About the service

A tier 3 service is a specialist-led, multidisciplinary weight management programme designed for people with severe obesity who need more intensive support. It includes input from dietitians, a weight management facilitator, doctor, mental health practitioner, psychologist, CBT therapist, physiotherapist and admin staff.

Your journey with the tier 3 service will begin with an initial telephone call. This call is for us to get to know you more and plan your treatment with us.

You will be invited to take part in a structured weight management group led by a dietitian. You may also be offered one-to-one support with other clinicians depending on your individual needs. Most of the appointments in the service will be virtual via telephone call or video call.

To get the most out of the programme, it’s important that you are ready to engage with the service and attend all appointments.

The team includes a range of members who are highly qualified and specialise in weight management. The team provides support following evidenced based information.

We do not focus on nutrition and exercise alone. We encourage working on whatever lifestyle factors are stopping you from reaching your targets.

Not everyone will be referred for surgery. The service can assess suitability and prepare those eligible for tier 4 (surgical) services if appropriate.

No, bariatric surgery is not required. Many people referred to the service choose not to have surgery. Our aim is to help you build the skills, knowledge, and confidence to manage your weight long term. These tools will support your health and wellbeing, whether or not you decide to have surgery in the future.

Completing the tier 3 programme helps you prepare both physically and mentally for surgery. It supports you in making sustainable lifestyle changes that are essential for long-term weight management. During this time, you’ll work towards personal goals such as becoming more active, making time for self-care, starting a new hobby, or quitting smoking. Losing weight before surgery can also reduce the risk of complications and help improve your recovery.

Weight loss injections used in tier 3 services are medications that work by acting on appetite-regulating areas of the brain. This helps you feel fuller for longer and reduces hunger.

A healthcare professional will assess your suitability during the programme.

Yes. The injections are not a quick fix. For best results, they must be used alongside healthy eating, increased physical activity, and behaviour change strategies. The Tier 3 team can help to support with this.

If you don’t respond well to the injections or experience side effects, the medication may be stopped. Your team will continue to support you with other weight management strategies.

If you still meet our service criteria, we can still provide you with support.