Eligibility criteria for weight management services

Criteria to access lifestyle and coaching support provided by local councils:

• BMI: Over 28

And

• Pre-existing conditions: No
• How to get referred: You can self-refer or you can ask your GP to refer you. 

Criteria for access to the NHS Digital Weight Management programme:

• BMI: Over 30 (or over 27.5 for people of Asian, Chinese, Middle Eastern, Black African or African-Caribbean origin)

And

• Pre-existing conditions: Diabetes and/or high blood pressure

How to get referred: Via your GP or local pharmacist.

Criteria for tirzepatide (Mounjaro®):

• BMI: 40 or more (or 37.5 or more for people of Asian, Chinese, Middle Eastern, Black African or African-Caribbean origin) 

And

• Pre-existing conditions: At least four of the following conditions:
  • type 2 diabetes
  • high blood pressure (hypertension)
  • heart disease (cardiovascular disease)
  • abnormal blood fats (dyslipidaemia)
  • obstructive sleep apnoea.
• How to access treatment: From your GP or via GP referral to specialist weight management service.

Criteria for semaglutide (Wegovy®):

• BMI: 40 or more (or 37.5 or more for people of Asian, Chinese, Middle Eastern, Black African or African-Caribbean origin)

And

• Pre-existing conditions: At least four of the following conditions:
  • type 2 diabetes
  • high blood pressure (hypertension)
  • heart disease (cardiovascular disease)
  • abnormal blood fats (dyslipidaemia)
  • obstructive sleep apnoea.
• How to access treatment: Referral to Oviva or specialist weight management services via GP.

Criteria for orlistat:

• BMI: 28 or more plus other weight-related conditions, such as high blood pressure or type 2 diabetes OR a BMI of 30 or more

And

• Pre-existing conditions: If BMI is between 28 and 29.9, other weight-related conditions e.g. high blood pressure or diabetes

• Other criteria: Have made significant effort to lose weight through diet, exercise or lifestyle changes

• How to access treatment: Via your GP.

Criteria for Oviva (online specialist weight management service able to prescribe semaglutide (Wegovy®):

• BMI: 40 or over (37.5 or more for people of Asian, Chinese, Middle Eastern, Black African or African-Caribbean origin) 

And

• Pre-existing conditions: At least four of the following conditions:
  • type 2 diabetes
  • high blood pressure (hypertension)
  • heart disease (cardiovascular disease)
  • abnormal blood fats (dyslipidaemia)
  • obstructive sleep apnoea.
• Other criteria: Suitable for an online-only service 
• How to access treatment: Referral via your GP.

Criteria for hospital-based specialist weight management service:

• BMI: 40 or over (37.5 or more for people of Asian, Chinese, Middle Eastern, Black African or African-Caribbean origin)

And

• Pre-existing conditions: At least four of the following conditions:
  • type 2 diabetes
  • high blood pressure (hypertension)
  • heart disease (cardiovascular disease)
  • abnormal blood fats (dyslipidaemia)
  • obstructive sleep apnoea.
• Other criteria: Require more intensive support and intervention (for example psychological support)
• How to access treatment: Referral via your GP.

Criteria for fast-track referral to hospital specialist weight management service:

• BMI: 35 or over (32.5 or more for people of Asian, Chinese, Middle Eastern, Black African or African-Caribbean origin) 

And

• Other criteria: One or more of the following: 
  • Sight-threatening idiopathic intracranial hypertension, requiring lumbar punctures and/or is already impacting on sight
  • Awaiting transplant surgery that requires a BMI below 35
  • Have a cancer that is made worse by obesity (e.g., endometrial cancer)
  • Have a BMI of 50 or more and may be suitable for weight loss surgery
• How to access treatment: Referral via your GP.

Criteria for weight loss surgery:

• BMI: 

• • 40 or over

Or 

• between 35 and 39.9 with obesity related health condition e.g. type 2 diabetes or high blood pressure

Or

• people from an Asian, Chinese, Middle Eastern, Black African or African-Caribbean origin, bariatric surgery may be considered for people with a BMI of 37.5 or more, or between 32.5 to 37.4 if they also have another health condition that could improve with weight loss

And

• Other criteria (all must apply): 

• • all appropriate non-surgical measures have been tried, but the person hasn't achieved or maintained adequate, clinically beneficial weight loss
  • the person is fit enough to have anaesthesia and surgery
  • the person has been receiving, or will receive, intensive management as part of their treatment
  • the person commits to the need for long-term follow-up

How to access treatment: Referral via hospital specialist weight management service.

GPs and specialist weight management services will not be able to automatically prescribe weight-loss medication, such as tirzepatide (Mounjaro®) and semaglutide (Wegovy®) even if patients have already been prescribed it privately.

While there are certain weight-loss medications available for prescription on the NHS, these can only be prescribed to people who meet certain criteria, and have been assessed by the relevant health care professional that this treatment would be appropriate.

Some people who lose a large amount of weight can be left with loose skin. At this time, the NHS does not offer skin removal surgery following weight loss.  Patients who want to undergo surgery for loose skin will need to do so privately. 

If you decide to undergo skin removal surgery privately, you'll need to choose who will do it. They should have the right training, skills and insurance to safely carry out the procedure.

You can find out more about choosing where to have a cosmetic procedure on the NHS website here.