Newcastle Specialist Adult Weight Management Service ( Tier 3)- Guidance for Health care professionals

About Our Service

•We are a non-surgical tier 3 service for Newcastle patients with complex obesity. We offer support to enable sustained healthy behaviour change for weight loss.

•We offer specialist multi-disciplinary weight management assessment and interventions led by Psychology and Dietetics.

•We are currently a non-prescribing service.

•We offer support and fulfil the need for tier 3 support prior to bariatric surgery.

Interventions we offer

Photo Credit: European coalition for people living with obesity

·Group-based education sessions (face-to-face/online)

·Advising appropriate dietary regimens

·Addressing psychological barriers to unhealthy relationships with food

·Stabilisation of eating patterns and achievement of nutritional adequacy

·Addressing psychological distress related to eating, or specific problems that impact on eating behaviours

·Engaging patients in healthy conversations about lifestyle factors such as physical activity

Referral Criteria

The Service is for adults aged 18 and over who are registered with a Newcastle GP. Patients are eligible for the Service where:

-BMI 50¹ and above – all will be accepted, without prerequisite for tier 2 input.

-BMI 40¹ and above + engagement with a tier 2 or equivalent service in the past 2 years

-BMI ≥ 35¹ with co-morbidities² + engagement with a tier 2 or equivalent service in the past 2 years

•¹ A tolerance of BMI 2.5 on each criterion above for at-risk groups: Black African, Caribbean, and South Asian origin.

•² Obesity related co-morbidities: established cardiovascular disease; Type 2 diabetes; impaired glucose tolerance; severe hypertension; non-alcoholic fatty liver disease (NAFLD); obstructive sleep apnoea (OSA); polycystic ovarian syndrome; osteoarthritis and on medication; severe lower limb major joint disease (requiring orthopaedic intervention); idiopathic intracranial hypertension.

Inclusion Criteria

•Patient has not undergone weight loss surgery within the last 24 months

•Patient has not disengaged from or completed treatment within this service within the last 12 months

•Patient is not pregnant

•Patient does not have an active, uncontrolled medical condition or unstable psychiatric disorder/mental health condition

•Patient does not have active alcohol or substance misuse

•Patient consents to a referral to weight management service

•NICE guidance states “all appropriate measures have failed to achieve or maintain adequate clinically beneficial weight loss for at least six months”

•Patient has been recently screened (i.e. within the last 6 months) to rule out underlying endocrinology factors contributing to weight and support monitoring. Screening to include a measure of blood pressure (BP) and the following blood tests: FBC, U&Es, Bone Biochemistry, TSH, HBA1C, Lipid Profile (ideally fasting) and Liver Function tests. We are unable to progress referrals unless these blood tests and measure of BP have been undertaken

•Previous engagement with a Tier 2 weight management service within last 2 years (e.g. health coach sessions, PCN dietitian, local Tier 2 service or national digital Tier 2 service, slimming groups)