Overweight and obesity management

Before or during any discussions, think about the wider determinants and the context of overweight and obesity. These include:

• general health and current comorbidities

• weight-related comorbidities, including family history of weight-related comorbidities

• weight history and previous experiences of managing overweight or obesity

• experiences of weight stigma

• impact of bullying and adverse childhood experiences

• practicality of addressing weight and readiness to engage with change

• developmental stage (for children and young people)

• ethnicity

• language

• socioeconomic status and financial constraints

• personal and family circumstances, including living arrangements and major life events

• recent pregnancy

• how any medicines the person is taking may affect their weight or appetite

• current or previous experiences of eating disorders or disordered eating

• psychosocial considerations (for example, depression, anxiety or sense of self-esteem or self-perception)

• physical disabilities

• neurodevelopmental conditions and special educational needs and disabilities (SEND). [2025]

Before discussing overweight, obesity or central adiposity, take into account:

• the context of the discussion or appointment and whether it is appropriate or important to discuss weight or take measurements on this occasion

• that the subject of weight may have been raised many times before

• your own feelings and sensitivities about weight

• that people can be affected by an eating disorder at any weight (see NICE's guideline on eating disorders)

• cultural factors that may be relevant.
  
  For discussions with children and their families or carers, also:

• think about the vulnerability of young people to eating disorders, and the impact of measuring their weight

• tailor conversations with the child or young person to their age, maturity and level of understanding, so that they are able to engage with the discussion and be involved with the decisions about their healthcare. [2025]

Ask permission to discuss overweight, obesity or central adiposity. If they do not wish to discuss it further on this occasion, respect the person's choice (and that of their family or carer, if relevant) and either explore the reason sensitively or delay discussion until an appropriate time. [2025]

Record the outcome of the discussion to ensure that subsequent healthcare professionals are aware that the matter has been raised, and know about the person's views and any actions already taken to manage overweight or obesity. [2025]

Ensure that all discussions linked to overweight, obesity and central adiposity are conducted in a sensitive, non-judgemental and person-centred manner by:

• using non-stigmatising language (for example, 'living with overweight')

• identifying and exploring the person's own preferred terms (and those of their family or carers, if relevant)

• focusing on improvements in health and wellbeing rather than simply talking about weight (for example, using terms like 'healthier weight' and 'improved health' may be more acceptable than 'preventing obesity' for some people)

• staying positive, supportive and solution-based

• taking into account the person's thoughts, views and cultural, religious or spiritual beliefs (and those of their family or carers, if relevant) about overweight and obesity management

• being mindful of the factors that prevent or restrict weight loss (for example, some medicines)

• taking into account the determinants and context of overweight and obesity (see recommendation 1.1.1)

• for children and young people, using accurate facts and figures, for example growth charts, to visually show their weight and BMI centile. [2025]

Ensure that all written, visual and verbal communications with people living with overweight and obesity use non-stigmatising language and images and is tailored to any particular needs, such as Easy Read literature. Resources and advice that could help conduct conversations in a sensitive and positive way include:

• NHS England's healthier weight competency framework

• Office for Health Improvement and Disparities' healthy weight coaching on how to have sensitive conversations about weight and health with adults

• Public Health England's guide to brief interventions with adults: let's talk about weight (which provides practical advice and tools to support health and care professionals make brief interventions in weight management for adults)

• Public Health England's guide to conversations about weight management with children and families: let's talk about weight (which highlights a focus for many children and young people on weight maintenance and growing into a healthier weight, rather than weight loss)

• National Child Measurement Programme conversation framework for talking to parents (which can also be used for discussions about weight outside the programme)

• obesity image banks [2025]

Equip specialist settings for treating people who are living with obesity with, for example, suitable seating and adequate weighing and monitoring equipment. [2006]

Ensure hospitals have access to suitable equipment – such as larger scanners and beds – when providing general care for people who are living with severe obesity. [2006]