Open Access Highly Accessed Research article

Referrals for pediatric weight management: the importance of proximity

Kathryn A Ambler12, Douglas WJ Hagedorn3 and Geoff DC Ball12*

Author Affiliations

1 Department of Pediatrics, Faculty of Medicine & Dentistry, University of Alberta, Edmonton, AB, Canada

2 Pediatric Centre for Weight and Health, Alberta Health Services, Edmonton, AB, Canada

3 Department of Geography, Faculty of Arts, University of Calgary, Calgary, AB, Canada

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BMC Health Services Research 2010, 10:302  doi:10.1186/1472-6963-10-302

Published: 1 November 2010



Limited access to weight management care can have a negative impact on the health and well-being of obese children and youth. Our objectives were to describe the characteristics of clients referred to a pediatric weight management centre and explore potential differences according to proximity.


All demographic and anthropometric data were abstracted from standardized, one-page referral forms, which were received by a pediatric weight management centre in Edmonton, AB (Canada) between April, 2005 and April, 2009.


Referrals (n = 555; 52% male; age [mean +/- standard deviation]: 12.4 +/- 2.6 y; BMI: 32.3 +/- 6.8 kg/m2; BMI percentile: 98.4 +/- 1.7; BMI z-score: 2.3 +/- 0.4) were received from 311 physicians. Approximately 95% of referrals were for boys and girls classified as obese or very obese. Based on postal code data, individuals were dichotomized as either living within (local; n = 455) or beyond (distant; n = 100) the Edmonton Census Metropolitan Area. Numerous families resided several hundred kilometres away from our centre. Overall, distant clients were taller, weighed more, and were more overweight than their local counterparts. For distant clients, the degree of overweight was higher in youth versus children.


Pediatric weight management services must be designed to optimize access to health services, especially for distant clients who may be at increased obesity-related health risk.