
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
Your patient must meet one of the following
40 kg/m² or above
Includes patients who may not have tried weight loss services, where the GP feels they will benefit from Tier 3 input sooner.
35 kg/m² or above
With one or more comorbidity.
One or more of: hypertension, cardiovascular disease, or sleep apnoea
Has tried Tier 2 weight loss services for at least 12 weeks and been assessed as requiring specialist services
30 kg/m² or above
Or above 27.5 kg/m² for people of South Asian, Chinese, other Asian, Middle Eastern, Black African or African-Caribbean family background.
Has type 2 diabetes
May be considering bariatric surgery
Exclusion criteria
Under 18
Pregnant or breastfeeding
Uncontrolled hypertension or heart condition
Active or suspected untreated eating disorder including binge eating disorder, or purging within the last 3 months
Active cancer
Bariatric surgery in the past two years
Unstable or severe mental illness beyond the expertise of primary care
Unstable alcohol or drug use (can refer if in recovery for 3 or more months)
Unstable hypothyroidism (can refer if stable)
Unstable Cushing's syndrome (can refer if stable)
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.
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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.
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