People have the right to be involved in discussions and make informed decisions about their care, as described in NICE's information on making decisions about your care.
Making decisions using NICE guidelines explains how we use words to show the strength (or certainty) of our recommendations, and has information about prescribing medicines (including off-label use), professional guidelines, standards and laws (including on consent and mental capacity), and safeguarding.
Health and social care professionals should follow our general guidelines for people delivering care:
Read this guideline alongside:
NICE guidelines on behaviour change: digital and mobile health interventions, behaviour change: individual approaches, eating disorders, and looked after children and young people
Public Health England's Whole systems approach to obesity and weight management interventions: standard evaluation framework
Read this section alongside:
Identify an obesity partnership group to work on joint approaches to reduce obesity and overweight in line with Public Health England's 'Whole systems approach to obesity', Guide to commissioning and delivering tier 2 weight management services for adults, and Guide to commissioning and delivering tier 2 weight management services for children and their families. [2012, amended 2025]
Ensure overweight and obesity management services are accessible, with no upper limit on either BMI or age for referral. Include services suitable for people with different degrees of obesity and complexity of needs, including people with very high BMI, those aged 65 or over, people with learning disabilities or severe mental health conditions. [2025]
For a short explanation of why the committee made the 2025 recommendation and how it might affect services, see the rationale and impact section on planning and funding services and interventions .
Full details of the evidence and the committee's discussion are in evidence review E: increasing uptake of weight management services in children, young people and adults.
Commission or recommend overweight and obesity management interventions for adults that focus on effective overweight and obesity management and:
are multicomponent, covering dietary intake, physical activity and behaviour change
adopt a respectful, non-judgemental approach
monitor weight and participants' personal goals throughout the programme
monitor indicators that people are engaged and meeting their goals (for example for fruit and vegetable intake or amount of physical activity) and use a variety of methods to encourage behaviour change in relation to:
problem solving
goal setting
how to carry out a particular task or activity
helping the person identify sources of support (such as friends and family or workplace programmes)
self-monitoring of weight and behaviours that can affect weight
feedback from participants on their own progress and their views of the overall programme. [2014]
Commission or recommend interventions for adults that:
include achievable goals for weight loss that are agreed for different stages, including goals for the first few weeks, end of the programme or referral period (and for 1 year)
include specific dietary goals (for example, for a clear energy intake or a specific reduction in energy intake) in line with the Department of Health and Social Care advice on weight management and tailored to the person's needs (note: the price of any recommended dietary approaches should not be prohibitive; individual advice from a Registered dietitian or UKVRN registered nutritionist administered by the Association for Nutrition may be beneficial)
help the person track their weight and the progress they have made towards individual goals throughout. [2014]
Ensure interventions:
include sustainable ways the person can reduce sedentary behaviour and fit more physical activity into everyday life over the long term (for example, walking)
take any medical conditions the person may have into account when planning any physical activity sessions
have a qualified physical activity instructor leading any supervised activity sessions; for example, a physiotherapist or a practitioner member of the CIMSPA (Chartered Institute for the Management of Sport and Physical Activity)
last at least 3 months, with weekly or fortnightly sessions
monitor and review progress toward individual goals throughout the intervention
are developed by a multidisciplinary team that includes healthcare professionals with expertise in overweight and obesity management, nutrition, psychology or physical activity
are run by staff who are trained in delivering overweight and obesity management interventions and take part in regular professional development sessions. [2014]
Commission and recommend interventions for adults that encourage people to make lifelong behavioural changes and prevent future weight gain, by:
fostering independence and self-management (including self-monitoring)
encouraging dietary behaviours that support weight maintenance and can be sustained in the long term (for example, emphasise that national programmes that promote healthy eating like NHS Better Health can support overweight and obesity management)
emphasising the wider benefits of keeping up levels of physical activity over the long term
discussing strategies to overcome any difficulties in maintaining behavioural changes
encouraging family-based changes
discussing sources of ongoing support once the intervention or referral period has ended (opportunities could include the programme itself, online resources or support groups, other local services or activities, and help from family or friends). [2014, amended 2025]
Tailor interventions to support the needs of different groups. For example by holding sessions that are men- or women-only, or at different times of the day (such as interventions for children outside school hours, and ones for adults outside common working hours), and at venues that have good transport links or are used by a particular community. Think about providing childcare to support parents or carers attending sessions. [2014]
Engage local businesses in the wider approach to preventing overweight and obesity, and encourage them to promote health and wellbeing. For example:
workplace health initiatives that support and encourage employees (and their families) to adopt a healthy diet
developing and implementing active travel plans to encourage employees and their families to walk and cycle
ensuring the range and content of any food and drinks they sell does not create an incentive to overeat, and gives people the opportunity to eat healthily
actively supporting community initiatives on health and wellbeing (for example, as part of a social value approach to their business). [2012, amended 2025]
Encourage all local businesses and social enterprises to recognise their corporate health and wellbeing responsibilities in relation to:
products – for example, ensuring the range and content of the food and drinks they sell does not encourage or incentivise to overeat and gives people the opportunity to eat healthily
wider social interests – such as actively supporting wider community initiatives on health and wellbeing. [2012]
See also NICE's guidance on physical activity in the workplace, preventing cardiovascular disease, alcohol-use disorders and type 2 diabetes, and Public Health England's physical activity, healthy eating and healthier weight toolkit for employers.
