Tier 2:

Services available are:

• GP support plus Southwark Healthy Lifestyle Hub

• 12 week programme including a 1:1 initial assessment with a physical activity specialist followed by 11 weekly exercise and nutrition education sessions. Follow up at 6, 12, and 24 months.

Tier 3:

Services available are:

• A 1:1 initial assessment with a dietitian. 12 group sessions over the course of a 12 month period. Patients reviewed by a MDT. Follow up at 18 and 24 months.

• Groups are led by a mixture of dietitians, psychologists and physical activity specialists.

• Patients will also have access to support via the OVIVA app. 
  

Tier 4:

Services available are:

Bariatric surgery is provided by Guys' and St Thomas' if the patient meets the below criteria -

• a body-mass index (BMI) between 30 to 35kg/m2, with recent onset type 2 diabetes

• a BMI between 35 and 40, with other significant disease that could improve if they lost weight (for example, type 2 diabetes or high blood pressure)

• a BMI of more than 40

• a BMI of more than 50kg (weight-loss surgery should be considered as first line treatment) not managed to maintain weight loss using non-surgical measures, such as tier 3 weight management