Weight management

NHS Dorset is currently reviewing weight management services and weight loss drug provision as part of these services. This will ensure a complete service including prescribing and wrapround care can be provided locally to the population of Dorset to enable the best outcomes.

NHS Dorset will publish a local obesity management plan when the review is concluded later in 2025 to fulfil the requirements of the updated NICE guidance on obesity. This plan will be phased in over a 12-year period.

Whilst this is ongoing, NHS Dorset advises that this review does not impact on a person’s eligibility to be referred to online services if they qualify to provide services under the ‘right to choose’ regulations. People must meet our local eligibility criteria to be referred – these are in line with NICE guidelines and our local commissioning statements on prescribing of weight loss drugs.

GPs and other health professionals, as always, will only refer you if they believe that it is clinically appropriate to do so.

GPs may refer you to a specialist weight management provider under ‘right to choose’ but GPs are not obliged to undertake physical assessments on behalf of other services, shared care, monitoring, or prescribing if it sits outside of their clinical competence, capacity, or locally agreed care pathways.

Individual drug information and Dorset Formulary site

Weight management – NHS Dorset

Semaglutide for managing overweight and obesity

Semaglutide (Wegovy) is recommended as an option for weight management, including weight loss and weight maintenance, alongside a reduced-calorie diet and increased physical activity in adults, only if:

• it is used for a maximum of 2 years, and within a specialist weight management service providing multidisciplinary management of overweight or obesity (including but not limited to tiers 3 and 4), and:
• people have at least 1 weight-related comorbidity and:
  • a body mass index (BMI) of at least 35.0 kg/m2, or
  • a BMI of 30.0 kg/m² to 34.9 kg/m² and meet the criteria for referral to specialist weight management services in NICE’s guideline on obesity: identification, assessment and management.

Lower BMI thresholds (usually reduced by 2.5 kg/m²) for people from South Asian, Chinese, other Asian, Middle Eastern, Black African or African Caribbean family backgrounds are appropriate.

Stopping semaglutide is appropriate if less than 5% of the initial weight has been lost after 6 months of treatment. Treatment will only be funded for a maximum of 2 years.

NHS Dorset notes the consultation on NHS England’s proposals for a phased launch of obesity injection, tirzepatide (Mounjaro).

NHS Dorset is considering the NICE TA and how it will be provided within weight management services locally in 90 days and 180 days in locally commissioned services after the TA publication.

The Technology Appraisal has concluded the evidence suggests that tirzepatide is more effective than semaglutide when used alongside diet, exercise and psychological support.

How this will affect current services:

• • Secondary care weight management services will be able to provide tirzepatide. Prescribing or monitoring responsibility for tirzepatide will not be passed to primary care from those services.
  • Primary care are not commissioned to provide weight management services and will not be able to prescribe tirzepatide for obesity.
  • Private provider or any qualified provider service requests for general practice to take on prescribing will not be accommodated.
  • Shared care with primary care from specialist services will not be supported until the drug is classified as AMBER status for weight management in the Dorset Formulary and a template is agreed with all providers.

Tirzepatide (known in the UK under the brand name Mounjaro) has recently been approved for use in the NHS in line with NICE TA11156.

(Project information | Tirzepatide for managing overweight and obesity [ID6179] | Guidance | NICE)

NICE is the National Institute for Health and Care Excellence and is an executive non-departmental public body of the Department of Health and Social Care.

As commissioners, NHS Dorset Integrated Care Board (ICB) is currently considering how Tirzepatide will fit with existing weight management services in the county in order to achieve the best outcomes for patients. These services also include support on achieving a low-calorie diet and increasing exercise along with psychological support.

Initially, Tirzepatide will only be available through existing specialist weight management services. Eventually, Tirzepatide will be available locally via a dedicated service. More information will be available in 2025.

For more information on weight management services in Dorset visit LiveWell Dorset.