Specialist Weight Management Service
Second Nature is now available to your patients via NHS Right to Choose. Find your local eligibility criteria, referral forms, and everything you need to get started.
Eligibility criteria
50 kg/m²* or above
35 kg/m² or above
With one or more comorbidities that could be improved with weight loss, indicated below:
Established type 2 diabetes mellitus diagnosed more than six years ago
Established diagnosis of OSA (sleep clinic confirmation via sleep study)
Heart failure NYHA Class III/IV that has required hospitalisation. See also National Library of Medicine
Metabolic dysfunction-associated steatotic liver disease (MASLD) with moderate/severe liver fibrosis diagnosed by a hepatologist
Chronic kidney disease stage 4 and 5, when referred by a nephrologist
Idiopathic intracranial hypertension (IIH) with impending visual compromise, when referred by a neurologist
35 kg/m²* or above
With 1 of the additional requirements indicated below:
Referral from assisted conception service for infertility in which weight is a barrier to assisted conception after assessment by the assisted conception service.
Referral from a secondary care service where weight loss is recommended by the specialist and evidence indicates that this will enable or significantly improve the outcome of a time-sensitive procedure/treatment, in cases where activities of daily life are severely restricted, including:
Total hip replacement
Total knee replacement
Incisional hernia repair (Subject to the patient meeting the other criteria within The specialist management of abdominal wall hernia in adult NHS Devon policy)
The referring specialist should include the clinical justification, target BMI and details of restrictions on activities of daily living in the referral. For procedures/treatments not listed above, specialists must also include evidence that weight loss is likely to improve the outcome of the procedure/treatment.
35 kg/m²* or above
With specialist support required to achieve weight loss, due to another complex medical need indicated below:
Type 1 diabetes mellitus (to provide support with insulin adjustment).
Suspicion of, or confirmed, rare monogenic or hypothalamic cause of obesity (to assess for an underlying condition).
*For people from South Asian, Chinese, other Asian, Middle Eastern, Black African or African-Caribbean ethnic backgrounds, the qualifying BMIs are 2.5 kg/m² lower (e.g. 47.5 kg/m² instead of 50 kg/m²).
Exclusion criteria
• Age below 18 years
• Pregnancy
• Previous engagement with a Specialist Weight Management Programme
• Bariatric surgery in the last two years (NHS or private)
• Unable to make changes to eating behaviours e.g. in a care setting where meals are provided
• Unable to engage with all aspects of the programme e.g. unstable mental health, uncontrolled hypertension prohibiting exercise
• Patients solely seeking injectable weight loss medications. See information below regarding weight loss medications
• Patients over the age of 75 if clinically deemed that weight reduction poses greater risk of harm from a weight management programme e.g., frailty.
• Patients with mental health issues, active eating disorders or active substance misuse where engagement with the service will lead to worsening of their issue or put themselves/others at risk.
• Patients with learning disabilities or neurodiversity if reasonable adjustments cannot be made.
• People who complete a Specialist Weight Management intervention will not be given an opportunity to join for a second time, unless exceptional circumstances have been identified.
Two pathways, both consultant-led.
We assess each patient and personalise their care.
Our specialist team includes consultant physicians, specialist dietitians, health psychologists, pharmacists, nurses and exercise specialists.
Consultant-led MDT. GLP-1 prescribing (Wegovy) where clinically appropriate. Dietetic, psychological, and behavioural support for up to 24 months.
Consultant-led MDT. Dietetics, psychology, exercise support. Structured lifestyle programme for 12 months.
Refer to us
Referrals can be submitted via NHS e-RS or directly by NHS mail. Follow the steps below for your area.
1
If you can't import files into your clinical system, download the .docx referral form and complete it as a Word document.
Using Ardens, DXS or another local form management system?
Check there first; if we're not listed yet, ask your file management lead to add this form.
2
Need help identifying eligible patients in your practice?
Find potentially eligible patients faster
For EMIS users
Our search files are built around the specialist weight management criteria for your area, so your team doesn’t have to build the search from scratch. Import once using the EMIS step-by-step guide, then run it whenever you want an up to date list.
Download the EMIS search file
If you have a question about the referral process, contact
Matt Reid (Partnerships Associate) at matthew.reid@secondnature.io or call 07540235288.
