Overweight and obesity management
NICE guideline
NG246
Published: 14 January 2025
Planning and delivering
overweight and obesity
services and interventions
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 (https://www.nice.org.uk/about/nice-
communities/public-involvement/your-care).
Making decisions using NICE guidelines
(https://www.nice.org.uk/about/what-we-do/our-
programmes/nice-guidance/nice-guidelines/using-
NICE-guidelines-to-make-decisions) 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:
Babies, children and young people's experience of
healthcare
(https://www.nice.org.uk/guidance/ng204)
Decision making and mental capacity
(https://www.nice.org.uk/guidance/ng108)
Medicines adherence
(https://www.nice.org.uk/guidance/cg76)
Medicines optimisation
(https://www.nice.org.uk/guidance/ng5)
Multimorbidity
(https://www.nice.org.uk/guidance/ng56)
Patient experience in adult NHS services
(https://www.nice.org.uk/guidance/cg138)
People's experience in adult social care services
(https://www.nice.org.uk/guidance/ng86)
Service user experience in adult mental health
(https://www.nice.org.uk/guidance/cg136)
Shared decision making
(https://www.nice.org.uk/guidance/ng197)
Transition from children's to adults' services
(https://www.nice.org.uk/guidance/ng43).
Read this guideline alongside:
NICE guidelines on behaviour change: digital and
mobile health interventions
(https://www.nice.org.uk/guidance/ng183),
behaviour change: individual approaches
(https://www.nice.org.uk/guidance/ph49), eating
disorders (https://www.nice.org.uk/guidance/ng69),
and looked after children and young people
(https://www.nice.org.uk/guidance/ng205)
the National Obesity Audit
(https://digital.nhs.uk/data-and-information/clinical-
audits-and-registries/national-obesity-audit)
Public Health England's Whole systems approach to
obesity
(https://www.gov.uk/government/publications/whole-
systems-approach-to-obesity) and weight
management interventions: standard evaluation
framework
(https://www.gov.uk/government/collections/weight-
management-guidance-for-commissioners-and-
providers)
the UK Chief Medical Officers' physical activity
guidelines
(https://www.gov.uk/government/publications/physical-
activity-guidelines-uk-chief-medical-officers-
report)
the NHS Eatwell guide (https://www.nhs.uk/live-
well/eat-well/)
the Childhood obesity: applying All Our Health
guidance
(https://www.gov.uk/government/publications/childhood-
obesity-applying-all-our-health/childhood-obesity-
applying-all-our-health).
Read this section alongside:
Department of Health and Social Care's guidance
on the preparation of integrated care strategies
(https://www.gov.uk/government/publications/guidance-
on-the-preparation-of-integrated-care-
strategies/guidance-on-the-preparation-of-
integrated-care-strategies)
Hewitt Review: an independent review of integrated
care systems
(https://www.gov.uk/government/publications/the-
hewitt-review-an-independent-review-of-
integrated-care-systems)
NHS England's information on integrated care
systems
(https://www.england.nhs.uk/integratedcare/)
NIHR Evidence's How can local authorities reduce
obesity? (https://evidence.nihr.ac.uk/how-local-
authorities-can-reduce-obesity/)
Public Health England's:
Adult weight management: key performance
indicators (https://urlsand.esvalabs.com/?
u=https%3A%2F%2F2.zoppoz.workers.dev%3A443%2Fhttps%2Fwww.gov.uk%2Fgovernment%2Fpublications%2Fadult-
weight-management-key-performance-
indicators&e=9f250c40&h=f6a57b5c&f=y&p=n)
Community centred public health: taking a whole
system approach
(https://www.gov.uk/government/publications/community-
centred-public-health-taking-a-whole-system-
approach)
Guide to commissioning and delivering tier 2
adult weight management services
(https://urlsand.esvalabs.com/?
u=https%3A%2F%2F2.zoppoz.workers.dev%3A443%2Fhttps%2Fwww.gov.uk%2Fgovernment%2Fpublications%2Fadult-
weight-management-services-commission-and-
provide&e=9f250c40&h=3279aad1&f=y&p=n)
Guide to commissioning and delivering tier 2
weight management services for children and
their families
(https://www.gov.uk/government/publications/child-
weight-management-commission-and-provide-
services)
Healthy weight environments: using the planning
system
(https://www.gov.uk/government/publications/healthy-
weight-environments-using-the-planning-
system)
Whole systems approach to obesity
(https://www.gov.uk/government/publications/whole-
systems-approach-to-obesity)
1.19 Planning and commissioning
services and interventions for all
ages
Planning and funding services and
interventions
1.19.1 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
(https://www.gov.uk/government/publications/adult-
weight-management-services-commission-and-
provide), and Guide to commissioning and delivering
tier 2 weight management services for children and
their families
(https://www.gov.uk/government/publications/child-
weight-management-commission-and-provide-
services). [2012, amended 2025]
1.19.2 Ensure overweight and obesity management
services (terms-used-in-this-guideline#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
(rationale-and-impact#planning-and-funding-
services-and-interventions-2).
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
(https://www.nice.org.uk/guidance/ng246/evidence/e-
increasing-uptake-of-weight-management-services-
in-children-young-people-and-adults-pdf-
13620147374).
