Specialist weight management

Current Service Delays

The Specialist Weight Management Service (SWMS) is a small, specialist service, and demand for support has increased significantly in recent years, with around 27–30% of adults in Gloucestershire now living with obesity. Unfortunately, this means there is currently a long wait for treatment - approximately three years. Patients are assessed and treated in order of their referral date or medical urgency.

October 2025 Waiting List statement

• We are currently contacting patients who were referred in April 2022

Weight Loss Medications update

The new GLP-1 injectable weight loss medications e.g., Saxenda, Semaglutide/Wegovy, Tirzepatide/Mounjaro have recently received much press attention.

Weight loss medicine as a treatment option was introduced in August 2025, initially for 12 months as a pilot pathway for a limited number of patients in the specialist service. Following muti-disciplinary assessment appointments you may be offered this as a treatment if both you and your clinician agree it is the most appropriate treatment option. We are currently contacting urgent patients and those at the top of the waiting list.

This is not a dedicated service to meet the demand for these medications in Gloucestershire, we are working closely with NHS commissioners on the development of a new, county-wide pathway for weight management to improve access and support for patients. This new pathway is expected to be introduced in 2026.

Once referral routes to a dedicated service have been agreed, these medications will be subject to locally agreed criteria and your GP will need to check that you meet these criteria prior to referral. 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

Urgent prioritisation
We will prioritise patients as urgent if they meet the following criteria:

• 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)
  • Weight-related cancer, where the specialist team has advised that:
    • Current BMI increases the risk of poor outcome or future recurrence, and
    • Weight loss is urgently required to proceed with treatment or access interventions to reduce cancer risk.

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 – 4pm, Monday – 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.