Last updated: 10/12/2025
Increase referrals to behavioural weight management programmes
Extend access to NHS Digital Weight Management Programme so that 250,000 people living with a BMI of 30 or above are offered a free referral via primary care (as per 10 Year Health Plan for England)
- Moderate impact on obesity
A percentage estimate of how much the policy would reduce national obesity rates
- Relative reduction in obesity prevalence: 1%
- Very high evidence quality
A rating of the strength of evidence, accounting for both reliability and validity of the evidence
- Reliability and validity rating: 5/5
- Moderate cost to governments
Cost to UK and devolved governments over 5 years
- Costs to governments over 5 years: £95m
- Benefit to governments per year: £0.5bn
What is the policy?
The 10 Year Health Plan for England, published in July 2025, announced that they would expand access to NHS Digital Weight Management Programmes to approximately 250,000 people per year.
Behavioural weight management programmes (BWMPs) aim to achieve weight loss through changes to diet, physical activity, or both. Programmes include behavioural support components, such as motivational interviewing, establishing social support, and goal setting to support individuals with weight loss. The National Institute of Clinical Excellence (NICE) guidelines recommend the use of BWMPs for the treatment of adults with obesity, and some local authorities fund referrals to such programmes via NHS treatment pathways.
BWMP is an umbrella term for a variety of different programmes. Total diet replacement (TDR) is one type of more extensive BWMP. However, the present policy does not include TDR in the impact modelling; instead, a TDR policy was separately modelled here.
Recent context
In the UK, different tiers of weight management services cover different activities. Definitions vary locally, with tier 1 typically covering universal services (primary care delivered education), tier 2 covering community-based support, tier 3 covering specialist weight management services and tier 4 covering surgical interventions, including bariatric surgery. BWMPs fall under tier 2 services.
NICE guidance on the prevention and management of overweight and obesity in adults sets out the guidelines for referral to weight management services. Existing guidance recommends that individuals be referred to a BWMP if they are aged 18+, have a BMI of 30 or above (adjusted to 27.5 or above for some ethnic groups) and have had a diagnosis of diabetes or hypertension. In our modelling, we considered all adults living with a BMI of 30 or greater eligible, regardless of diabetes or hypertension status.
Weight management services are devolved in Wales and included in the Healthy Weight, Healthy Wales whole-system approach to healthy weight. The programme funds a national team within Public Health Wales and systems officers within Health Board Public Health Teams. Funding comes from the Welsh government and individual Health Boards.
In Scotland, responsibility for the operation and availability of weight management services is assigned to regional Health Boards. Scotland’s Diet and Healthy Weight Delivery Plan considers access to efficient weight management services to be a core outcome to tackling obesity and overweight in Scotland.
Considerations for implementation
For implementation of this policy, which is proposed in England only, the services are often delivered remotely through the Digital Weight Management Programme, which was rolled out nationally in July 2021. Our EAG advised that the impacts of these interventions might be slightly smaller than their face-to-face counterparts, but may be a more viable route to scale.
During implementation, consideration should be given to the accessibility of these services and whether they are reaching the populations who are most in need of them. For more information, go to the section ‘Behind the averages: impact upon inequalities’.
Adherence is a known problem. Not everyone who begins weight management services will complete the intervention and treatment adherence will impact the effectiveness of the programme.
Estimating the population impact
We estimated that this policy would reduce the prevalence of adult UK obesity rates by approximately 1%
Estimating the per-person impact
We estimated that this policy would reduce average body weight by approximately 3.9kg for those taking up behavioural weight management programmes
When modelling the impact of this intervention we assumed that 45% of people enrolled to attend the programme would lose an average of -3.9kg of weight after one year (based on a service evaluation by Taylor et. al., 2024). Together, this accounts for dropping out and non-completion of the programme. We assumed that lost weight would be regained at a rate of 0.32kg per year post-intervention (based on Hartmann-Boyce et al., 2023).
Estimating the population reach
In our analytical model, we applied the effect sizes to adults living with obesity (ie, people aged 18 or above, with a BMI of ≥ 30). We did not estimate the impact of this policy on children.
Changes in the prevalence of people living with obesity
We find that as a result of this policy, the percentage reduction in the prevalence of obesity is approximately 1%. Table 1 shows the percentage of adults moving from a BMI ≥ 30 into a healthier BMI category following the introduction of this programme.
| Adults (England and Wales) | Children (England and Wales) | Adults (Scotland) | Children (Scotland) |
| 1% | Not applicable | In progress | Not applicable |
Cost and benefits
Cost over 5 years
We estimated that this policy would cost the governments approximately £95 million over five years
Table 2 shows a breakdown of costs. The estimated per-patient cost of a BWMP is approximately £70. To expand the service to 250 thousand people per year, our modelling suggests that the direct costs to the UK and devolved governments would be approximately £95 million. In our cost estimates, we do not include the cost of infrastructure, so these figures may be underestimated.
| Group affected | Cost | Horizon | Detail |
| Costs | |||
| Governments | £95m | Over 5 years | Increased provision of funding |
Total annual benefit
We estimated that this policy would have an annual benefit of approximately £0.5 billion
Using analysis conducted by the Tony Blair Institute and Frontier Economics, we estimate this policy would result in benefits of £0.5 billion per year on average compared to the baseline. Approximately two-thirds of this saving would benefit individuals (via quality-adjusted life years and informal social care). The remaining third relates to savings that benefit the state via NHS treatment costs, productivity and formal social care. See our Methods page for more information about the cost breakdowns.
Behind the averages: impact on inequalities
Increased uptake of weight management services across the population would help to reduce the prevalence of obesity across the UK.
However, evidence suggests some groups are more likely to take up weight management services than others. There are few widely implemented weight management programmes designed for specific population groups, meaning the cultural and content applicability of existing programmes is likely to vary by population group. People living in deprived areas and with complex additional needs, such as disabilities, along with men, are less likely to engage and more likely to drop out. This has the potential to widen health inequalities. Co-designing services with underserved groups to better meet their needs may be an effective way to counter this.
Rating the strength of evidence
We asked experts working in the fields of obesity, food, and health research to rate the strength of the evidence base for each policy, taking into account both reliability (size and consistency) and validity (quality and content) of the evidence. Policies were rated on a Likert scale of 1-5 (none, limited, medium, strong, and very strong evidence base). The Blueprint Expert Advisory Group rated this policy as having a Very Strong evidence base.
Increase referrals to total diet replacement programmes
Everyone with a BMI of 30 or above is offered a free referral to a total diet replacement programme via primary care