Follow Public Health England's guide to delivering and commissioning tier 2 adult weight management services and commission services and interventions that meet the measures set out in the National Obesity Audit advice for the Community Services Data Set, and Public Health England's 'Adult weight management: key performance indicators'. [2014, amended 2025]
Ensure equipment and facilities for overweight and obesity management interventions meet the needs of most people who are living with overweight or obesity. For example, providers of services and interventions should ensure there are large blood pressure cuffs and suitably sized chairs without arms. Any new scales purchased should be able to accurately weigh everybody using the service. Agree a process for using equipment from more specialist services, such as hospital weighing scales, when needed. [2014, amended 2025]
Ensure scales used by overweight and obesity management interventions for monitoring people's weight are regularly calibrated. [2014]
Equip specialist settings (including paediatric settings) for treating people who are living with severe obesity with, for example, suitable seating, suitable toilets and adequate weighing and monitoring equipment. Ensure hospitals have access to specialist equipment – such as larger scanners and beds – when providing general care for people who are living with severe obesity. [2006, amended 2025]
Ensure local or regional strategic partnerships are:
aware of, and committed to, the overweight and obesity strategy in the joint local health and wellbeing strategy
aware of the impact of obesity on other priorities. [2012]
Ensure overweight and obesity prevention interventions are highly visible and easily recognisable. To increase recognition and minimise costs, think about adapting a widely known campaign (such as NHS Healthier Families) for use locally. [2012]
Ensure partners have shared vision, speak with a common voice and are clearly identifiable to the community. Promote all relevant activities using the same overweight and obesity management campaign materials and use this branding consistently over the long term. [2012]
Work with partners and the local media to advocate for action on overweight and obesity. [2012]
Make the relevance of a wide range of initiatives for managing overweight and obesity clear, for example in annual reports. [2012]
Ensure all those commissioning overweight and obesity management services are aware of:
the number of people living with overweight or obesity locally, including any variations between different groups
the effect of the local environment and health inequalities on the prevention and management of obesity
the local overweight and obesity management pathway and the role of overweight and obesity management services in the local strategic approach to preventing and managing overweight and obesity
the range of interventions that could be commissioned locally (see the sections on service and intervention specifications and equipment and reviewing success)
opportunities to continue professional development or any training available on overweight and obesity management. [2025]
Raise awareness of overweight and obesity management interventions among health and social care professionals who may refer people to them. This includes GPs and staff involved in the National Child Measurement Programme and the Healthy Child Programme. For example, publicise professional networks and ensure staff are familiar with the interventions available and how to make referrals (see also the National Child Measurement Programme: operational guidance). [2025]
Make online and social media resources available and accessible for health and social care professionals to share with adults, children, young people and their family and carers. [2025]
These recommendations are for local or regional strategic partnerships.
