Title: Draft NHS Leicester, Leicestershire and Rutland Adult Obesity Pathway
1Draft NHS Leicester, Leicestershire and Rutland
Adult Obesity Pathway
Interventions City County
Risk Level
Is the patient ready to lose weight?
Intervention Descriptor
Refer for Bariatric Assessment/Surgery
If Yes, after brief intervention refer to
appropriate intervention T1,T2 or T3 NB All
patients should be encouraged to use TIER
0 interventions
Very High Risk Patients presenting with a BMI
of 50 or 45 with significant co- morbidities
(local) East Midlands Commissioning Guidance
Bariatric Surgery Policy
ASSESSMENT ( NICE Guidance NICE CG43
EXIT STRATEGY Post intervention lifestyle change
should be self sustained to achieve/maintain
healthy weight
IDENTIFICATION
TIER 3 Surgical Intervention
DHAL LEAP 11 Dietetic Appointments
(LNDS) (Referral form hyperlink) ALS
TIER 2 Specialist Community Weight Management
Services Intensive behavioural change service for
individuals suffering with complex co-morbidities
and/or long term weight issues
High Risk -Patients presenting with A BMI 30-39
with co-morbidities -Patients with a BMI
gt40 -South Asian with a BMI 25
with co-morbidities
FAB Counter- Weight ALS
(link) ALS Criteria
TIER 1 Community Weight Management
Services First line weight intervention service
Provides basic nutrition and exercise support to
reduce weight and improve quality of life
Medium Risk Patients presenting with a BMI
25-29.9 or Patients presenting with A BMI
30-39.9 without co- morbidities
-Health Trainers Leicester Health Trainers
-Change 4 Life (C4Life hyperlink) -Physical
Activity Groups -Leisure Centre/ Community Based
Classes (3 x 30 Pledge) Active Together Self
referral to other suitable commercial groups
that have multi- component approach and
follow NICE Guidance
Low Risk Patients presenting with a BMI 25 and
have no co-morbidities
If patient NOT ready, Signpost to TIER 0 And
encourage patient to utilise
TIER 0 Universal Healthy Weight
Activity Population Wide intervention and
services (Open Access e.g. Leisure Centres, Green
Spaces, Active Travel, Workplace Health,
Community Physical Activity Sessions)
RELAPSE RE-ASSESSMENT NEEDED
RE-ASSESS
If patient has specific condition refer to
specific condition charts for in depth
assessment/ intervention