Background: Despite National guidance recommending their use, there is uncertainty regarding the best way to deliver weight management services across the UK and worldwide.
Methods: To ascertain access, provision and interventions used in lifestyle Tier 2 and specialist Tier 3 weight management services in Scotland, a survey was distributed to all mainland health boards covering pathways for referral, eligibility criteria, intervention format and definitions of attendance completion and adherence.
Results: Nine Health boards provided information on their weight management services. The provision of services was low. Only four health boards offered services for those with a BMI 25-30 kg/m2. Lifestyle Tier 2 services were mainly weekly or fortnightly group sessions for 8-12 weeks delivered by dietitians or community workers. Specialist Tier 3 services were largely similar to lifestyle Tier 2 services. The provision of specialist interventions including pharmacotherapy, cognitive behavioural therapy sessions and low-calorie prescribed diets was low.
Conclusions: This national survey has illustrated large disparities in the provision of weight management across Scotland, a likely consequence of uncertainty regarding best practice. There is a clear requirement for the evaluation of existing services to identify those that lead to the largest improvements in health outcomes and are cost-effective.
Keywords: obesity; service provision; survey; weight management.
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