Specialist weight management

Current Service Delays

The Specialist Weight Management Service (SWMS) is a specialist NHS service for adults living with obesity who meet the service eligibility criteria.

Demand for specialist weight management support has increased significantly in recent years. As a result, there is currently a waiting list for assessment and treatment, and patients may wait approximately four years before being offered an appointment.

Referrals are prioritised according to clinical urgency. Patients who do not meet urgent criteria are generally seen in order of their referral date.

July 2026 Waiting List statement

Whilst the care of all patients remains important to us, the Specialist Weight Management Service is currently experiencing a high volume of referrals requiring urgent assessment and treatment. Due to the limited capacity of the specialist team, we are currently prioritising new referrals that meet the criteria for urgent assessment.

As a result, there are delays to assessment and treatment for both urgent and routine referrals. Patients referred routinely may experience a significant wait before being offered an appointment. At present, routine referrals from July 2022 remain on the waiting list awaiting assessment.

We continue to review referrals according to clinical urgency and will contact patients when an appointment becomes available.

Urgent Assessment Criteria

The Specialist Weight Management Service has agreed criteria with Gloucestershire Integrated Care Board (ICB), which commissions the service, for identifying referrals that may require urgent assessment.

Patients may be considered for urgent assessment if they have:

• BMI >50 kg/m², or >40 kg/m² with at least one agreed co-morbidity, and
• one of the following:
  • Weight loss required for organ transplantation
  • Idiopathic intracranial hypertension (IIH)
  • Certain cancers (or pre-cancerous conditions) where your specialist team has advised that:
    • Weight loss would reduce risk or improve outcomes

Weight loss medications (Ozempic, Mounjaro) update

Patients registered with a Gloucestershire GP

Weight loss medicine as a treatment option was introduced in our service in August 2025, initially for 12 months as a pilot pathway for a limited number of patients. It is not intended that we have the staff or capacity to meet the demand for everyone wishing to try this treatment option. Gloucestershire Integrated Care Board is working on the development of a new, county-wide pathway for weight management, which we hope will improve access and support for patients.

Who can have weight loss medications in your service?

Under national guidance, to be eligible, you must have one of an agreed list of co-morbidities. Following muti-disciplinary assessment appointments, if you are eligible, you may be offered this as a treatment if both you and your clinician agree it is the most appropriate treatment option.

Due to current service capacity constraints, we are currently only able to offer assessment and treatment to patients who meet our urgent clinical review criteria.

For the latest information on the availability of weight loss medication in Gloucestershire please see the Gloucestershire ICB website Weight loss medication : NHS Gloucestershire ICB

For patients registered with a Herefordshire and Worcestershire GP surgery referred to SWMS

Our service has been commissioned to provide a medication pathway but requires the medications to be funded by the appropriate Integrated Care System (ICS). We have contacted Herefordshire and Worcestershire under which your GP is registered, they have advised that they are currently not able to fund this medication. As a result, we are unable to offer GLP-1 medication for our Hereford and Worcestershire patients.

Our treatment offer would be self-management and/or work up and referral on to bariatric surgery for patients interested in pursuing this and where there are no contraindications to onward referral.

• Further information about current weight management services and support in your county is available on the Herefordshire and Worcestershire Integrated Care System Weight Management website: https://www.hwics.org.uk/our-services/weight-management
• This website is updated as local commissioning arrangements develop in line with national guidance and implementation plans.
• We will continue to monitor local and national guidance, and any changes to funding arrangements will be reflected in our service provision.

Wraparound care requirement

Weight loss medication cannot be prescribed without engagement in our wraparound care programme. This is because NICE guidelines state that medication must be provided alongside tailored diet and physical activity advice and/or support from a Specialist Weight Management Service.

Previous prescribing position

Any information you have received from SWMS reflects the service offer at the time it was given. Prior to August 2025, SWMS did not have a prescriber within the team and was therefore unable to provide medication.

If you would like to discuss your concerns further, you can contact the Patient Advice and Liaison Service (PALS) on 0800 019 3282 (Monday–Friday, 9 am–4 pm).

• If your call cannot be answered immediately, please leave a message and the team will call you back.
• You can also email ghn-tr.pals.gloshospitals@nhs.net or write to:
  PALS Office, Gloucestershire Royal Hospital Great Western Road Gloucester GL1 3NN

Referrals

Referrals primarily come from GPs but are also currently accepted from secondary care teams within our hospitals, such as the Diabetes, Sleep Clinic and Physiotherapy departments

SWMS Access Criteria

Aged >18 years

BMI >50kg/m2 or >40 kg/m2 with at least one agreed co-morbidity from list below:

• Idiopathic intracranial hypertension (IIH)
• Essential surgery refused e.g. transplant, cancer treatment
• Sleep apnoea
• Diabetes and Pre-diabetes
• Hypertension (requiring treatment)
• Hyperlipidaemia (requiring treatment)
• Atrial Fibrillation
• Ischaemic Heart Disease
• PCOS
• Fertility problems
• NAFLD/NASH
• MSK or significant osteoarthritis, where surgery is refused due to BMI
• Other routine surgery or intervention refused due to BMI

About the service

The Specialist Weight Management Service (SWMS) is a small, multidisciplinary service for patients living with obesity and is provided by Gloucestershire Hospitals NHS Foundation Trust. The service is psychologist-led and includes specialist dietitians who provide a high level of support for patients to promote and maintain weight loss in order to improve health and quality of life.

The team

Our small and friendly team is made up of:

• Specialist Psychologists
• Specialist Dietitians
• Specialist Nurse
• Clerical Support Staff
• Student Dietitians on clinical placement

Assessment Appointments

We currently see the majority of our patients in appointments via video or telephone calling; however, we also can see patients face to face if required.

• Once a referral has been accepted, patients are offered assessment appointments so that clinicians can understand their challenges with weight.
• Once the information is collected, the clinicians can see if now is a good time for treatment, or if other steps need to be taken first.
• If the clinicians feel that our service is not a good fit for your needs, recommendations will made to your GP about what else might help your weight.

Treatment

• Most people will be offered our standard pathway, which is a weight management group delivered online.
• Appointments in group treatments run fortnightly and typically last 1hr 45 mins, with a planned break.
• Our groups are small and friendly; we do not weigh you, we ask you to self-report your weight and we do not discuss your weight with others in the group.
• During treatment, we take a non-prescriptive approach (we won’t tell you what to do) and we don’t focus on the use of weighing scales as the only outcome measure; we look at other benefits of our treatment programmes e.g. quality of life, confidence, mobility, self-esteem, self-care

Contact Us

Our office hours are: 8am to 4pm, Monday to Friday (excluding bank holidays)

• You can email us at: ghn-tr.swms.team@nhs.net
• You can call us on: 0300 422 6174 (we have a voicemail service which is regularly monitored during working hours)

Emotional eating

Dr Gail Bohin talks about what the term 'emotional eating' and what this means

What our patients say about us

“My whole life has changed – I am more outgoing and confident. I am able to enjoy life to the full whereas before, I was just existing. Be open minded and listen and think about the advice and help given – enjoy the journey one step at a time; be strong - believe you can achieve.”

“I found the service to be valuable because it’s not so much about losing pounds or inches but changing attitudes that we have towards food. If these can be changed then the pounds take care of themselves.”

Weight Loss Surgery

If weight loss surgery (also known as bariatric surgery) is something you are considering, this will be discussed during your initial appointments. This will include eligibility, treatment pathways to surgery and behaviours required to be in place before surgery will be considered.

Visit our Bariatric Surgery pages for more information, including videos, on bariatric surgery here at Gloucestershire Hospitals.