Key components of interventions
1.19.3 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]
1.19.4 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
(https://www.gov.uk/government/collections/weight-
management-guidance-for-commissioners-and-
providers) 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 registered nutritionist may be
beneficial)
help the person track their weight and the progress
they have made towards individual goals throughout.
[2014]
1.19.5 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]
1.19.6 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]
1.19.7 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]
Working together on local approaches to
prevent overweight and obesity
Involving local businesses and social enterprises
1.19.8 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]
1.19.9 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 (https://www.nice.org.uk/guidance/ph13),
preventing cardiovascular disease
(https://www.nice.org.uk/guidance/ph25), alcohol-use
disorders (https://www.nice.org.uk/guidance/ph24) and
type 2 diabetes (https://www.nice.org.uk/guidance/ph35),
and Public Health England's physical activity, healthy
eating and healthier weight toolkit for employers
(https://www.bitc.org.uk/toolkit/physical-activity-healthy-
eating-and-healthier-weight-a-toolkit-for-employers/).
Service and intervention specifications
and equipment
1.19.10 Follow Public Health England's guide to delivering
and commissioning tier 2 adult weight management
services
(https://www.gov.uk/government/publications/adult-
weight-management-services-commission-and-
provide) and commission services and interventions
that meet the measures set out in the National
Obesity Audit advice for the Community Services
Data Set (https://digital.nhs.uk/data-and-
information/clinical-audits-and-registries/national-
obesity-audit), and Public Health England's 'Adult
weight management: key performance indicators'.
[2014, amended 2025]
1.19.11 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]
1.19.12 Ensure scales used by overweight and obesity
management interventions for monitoring people's
weight are regularly calibrated. [2014]
1.19.13 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]
Raising awareness of overweight and
obesity management options
Raising awareness among commissioners and
providers
1.19.14 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]
1.19.15 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
(https://www.nhs.uk/healthier-families/)) for use
locally. [2012]
1.19.16 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]
1.19.17 Work with partners and the local media to advocate
for action on overweight and obesity. [2012]
1.19.18 Make the relevance of a wide range of initiatives for
managing overweight and obesity clear, for example
in annual reports. [2012]
1.19.19 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 (planning-and-delivering-overweight-
and-obesity-services-and-interventions#service-
and-intervention-specifications-and-equipment)
and reviewing success (planning-and-delivering-
overweight-and-obesity-services-and-
interventions#reviewing-success))
opportunities to continue professional
development or any training available on
overweight and obesity management. [2025]
Raising awareness among health and social care
professionals
1.19.20 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
(https://www.gov.uk/government/publications/national-
child-measurement-programme-operational-
guidance)). [2025]
1.19.21 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]
Raising public awareness
These recommendations are for local or regional strategic
partnerships.
1.19.22 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]
1.19.23 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 (terms-used-in-this-
guideline#behavioural-overweight-and-obesity-
management-services) and interventions (terms-
used-in-this-guideline#behavioural-overweight-
and-obesity-management-interventions-2) 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]
1.19.24 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]
1.19.25 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 (rationale-and-impact#raising-
awareness-of-overweight-and-obesity-management-
options-2).
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
(https://www.nice.org.uk/guidance/ng246/evidence/e-
increasing-uptake-of-weight-management-services-
in-children-young-people-and-adults-pdf-
13620147374).
Reviewing interventions for adults
These recommendations are for those providing
interventions.
Reviewing success
1.19.26 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
(planning-and-delivering-overweight-and-
obesity-services-and-interventions#key-
components-of-interventions)). [2014, amended
2025]
Collecting, assessing and sharing information about
participants
1.19.27 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]
1.20 Planning and commissioning
interventions for children and
young people
See also the section on raising awareness of overweight
and obesity management options (planning-and-delivering-
overweight-and-obesity-services-and-
interventions#raising-awareness-of-overweight-and-
obesity-management-options).
1.20.1 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]
1.20.2 Ensure those with more complex needs, their
families and carers, have a contact in specialist
services who can help them manage their weight.
[2013]
Involving a multidisciplinary team for
children and young people
1.20.3 Develop the components of behavioural overweight
and obesity management interventions (terms-
used-in-this-guideline#behavioural-overweight-
and-obesity-management-interventions-2) with the
input of a multidisciplinary team. [2025]
1.20.4 The multidisciplinary team should comprise
professionals who specialise in children, young
people and overweight and obesity management,
including:
a Registered dietitian or registered nutritionist
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]
1.20.5 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 (rationale-and-impact#involving-a-
multidisciplinary-team-for-children-and-young-
people-2).
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
(https://www.nice.org.uk/guidance/ng246/evidence/g-
effectiveness-and-acceptability-of-weight-
management-interventions-in-children-and-young-
people-pdf-13620147376).
Contracts and intervention specifications
1.20.6 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]
1.20.7 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]
Supporting interventions in the long term
1.20.8 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
(https://www.nice.org.uk/guidance/ph6/chapter/Recommendations#principle-
7-evaluating-effectiveness). [2013]
© NICE (National Institute for Health and Care Excellence) 2025. All rights reserved. Subject to Notice of rights
(https://www.nice.org.uk/terms-and-conditions#notice-of-rights).
