Draft NHS Leicester, Leicestershire and Rutland Adult Obesity Pathway

1. Draft NHS Leicester, Leicestershire and Rutland Adult Obesity Pathway Interventions City County Risk Level Is the patient ready to lose weight? Intervention Descriptor Very High Risk Patients presenting with a BMI of ≥ 50 or ≥ 45 with significant co- morbidities (local) *East Midlands Commissioning Guidance Bariatric Surgery Policy If Yes, after brief intervention refer to appropriate intervention T1,T2 or T3 NB: All patients should be encouraged to use TIER 0 interventions Refer for Bariatric Assessment/Surgery ASSESSMENT ( NICE Guidance NICE CG43 EXIT STRATEGY Post intervention lifestyle change should be self sustained to achieve/maintain healthy weight IDENTIFICATION TIER 3 Surgical Intervention High Risk -Patients presenting with A BMI ≥30-39 with co-morbidities -Patients with a BMI >40 -South Asian with a BMI ≥25 with co-morbidities TIER 2 Specialist Community Weight Management Services Intensive behavioural change service for individuals suffering with complex co-morbidities and/or long term weight issues DHALLEAP 1:1 Dietetic Appointments (*LNDS) (Referral form hyperlink) ALS Medium Risk Patients presenting with a BMI ≥ 25-29.9 or Patients presenting with A BMI ≥ 30-39.9 without co- morbidities TIER 1 Community Weight Management Services First line weight intervention service Provides basic nutrition and exercise support to reduce weight and improve quality of life FAB Counter- Weight ALS(link) ALS Criteria Low Risk Patients presenting with a BMI ≤ 25 and have no co-morbidities -Health Trainers Leicester Health Trainers -Change 4 Life (C4Life hyperlink) -Physical Activity Groups -Leisure Centre/ Community Based Classes (3 x 30 Pledge)Active Together Self referral to other suitable commercial groups that have multi- component approach and follow NICE Guidance If patient NOT ready, Signpost to TIER 0 And encourage patient to utilise TIER 0 Universal ‘Healthy Weight’ Activity Population Wide intervention and services (Open Access e.g. Leisure Centres, Green Spaces, Active Travel, Workplace Health, Community Physical Activity Sessions) RE-ASSESS RELAPSE RE-ASSESSMENT NEEDED * If patient has specific condition refer to specific condition charts for in depth assessment/ intervention