We are pleased to introduce YUNO Clinic, a Paediatric EASO COM in Bucharest, Romania, led by Dr Bogdan Pascu, MD, PhD. This COM delivers multidisciplinary, non-surgical paediatric obesity care with a focus on clinical and metabolic evaluation, early metabolic risk identification, and long-term cardiometabolic health in children and adolescents. Alongside clinical practice, this COM team integrates structured data collection and clinical research to support ongoing refinement of care pathways for children living with obesity.
Dr Pascu, welcome! Please could you tell us about your multidisciplinary team and the services your COM provides?
At YUNO Clinic, our COM brings together a multidisciplinary team of more than 10 healthcare professionals dedicated to the comprehensive management of paediatric obesity. The core team includes four endocrine consultants, four specialist weight management dietitians, one clinical psychologist, one psychology therapist, and one weight management nurse specialist. We also collaborate closely with consulting paediatric specialists in cardiology, gastroenterology, genetics and neurology to ensure proper assessment and management of obesity-related comorbidities.
Our COM team delivers a full spectrum of non-surgical approaches to paediatric obesity care. This includes clinical and metabolic evaluation, medical nutrition therapy, pharmacotherapy when appropriate, psychological support, behaviour change interventions, and structured physical activity guidance for children and their families. Digital follow-up and remote support are integrated into our care model, helping to maintain continuity and accessibility for families. All services are delivered using a family-centred, evidence-based approach, focused on supporting healthy growth, improving metabolic health, and providing sustainable, individualised care tailored to each child’s clinical and developmental needs.
In addition to clinical practice, our COM team actively engages with the wider community and health system through public education and advocacy activities. Team members participate in public debates and television and medical TV programmes to raise awareness about childhood obesity prevention and treatment. I have also authored a book reflecting on personal childhood experience with obesity, contributing to public understanding, destigmatisation, and early prevention messaging.
Thank you – it’s great to hear more about your COM’s work. Could you please share a clinical example that illustrates your multidisciplinary approach?
A recent clinical case illustrates the importance of multidisciplinary assessment in paediatric obesity care. We provided care for a 15-year-old adolescent with obesity, severe insulin resistance, and hormonal findings consistent with functional hypogonadism, including low SHBG and low total testosterone levels. Testosterone therapy had previously been initiated elsewhere. Following comprehensive multidisciplinary reassessment, we identified obesity-related metabolic dysfunction as the underlying cause and discontinued testosterone therapy. Instead, treatment focused on addressing the metabolic drivers through medical nutrition therapy, behavioural and psychological support, structured physical activity, and pharmacological treatment including metformin and a GLP-1 receptor agonist. This approach resulted in improvement of both metabolic and hormonal parameters while avoiding unnecessary long-term hormone replacement. The case highlights the importance of accurate diagnosis and integrated care in managing complex obesity-related endocrine disturbances.
Thank you for sharing that example. What recent achievements, research activities, or innovations would you like to highlight from your COM?
Research and innovation are central to our COM activities. Over the past year, we published an original clinical study in the journal Medicina titled “Assessment of Insulin Resistance and Body Composition in Children with Overweight and Obesity: A Pilot Study Using Bioimpedance and Principal Component Analysis”. This study examined metabolic risk profiles and body composition phenotypes in a cohort of 210 children aged 1-18 years attending our paediatric obesity service. The findings highlight the value of combining bioimpedance-based body composition analysis with metabolic biomarkers to improve early identification of insulin resistance and cardiometabolic risk. This work reflects our commitment to precision phenotyping and early intervention, and it has already helped refine our clinical assessment protocols and risk-stratified care pathways.
To support both clinical care and research, we have also developed a structured internal data collection system that allows systematic monitoring of anthropometric, metabolic, and body composition parameters. This infrastructure supports high-quality follow-up, facilitates research integration, and enables continuous improvement of our multidisciplinary care model.
What are your COM’s main goals, priorities and challenges for the coming years?
Over the next few years, our COM aims to strengthen early prevention and precision care in paediatric obesity. Our key priorities include:
- Expanding research and structured data collection
- Integrating metabolic and body composition phenotyping into routine care
- Refining evidence-based pharmacological pathways
- Expanding school and community public health and obesity prevention initiatives
- Continuing alignment with EASO standards and European best practice
Our team will continue participation in ECO, EASO Masterclasses, and COMs Summits, supporting integration of current evidence into multidisciplinary practice.
A key challenge remains limited systemic support for prevention programmes and access to comprehensive treatment, including pharmacological therapies. Improving access to multidisciplinary care is essential to strengthening long-term outcomes.
In the coming years, our overall goal is to strengthen early identification and deliver personalised, evidence-based care to support long-term metabolic health outcomes for children and adolescents with obesity.
This edition highlights YUNO Clinic, a Paediatric EASO COM in Bucharest, Romania, led by Dr Bogdan Pascu. The centre delivers comprehensive, family-centred, non-surgical obesity care for children and adolescents, integrating multidisciplinary clinical expertise with structured data collection and research to support early metabolic risk identification and precision care. The interview showcases the team’s collaborative approach, community engagement and public advocacy, alongside their commitment to advancing evidence-based paediatric obesity management in alignment with EASO standards.
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