Tier 2:

Services available are:

• NHS National Digital Weight Management Programme

Tier 3:

Services available are:

• ‘The Weigh Ahead’ service is a Specialist Community Weight Management Service for severe and complex obesity, providing an intensive level of support to patients through a multi-disciplinary team (MDT) approach.
  
  Referral Criteria:

• Patients must be aged 16 or over

• Patients must have a BMI ≥ 35 (with co-morbidities; see list of significant co-morbidities below) OR a BMI ≥ 40 (without co-morbidities)

• Patients must have complied with a range of weight loss interventions at Tiers 1 and 2 of the pathway over a 2 year period and have failed to achieve or maintain weight loss goals*

• Would also accept people with co-morbities that do not meet all of the above criteria

Tier 4:

Services available are:

• Bariatric Surgery

• Patients will need to complete the Tier 3 specialist obesity management programme prior to being considered for bariatric surgery, this is in line with the current bariatric referral policies. Some patients may
  be considered for bariatric surgery on successful completion of the Tier 3 programme if appropriate.

• Patients will still need to fulfil the national criteria as well as any locally determined criteria for bariatric surgery to be eligible regardless of completion of the Tier 3 programme.