Specialist weight-loss services in England unable to keep up with spiraling demand

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

ICBs are responsible for planning health services for their local population. At least seven out of 42 ICBs across the country—covering Manchester, Bristol, Suffolk, Leicester, Essex, and much of Yorkshire—have had to close a specialist (tier 3) weight management service list in their area, with many warning that demand is far exceeding capacity, reports Elisabeth Mahase.

Experts have said the rise in obesity and the demand for weight-loss injections may be fueling the increase in referrals, but they blame a lack of consistent government policy for hindering the ability of weight management services to keep up with the growing demand.

Across England, over two-thirds (64%) of adults are estimated to be overweight or obese. But in April 2022, the government pulled its £100m (€121m; $131m) funding grant for weight management services in England, just a year after it was announced.

Nerys Astbury, associate professor of diet and obesity at the University of Oxford, described the availability of specialist weight management services as "unequal and very limited, or completely absent in some regions." She told The BMJ that even where services do exist, "they are over-subscribed, waiting lists have been capped, or budgetary limitations mean services are at risk of being de-commissioned."

In some areas, even tightening the access criteria has failed to quell demand. For example, Greater Manchester ICB has had to pause referrals to its service in Bolton, while other localities remain open but are struggling. The ICB is now conducting a review of its entire obesity pathway.

David Buck, senior fellow at The King's Fund, said the government has had a "mixed record in the past on supporting health and weight management services, including reducing funding." He said a "more strategic response" to tackling obesity, including through specialist services, was now needed.

GPs are also feeling the pressure of the obesity crisis. Samuel Parker, a GP and deputy chair of the British Medical Association's North East Regional Council, is demanding an "increase in funding for UK-based weight management services paid for by an increase in the sugar tax."

Buck said that the increasing obesity crisis and demand for weight-loss services require the government to take "bold action" to help people to live healthier lives, particularly as demand for support far exceeds what local services are set up to offer.

He pointed to recent polling by The King's Fund which indicated strong public support (65%) for restricting the advertising of unhealthy food and drink, and for the government to require companies to reduce the salt, sugar, and fat in their products (67% support).

"In the long run, prevention policies, including those to tackle obesity, will be far cheaper than treating the symptoms of ill-health and a new government needs to act decisively," Buck said.