Inclusion:
Routine
• Age ≥ 18

• BMI ≥35 and at least one weight related co-morbidity (e.g. type 2 diabetes, hypertension, sleep apnoea etc)

• BMI ≥40

• Has engaged with available tier 2 services without
achieving weight loss for at least 6 months.
List of currently available tier 2 included elsewhere

• Registered with a Somerset GP

• Complications following prior bariatric surgery such as malnutrition or hypoglycaemia (if suspected surgical problem such as abdominal pain/vomiting – refer to upper GI surgery)

Urgent:
• Age ≥18 AND
• Awaiting cancer surgery which is currently delayed due to raised BMI ≥35

Exclusion

• Pregnant

• Ongoing Binge eating disorder – refer to binge eating service

• Ongoing severe mental health disorder (e.g. severe depression/schizophrenia must be stable before referral)

Bariatric Surgery:
• Exclusions: Suspected surgical complications. Refer to Upper GI

• Education, nutritional advice and follow up for patients who have had previous (NHS or private) bariatric surgery (contact Advice and Guidance for details of recommended supplements and monitoring)