NICE recommends better support for weight-loss patients after treatment

Patients who have undergone weight-loss treatment need better support after their treatment ends to maintain a healthy weight, according to guidance from the National Institute for Health and Care Excellence (NICE).

The guidance ‘Quality standard for overweight and obesity management’ emphasises the importance of continuity of care, long-term behavioural change, and structured post-treatment support to help patients maintain a healthy lifestyle and keep the weight off.

The updated guidance recommends that healthcare workers monitor patients for at least a year after completing their treatment and establish clear protocols for the ongoing support they will provide. This includes a tailored action plan to prevent weight gain, which patients can easily implement if changes are not maintained, as well as regular check-ins with healthcare professionals.

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The independent committee recognised the importance of advice on daily habit changes and access to online platforms, such as the NHS Better Health platform, as well as NHS dietitians and nutritionists.

Patients must have social support to maintain changes, and the standard highlights the need to direct people to peer support groups, such as keep-fit or walking groups, that also encourage physical activity. Additionally, the guidance suggests that patients discuss lifestyle changes with family and friends, ultimately promoting independence and self-management to prevent future weight gain.

Advice from NICE in the guidance for quality provision of care includes:

• Adults with a long-term condition have at least annual recording of their BMI and, if they have a BMI lower than 35 kg/m², recording of waist-to-height ratio.
• People living with overweight or obesity who are prescribed medicines for weight management receive wraparound care focusing on diet, nutrition and increasing physical activity.
• People who are stopping medicines for weight management or have completed a behavioural overweight and obesity management intervention be given advice for maintaining changes and support for improving their health and wellbeing.
• Children and young people aged over 2 years have opportunistic recording of their BMI at key points of contact with a healthcare professional.
• People with a learning disability be supported to access overweight and obesity management services.
• Stigma from health and care professionals can act as a barrier to accessing care for people living with overweight, obesity or central adiposity and it can lead to worse mental and physical health outcomes during treatment.
• People having discussions with health and care professionals about living with overweight, obesity or central adiposity should be communicated with in a person-centred manner using non-judgemental and non-stigmatising language.

Professor Jonathan Benger, deputy chief executive and chief medical officer at NICE: ‘We know that the transition period after treatment is crucial, and people need structured support to maintain the positive changes they’ve made. This new standard makes sure services provide that vital continuity of care, and it supports the NHS 10 Year Plan to shift from a ‘sickness service’ to a genuine health service focused on prevention.’

Currently, 64 per cent of adults in England are living with overweight or obesity, putting them at an increased risk of heart disease, type 2 diabetes, cancer and musculoskeletal problems.

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Obesity issues cost the NHS £11.4 billion per year and has a wider economic impact of £74.3 billion per year.

The new quality standard replaces three previous reports and comes as new weight loss drugs, such as semaglutide (Wegovy) and tirzepatide (Mounjaro), are available through either specialist NHS services or GP practices, respectively. Around 240,000 people are expected to be offered tirzepatide over the next three years.

Dr Rebecca Payne, Chair of NICE’s Quality Standards Advisory Committee, emphasised that weight management is a long-term journey, requiring sustained effort rather than short-term fixes. She said: ‘The evidence is clear that advice and support for maintaining weight after stopping medicines or completing behavioural interventions can help prevent weight regain and enable people to experience lasting benefits.’

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Dr Payne added: ‘We’ve seen excellent examples of services that already provide comprehensive discharge planning and ongoing support. This quality standard will help ensure all healthcare providers adopt these best practices, giving every person the best chance of maintaining their weight management success over the long term.’

The new standard is now expected to be implemented across healthcare services in England and Wales. Advice on its roll-out is available on the NICE website.