Weight management and support to achieve a healthier weight
Managing your weight can be difficult, and losing weight and keeping it off is not always easy. There are many reasons why someone may find it harder to maintain a healthier weight, including health conditions, medicines, genetics, mental health, lifestyle and other factors. Making changes can take time, and different approaches work for different people.
Living with overweight or obesity can increase the risk of developing a number of health conditions, including type 2 diabetes, high blood pressure, heart disease, stroke and some cancers.
Even losing a small amount of weight can have health benefits.
If you would like support with managing your weight, there are a range of NHS options available. The right support will depend on your individual circumstances, health needs and eligibility.
Your GP practice or local NHS weight management service can advise you about the support available locally and what may be appropriate for you.
- Tier 1: Universal prevention services - Tier 1 services are delivered by local public health teams and involve primary care professionals such as GPs, nurses, health visitors, and school nurses, often supported by pharmacists, local leisure providers, and allied organisations The aim is universal prevention, promoting healthy lifestyle behaviours, reducing obesity risk, and providing self-management tools for the general population
- Tier 2: Lifestyle multicomponent weight management - Tier 2 services are commissioned by local authorities and focus on lifestyle weight management. They are typically delivered in community settings, often in group formats, and provide structured support on diet, nutrition, physical activity, and behaviour change. These programmes are usually time-limited, commonly lasting around 12 weeks, and aim to help participants develop sustainable healthy habits
- Tier 3: Specialist multi-disciplinary weight management is for people with complex obesity who need more intensive support than Tier 1–2 programmes. It includes:
- Dietitian‑led nutrition plans
- Behaviour & Psychological support for eating behaviours
- Physical‑activity guidance
- Medical oversight, including eligibility assessment for weight‑loss medications (e.g., Wegovy/Saxenda/Mounjaro) depending on local NHS criteria. NB note that Ozempic cannot be prescribed for weight loss, only for treatment of diabetes.
- Preparation for Tier 4 (bariatric surgery) if appropriate
- Programmes typically last 6 months to 2 years, depending on provider and pathway
- Tirzepatide (Mounjaro®): a primary care service GP-led service
- Tier 4: Bariatric specialist services are specialist bariatric surgery pathways delivered in hospital settings. They include:
- Pre‑operative preparation
- Bariatric procedures (e.g., gastric bypass, sleeve gastrectomy, gastric band)
- Surgical procedure
- Long‑term follow‑up and monitoring
NHS Birmingham and Solihull and Black Country ICBs are providing Tirzepatide (Mounjaro®) for the management of obesity for an eligible cohort of people who meet the following criteria.
- Age 18+ and have a BMI of 35 or more (or 32.5 or more for people from minority ethnic backgrounds),
And have at least four of the five following long-term conditions:
- Type 2 diabetes
- High blood pressure (hypertension)
- Cardiovascular disease
- Dyslipidaemia
- Obstructive sleep apnoea
This is in line with national NHS England guidance and NICE recommendations.
If you have previously accessed Tirzepatide through a private provider, the NHS may only continue treatment if you meet the current NHS eligibility criteria following an assessment by the Integrated Care Board’s commissioned weight management service or by an appropriately trained health care professional within your GP practice
If you do not meet the current eligibility criteria, you will be advised of this. Whilst we recognise this may be disappointing, it's important to note there are other NHS services that can support you. These may include:
- Tier 2 weight management programmes
- Dietitian referrals
- Digital tools and lifestyle coaching
Please be aware if you contact an NHS service with questions about your private tirzepatide prescription, including stopping or tapering off the drug, you will be advised to speak with your private provider.
You can find out more information in our Frequently Asked Questions here.
The NHS has a range of advice and tools to help with weight loss which you can find here.
NHS Digital Weight Management Service is a targeted support offer and access to weight management services in primary care for adults with a diagnosis of type 2 diabetes or hypertension with a BMI of 30+ (adjusted for ethnicity)
Find out more about the NHS England » About the NHS Digital Weight Management Programme here
The Healthier You NHS Diabetes Prevention Programme is a behaviour change programme that focuses on looking at the factors that are increasing your risk of Type 2 diabetes and helping you to develop a plan to make healthy lifestyle changes, including managing your weight. The programme is free for adults living in Birmingham, the Black Country and Solihull. A GP referral or a self-referral with a recent blood sugar test result from your GP practice is required
Specialist Weight Management Services
University Hospital Birmingham NHS Foundation Trust, The Royal Wolverhampton NHS Foundation Trust, Walsall Healthcare Hospital Trust, Sandwell and West Birmingham NHS Trust, Dudley Group Foundation NHS Trust and Birmingham Community Healthcare NHS Foundation Trust all run specialist weight management programmes.
The NHS in Birmingham, Black Country and Solihull is seeing unprecedented demand for these services driven by rising levels of obesity, growing awareness of weight-related health risks, increased interest in bariatric surgery, and the emergence of weight-loss medications.
Eligibility criteria has been introduced to prioritise patients with the most urgent and complex health needs, including those requiring weight loss to access life-saving treatments such as surgery, cancer care, or organ transplants.
Weight loss medication is not available via these services, and you will only be referred to these services by a GP and you have been assessed and you meet one or more of the following criteria:
- People with a body mass index (BMI) of over 50.
- People with a BMI of more than 35 and type 2 diabetes (for less than 10 years);
- Patients with pre-cancerous or cancerous conditions in which weight management would improve outcomes or aid access to therapies.
- Patients requiring urgent weight loss for organ transplant.
- Patients with Idiopathic intracranial hypertension (IIH) requiring frequent lumber punctures and/or visual compromise.
- Patients undergoing planned time sensitive surgery (including bariatric surgery) for life-limiting conditions, where high BMI is the primary barrier to surgery and weigh loss would be beneficial.
- Where weight loss is required for assisted conception in women under the care of a fertility service, in cases where weight loss would be beneficial.
- Patients with severe obstructive sleep apnoea (OSA), obesity hypoventilation syndrome (OHS) and/or severe asthma.
- Patients with proven genetic cause of obesity and not eligible for setmelanotide.
*Life-limiting defined as any condition where life is extended by the intervention.
Access to weight management medicines through primary care
The NHS has introducing weight management medicines, including tirzepatide (Mounjaro®), into primary care as part of a nationally led programme. The programme is being introduced in phases, with national guidance setting out which groups of people are eligible and how the programme should be delivered.
It is important to understand that not every GP practice will necessarily provide tirzepatide through this programme. Individual GP practices make decisions about whether they participate in the primary care programme and how they deliver the service within their practice.
This means that being eligible for treatment under the national criteria does not necessarily mean that you will be able to receive tirzepatide from your own GP practice. Your GP practice will be able to tell you whether it is participating in the programme and what options are available to you.
The Birmingham, Black Country and Solihull Integrated Care Board (ICB) cluster is responsible for implementing the national programme locally and supporting the development of appropriate local pathways. However, the decision to participate in the programme is that of each individual GP practice.
If your GP practice is not participating, this does not mean that you cannot receive support with managing your weight. There are other NHS weight management services and support available, depending on your individual circumstances and eligibility.
It is also important to remember that weight management medicines are not suitable or necessary for everyone. Decisions about treatment should be made with a healthcare professional and take account of your individual health needs, preferences, potential benefits and risks.
Medicines are intended to be used alongside healthy eating, physical activity and appropriate behavioural support.
Birmingham, Black Country and Solihull ICBs are actively reviewing the weight management services available to our patients at this time. We will provide updates on any changes to the services as they are agreed.
For more information visit the Overweight and obesity in adults on the NHS website here.
