Obesity: Integrated care boards close lists for weight management services as demand skyrockets

One in six integrated care boards (ICBs) in England has stopped accepting new patients for specialist weight management services as referral numbers spiral out of control, a BMJ investigation has found.

At least seven of 42 ICBs around the country—covering Manchester, Bristol, Suffolk, Leicester, Essex, and much of Yorkshire—have had to close a tier 3 weight management service list in their area, with many warning that demand far exceeds capacity. Tier 3 services involve multidisciplinary teams—including physicians, physiotherapists, dietitians, and mental health specialists—to support patients, sometimes providing access to weight loss drugs such as semaglutide.

The rise in obesity and the demand for weight loss injection pens may be fuelling the increase in referrals, experts have said. But they blame a lack of consistent government policy for hindering the ability of weight management services to keep up with the growing demand.

One ICB, NHS West Yorkshire, closed the list for its Leeds service in July 2023, when the service was treating 1323 patients—far more than the 250 new annual referrals estimated when the service was recommissioned in 2019.1 It told The BMJ that the availability of such specialist services was “limited” across West Yorkshire and that “waiting lists are long.” It added that access would “widen over time, when our resources allow.”

A month earlier, North Bristol NHS Trust (which comes under NHS Bristol, North Somerset, and South Gloucestershire ICB) had to close its list, citing similar capacity issues.2 Tim Whittlestone, chief medical officer …