Weight management

Weight management services in England are currently categorised into 4 tiers:

• Tier 1: Universal prevention services - Tier 1 services are delivered by local public health teams and involve primary care professionals such as GPs, nurses, health visitors, and school nurses, often supported by pharmacists, local leisure providers, and allied organisations The aim is universal prevention, promoting healthy lifestyle behaviours, reducing obesity risk, and providing self-management tools for the general population

• Tier 2: Lifestyle multicomponent weight management - Tier 2 services are commissioned by local authorities and focus on lifestyle weight management. They are typically delivered in community settings, often in group formats, and provide structured support on diet, nutrition, physical activity, and behaviour change. These programmes are usually time-limited, commonly lasting around 12 weeks, and aim to help participants develop sustainable healthy habits

• Tier 3: Specialist multi-disciplinary weight management for people with complex obesity who need more intensive support than Tier 1–2 programmes. It includes:
  • Dietitian‑led nutrition plans
  • Behaviour & Psychological support for eating behaviours
  • Physical‑activity guidance
  • Medical oversight, including eligibility assessment for weight‑loss medications (e.g., Wegovy/Saxenda/Mounjaro) depending on local NHS criteria.  NB note that Ozempic cannot be prescribed for weight loss, only for treatment of diabetes
  • Preparation for Tier 4 (bariatric surgery) if appropriate
  • Programmes typically last 6 months to 2 years, depending on provider and pathway
  • Tirzepatide (Mounjaro®): a primary care service GP-led service 

Please note BSOL ICB do not fund weight management drugs via Tier 3 at this time.

• Tier 4: Bariatric specialist services are specialist bariatric surgery pathways delivered in hospital settings. They include:
  • Pre‑operative preparation
  • Bariatric procedures (e.g., gastric bypass, sleeve gastrectomy, gastric band)
  • Surgical procedure
  • Long‑term follow‑up and monitoring

Tirzepatide (Mounjaro®): A new treatment option for managing obesity

NHS Birmingham and Solihull and Black Country ICBs are providing Tirzepatide (Mounjaro®) for the management of obesity for an eligible cohort of people who meet the following criteria.

• Age 18+ and have a BMI of 35 or more (or 32.5 or more for people from minority ethnic backgrounds),

And have at least four of the five following long-term conditions:

• Type 2 diabetes
• High blood pressure (hypertension)
• Cardiovascular disease
• Dyslipidaemia
• Obstructive sleep apnoea

This is in line with national NHS England guidance and NICE recommendations.

If you have previously accessed Tirzepatide through a private provider, the NHS may only continue treatment if you meet the current NHS eligibility criteria following an assessment by the Integrated Care Board’s commissioned weight management service or by an appropriately trained health care professional within your GP practice

If you do not meet the current eligibility criteria, you will be advised of this. Whilst we recognise this may be disappointing, it's important to note there are other NHS services that can support you. These may include:

• Tier 2 weight management programmes
• Dietitian referrals
• Digital tools and lifestyle coaching

Please be aware if you contact an NHS service with questions about your private tirzepatide prescription, including stopping or tapering off the drug, you will be advised to speak with your private provider.

You can find out more information in our Frequently Asked Questions here.

The NHS is introducing weight management medicines, including tirzepatide (Mounjaro®), into primary care as part of a nationally led programme. The programme is being introduced in phases, with national guidance setting out which groups of people are eligible and how the programme should be delivered.

It is important to understand that not every GP practice will necessarily provide tirzepatide through this programme. Individual GP practices make decisions about whether they participate in the primary care programme and how they deliver the service within their practice.

This means that being eligible for treatment under the national criteria does not necessarily mean that you will be able to receive tirzepatide from your own GP practice. Your GP practice will be able to tell you whether it is participating in the programme and what options are available to you.

The Birmingham, Black Country and Solihull Integrated Care Board (ICB) cluster is responsible for implementing the national programme locally and supporting the development of appropriate local pathways. However, the decision to participate in the programme is that of each individual GP practice.

If your GP practice is not participating, this does not mean that you cannot receive support with managing your weight. There are other NHS weight management services and support available, depending on your individual circumstances and eligibility.

It is also important to remember that weight management medicines are not suitable or necessary for everyone. Decisions about treatment should be made with a healthcare professional and take account of your individual health needs, preferences, potential benefits and risks.

Medicines are intended to be used alongside healthy eating, physical activity and appropriate behavioural support.

Be Active+ Exercise Referral Scheme – this free programme is available to sedentary or inactive individuals aged 14 and over, who are registered at a Birmingham GP, and have an existing health condition or other risk factors for disease. A patient needs to have 2 or more low risk conditions, or 1 or more medium risk conditions according to the inclusion criteria. The programme is 12 weeks and offered at a number of leisure facilities.

