Weight Management Services Referral Pathways

We provide integrated weight management counseling in the following three clinics located at Children's Hospital.

Referrals to the Pre-Diabetes Clinic are for children who meet these criteria:

• HgbA1C greater or equal to 6.0
• Blood glucose ≥ 200 mg/dl and symptoms of diabetes
• Fasting glucose ≥ 126 on at least 2 occasions
• 2 hour oral glucose tolerance value ≥ 200

Refer to the Pre-Diabetes clinic by calling (615) 322-7842. Patients will see a registered dietitian as part of their initial visit.

Referrals to the Lipid clinic are for children with elevated fasting lipid levels meeting these criteria:

• Family history of premature cardiovascular disease
• Total cholesterol (fasting) >200
• LDL (fasting) ≥ 160 or LDL (fasting) of 130-159 following 12 months of lifestyle modifications
• Triglycerides (fasting) > 500 or Triglycerides (fasting) ≥ 200 after 6 months of lifestyle modifications
• HDL <35

Refer to the Lipid clinic by calling (615) 936-1450. Patients will see a registered dietitian as part of their initial visit.

For referrals to the ROSA clinic, children should have refractory obstructive sleep apnea, meeting these criteria:

• Documented tonsillectomy and adenoidectomy
• Documented obstructive sleep apnea on polysomnography

Refer to the ROSA clinic by calling (615) 936-8176.

We also refer to these additional specialty clinics as indicated. Patients referred to these clinics will not see a weight specialist or weight management provider.

Endocrinology

• Short stature
• Slowing growth velocity
• Hyperandrogenism in pubertal girls and/or amenorrhea
• Signs of precocious puberty

Refer to Endocrinology by calling (615) 322-7427.

Sleep disorders

• Snoring
• Daytime sleepiness
• Other signs of sleep apnea

Refer to the Sleep Disorders program by calling (615) 343-7617.

Gastroenterology

• Persistent AST and or ALT > 25 percent above upper limit of normal
• Vitamin D deficiency: if 25 (OH) Vitamin D level is < 30 ng/ml

Refer to Pediatric Gastroenterology by calling (615) 322-7449.

Hypertension

For children diagnosed with hypertension, refer to Nephrology by calling (615) 322-7416.

Nutrition Clinic

We also recommend referrals to the Nutrition clinic for consultation and follow up, as indicated, with a registered dietitian. There is strong evidence for improving outcomes when RDs are involved in care.

Refer to Nutrition by calling (615) 936-3952.