Variations in weight management services in Scotland: a national survey of weight management provision

J Public Health (Oxf). 2016 Sep;38(3):e325-e335. doi: 10.1093/pubmed/fdv132. Epub 2015 Sep 19.


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.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Humans
  • Obesity / psychology
  • Obesity / therapy
  • Patient Compliance / statistics & numerical data
  • Referral and Consultation / statistics & numerical data
  • Scotland
  • Surveys and Questionnaires
  • Weight Reduction Programs / methods
  • Weight Reduction Programs / organization & administration
  • Weight Reduction Programs / statistics & numerical data*
  • Young Adult