Beezee in Birmingham - courses that provide adults with a disability or learning needs with 1:1 nutrition support from a dietician, realistic weight goals based on your medication and health conditions, with friendly support network of people like you. The service is for adults aged 16 years and over, living with a physical, visual impairment, learning disability or autism. Participants must have the ability to consent to take part and have Body Mass Index (BMI) of 25kg/m2 (or more than 23kg/m2 if you are of Asian or Black origin). Participants need to live in Birmingham or be registered with a Birmingham GP.  You can self-refer to Beezee by emailing beezee.bodies@nhs.net, calling 03308 186 308 or via the website.

Birmingham Digital Adult Weight Management Programme - Healum – 12-week adult weight management programme delivered via a mobile app for those who are aged 16 or over, have a BMI of 25kg/m2 (or more than 23kg/m2 if you are of Asian or Black origin) and live in Birmingham or are registered with a Birmingham GP. You can self-refer by emailing birmingham.awm@healum.com

BeeZee Families - is a free 16-week programme designed to help children aged 5-12 who are above a healthy weight, along with their families. You can self-refer via the website and the programme helps families to adopt lasting healthy habits. Led by experts, the programme provides practical advice, fun activities, and a supportive environment to encourage positive lifestyle changes. Families can choose from different ways to participate, making it easier to fit the programme into their schedules. Participants can attend in-person weekly group sessions, which include tailored support, engaging activities, and take-home resources. Online group sessions offer a more flexible option with weekly one-hour interactive sessions over 10 weeks, plus two check-in calls. For those needing even more flexibility, BeeZee Academy provides self-paced online learning for six months. The programme is available to families in Birmingham with children who are above their ideal weight according to the NHS BMI centile chart.

Solihull on the move - free activities, local community groups and clubs, and home exercise options. 

Healthy Weight Programmes - a number of options are available to support residents concerned about their weight in Solihull. 

DocSpot Exercise referral - a 12-week physical activity programme for adults in Solihull with long-term health conditions and those at risk of developing a condition. It is a great opportunity to improve health and wellbeing through a tailored programme of physical activity. Regular physical activity can help prevent and manage over 20 health conditions. To be referred to the programme adults must contact their GP.

The NHS has a range of advice and tools to help with weight loss which you can find here.

NHS Digital Weight Management Service  - a targeted support offer and access to weight management services in primary care for adults with a diagnosis of type 2 diabetes or hypertension with a BMI of 30+ (adjusted for ethnicity)

NHS Type 2 Diabetes Path to Remission Programme - a low-calorie treatment for adults in Birmingham and Solihull living with Type 2 diabetes who are above a healthy weight. The 12-month programme is completely free, but individuals can only take part via referral from their GP practice.

The Healthier You NHS Diabetes Prevention Programme is a behaviour change programme that focuses on looking at the factors that are increasing your risk of Type 2 diabetes and helping you to develop a plan to make healthy lifestyle changes, including managing your weight.  The 9 month programme is free for adults living in Birmingham and Solihull. A GP referral or a self-referral with a recent blood sugar test result from your GP practice is required

Specialist Weight Management Services - University Hospital Birmingham NHS Foundation Trust and Birmingham Community Healthcare NHS Foundation Trust both run specialist weight management programmes. 

The NHS in Birmingham and Solihull is seeing unprecedented demand for theseservices - driven by rising levels of obesity, growing awareness of weight-related health risks, increased interest in bariatric surgery, and the emergence of weight-loss medications.

Eligibility criteria has been introduced to prioritise patients with the most urgent and complex health needs, including those requiring weight loss to access life-saving treatments such as surgery, cancer care, or organ transplants.

Weight loss medication is not available via these services, and you will only be referred to these services by a GP if the GP has assessed that you meet one or more of the following criteria:

• People with a body mass index (BMI) of over 50;
• People with a BMI of more than 35 and type 2 diabetes (for less than 10 years);
• Patients with precancerous or cancerous conditions in which weight management would improve outcomes or aid access to therapies.
• Patients requiring urgent weight loss for organ transplant.
• Patients with Idiopathic intracranial hypertension (IIH) requiring frequent lumber punctures and/or visual compromise.
• Patients undergoing planned time sensitive surgery (including bariatric surgery) for life-limiting conditions, where high BMI is the primary barrier to surgery and weigh loss would be beneficial.
• Where weight loss is required for assisted conception in women under the care of a fertility service, in cases where weight loss would be beneficial.
• Patients with severe obstructive sleep apnoea (OSA), obesity hypoventilation syndrome (OHS) and/or severe asthma.
• Patients with proven genetic cause of obesity and not eligible for setmelanotide.

*Life-limiting defined as any condition where life is extended by the intervention.