Think about the following in messages about weight and obesity:
which media types will best reach the intended groups
tailoring language to the situation or intended audience (for example, using 'healthier weight' rather than 'preventing obesity', talking more generally about health and wellbeing, or mentioning specific community issues)
using non-judgemental language and non-stigmatising images
using materials that include a variety of body shapes, disabilities and ethnicities
using local insight to help develop communications for subgroups within a community or specific at-risk groups. [2012, amended 2025]
Engage with children's centres, libraries, the local media, schools and colleges, and professional and voluntary organisations working with children, young people and adults to raise awareness of behavioural overweight and obesity management services and interventions for children, young people and adults. Publicity could include:
who the intervention is for (for interventions for children and young people this includes age range, eligibility criteria, and the level of family involvement needed)
how to enrol (including whether participants can self-refer or need a formal referral from a healthcare professional)
aims, and type of activities involved
the time, location, length of each session, and the number of sessions
general public health messages such as moving more and eating more fruit and vegetables. [2025]
Ensure the local population is aware of:
the health and potential psychosocial benefits of having and maintaining a healthier weight at any age
the range of overweight and obesity management services available locally and nationally
local sources of information and advice such as GPs, practice nurses, health visitors and pharmacists
national sources of accurate information and advice.
Include details of information sources in all communications about overweight and obesity. [2025]
Maintain an up-to-date list of local overweight and obesity management interventions for adults, children and young people. Regularly share the list, or make it accessible, to organisations in the public, community and voluntary sectors. [2025]
For a short explanation of why the committee made the 2025 recommendations and how they might affect services, see the rationale and impact section on raising awareness of overweight and obesity management options .
Full details of the evidence and the committee's discussion are in evidence review E: increasing uptake of weight management services in children, young people and adults.
These recommendations are for those providing interventions.
Collect evidence for health and wellbeing boards showing that interventions:
are effective at 12 months or beyond (the following programmes currently available in the UK have been shown to be effective at 12 to 18 months: [in alphabetical order] Slimming World and Weight Watchers)
continue to meet core components and best practice criteria for commissioning (see the section on key components of interventions). [2014, amended 2025]
Ensure overweight and obesity management interventions contact participants 12 months after the intervention is completed. This could be done by intervention providers or an additional commissioned service. Work with all referrers and providers to develop systems to share relevant information about people referred to overweight and obesity management interventions, in line with information governance and data protection requirements. [2014]
See also the section on raising awareness of overweight and obesity management options.
When commissioning interventions, take into account the needs of children and young people who are living with obesity or overweight and have special needs or disabilities. This could include offering specific interventions, if available, or making reasonable adaptations to mainstream interventions (including training staff), and evaluating both. [2013]
Ensure those with more complex needs, their families and carers, have a contact in specialist services who can help them manage their weight. [2013]
Develop the components of behavioural overweight and obesity management interventions with the input of a multidisciplinary team. [2025]
The multidisciplinary team should comprise professionals who specialise in children, young people and overweight and obesity management, including:
a Registered dietitian or UKVRN registered nutritionist administered by the Association for Nutrition
a physical activity specialist
a behaviour-change expert, such as a health promotion specialist
a health or clinical psychologist, or a child or adolescent psychiatrist, to provide expertise in mental wellbeing
a paediatrician or paediatric nurse
a community-based health professional (such as a public health nurse). [2013]
Ensure intervention content is regularly reviewed and updated by the multidisciplinary team. [2013]
For a short explanation of why the committee made the 2025 recommendation and how it might affect services, see the rationale and impact section on involving a multidisciplinary team for children and young people .
Full details of the evidence and the committee's discussion are in evidence review G: effectiveness and acceptability of weight management interventions in children and young people living with overweight and obesity.
Ensure the contract or intervention specification requires that height and weight are measured and that both BMI and BMI for age and sex are recorded for children and young people:
at start and end of the intervention
whenever an opportunity arises during the year after completion. [2013, amended 2025]
Specify in contracts any groups that may be at risk of health inequalities, such as children and young people from ethnic minority backgrounds, or from deprived or disadvantaged neighbourhoods. [2013]
Dedicate long-term, protected resources to support the development, implementation, delivery, promotion, monitoring and evaluation of overweight and obesity management interventions for children and young people. See the section on evaluating effectiveness (principle 7) in NICE's guideline on behaviour change: general approaches. [2013]