.
  • Obese children < 6 years
  • Other symptomatic obesity including obstructive sleep apnoea, hip or knee pain, high levels of psychological distress about weight
  • Signs of insulin resistance
Category 3
(appointment within 365 calendar days)
  • Obese children > 6 years

If your patient does not meet the minimum referral criteria

  • Consider other treatment pathways or an alternative diagnosis
  • If you still need to refer your patient:
    • Please explain why (e.g. warning signs or symptoms, clinical modifiers, uncertain about diagnosis, etc.)
    • Please note that your referral may not be accepted or may be redirected to another service
Standard Referral Information

Patient's Demographic Details

  • Full name (including aliases)
  • Date and country of birth
  • Residential and postal address including whether patient resides at an aged care facility
  • Telephone contact number/s – home, mobile and alternative
  • Medicare number (where eligible)
  • Name of the parent or caregiver (if appropriate)
  • Name of delegate and contact details (Department of Corrective Services)
  • Preferred language and interpreter requirements
  • Identifies as Aboriginal and/or Torres Strait Islander
  • Any special needs, access requirements and/or disability relevant to the referral

Referring Practitioner Details

  • Full name
  • Full address
  • Contact details – telephone, fax, email
  • Provider number
  • Date of referral
  • Signature
  • Nominated general practitioner’s details (if known), if the nominated general practitioner is different from the referring practitioner

Relevant clinical information about the condition

  • Presenting symptoms (evolution and duration)
  • Physical findings
  • Details of previous treatment (including systemic and topical medications prescribed) including the course and outcome of the treatment
  • All conservative options that have been pursued unsuccessfully prior to referral
  • Body mass index (BMI)
  • Details of any associated medical conditions which may affect the condition or its treatment (e.g. diabetes, BMI), noting these must be stable and controlled prior to referral
  • Any special care requirements where relevant (e.g. tracheostomy in place, oxygen required)
  • Current medications and dosages
  • Drug allergies
  • Alcohol, tobacco and other drugs use

Reason for request

  • To establish a diagnosis
  • For treatment or intervention
  • For advice and management
  • For specialist to take over management
  • Reassurance for GP/second opinion
  • For a specified test/investigation the GP can't order, or the patient can't afford or access
  • Reassurance for the patient/family
  • For other reason (e.g. rapidly accelerating disease progression)
  • Clinical judgement indicates a referral for specialist review is necessary

Clinical modifiers

  • Impact on employment
  • Impact on education
  • Impact on home
  • Impact on activities of daily living functioning – low/medium/high
  • Impact on ability to care for others
  • Impact on personal frailty or safety
  • Identifies as Aboriginal and/or Torres Strait Islander

Other relevant information

  • Willingness to have surgery (where surgery is a likely intervention)
  • Choice to be treated as a public or private patient
  • Compensable status (e.g. DVA, Work Cover, Motor Vehicle Insurance, etc

Essential referral information

Without this information the referral will be returned

  • General referral information
  • Current height and weight, and include date of measurement
  • Fasting glucose  insulin U&E LFT FBC iron studies CRP TFT results
  • Report presence or absence of Red flags

    Presence of Red flags
    • Significant obstruction in sleep with repeated arousals and distress
    • Type 2 diabetes (random glucose > 11 or fasting >7.0) use diabetes CPC referral guide
    • Recent rapid change in weight (gain or loss)
    • Hypertension >95 centile for age with appropriate size cuff
Additional Referral Information

Highly desirable information – may change triage category

  • History of obesity-related burden of disease – sleep disturbance, exercise limitation, orthopaedic pain, psychological disturbance
  • Height/weight/head circumference and growth charts with prior measurements if available
  • Diet history including if:
    • the child has a very restricted diet, or specific dietary restrictions (refer to a dietitian)
    • extreme weight loss behaviours, signs of eating disorders, high level of negative body image and/or negative social experiences are evident (refer to psychological services)

Desirable Information- will assist at consultation

  • Assessment of parental obesity and other family history
  • Other past medical history
  • Pregnancy and birth history
  • Immunisation history
  • Developmental history
  • Medication history
  • Allergies
  • Significant psychosocial risk factors (especially parents mental health, family violence, housing and financial stress, department of child safety involvement)
  • Other physical examination findings inclusive of CNS, birth marks or dysmorphology
  • Any other relevant laboratory results or medical imaging reports
Clinical Override

Clinical override of referral criteria may be requested in the following situations:

  • Inability to include essential referral information. If a specific test result is unable to be obtained due to access, financial, religious, cultural or consent reasons.
  • Patient does not meet minimum referral criteria. If the patient does not meet the criteria for referral but the referring practitioner believes that the patient requires specialist review.
  • Presence of clinical modifiers. The presence of clinical modifiers (as listed above in Standard referral information) may impact on the categorisation of a patient.

Include the reason for request for clinical override as part of the referral. Referrals are reviewed by the triaging specialist who determines the most appropriate course of action.

Out of catchment

West Moreton Health is responsible for providing a public health service to people who reside within its catchment area. To appropriately manage demand for service we do not accept referrals from outside this catchment area. If your patient does live outside the West Moreton Health area and it is deemed socially or clinically necessary for their care to be received in the West Moreton Health Service, inclusion of information regarding their particular medical and/or social factors will assist with the triaging of your referral.


To provide feedback about contents on this website or general referral questions please email or phone 3413 7402.