Supporting Your Referral to the Specialist Weight Management Service (SWMS)

This page provides an overview of how you can support individuals who may be suitable for referral to the Specialist Weight Management Service (SWMS).

About the Service

The Specialist Weight Management Service (SWMS) is a Tier 3, multi‑disciplinary programme delivered by a team of clinical experts, including Dietitians, Occupational Therapists and a Consultant Endocrinologist. The service offers intensive, personalised support for people who are ready to make long‑term lifestyle changes to improve their health.

Referral Criteria

Patients may be referred to SWMS if they:

  • Are motivated and willing to engage in lifestyle change, and
  • Have a BMI greater than 50 kg/m², or
  • Have a BMI greater than 40 kg/m² with at least one major obesity‑related comorbidity.

Pathway to Weight-Loss Surgery

SWMS provides a structured route for patients who may be candidates for weight-loss (bariatric) surgery. Before surgery is considered, all non-surgical weight‑management options must be fully explored. These include:

  • Lifestyle and dietary modifications
  • Behavioural change for effective self‑management
  • Pharmacotherapy, including Orlistat

This assessment period typically lasts up to 6 months.

Exploring these approaches helps identify individuals who are most likely to benefit from surgery. Bariatric surgery is invasive, non‑reversible, and does not guarantee long‑term weight stability; therefore, selecting the right candidates is essential for achieving the best outcomes.

For detailed information on possible surgical risks, visit: Complications of weight loss surgery - NHS.

What Makes SWMS Different

Unlike standard weight‑management programmes, SWMS is led by a clinical multi‑disciplinary team and provides intensive, personalised care tailored to each person’s needs and readiness for change.

Monthly Intake Sessions

SWMS holds monthly intake sessions throughout the year. Individuals invited to attend will receive a comprehensive assessment, which includes:

  • Detailed dieting history and patterns of weight change
  • Full medical history and current medications
  • Evaluation of current diet and nutritional adequacy
  • Assessment of wellbeing and expectations from the service
  • Smoking status
  • Screening for anxiety and depression
  • Identification of barriers to lifestyle, activity, and eating‑habit changes

What We Offer

The service provides both individual one‑to‑one appointments and supported video‑based education programmes.

Our Eatwell programme offers seven self‑directed learning modules designed to help patients make informed, confident choices about nutrition and healthy living. Each week, they’ll receive email guidance to support goal‑setting, highlight key learning points, and encourage personal reflection.


They also have access to weekly support from a clinician, by email or phone, to answer questions, clarify information, and help them get the most out of the modules.

This two‑module self‑guided course helps patients explore their eating habits, emotional relationship with food, and the triggers behind cravings. They’ll learn to distinguish between physical hunger and cravings, identify their personal patterns, and discover practical strategies to manage or reduce cravings effectively.

Our bariatric surgery information session provides a comprehensive overview of life before and after surgery. This one‑off video session covers the different surgical options available, what to realistically expect, and the long‑term lifestyle changes required. Participants are encouraged to reflect on how strict dietary adjustments may affect daily routines and social life, helping them prepare for lasting success.

We are only able to fast‑track referrals when we receive written confirmation from a medical team stating that a life‑prolonging procedure, such as an organ transplant or cardiac surgery, can only proceed if a specific weight or BMI requirement is met.
 

This ensures that urgent cases are prioritised appropriately and in line with clinical necessity.

GLP‑1 receptor agonists such as Semaglutide (Wegovy) and Tirzepatide (Mounjaro) are not available through our Tier 3 Weight Management Service due to current funding limitations.
Patients who require these medications will need to be supported through alternative prescribing pathways, in line with local NHS guidance.

NHS Lancashire and South Cumbria ICB Policy (November 2025)

In November 2025, the NHS Lancashire and South Cumbria Integrated Care Board (ICB) introduced a prescribing policy for Tirzepatide (Mounjaro).
Under this policy, GP practices are responsible for identifying and contacting patients who meet the ICB’s eligibility criteria.

Eligibility: First‑Priority Group

To qualify, patients must meet all of the following:

Body Mass Index

  • BMI ≥ 40, or
  • BMI ≥ 37.5 for people from minority ethnic family backgrounds

Socioeconomic Criteria

  • Live in an area ranked within the most deprived category (IMD‑1) according to the Government’s Index of Multiple Deprivation

Health Conditions

  • Have at least four of the following long‑term conditions:
    • Non‑diabetic hyperglycaemia or Type 2 Diabetes Mellitus (T2DM)
    • Hypertension (HTN)
    • Dyslipidaemia
    • Established cardiovascular disease (CVD)
    • Obstructive sleep apnoea

Important Notes

  • Tirzepatide must be used alongside dietary and lifestyle support to maximise outcomes and maintain progress after treatment ends.
  • Eligible patients referred to us will be prioritised and placed at the top of our waiting list for timely access to lifestyle support.
  • Our service provides lifestyle advice only. We cannot offer medication monitoring, dose adjustments, or clinical management of GLP‑1 therapy.

We generally advise against rapid weight loss solely to help a patient reach a “target” weight before surgery, as losing weight too quickly can negatively affect postoperative recovery. According to NICE guidance, a safe and sustainable rate of weight loss is 1–2 pounds per week. Please help patients set realistic expectations about the pace of healthy weight reduction.

The priority is achieving a smooth and successful recovery, supported by weight loss that is sustainable in the long term. In rare cases, faster weight loss may be considered, but only if the patient can safely tolerate the significant calorie restriction required.

You are welcome to refer patients currently under your care if you have already discussed their weight and its impact on their health with them. Please ensure that you obtain the patient’s explicit consent before making a referral.

Motivation plays a key role. Patients who are ready and willing to engage with lifestyle changes are more likely to achieve positive outcomes.

10 essential facts about obesity that every health professional should know

(Royal College of Physicians (2013)- Action on obesity- comprehensive care for all)

  • In the UK 1 in 4 adults are obese (2012)
  • In the UK 1 in 5 children aged 10-11 are obese (2011)
  • Obesity is strongly heritable (60% of weight variance is attributed to heredity) yet currently known gene mutations and polymorphisms account for <5% of weight variability.
  • Diagnosis by BMI requires measuring height and weight accurately; risk stratification in overweight and modest obesity requires measuring waist circumference and possible use of the clinical staging system (Edmonton Obesity Staging System (EOSS).
  • Prevention and long-term weight loss maintenance require sustained changes in diet and physical activity habits.
  • Obesity is a major risk factor in diabetes (5 x), cancer ( 3 x the risk of colon cancer), and heart disease (2.5 x).
  • Obesity is a major cause of health inequality and impaired quality of life and costs the NHS £5.0 billion per year (2012).
  • Modest weight loss (~10kg) helps to improve diabetes, improves quality of life and reduces morbidity.
  • An energy deficit of only 100Kcals per day predicts a 0.5kg weight loss in a month.
  • Cost-effective treatment in appropriate adults includes commercial weight loss programmes such as weight watchers, GP schemes such as counterweight, pharmacotherapy such as orlistat, or bariatric surgery.