NHS weight loss in London

Start your journey with lifestyle changes

Weight loss often begins with making small, manageable changes to your daily routine. These are the basics that can help you build a strong foundation for long-term success:

• Diet Eating a healthy, balanced diet is one of the most important parts of weight loss. The NHS recommends: Eating plenty of fruit and vegetables, choosing wholegrains like brown rice or wholemeal bread, and cutting back on sugary and fatty foods. There are free resources online, like the NHS Eatwell Guide, to help you get started.
• Exercise Staying active is a great way to burn calories and improve your overall health. The NHS suggests aiming for at least 150 minutes of moderate exercise a week, like brisk walking, cycling, or swimming. London has lots of opportunities for exercise, from local gyms to scenic walking routes.
• Counselling and mental health support Weight loss isn’t just physical - it’s emotional too. Counselling and behavioural therapy can help you stay motivated and address habits or feelings that make weight loss harder. Ask your GP about counselling services available through the NHS or local charities in London.

Tier II and Tier III weight management services

For people who need extra help, the NHS offers structured weight management programmes at different levels. These different levels are known as "tiers", and represent specialist services. Tier 2 is the first level of service, Tier 3 is the more specialised, or advanced, service.

What are Tier2 and Tier 3 services?

• Tier 2 services - These programmes focus on diet, activity, and behaviour changes, often run by dietitians and other specialists.
• Tier 3 services - These are for people who need more medical supervision, including input from doctors and psychologists. This is where surgery is considered.

How to access these services in London

Your London GP can refer you to these programmes if you meet the criteria. Be sure to speak with your GP about your weight loss goals and any challenges you’re facing.

What these services can do for you

• Offer personalised plans tailored to your needs
• Provide regular check-ins to track your progress
• Help with motivation, accountability, and making sustainable changes
• Consideration for surgical treatments
• More specialised medication

Weight loss medications on the NHS

If lifestyle changes and structured programmes aren’t enough, the NHS may offer medications to help you lose weight.

• Orlistat Orlistat blocks some of the fat you eat from being absorbed by your body. NHS eligibility criteria includes: Age - ≥18 years, BMI ≥30, OR BMI ≥28 with weight-related conditions (such as type 2 diabetes, hypertension, or hypercholesterolaemia). To be provided alongside a reduced-calorie diet. May be prescribed by a GP or available at pharmacies at a lower dosage. References: BNF, Medicines.org.uk, NICE CKS.
• Saxenda Saxenda is a daily injection that helps you feel full and eat less. NHS eligibility criteria includes: Age - 18-74 years, BMI ≥35 kg/m² or ≥32.5 kg/m² for high-risk ethnicities. Must have non-diabetic hyperglycemia, cardiovascular risk factors, no severe health problems, and prior weight loss attempts. Requires specialist prescription. References: BNF, Medicines.org.uk, NICE CKS.
• Wegovy Wegovy is a weekly injection similar to Saxenda, but it’s more effective. NHS eligibility criteria includes: Age - 18-84 years, BMI ≥30 kg/m² or ≥27.5 kg/m² for high-risk ethnicities. Must have a weight-related health condition and prior weight loss attempts. Requires specialist prescription. References: BNF, Medicines.org.uk, NICE CKS.
• Future option - Mounjaro Mounjaro is a newer medication that works in a similar way to Wegovy and Saxenda. It has been authorised for use in the NHS but is not yet available.

NHS weight loss surgery

For people with severe obesity, weight loss surgery may be an option on the NHS.

Eligibility for surgery

You might qualify for surgery in London if:

• Your BMI is over 40, or over 35 with serious weight-related health problems like diabetes.
• You’ve tried other weight loss methods without success.

What surgery involves

• Types of surgery include gastric band, sleeve gastrectomy, and gastric bypass.
• Surgery is combined with long-term follow-up care and lifestyle changes to maintain results.

Accessing surgery in London

Speak to your NHS GP about a referral if you think weight loss surgery could be right for you. NHS hospitals have skilled teams to support patients through the process.